Left Preauricular Area Research Articles

下顎関節突起に生じた軟骨芽細胞腫の1例

Chondroblastoma is a rare benign tumor of the head and neck. We report a case of chondroblastoma of the mandibular condyle. A 56-year-old woman was referred to our department for the treatment of a left mandibular condyle tumor, which was detected on computed tomography （CT）. The patient had a 3-month history of intermittent pain in the left pre-auricular area, accompanied by episodic trismus and subjective swelling around the lesion. CT and magnetic resonance imaging （MRI） revealed an osteolytic defect in the anterior portion of the left mandibular condyle and a mass extending anterolaterally. The biopsy diagnosis was a chondroblastoma. We performed an en bloc resection that included part of the mandibular ramus. There has been no sign of recurrence for 26 months postoperatively.

Accidental out-of-hospital delivery complicated by acute neonatal parotitis: Case report and a review of the literature

Neonatal suppurative parotitis is a rare and unusual infection. It presents with swelling, pain and erythema over the affected gland. The most common causative organism is Staphylococcus aureus. The infection is thought to be an ascending infection from the oral cavity. Most cases are managed conservatively with antibiotics. We present the case of a 10-day old, full-term girl who presented with restlessness and a fever. The delivery was an out-of-hospital unattended delivery that took place near the hospital parking facility. The child was offered antibiotic preventive treatment due to the contaminated delivery but the parents declined. The patient was admitted to the pediatric ward for a full workup of neonatal fever. Empiric antibiotic treatment was commenced. After admission an erythematous swelling was seen over the left preauricular area. Intraorally, pus was seen draining from the left Stensen duct. These findings were compatible with acute parotitis. Pus from the oral cavity grew Staphylococcus aureus . Acute suppurative parotitis is rare in the neonatal period. In the past 42 years, only 38 cases have been described in the English language medical literature. Parotitis is unilateral in most cases. We discuss the typical presentation and pathogenesis of this disorder. Unplanned, unattended and out-of-hospital deliveries carry an increased risk of perinatal morbidity and mortality. It is possible that the contaminated delivery and the parental refusal of prophylactic antibiotic treatment contributed to the onset of infection in this case.

Localized pemphigus herpetiformis: two case reports

Pemphigus herpetiformis (PHF) is a rare variant of pemphigus that combines the clinical features of dermatitis herpetiformis and immunopathological features of pemphigus. In previous case reports, distribution of lesions is usually generalized, involving trunk and limbs. We report two cases of localized PHF presenting with grouped pustules on bilateral dorsal feet and left preauricular area, respectively. Microscopic examination showed neutrophilic spongiosis, subcorneal pustules, and focal acantholysis. Both direct immunofluorescence of Case 1 and indirect immunofluorescence of Case 2 revealed moderate deposition of IgG in the intercellular space of upper epidermis. Based on the typical histologic features and immunopathological findings, diagnoses of PHF were made. However, the atypical and localized clinical presentation rendered the process of reaching a diagnosis more difficult. PHF should be added in the spectrum of differential diagnosis of localized pustular disorders.

Malignant Peripheral Nerve Sheath Tumor of the Infratemporal Fossa

Malignant peripheral nerve sheath tumor is a rare pathologic lesion in a patient without neurofibromatosis diseases. The patient is a 36-year-old man without any congenital or systemic diseases who presented with a firm and painful mass on the left preauricular and temporomandibular joint area with paresthesia of temporal region. Clinical diagnosis of this tumor was made with delay owing to the lack of initial sign and symptoms and its location.

Lateral cervical ectopic thyroid masses with eutopic multinodular goiter: an unusual presentation

Multiple thyroid ectopia with a normally located thyroid gland is a very rare condition. We present a 34-year old Nigerian woman who had had anterior and left-sided lateral neck swellings for the past 15 years. She was clinically euthyroid and thyroid function test results were normal. Neck ultrasonography revealed multinodular goiter with extension to the left pre-auricular area. Fine Needle Aspiration Cytology (FNAC) was negative for malignancy. She underwent sub-total thyroidectomy and complete excision of three distinct lateral neck masses. Histopathology of the four tissue specimens showed that they were adenomatous goiter without evidence of malignancy. Benign, multiple, laterally located ectopic goiter in the neck can co-exist with normally located multinodular goiter. We report the first case of three ectopic thyroid tissues in the lateral neck co-existing with a normally located multinodular goiter. Although this entity is rare, it should be considered in the differential diagnosis of multiple neck masses.

