Background: Schwannomas are benign tumors originating from Schwann cells and commonly occur in the head and neck region. However, schwannomas arising from the upper cervical nerve roots are exceedingly rare [1,2]. Case Presentation: We report a 65-year-old man presenting with a slowly progressive right lateral cervical mass associated with moderate shoulder-radiating pain. Contrast-enhanced computed tomography revealed a well-circumscribed dumbbell-shaped mass in the right posterior cervical space with foraminal extension at the C2–C3 level. Complete surgical excision via a posterior approach was performed with preservation of the C2 nerve root. Histopathological and immunohistochemical analyses confirmed the diagnosis of schwannoma. Postoperative recovery was uneventful, and no recurrence was observed after 16 months of follow-up. Conclusion: Upper cervical nerve root schwannomas are rare entities. Accurate preoperative imaging and meticulous surgical resection allow complete tumor removal with excellent functional outcomes [3,4].

Abstract Background Rhinoscleroma is a chronic granulomatous infection caused by Klebsiella rhinoscleromatis , predominantly affecting the upper respiratory tract. Tracheal involvement is uncommon and may lead to progressive airway obstruction, delayed diagnosis, and severe respiratory complications. Methods We conducted a retrospective descriptive study of patients diagnosed with tracheal rhinoscleroma at the Department of Pulmonology of Hassan II University Hospital, Fez, between 2011 and January 2026. Clinical presentation, radiological findings, bronchoscopic characteristics, histopathological features, therapeutic management, and outcomes were analyzed. Results Five patients were included, comprising three women and two men, with a median age of 49 years (range: 10–50 years). Progressive dyspnea was present in all patients; while wheezing and inspiratory stridor were observed in selected cases. Subglottic involvement was the predominant localization. Bronchoscopic findings included circumferential inflammatory stenosis, pseudomembranous lesions, and complex subglottic narrowing. Computed tomography demonstrated tracheal wall thickening and luminal narrowing in most patients. Histopathological examination demonstrated chronic granulomatous inflammatory infiltrates compatible with rhinoscleroma. Three patients required interventional bronchoscopic management, including repeated bronchoscopic dilatations in one pediatric patient and emergency tracheostomy. All patients received prolonged ciprofloxacin therapy. Clinical outcome was favorable in most cases, although one patient developed ENT recurrence during follow-up. Conclusion Tracheal rhinoscleroma remains a rare but potentially severe cause of upper airway obstruction. Diagnosis is frequently delayed because of nonspecific clinical manifestations and its resemblance to other chronic airway diseases. Histopathological confirmation remains essential. Early recognition associated with prolonged antibiotic therapy and multidisciplinary airway management may improve prognosis and reduce irreversible airway stenosis.

Anaplastic thyroid carcinoma (ATC) is a rare, rapidly progressive, and highly aggressive tumor. It’s characterized by a rapid onset with local and distant metastases, local progression and distant evolution. ATC is ranked among the most lethal of all human malignancies and has a poor prognosis. The median overall survival of patients varies from 4 to 10 months aftes diagnosis. There is an hypothesis that claims that poorly differentiated thyroid tumors like anaplastic carcinoma develop from well-differentiated thyroid tumors. Its treatment is an emergency and requires surgery (if possible), chemotherapy and radiotherapy. We report here a case of a 69 years old female patient who presented with a massive anterior neck mass rapidly growing up in one month. It revealed to be an anaplastic carcinoma developped on an papillary carcinoma. After surgery and radio-chemotherapy, the patient had evolved well. After three years of control, non evidence of recidivism has been found.

The diffuse neurofibroma is a rare but particular form of neurofibroma, mainly occurring in children and young adults. About 10% of patients with diffuse neurofibroma have neurofibromatosis type 1. Due to its rare association with neurofibromatosis, it is a rare and difficult diagnosis. Its imaging appearance is very similar to that of a vascular malformation, and it is often misdiagnosed until pathological study proves otherwise. We report the case of a 48-year-old patient who complained a mass in the right supraclavicular region, with imaging suggesting a hemangiopericytoma. However, it was later found to be a diffuse neurofibroma.

