International Journal of Head and Neck Surgery

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2017 | October-December | Volume 8 | Issue 4

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Can the doctor still know better?

[Year:2017] [Month:October-December] [Volume:8] [Number:4] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/ijhns-8-4-iv  |  Open Access |  How to cite  | 



Akash Pramod Sali, Ayushi Sahay, Chhavi Gupta, Bhausaheb Pandurang Bagal, Shubhada Vijay Kane

Hodgkin Lymphoma involving Thyroid: Case Report and Comprehensive Review

[Year:2017] [Month:October-December] [Volume:8] [Number:4] [Pages:9] [Pages No:131 - 139]

Keywords: Biopsy, Fine needle aspiration cytology, Hodgkin lymphoma, Surgery, Thyroid

   DOI: 10.5005/jp-journals-10001-1322  |  Open Access |  How to cite  | 


Aim: To report a case of Hodgkin lymphoma involving thyroid gland and to review the literature for the same. Background: Thyroid lymphomas occur most commonly in the form of non-Hodgkin lymphomas. In contrast, Hodgkin lymphoma involving the thyroid gland is a relatively rare scenario and which, by virtue of its rarity, is mistaken for usual thyroid lesions both on clinical and cytological examination. Case report: A 34-year-old female was presented with anterior neck mass and breathlessness. The fine needle aspiration cytology of the mass was suspicious for Hodgkin lymphoma and the diagnosis was further confirmed on a thyroid biopsy. Suspicion of Hodgkin lymphoma on cytology in this patient ensued proper medical management, thus averting a surgical treatment. Patient defaulted chemotherapy and died 6 month after initial diagnosis. Conclusion: A careful cytological examination assisted with ancillary techniques ensures a proper treatment strategy and avoids unnecessary surgical intervention. Clinical significance: With thorough literature review, this study highlights the way immunocytochemistry and thyroid biopsy dictates the treatment decision when dealing with uncommon tumours at this site.



Harendra Kumar Gautam, Devendra Maurya, Sanjay Sharma

Outcome of Microscopic-assisted Thyroid Surgery: An Institutional Retrospective Study

[Year:2017] [Month:October-December] [Volume:8] [Number:4] [Pages:5] [Pages No:140 - 144]

Keywords: Microscopic, Recurrent laryngeal nerve palsy and hypocalcemia, Thyroid

   DOI: 10.5005/jp-journals-10001-1323  |  Open Access |  How to cite  | 


Background: Microscopic-assisted thyroid surgery approach helps surgical performance and prevents complications. Aims and Objectives: The aim of the present retrospective study was to review the thyroid surgery performed by using microscope in a single institution and analyze the outcomes with respect to those reported in the literature. Materials and Methods: A total of 30 patients were included with more than 11 years of age presented with thyroid nodule, and thyroidectomy was done under microscopic vision. Results: Majority of the patients were between 21 years and 40 years of age. Female:male ratio was about 5.6:1. Swelling in front of the neck was the most common presentation. Most common solitary thyroid swelling was the colloid goiter. Commonest surgery performed was hemithyroidectomy (93.34%). Among the 30 patients, only two patients (0.6%) had unilateral vocal fold immobility treated with medical therapy, phoniatric and neck physiotherapy. All two patients showed complete laryngeal recovery of motility within 6-8 weeks after treatment. There were no cases of permanent unilateral or bilateral vocal cord palsy. In three patients, there were signs and symptoms of hypocalcemia. In three patients (10%), the restoring of biochemical parameters and the resolution of symptoms occurred between 2 weeks and 6 weeks. Conclusion: Microscopic-assisted thyroidectomy is a feasible and efficacious surgical procedure. It significantly reduces the complications without increasing the operating time in thyroid surgery procedures.



Yemeng Lu-Myers, Elizabeth Nichols, Kevin D Pereira

Enlarging Painful Neck Mass in a Child: Urgent or Elective?

[Year:2017] [Month:October-December] [Volume:8] [Number:4] [Pages:5] [Pages No:145 - 149]

Keywords: Brachial cleft cysts, Dermoid cyst, Lymphatic malformation, Pediatric neck mass, Suppurative lymphadenitis

   DOI: 10.5005/jp-journals-10001-1324  |  Open Access |  How to cite  | 


Four pediatric patients with enlarging, painful, and acutely infected lateral neck masses presented to the emergency department of a tertiary care Children's Hospital are described. These masses include suppurative lymphadenitis, brachial cleft anomaly, dermoid cyst, and an infected lymphatic malformation. Differences between these four disease processes in presentation, exam findings, and radiological features are highlighted to help determine the level of acuity in care. The immediate and subsequent management of the patients is described to help guide subspecialty consultations for intervention.