A Slowly Growing Ulcerated Nodule on the Scalp—Quiz Case

A 23-year-old African American woman presented with a dark plaque containing a nodule on her cheek. Although the plaque had been present since birth, a small area of it had become raised over the last 6 months before presentation. Physical examination revealed a 4.5-cm, wellcircumscribed, asymmetrical, verrucous, brown-black plaque on the left preauricular area (Figure 1). A pedunculated nodule arose from the inferior margin (arrow). A complete excision was performed, and the specimen was sent forhistologic examination(Figures2,3, and4). What is your diagnosis?

Painful preauricular mass

In early January 199 1, a 22-year-old white woman presented to the Facial Pain Clinic at the University of Texas Health Science Center at San Antonio with a l-month history of increasing swelling and tenderness in the left preauricular area. The patient denied any history of trauma to the region but had recently been treated with antibiotics for an external ear infection and an episode of conjunctivitis. The patient’s past medical history was remarkable for an ovarian cyst, removed in 1986, and intermittent temporomandibular disorders. She admitted to being under unusually high amounts of stress recently, and had been taking ibuprofen for headaches, fever, and general malaise, which she believed were residual symptoms from the flu. Present symptoms included constant headaches in the anterior temporal regions bilaterally, which the patient described as throbbing and more common in the afternoon. The patient also complained of left preauricular pain that was constant and worse in the mornings. Pain was also present in the cervical and trapezius regions bilaterally, which was constant and most intense in the mornings. The patient limited her diet to soft foods because of the facial pain and she perceived an inability to open her mouth as wide as normal. She denied any systemic signs and symptoms, but acknowledged sleep disruption for the past 6 months. The patient had experienced an episode of extreme trismus 1 year earlier, which occurred on awakening. She reported facial muscle soreness every morning and was aware of diurnal clenching. Her pain improved with moist heat and simple analgesics and worsened with eating. The patient denied having joint sounds or ear pain. Physical examination revealed a rubbery, mobile, erythematous, tender mass in the left preauricular area measuring 3 X 2 cm, and an ipsilateral granulomatous lesion extending from the medial palpebral commissure onto the side of the nose (Fig 1). The patient stated that the preauricular lesion had begun approximately 2 weeks earlier and had be-

副咽頭間隙のchondrosarcomaの一症例

A case of chondrosarcoma in parapharyngeal space is reported. The patient was a 30-year-old man who complained of disturbance of opening mouth and tenderness from the left preauricular area to the angle of the mandible. CT revealed a tumor of left parapharyngeal space. The tumor was removed via a transparotid-cervical approach, and radiation therapy was done postoperatively.

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<h3>PATHOLOGY QUIZ CASE 1</h3> Timothy R. Carter, MD, Charlottesville, Va A 3-month-old female infant presented with a 6 × 4-cm, soft, nontender mass in the left preauricular area. The overlying skin showed a small central focus of bluish pigmentation. This mass was first noted one month after birth and roughly tripled in size over the next four to five weeks. This lesion is illustrated in Figs 1 through 3. What is your diagnosis? <h3>PATHOLOGIC QUIZ CASE 2</h3> David M. Stone, MD; Carl F. Wurster, MD; John F. Hamilton, MD, Chicago A 51-year-old man presented with multiple cranial nerve defects on the left side that had been present for 13 months. They began with left lateral gaze paralysis following a flutype illness, which quickly progressed to complete ophthalmoplegia. He subsequently developed a left-sided facial paralysis, difficulty chewing foods, and ipsilateral pain with hypoesthesia in middle and lower aspects of the face.

Suspected Multiple Primary Tumors of the Lacrimal and Parotid Glands

A 63-year-old man had apparent primary tumors of the lacrimal and parotid glands. Initially an adenocarcinoma of ectopic lacrimal gland origin was suspected following biopsy of a mass in the left orbit. The patient received radiation therapy to this area and showed no recurrence of the original lesion or development of other tumors for a period of 27 months. At that time, the patient returned with a mass in the left preauricular area. This was surgically resected and found to be an adenocarcinoma of the left parotid gland. Both tumors were histologically similar, mucin-secreting adenocarcinomas. There has been no further evidence of tumor growth in an additional three-year period.

Radiation Dermatitis Secondary to Radon Needles

To the Editor.— This letter illustrates a case of radiation dermatitis unusual and disappearing cause. Report of a Case.— In October 1968, a 47-year-old white man stated that 25 years previously radon needles had been implanted in both cheeks for the treatment of acne. For many years he had been aware of scars in both preauricular areas. In the last year or so a nonhealing crusted ulcer had appeared over the right jawline. X-ray films of the face revealed the radon needles in place without any other abnormal radiologic findings (Figure). The left preauricular and mandibular area showed an atrophic, telangiectatic, firm scar, 3.5×2.0 cm in size, with mottled pigmentation at the edges. The corresponding area on the right presented the same appearance but with the addition of a crusted, deep, slighly purulent ulcer occupying most of the upper portion of the scar. Scanning with a sensitive α-counter over both