Introduction: Leiomyosarcoma (LMS) is a rare, highly aggressive malignant mesenchymal tumor derived from smooth muscle cells. While common in the uterus and retroperitoneum, its primary occurrence in the oral cavity is exceptionally rare, posing significant diagnostic and therapeutic challenges, particularly in elderly patients with multiple comorbidities. Case Presentation: We report the case of a 78-year-old male, hypertensive and diabetic, presenting with a progressively enlarging, ulcerated lesion of the hard palate evolving over five months. Preoperative imaging demonstrated an invasive mass with palatine bone erosion. Initial biopsy suggested a smooth muscle tumor of uncertain malignant potential (SmTUMP), but definitive histopathological analysis following radical surgical excision confirmed a high-grade leiomyosarcoma. The patient underwent an infrastructure maxillectomy with clear margins followed by adjuvant chemotherapy. Conclusion: Oral leiomyosarcoma is a lethal malignancy that mimics benign smooth muscle tumors or more common carcinomas. In the geriatric population, metabolic comorbidities such as diabetes and hypertension necessitate a tailored multidisciplinary approach to manage surgical risks and adjuvant toxicity. Radical resection remains the mainstay for achieving local control and improving survival outcomes.

OBJECTIVES:To evaluate the diagnostic accuracy of middle ear partial filling on temporal bone computed tomography (CT) scan for middle ear cholesteatoma identification using supervised machine learning models. METHODS:We conducted an observational case-control study that retrospectively analyzed temporal bone CT scans from 212 patients from a single tertiary healthcare institution using supervised machine learning models, including k-Nearest Neighbors (kNN), Neural Networks, Logistic Regression, Support Vector Machine (SVM), and Random Forest. The study assessed the diagnostic value of partial middle ear filling for cholesteatoma. Limitations such as dataset imbalance and data complexity were addressed.  Results. In internal validation, kNN and Neural Networks achieved the highest performance (area under the receiver operating characteristic curve [AUC]: 1.000, classification accuracy [CA]: 99.6-99.7%, F1: 0.996-0.997), followed by Logistic Regression (AUC: 0.998, CA: 98.3%, F1: 0.983) and SVM (AUC: 0.997, CA: 97.5%, F1: 0.975). Random Forest performed the weakest (AUC: 0.980, CA: 92.0%, F1: 0.919). External validation (125 cases) revealed Neural Networks' superior generalizability (four errors), outperforming Logistic Regression (five), SVM (seven), Random Forest (28), and kNN (45). kNN demonstrated notably lower generalizability, suggesting limited robustness for unseen data.  Discussion. The study highlights the effectiveness of machine learning in diagnosing cholesteatoma. Addressing data imbalance and variability in CT scans was crucial for model performance. Further research is needed to refine these models and explore their integration into clinical practice.

Semicircular canal dehiscence (SCCD) is a rare inner ear disease caused by an anatomical defect in the bony covering of the semicircular canal (SCC). This condition most commonly affects the superior semicircular canal, and less frequently involves multiple canals in one or both ears. Although the clinical and physiological features of a single SCCD are well known, there are only a few reported cases of multiple semicircular canal dehiscences. Thus, their clinical and physiological characteristics require further investigation. We present the case of a 59-year-old male patient of Moroccan ethnicity who presented with chronic imbalance and mild dizziness, induced by loud noises. As a dentist, he experienced extreme difficulty while drilling his patients' teeth, exhibiting nausea, tachycardia, and sweating. Clinical oto-vestibular and neurological examinations, tonal audiometry, and videonystagmography (VNG) revealed peripheral vestibular syndrome. Bilateral multiple SCCD was subsequently confirmed using high-resolution computed tomography imaging of the temporal bone. The clinical manifestations in this case were primarily neurovegetative symptoms of vestibular dysfunction. Functional assessments revealed vibratory-induced down-beating nystagmus and left preponderance on caloric testing. Computed tomography (CT) imaging confirmed dehiscence in the posterior and superior semicircular canals on the right side, and posterior semicircular canal dehiscence on the left side.