Jeyashanth Riju, Shaji Thomas, Remya Rajan

Squamous Cell Carcinoma of Mandible in a 10-year-old girl

[Year:2017] [Month:October-December] [Volume:8] [Number:4] [Pages:3] [Pages No:150 - 152]

Keywords: Free fibular flap, Malignancy in children, Oral cancer, Pediatrics, Squammous cell carcinoma

   DOI: 10.5005/jp-journals-10001-1325  |  Open Access |  How to cite  | 


Aim: To study the importance of early recognition of oral cancer in children and its most suitable management. Background: Head and neck cancers are the sixth most common cancer worldwide with rare incidence in children. It is associated with a poor prognosis. Case description: A 10-year-old healthy girl with good oral hygiene presented with complaints of lesion in right mandible for 3 months duration. Incision biopsy of lesion showed squamous cell carcinoma. Computerized tomography showed cortical erosion of mandible, with no significant neck nodes. Case was discussed in multidisciplinary team and options were weighed. After discussing with patients' relatives, it was decided to proceed for surgery. Conclusion: Surgery was undertaken, patient underwent wide excision of lesion with segmental mandibulectomy, neck dissection and free fibular reconstruction of the defect. She is on regular follow-up for the past one year, with no evidence of lesion. Clinical Significance: Squamous cell carcinoma of mandible in children is very rare. Treating physician should be aware of such unusual presentation of highly mortal disease. Literature review on treatment being sparse and surgery followed optimal reconstruction is a major challenge.



Sachana Prasad, Amitabha Roychoudhury, Soumitra Ghosh

Collaural Fistula: A Diagnostic Challenge

[Year:2017] [Month:October-December] [Volume:8] [Number:4] [Pages:4] [Pages No:153 - 156]

Keywords: Branchial cleft anomalies, Collaural fistula, CT fistulogram

   DOI: 10.5005/jp-journals-10001-1326  |  Open Access |  How to cite  | 


Aim: To emphasize on a comprehensive approach for correct diagnosis and treatment of first branchial cleft anomalies. Background: First branchial cleft anomalies are congenital malformations accounting for less than 8% of all branchial cleft anomalies. Case Description: We report a case of a 55-year-old female with a discharging collaural fistula that was misdiagnosed earlier and treated with repeated incision and drainage. Diagnosis was confirmed by history and CT fistulogram and the lesion was completely excised with no further recurrences. Conclusion: Due to the varied presentations of the first branchial cleft defects, a compartmentalized approach by the clinician may lead to misdiagnosis and incorrect treatment. Clinical Significance: The rare occurrence and diverse clinical presentations of these embryological defects have led to frequent delay in diagnosis as well as inadequate treatment. Correct diagnosis at primary presentation should be advocated for such rare entities.



PK Sahu, JR Galagali, Kamal D Joshi, S Saxena

Aggressive Giant Cell Tumour of Maxilla

[Year:2017] [Month:October-December] [Volume:8] [Number:4] [Pages:3] [Pages No:157 - 159]

Keywords: Benign tumour, GCT, Giant cell tumour, Maxilla

   DOI: 10.5005/jp-journals-10001-1327  |  Open Access |  How to cite  | 


Giant cell tumours (GCT) of bone are infrequently encountered in craniofacial skeleton and require careful evaluation to differentiate it from other giant cell lesions. The management of these tumours is ofter complicated, as complex anatomy of the region makes complete resection difficult and lesion has significant recurrence rate. Loco regionally advanced disease makes complete resection even more challenging. Here, a case of locoregionally advanced GCT maxilla in 37-year-old female is reported. The patient was successfully managed with complete resection and reconstruction of orbital floor using temporalis muscle flap sling. Key Messages: Giant cell tumours of head and neck are rare. However, they require careful evaluation to differentiate it from other similar lesions and a comprehensive management, considering their recurrent nature and probable malignant transformation.



Vamshi Krishna Thamtam, Abhiram Kalle

Mammary Analogue Secretory Carcinoma of Salivary Gland. A Case Report Emphasizing its Diagnostic Histological, Immunohistochemistry and Molecular Findings

[Year:2017] [Month:October-December] [Volume:8] [Number:4] [Pages:4] [Pages No:160 - 163]

Keywords: Histology, Mammary analogue secretory carcinoma, Molecular

   DOI: 10.5005/jp-journals-10001-1328  |  Open Access |  How to cite  | 


Mammary analogue secretory carcinoma is a recently described salivary gland tumor that shares morphologic and genetic characteristics with secretory carcinoma of the breast. Due to its complex and heter\\ogeneous presentation, most of these tumors were previously labeled histologically as acinic cell carcinoma, mucoepidermoid carcinoma or adenocarcinoma not otherwise specified. Here we present a case of MASC of the parotid gland in a 55-year-old man and discuss the histological, IHC and molecular features that will facilitate its diagnosis and differentiation from its histologic mimics.


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