Eagle syndrome or foreign body throat?

Eagle syndrome is a rare condition caused by an elongated styloid process or abnormal calcification of the stylohyoid ligament complex. Patients typically present with recurrent throat pain, neck or facial pain, sensation of foreign body in the throat, or even dysphagia. The finding of an elongated styloid process is usually incidental, with patients having no related symptoms. Only patients with symptoms are diagnosed with Eagle syndrome. This condition may be difficult to diagnose due to its rarity and the nonspecific nature of signs and symptoms. Diagnosis is mainly by clinical assessment and confirmation with radiological evidence. We present a unique case of eagle syndrome in a patient who complained of acute neck pain after eating fish

Paediatric oropharyngeal tularaemia requiring surgical intervention

Tularaemia is a rare infectious disease endemic in most European countries caused by the bacterium Francisella tularensis. 1 Patients often show acute non-specific symptoms, which causes a delay in diagnosis and proper treatment, potentially resulting in significant morbidities such as deep neck abscess, meningitis, endocarditis and septic shock. The authors present a case of a 5-year old boy with a 4-day history of fever, sore throat and painful cervical lymphadenopathy, whose clinical progression worsened despite being treated with recommended antibiotics as per WHO guidelines once the diagnosis of Tularaemia was confirmed by serologic tests. He developed a parapharyngeal abscess and a persistent left necrotic cervical lymph node, which both were surgically drained and excised, respectively, and an extended course of antibiotic was given. Subsequently, the patient fully recovered from the illness and the follow-up was negative for relapse. © BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ

Papillary Thyroid Carcinoma Presenting As a Cystic Neck Lesion: Case Series

Introduction: Papillary thyroid carcinoma (PTC) constitutes 75–85% of all thyroid cancers. PTC usually presents as a subtle, commonly slow-growing, painless thyroid mass or a solitary nodule in the neck. This presentation of a cystic neck lump, without the presence of a thyroid nodule, may imitate the course of a benign disease, thus delaying diagnosis and proper treatment.  Case Report: Three cases that had been initially presented as a cystic neck lesion in which a benign etiology was considered primarily were compiled in this study. PTC was only diagnosed after surgical excision of these cystic neck lesions in the first two cases, and after performing fine needle aspiration cytology (FNAC) and an 18fluorine-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET CT) scan in the latter case.  Conclusion: PTC can sometimes present as a cystic neck mass; a presentation which is usually related to a benign lesion. This case series emphasizes that patients who appear to have a solitary cystic neck mass must be treated with a high index of clinical suspicion. Although not a first-line imaging modality, 18F-FDG-PET can be extremely useful in assessing patients with a cystic neck lesion, where diagnosis is still uncertain after standard investigations such as ultrasonography and FNAC have been performed