Background: Acute invasive fungal cellulitis is a potentially leathal infection due to opportunistic fungi of the order Mucorales, mainly affecting immunocompromised individuals. Due to its non-specific symptomatology, dominated mostly by tissue necrosis, diagnosis is often delayed, adversely affecting prognosis. This infection predominantly arises in the nose and paranasal sinuses. Mucormycosis affecting sollely the cheek region are uncommon. We believe this ist he first case of a localized mucormycosis of the cheek. Moreover, Actinomycoses and mucormycoses occur most often in patients with immunodepression, and their association is less well described in the literature. Case Presentation: We present the clinical, biology and imaging findings of a rare case of jugal mucormycosis associated with actinomycosis in a 56-year-old female patient who presented with unbalanced diabetes and discuss diagnostic and therapeutic challenges. Discussion & Conclusion: Mucormycosis and actinomycosis are rare infections that occur most frequently in immunocompromised patients, Mucormycosis is caused by the Rhizopus arrhizus species. The cutaneous localization of mucormycosis is uncommon and is favored by a breach, be it a burn, a catheter or any other cutaneous trauma. Cervicofacial Actinomycosis occurs in over 60% of cases in the maxillofacial region. It is the anatomopathological examination which gives a diagnosis of certainty of these two pathologies and their late diagnosis is coupled with serious complications.

Parathyroid carcinoma is an exceptionally rare malignant tumor of the parathyroid gland. Clinically, it most often presents as severe primary hyperparathyroidism. Diagnosis relies on histopathological analysis, although it is often difficult to establish due to the lack of clearly pathognomonic criteria. Management is primarily based on complete surgical excision. We report the case of a 55-year-old woman with no significant medical history, admitted for evaluation of a suspicious parathyroid nodule discovered in the context of hyperparathyroidism. She underwent parathyroidectomy along with total thyroidectomy. The postoperative course was favorable, with normalization of laboratory parameters and no signs of recurrence. This case highlights the diagnostic complexity of parathyroid carcinoma, despite suggestive clinical, biological, and imaging findings. Histological diagnosis remains challenging due to overlapping features with benign lesions. Complete surgical excision during the initial operation is the main favorable prognostic factor, both for therapeutic success and prevention of recurrence.

There is a clear association between radiotherapy and an increased risk of developing secondary cancers, including sarcomas. Leiomyosarcoma is one of the rare secondary tumors reported after radiotherapy treatment. We report a rare case of laryngeal leiomyosarcoma in a 72-year-old patient with a history of radiotherapy for nasopharyngeal carcinoma treated seventeen years earlier. The patient mainly presented with progressively worsening dysphagia. The treatment consisted of surgical excision followed by adjuvant radiotherapy. The outcome was favorable. Through this case report, we aim to highlight this rare secondary tumor and its association with the effects of radiotherapy. We will also review the main therapeutic modalities for this entity.

Tuberculosis of the lacrimal gland is a rare manifestation of extrapulmonary tuberculosis. It may occur in isolation or in association with pulmonary tuberculosis. The diagnosis is strongly supported by histopathological examination. Treatment relies on anti-tuberculous therapy. We report the case of a 53-year-old woman with no significant medical history who presented with chronic right-sided epiphora associated with the progressive appearance of a swelling in the region of the right lacrimal gland. A biopsy of the mass was performed, and histopathological analysis confirmed the diagnosis of tuberculous dacryoadenitis. The patient received anti-tuberculous therapy, which resulted in significant clinical improvement maintained over a one-year follow-up period. Primary mycobacterial infection of the lacrimal gland is extremely rare. Its clinical presentation is variable, making diagnosis challenging. Therefore, it should be considered in the differential diagnosis of any lacrimal gland hypertrophy, especially in endemic regions.

Background: Fibrous dysplasia (FD) of bone is a rare sporadic benign congenital condition in which normal bone is replaced by fibro-osseous tissue with immature osteogenesis. Sarcomatous transformation is exceptional. The most common presenting features in craniofacial forms include atypical facial pain and headaches. Case Presentations: we report here 2 cases, that of a 36 year old male and of a 43 female, who both presented with a similar history of headaches. The male patient refused surgery so removal of the diseased bone was not an option. However, as the limited growth of this lesion have been established, only further, albeit close, observation was planned. The female patient underwent a successful removal of her tumour through an endoscopic approach. At the 1.5 year follow-up, she remains disease free. Conclusion: craniofacial fibrous dysplasia can present itself in myriad ways, therefore, the diagnosis should always be considered in case of headache, neuralgia or sensory disorders. Modern imaging modalities and histopathologic analysis have made the diagnosis reasonably straightforward. A medico-surgical approach is useful for these patients. Surgery ―when indicated― is tailored to the specific clinical presentation. The goal is to be as minimally invasive as possible while still achieving the desired outcome, prioritizing the preservation of existing function.

