Salma Benazzou

Primary extranodal non-Hodgkin lymphoma of the oral cavity.

Abstract Lymphoma is the second most common neoplasm of the head and neck after squamous cell carcinoma. Nearly 24% to 48% of non-Hodgkin lymphoma can arise in extranodal localizations and 3% to 5% of which were primarily located in the oral cavity. Waldeyer ring is the most frequently involved site. The authors report 2 cases of primary extranodal non-Hodgkin lymphoma of the oral cavity, not of the Waldeyer ring.

Orbital hydatid cyst: Review of 10 cases

BACKGROUND Echinococcosis represents one of the most common human parasitoses in some geographical areas. Orbital involvement is extremely rare. MATERIALS AND METHODS In the records of our Medical University Centre between 1984 and 2006, we found 10 cases of orbital hydatid cyst. RESULTS Among them, 6 males and 4 females; the ages ranged from 2 to 60 years and 7 cases (70%) were less than 12 years of age. The main symptoms of orbital hydatid cyst were slowly progressive unilateral proptosis (100%) with visual loss (90%). The presumptive diagnosis was made on the images obtained from computed tomography and/or magnetic resonance imaging. Surgical removal was the main treatment; although, it is frequently complicated with cyst rupture and spillage of the contents. For this reason, we adopted the technique of cyst puncture with irrigation. A postoperative antihelminthic treatment has always been used. CONCLUSION Hydatid cyst is an endemic disease in Morocco. Orbital involvement should be considered in the differential diagnosis of proptosis especially in children known to have been in affected geographical areas.

Third molar extraction with massive hemorrhage treated by embolization.

Impaction of the third molar is relatively frequent in oral and maxillofacial surgery, and its removal is a usual operation with mostly unremarkable outcome. We report a case of bleeding that occurred after a left upper third molar extraction, which necessitated in emergency an angiography with embolization.

Giant pediatric cervicofacial lymphatic malformations.

PurposeLymphatic malformations (LMs) are benign lesions. Most of them are found in head and neck regions as asymptomatic mass, but giant lymphangiomas may affect breathing or swallowing and constitute a major therapeutic challenge. MethodsA retrospective analysis of giant head and neck LMs with impairment of respiration or swallow for the past 11 years was performed in the Department of Maxillofacial Surgery and ENT of the Avicenne Medical University Center. ResultsSeven patients with large and extensive LMs of the head and neck were identified. There were 3 males and 4 females with a mean age of 6 years. The predominant reason for referral was airway compromise necessitating tracheostomy (57%) and dysphagia (43%). Three patients had macrocystic lesions; others were considered mixed or microcystic. All the patients underwent surgical excision as a primary treatment modality. Complete surgical resection was realized in 4 patients, and subtotal resection in 3 patients. Of 7 patients, 4 patients had complications including nerve damage and recurrence of the disease. The majority of the patients underwent only a single surgical procedure. ConclusionsCervicofacial LMs in children should be managed in multidisciplinary setting. Surgery remains the first treatment for managing giant, life-threatening lesions.

L’exentération orbitaire

PURPOSE Orbital exenteration is a disfiguring surgery. The surgery is mostly performed for advanced neoplasms of the eyelid in an attempt to achieve cure with tumor free margins. Reconstruction is a real challenge, especially in elderly patients with significant comorbidities. PATIENTS AND METHODS We operated 15 patients presenting with palpebral and orbital tumors, between January 2000 and December 2007. We collected the clinical data concerning patients, tumor, treatment, and recurrences. RESULTS Ten male and five female patients with a mean age of 56 years at diagnosis presented with ulcerative palpebral malignant tumor, and impaired ocular motility. Basal cell carcinoma was the most common (80%). All patients underwent exenteration, (subtotal three, total eight, and extended four patients). The cavity was filled with a temporal muscle flap in ten cases, Mustardé flap in three cases, latissimus dorsi myocutaneous free flap in one case, and a jugal V-Y flap in one case. The mean follow-up was 23 months with good healing without radiotherapy tissue alteration. Four patients had a recurrence and one patient died from metastases. DISCUSSION The goals of reconstruction are functional and esthetic. Given the initial tumoral extension, we choose to use a regional or microsurgical flap for functional reconstruction. The flap provides a good cutaneous coverage, rapid healing, closure of orbital nasal and sinus communications, or of orbital and cranial communications. It is not damaged by radiotherapy.

Un cas de dysplasie fibreuse kystique craniofaciale

INTRODUCTION Fibrous dysplasia is a benign, idiopathic, fibro-osseous disease. CLINICAL CASE A 17-year-old girl had presented with left proptosis for the previous two years, associated to homolateral hemicranial pain. Clinical examination was normal except for non-reducible axile exophthalmia. Computed tomography and magnetic resonance imaging of the head revealed an extensive cystic tumor of the left fronto-ethmoido-sphenoidal region, with compression of the left frontal lobe and medial orbital wall. The radiological appearance suggested a mucocele but histological examination, after surgery, proved a fibrous dysplasia. DISCUSSION Fibrous dysplasia with fronto-sphenoido-ethmoidal localization may be misdiagnosed as mucocele. Histology proves the diagnosis.