Management of neoplasms of the head and neck in children. 1. Benign tumors

Huge maxillofacial teratomas

Teratomas arising from the head and neck are extremely rare. Sporadic reports in the literature mostly involve infant and young people. In this clinical report, we present a huge teratoma of the infratemporal fossa in an old patient. Current diagnosis and management approaches of this rare entity are described.

Laryngeal lymphatic malformation in a newborn

Stridor in a neonate evokes a series of prompt evaluations to determine the etiology. Common etiologies include inherent structural defects (such as laryngomalacia), vocal fold paralysis, acquired infectious etiologies, or extrinsic compressions. We report a neonate with a lymphatic malformation (lymphangioma) initially confined to the larynx that presented with stridor and progressive respiratory failure. Only seven other cases have been reported to present with lymphatic malformation confined solely to the larynx. There are several different modalities available to treat this condition, but recurrences are common. The presentation and management are discussed below. Physicians should be aware that stridor in a neonate can result from this unusual intrinsic obstruction of the larynx.

Mature Teratoma of the Nasal Vestibule: A Case Report

Teratomas are rare congenital neoplasms that arise from pluripotent cells. They consist of tissue from all three embryonic germ layers. According to most studies, teratomas of the head and neck account for only 2 to 9% of all cases. In this article, we report the first case of a teratoma of the nasal vestibule in a newborn. We also discuss methods of diagnosis and treatment of upper airway teratomas, and we include a brief review of the literature.

Evaluation of head and neck masses

There is always concern for a malignancy or other serious disease when a child presents with a chief complaint of a neck mass. However, a neck mass in child is commonly inflammatory or congenital rather than neoplastic. A complete history and physical exam will often provide enough information to guide management and reassure the concerned parents. In some cases, laboratory tests, radiologic studies or a surgical procedure may be necessary to determine a specific diagnosis and treatment plan. An organized and systematic approach is recommended and detailed in this review.

The surgical management of giant cervicofacial lymphatic malformations

Giant cervicofacial lymphatic malformation, a potentially life-threatening congenital malformation, historically has been removed in staged resections. However, complete surgical extirpation is desirable and can be achieved with the aid of a multidisciplinary team. The authors present the case of a 12-year-old girl who had an extensively enlarged cervicofacial lymphatic malformation. Effective treatment involved aggressive surgical excision, facilitated by mandibular osteotomies to provide access to the floor of the mouth, the tongue, and the pharyngeal wall. In addition, total removal of involved facial and neck skin was performed. The remaining soft tissue defect was reconstructed primarily with an abdominal musculocutaneous free flap. In the 5 years since the procedure, there has been no recurrence. Based on this experience, excision of involved skin and mandibular access osteotomies are important techniques to help completely remove cervicofacial lymphatic malformations with oral involvement, thus potentially reducing the number of recurrences. In addition, these cases require the best efforts of a multidisciplinary team to achieve a successful result so that complete and radical excision can be performed with the hope of avoiding the pitfalls of multiple resections.

Parotid lymphangioma. A case report

Parotid lymphangiomas occur rarely in childhood, and they are usually detected in infancy or early childhood. They grow slowly and present as painless, soft fluctuant masses. Rapid enlargement of the mass is usually associated with trauma, infection or hemorrhage into the cysts, and enlargement can lead to severe complications due to mass effect such as tracheal or esophageal compression and facial weakness. We report a case of parotid lymphangioma with clinical presentation of a rapidly enlarging mass in the left parotid region and facial palsy after aspiration of the mass at the age of 10 years. The facial weakness resolved completely when the size of mass decreased spontaneously.

Paediatric tumours of the jaws in northern Nigeria. Clinical presentation and treatment

134 cases of paediatric tumours of the jaws in Nigerian children are reviewed. Non-odontogenic tumours and tumours of mesenchymal origin were the commonest. Among malignant disease cases, Burkitt's lymphoma predominated. Late presentation for treatment and gross disfigurement were typical clinical findings. Most of the non-Burkitt malignant lesions had grown to inoperable proportions and the few that were amenable to aggressive surgery responded poorly to treatment.

Teratoma of the mastoid region in a newborn

Teratomas are congenital tumours arising from pluripotent cells and usually consisting of tissue arising from all 3 embryonic germ layers. Teratomas are quite uncommon in head and neck sites and to date only 150 such cases have been reported. A rare case of teratoma of the mastoid region in a newborn is reported. The method of diagnosis and treatment are discussed and the literature is reviewed.

Immature teratoma of the larynx

Teratomas are unusual tumors which occasionally occur in the head and neck. The tumor consists of the three basic germ-cell layers, in various degrees of maturation. Because of its malignant potential in adults, complete surgical excision is recommended. The patient we have described is believed to provide the first reported case of laryngeal teratoma in the English literature.

The use of the carbon dioxide laser in head and neck lymphangioma

The carbon dioxide laser has been used to treat various lesions of the head and neck, ranging from carcinomas to hemangiomas, and even including tatoos. A search of the literature does not reveal any reports of the carbon dioxide laser being used to treat lymphangioma. This report discusses the efficacy of treating lymphangioma of the air and food passages with the carbon dioxide laser, and presents three patients who have been treated in this fashion-two for palliation and one for cure.