Adenoid cystic carcinoma is a rare tumor, constituting around 5% of primary malignant neoplasms of the external ear canal. It carries a high risk of local recurrence and distant metastases, primarily to the lungs. This is often attributed to delayed diagnosis and to initial symptomatology resembling benign ear affections. Management typically involves surgical resection followed by radiotherapy. Chemotherapy is reserved for palliative purposes in metastatic stages. We present a case of a 71-year-old patient diagnosed with adenoid cystic carcinoma of the external ear canal. The patient complained of otalgia evolving over three years, along with a gradual hearing loss. The patient underwent surgical tumor resection followed by radiotherapy.

Primary laryngeal lymphoma is rare, accounting for less than 1% of all laryngeal cancers. Treatment depends on the stage and severity of the disease. We here report the exceptional case of a 64-year-old woman, non-smoker, suffering from dysphagia for solids and a foreign body sensation. Laryngoscopy and biopsies revealed polyploid tumor of the left epiglottic fold. The diagnosis of diffuse large B-cell lymphoma was made. The patient underwent chemotherapy followed by radiotherapy, with significant improvement at 2-year follow-up, with no local recurrence. Due to the rarity of this disease and the variety of symptoms, the optimal management strategy for this type of cancer is controversial, requiring a specific diagnostic and therapeutic approach.

Le lymphome primitif du larynx, une entité rare, constitue moins de 1% de tous les cancers laryngés. Son traitement dépend de son stade et de sa gravité. Nous présentons le cas exceptionnel d´une femme de 64 ans, non-fumeuse, souffrant d´une dysphagie aux solides et d´une sensation de corps étranger. Une laryngoscopie et des biopsies ont révélé une tumeur polyploïde sur le repli ary-épiglottique gauche, confirmée comme un lymphome malin non hodgkinien B diffus à grandes cellules. La patiente a bénéficié d´une chimiothérapie suivie d´une radiothérapie, avec une amélioration notable sur les 2 années de suivi, sans récidive locale. En raison de sa rareté et de la variété des symptômes, la prise en charge optimale de ce type de cancer reste controversée, nécessitant une approche diagnostique et thérapeutique spécifique, ce qui en fait un cas intéressant à publier.

BackgroundDistinguishing between middle ear cholesteatoma and chronic suppurative otitis media (CSOM) is an ongoing challenge. While temporal bone computed tomography (CT) scan is highly accurate for diagnosing middle ear conditions, its specificity in discerning between cholesteatoma and CSOM is only moderate. To address this issue, we utilized trained machine learning models to enhance the specificity of temporal bone CT scan in diagnosing middle ear cholesteatoma. Our database consisted of temporal bone CT scan native images from 122 patients diagnosed with middle ear cholesteatoma and a control group of 115 patients diagnosed with CSOM, with both groups labeled based on surgical findings. We preprocessed the native images to isolate the region of interest and then utilized the Inception V3 convolutional neural network for image embedding into data vectors. Classification was performed using machine learning models including support vector machine (SVM), k-nearest neighbors (k-NN), random forest, and neural network. Statistical metrics employed to interpret the results included classification accuracy, precision, recall, F1 score, confusion matrix, area under the receiver operating characteristic curve (AUC), and FreeViz diagram.ResultsOur training dataset comprised 5390 images, and the testing dataset included 125 different images. The neural network, k-NN, and SVM models demonstrated significantly higher relevance in terms of classification accuracy, precision, and recall compared to the random forest model. For instance, the F1 scores were 0.974, 0.987, and 0.897, respectively, for the former three models, in contrast to 0.661 for the random forest model.ConclusionThe performance metrics of the presented trained machine learning models hold promising prospects as potentially clinically useful aids.

