Parathyroid carcinoma (PC) is a rare endocrine malignancy. We report 6 cases of PCs operated on in our department, during a period of 12 years (2010-2021). All of our patients presented severe hyperparathyroidism, high calcium levels, and very elevated parathormone (PTH) rates. Five were between the fifth and sixth decades of life and 1 patient was 37 years old. The parathyroid gland was only palpable in 1 case. All of our patients underwent cervical ultrasound and 5 of them underwent 99m Tc-MIBI scintigraphy. One of the patients presented bilateral parathyroid masses. All our patients were treated surgically: a parathyroidectomy was performed in all cases. In 1 patient, parathyroidectomy was performed in conjunction with a homolateral loboisthmectomy, as the diagnosis of PC was suspected preoperatively due to pulmonary metastases. The final anatomopathological study revealed PC in all cases. Follow-up was uneventful in 5 cases and 1 patient was lost to follow-up. Clinicians should suspect PC in patients with severe hypercalcemia, extremely elevated PTH levels, large parathyroid lesions, and distant metastases. Complete surgical resection, extended to the homolateral thyroid lobe, remains the recommended treatment.

Tonsillar tuberculosis, a rare observed presentation of Mycobacterium tuberculosis affecting the palatine tonsils. Often secondary and associated with concurrent pulmonary tuberculosis, it may clinically manifest as chronic or recurrent tonsillitis, occasionally mimicking malignant conditions. Diagnosis of this condition is often delayed and complex, frequently necessitating histopathological examination for confirmation. Its management predominantly hinges on antitubercular medications.We present two distinct cases of tonsillar tuberculosis. The first case involves a 64-year-old male receiving anti-TNF therapy for ulcerative colitis. He was hospitalized for lateral neck swelling and persistent ulceronecrotic angina despite initial antibiotic treatments. Tonsillar tuberculosis was suspected and confirmed by histopathological analysis. The second case involves a 46-year-old female presenting with right ulceronecrotic angina associated with ipsilateral jugulo-carotid adenopathy. The diagnosis of caseous-follicular tonsillar tuberculosis was confirmed by biopsy. The patient was initiated on antitubercular treatment for a period of 6 months, resulting in a significant improvement in symptoms. Neither patient had pulmonary tuberculosis.

Primary lymphoepithelial carcinoma of the salivary glands is an exceptional oncological condition that predominantly emerges within the parotid gland. A significant prevalence of lymphoepithelial carcinoma has been reported in the Inuit population, along with an associated positive serology for Epstein-Barr virus in these endemic regions. In this paper, we present a case of primary lymphoepithelial carcinoma of the parotid gland in a 68-year-old female patient with a history of diabetes and hypertension residing in a non-endemic area. Histology plays a critical role in the definitive diagnosis, and confirming the primary origin of lymphoepithelial carcinoma after ruling out metastasis from undifferentiated nasopharyngeal carcinoma. The mainstay of treatment is a combination of surgical resection and adjuvant radiotherapy. Inoperable forms are typically managed with chemoradiotherapy.

Journal of Neonatal Surgery is a peer-reviewed and open-access electronic journal. Only a few journals are being published on Neonatal Surgery especially from a developing country, which justifies the need of a new journal on this subject.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Anaplastic thyroid carcinoma is a rare and aggressive form of thyroid cancer that has a poor prognosis and a high mortality rate. It is characterized by rapid growth and invasion of nearby tissues. It typically presents as a rapidly growing goiter or nodule that is firm to the touch and firmly attached to the underlying structures. Case reports of unusual presentations of anaplastic thyroid carcinoma have been reported. The presentation of anaplastic thyroid carcinoma mimicking cervical tuberculosis is very unusual. We reported a case of a 65-year-old patient who had a left cervical swelling that had been evolving for 4 months, causing dysphagia. Initial imaging showed a necrotic mass in the left lobe of the thyroid, communicating with a second necrotic mass in the subcutaneous tissue that was fistulized to the skin and suggesting cervical tuberculosis. The mass was incised with pus and whitish material resembling caseous tuberculosis was discharged. Acid-fast bacilli (AFB) Polymerase chain reaction (PCR) was negative and biopsy revealed a nonspecific granulomatous lesion. Due to the growth of the mass and the presence of a permeation nodule, a second biopsy was performed, revealing anaplastic thyroid carcinoma. The patient was referred for radiochemotherapy due to tumor inoperability.