Background and objective Lymph node tuberculosis (LNTB) is a common manifestation of extrapulmonary tuberculosis (EPTB). GeneXpert is a rapid diagnostic molecular test that simultaneously detects tuberculosis and rifampicin (RIF) resistance. In this study, we aimed to assess the epidemiology of LNTB and diagnostic performance parameters of the GeneXpert in routine ENT practice. Methods We conducted a cross-sectional prospective study from January to July 2019, in the Department of Otorhinolaryngology and Head Neck Surgery at the Hassan II University Hospital Center of Fez, Morocco. The samples were collected using lymph node biopsy and subjected to GeneXpert assay, culture, and histopathology. Diagnostic performance parameters of the GeneXpert were calculated and compared with culture. Results All patients with cervical adenopathy were included. Lymph node biopsies were performed for all patients. The performance of the GeneXpert was assessed according to culture findings. Among the 75 cases, the mean age was 21.6 +/- 12.7 years with a female predominance (60%). GeneXpert was positive in 66.7% of specimens. The sensitivity and specificity of the GeneXpert assay were 78.6% and 40.4% respectively. GeneXpert accuracy was 54.6%. The positive predictive value (PPV) and negative predictive value (NPV) were found to be 44% (95% CI: 30.2-57.8) and 76% (95% CI: 59.3-92.7) respectively. Mycobacterium bovis was isolated in all samples, with no case of resistance to RIF found. Conclusions The performance of GeneXpert was found to be superior in terms of establishing the diagnosis of LNTB. It offers speedy and prompt results and clinicians should adopt it in routine clinical practice.

Laryngocele is a rare benign affection characterized by the abnormal dilatation of the laryngeal saccule or Morganii ventricle. Laryngocele can be classified as internal, external and mixed (both). Many laryngoceles are asymptomatic; Sometimes it is presented as cervical swelling causing airway obstruction in need of emergency intervention. Computed tomography scan is the most effective imaging method for diagnosis. Surgery is the treatment of choice. We are reporting a case of laryngocele in 50-year-old male, who presented a recent dysphonia and solid dysphagia, along with an anterior cervical mass. The diagnosis of laryngocele was confirmed by radiology and laryngoscopy. The patient was operated by cervical approach with a good evolution. In the following article, we discuss the establishment of the diagnosis and we review clinical and therapeutic characteristics of various types of laryngoceles.

Tumors of salivary glands are less frequent in the head and neck region. Pleomorphic adenoma (PA) is a benign tumor of major and accessory salivary glands. The soft palate is one of the most frequent sites among accessory salivary glands. This tumor can increase in size and cause oropharyngeal obstruction with a risk of asphyxia, endangering the patient's life. Treatment is based on complete tumor excision and it’s sometimes difficult. Histopathological examination confirms the diagnosis. In this study, we present a case of a large pleomorphic adenoma of the accessory salivary glands located in the soft palate, successfully treated with intraoral excision surgery after an initial tracheostomy.

Graves' orbitopathy (GO) is a rare autoimmune disease that affects patients in their fourth to sixth decade, resulting in retro-orbital inflammation and hypertrophy of extraocular muscles and orbital fat. It is the most common disease affecting the orbit globally, and treatment options vary depending on the severity and activity status of the affection, ranging from local measures such as lubricating eye drops and patching, glucocorticoid eye drops, mydriatics, nonsteroid anti-inflammatory medications to systemic glucocorticoids, and emergency orbital decompression surgery. Immunotherapy and orbital radiation may as well be used as a treatment option even though their efficiency remains controversial. This paper presents the cases of two patients with GO who underwent endoscopic endonasal decompressive surgery. These patients' medical records, including symptoms and duration, clinical examination, imaging results, preoperative preparation, surgery steps, and postoperative course and outcomes, were collected from various specialties, including ophthalmologists and endocrinologists. We highlight the importance of a multidisciplinary approach to managing GO and its complications, with endoscopic endonasal techniques emerging as a minimally invasive and effective way to treat compressive optic nerve forms of the disease. However, the timing of decompression remains crucial, and early intervention is recommended to avoid sight-threatening ophthalmopathy when medical therapies are ineffective.