Objectives:Obstructive sleep apnea syndrome is associated with cardiovascular diseases. Mean platelet volume has emerged as a marker of prothrombotic conditions and cardiovascular risk. The aim of this study was to investigate the association between the mean platelet volume and cardiovascular diseases in patients with obstructive sleep apnea syndrome. Methods:The medical records of 207 patients were analyzed. Obstructive sleep apnea syndrome was diagnosed by polygraphy, and patients were classified according to apnea-hypopnea index: control group: individuals with simple snoring (apnea-hypopnea index < 5), mild obstructive sleep apnea syndrome group (5 & LE; apnea-hypopnea index < 15), moderate obstructive sleep apnea syndrome group (15 & LE; apnea-hypopnea index < 30), and severe obstructive sleep apnea syndrome group (apnea-hypopnea index & GT; 30). Mean platelet volume was obtained from medical records. Cardiovascular diseases were defined if patients had hypertension, heart failure, coronary artery disease, or arrythmia. The independent predictors related to cardiovascular diseases in obstructive sleep apnea syndrome were determined by using multiple logistic regression analysis. Results:Of the patients, 175 were included in the analysis. Sixty-three (36%) were males and 112 (64%) were females. The mean age was 51.85 & PLUSMN; 11 years. There were, 26 (14.9%), 53 (30.3%), 38 (21.7%), and 58 (33.1%) participants in the simple snoring, mild, moderate, and severe obstructive sleep apnea syndrome groups, respectively. Cardiovascular diseases were significantly different between the four groups (p = 0.014). Mean platelet volume in severe obstructive sleep apnea syndrome group was significantly higher than in mild or moderate obstructive sleep apnea syndrome group and simple snoring group (p < 0.05). Moreover, there was a positive correlation between mean platelet volume levels and apnea-hypopnea index (r = 0.424; p < 0.001). The independent predictors of cardiovascular diseases in obstructive sleep apnea syndrome were age (p < 0.001; odds ratio = 1.134; confidence interval: 1.072-1.2), body mass index (p = 0.012; odds ratio: 1.105; confidence interval: 1.022-1.194), and mean platelet volume (p < 0.001; odds ratio: 2.092; confidence interval: 1.386-3.158). Conclusion:The present study demonstrated that there is an association between mean platelet volume levels and cardiovascular diseases in patients with obstructive sleep apnea syndrome.

The preoperative diagnosis of a paranasal epidermoid cysts (EC) is challenging and is frequently mistaken. We present the case of a patient who developed a swelling on the left side of the face. The clinical examination showed a fixed and poorly defined swelling in the left maxillary region, with a slightly painful bulge in the upper vestibular peri-gingival area. A computed tomography (CT) scan showed a well-encapsulated expansive hypodensity that filled the left maxillary sinus. Magnetic resonance imaging (MRI) revealed a mass hypo-intense on T1-weighted images, high intense on T2-weighted images, hyperintense on diffusion-weighted images, and had a low apparent diffusion coefficient with no contrast uptake observed after the injection of Gadolinium. Surgical excision under general anesthesia was considered. A combined approach using an endoscopic sinus and Caldwell-Luc approach was performed and the histopathological examination confirmed the diagnosis of an EC. In conclusion, the preoperative imaging, including CT scans and MRI, aids in diagnosing ECs and differentiating them from other sinus tumors. Postoperative follow-up involving endoscopic surveillance and CT scans is crucial to monitor for potential recurrence.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Introduction:laryngoscopy and tracheal intubation induce catecholaminergic release. Our study aimed to evaluate the hemodynamic impact of orotracheal intubation by McGrath® compared to the Macintosh laryngoscope in the elderly.Methods:we conducted a prospective randomized clinical trial that included elderly patients proposed for a scheduled surgery under general anesthesia with orotracheal intubation and divided into 2 groups: patients who were intubated using the McGrath® (group V) and patients who were intubated using the Macintosh direct laryngoscope (group M). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP), were recorded before induction of anesthesia (baseline), and at 1 min, 3 min, and 5 min after intubation. Our outcomes were the increase of SBP (∆ SBP), MAP (∆ MAP), and HR (∆ HR) between the two groups, during the 5 minutes following the start of the orotracheal intubation, intubation time and the incidence of its related complications.Results:sixty patients were included and randomized into 2 groups of 30. The average age of our sample was 70±6 years with a sex ratio of 1.22. Most of the patients were operated on for orthopedic, urologic, or abdominal surgery. There were no statistically significant differences between the two groups in terms of demographic characteristics and the duration of anesthesia (p> 0.05). The intubation time was significantly increased in group M (p≤0.001). There was a significant difference in SBP, MAP, and HR values at 1 min after orotracheal intubation compared with the baseline values in Group V(P<0,05) and Group M (p < 0.05). There was a significant increase in the first minute after tracheal intubation in terms of SBP (151±42 vs 134.5±26 mmHg, p=0.012), MAP (114±4 vs 102±17 mmHg, p=0.015), DBP (89±32 vs 84±16 mmHg, p=0.01), and HR (99.5±10 vs 94.5±2 b/min, p=0.008) when group M was compared to group V. The ∆SBP was significantly different between group M (∆SBP = 36.2±23.5mmHg) and group V (∆SBP= 30.77±21.6mmHg) (p = 0.005). There were 4 ventricular arrhythmias in group M versus zero in group V (p <0.0001). The postoperative sore throat was significantly decreased in group M vs V (p=0.036).Conclusion:the McGrath® videolaryngoscope decreased the hemodynamic fluctuations due to endotracheal intubation in elderly patients.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Airway management in neonates is difficult because of the risk of rapid hypoxia. It presents a challenge even for an experienced anesthesiologist. Oral tumors in neonates can obstruct the airway or feeding problems in the newborn. Surgical excision is the treatment of choice but these tumors can seriously worsen the conditions of intubation. To surmount these difficulties, a particular multidisciplinary approach and special precautions are needed. We describe the airway management and precautions taken in the anesthesia for surgical removal of a case of large congenital palate teratoma associated with a wide cleft palate in a 25-day-old girl. Impossible intubation was predicted on magnetic resonance imaging. The difficult airway management cart as well as an otorhinolaryngologist skilled in performing emergency tracheostomies in neonates were available. The patient was intubated by conventional laryngoscopy under sevoflurane inhalation anesthesia. The tumor was successfully resected. This case poses a challenge for managing the airway because of the possibility of obstruction of the airway and the difficulty of the airway that radiological exams have allowed us. So, a multidisciplinary team effort is needed for successful neonatal airway management.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Introduction: Chronic rhinosinusitis with nasal polyposis (CRSwNP) affects a significant number of asthmatic patients. Objective: To investigate the clinical presentation of CRSwNP in asthmatic patients and to evaluate its recurrence. Methods: This is a retrospective study about 150 patients operated for CRSwNP during a 9-year period from 2011 to 2020. Results: Sixty-two of these patients had asthma : 26 men (41.9%) and 36 women (58.1%) with a sex ratio of 0.72. For asthmatic patients, the main symptom was nasal obstruction. The second main symptom was smell disorders in 60 patients, followed by rhinorrhea in 43 patients. Sinusalgia was present in only 11 patients. The average endoscopic clinical stage was 2,39 in the right nasal cavity and 2,42 in the left cavity. There was no statistically significant correlation between asthma and the clinical stage of nasal polyposis (p>0.05). Blood eosinophilia was noted in 15 asthmatic patients (24,19%) and 19 non asthmatic patients (21,59%) The mean radiological score according the Lund-Mackay staging system was 21,94 for asthmatics and 21.01 for non-asthmatics. For asthmatic patients : 33,9% had a recurrence of their polyposis, the average time to recurrence was 22,76 months with an endoscopic clinical stage equal to 2 in most cases. For non-asthmatics, 21,59% had recurrence with a longer average time to recurrence (27,5 months) and a lower endoscopic clinical stage (equal to 1 in most cases) Conclusion: Clinical findings and polyps recurrence in asthmatic patients with CRSwNO seems to be comparabale to the non-asthmatics which does not suggest a particular diagnostic and therapeutic implications.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Burkitt Lymphoma (BL) is a highly aggressive B-type non-Hodgkin lymphoma. It rarely develops at the level of the sinonasal cavities, especially in young children. We present the case of a 2-year-old boy who presented with a 2-month history of nasal obstruction, snoring, and epistaxis followed by a recent dyspnea. Examination revealed a protruding tissue mass in the left nasal cavity. Computed tomography scan showed a homogenous soft-tissue mass in the left nasal cavity extending toward the ipsilateral orbit, infratemporal fossa, nasopharynx, as well as the ethmoid and maxillary sinuses. Magnetic resonance imaging revealed a homogenous infiltrating mass with a hypo-intense signal on T2-weighted images reaching the infratemporal fossa and oropharynx. Biopsy confirmed the diagnosis of BL. The patient was referred to the clinical hematology department and received complex chemotherapy. Following chemotherapy, imaging revealed significant regression of the mass. We performed a nasopharyngeal biopsy which confirmed the absence of any persistent disease. This case report highlights a rare case of an extensive sinonasal BL emphasizing the importance of a high level of suspicion to ensure an early diagnosis and treatment.

Introduction: Tuberculosis rarely occurs in the upper respiratory tract, however, unrecognized and without treatment can lead to disabling complications and remains an epidemiological threat. Objectives: The aim of the present study is to illustrate the clinical and imaging presentations of upper respiratory tract tuberculosis to avoid pitfalls in diagnosis and provide early treatment. Methods: We retrospectively reviewed the clinical records of patients diagnosed with tuberculosis of the upper respiratory tract in our department between 1990 and 2022. Results: We have collected 14 patients (9 males and 5 females). The average age of patients was 47 ± 18,8 years. The most commonly involved structure was the nasopharynx (6 cases) followed by the larynx (5 cases), oropharynx (2 cases), and paranasal sinus (1 case). Pulmonary tuberculosis was identified in 5 cases. The most common symptoms were nasal obstruction in nasopharyngeal and sinonasal tuberculosis (3 cases), horseness in laryngeal tuberculosis (5 cases), and sore throat and dysphagia in oropharyngeal tuberculosis (2 cases). A mass-like lesion mimicking a tumor was found on the computed tomography in six cases. The mean duration of antituberculous chemotherapy was 10 ± 2 months. A successful outcome of the treatment was achieved in all cases with a follow-up period of 2 to 6 years. Conclusions: Tuberculosis of the upper respiratory tract has non-specific clinical presentations and imaging appearances. It should be taken into consideration in the differential diagnosis of upper respiratory tract lesions. Early diagnosis and treatment can significantly improve the patient9s quality of life and reduce disease transmission.

Introduction : Chronic rhinosinusitis with nasal polyps (CRSwNP) is frequently associated with asthma. The computed tomography of paranasal sinuses is performed for the majority of patients who are going to be operated. Objective : This work aims to provide an overview of chronic CRSwNP focusing on its asthma-related radilogical presentations. Materiels and methods : This is a retrospective study about 150 patients operated for CRSwNP during a 9-year period between November 2011 and December 2020. Results : Our series included 70 men (46.7%) and 80 women (53.3%) with a sex ratio of 0.87. Asthma was noted in 62 patients (41.3%). There was no statistically significant correlation between asthma and the clinical stage of nasal polyposis (p>0.05). The mean Lund Mackay score was 21.01 in non-asthmatics and 21.94 in asthmatics. It appears that asthma was not objectively correlated with a higher Lund Mackay radiologic score (p=0.14). There is a more pronounced involvement of the sphenoidal sinuses in asthmatic patients. The involvement of the other sinuses and the ostio meatal complex was almost the same in patients with and without asthma. Conclusion : Asthma-associated CRSwNP is recognized as a more aggressive subtype of CRSwNP. In our population of patients, Asthma is an additional symptom and the radiologic presentation was not a therapeutic indicator for asthmatic patients.