Diagnosis and Endodontic Treatment of Odontogenic Cutaneous Sinus Tracts: A report of Two Cases

Introduction: The odontogenic cutaneous sinus tract (OCST), caused by pulp necrosis, creates connections between pathological spaces and anatomical structures. Extraoral manifestations pose diagnostic challenges leading to inappropriate treatments such as multiple surgery and antibiotic therapies. Effective management requires the treatment of dental pathology through endodontic therapy or extraction. This paper presents two cases of OCST and emphasizes the importance of accurate diagnosis and successful non-surgical endodontic treatment. Observations: Case report 1: A 23-year-old male patient referred by his dermatologist with a cutaneous sinus tract on his chin that had appeared five years ago. During this period, he reported spontaneous pain and pus discharge from the chin area. The examination revealed a periapical lesion associated with tooth number 31. Cone beam computed tomography (CBCT) revealed the existence of a localized perforation on the buccal alveolar table and a second root canal of the tooth. After six months of follow-up, the cutaneous sinus tract was significantly improved by the appropriate endodontic treatment. Case report 2: A 36-year-old female patient was referred by her dentist to examine a chin lesion that had appeared a month ago. In clinical examination and radiographic assessment, periapical lesion associated with two mandibular central incisor teeth #41 and #31 was observed. After identifying the source of infection, endodontic treatment was carried out, and a good improvement in fistula was observed after one month. Conclusion: The correct diagnosis and treatment of OCST are important for healing. CBCT aids to identify odontogenic origin of the sinus tract through the detection of apical periodontitis and bone lesion. Root canal therapy is the treatment of choice for these cases and should always be attempted first. Monitoring the patients is necessary until complete healing of the disease

Leucémie à plasmocytes : A propos de 5 observations cliniques: Plasma cell leukemia: report of 5 cases report

Plasma cell leukemia is a malignant plasma cell proliferation in bone marrow and peripheral blood. It is the most agressive form of plasma cell malignancies. It occurs in two forms: primary and secondary plasma cell leukemia. Plasma cell leukemia is defined by the presence of more than 2Giga/l peripheral blood plasma cells or plasmocytosis more than 20% of leukocyte count. In this context, we report 5 observations of plasma cell leukemia (1 case of primary plasma cell leukemia and 4 cases of secondary plasma cell leukemia) encountered during 9 years in Farhat Hached Hospital in Sousse-Tunisia. Through these observations, we describe clinical, paraclinical, prognostic and therapeutic characteristics of this pathology. La leucémie à plasmocytes est une prolifération maligne de cellules plasmocytaires dans la moelle osseuse et le sang périphérique. Elle représente la forme la plus agressive des néoplasies plasmocytaires. Elle se présente sous deux formes : une forme primitive et une forme secondaire compliquant un myélome multiple. Elle est définie par une plasmocytose sanguine supérieure à 2 Giga/l ou un taux de plasmocytes supérieur à 20% des leucocytes. Dans ce contexte, nous rapportons 5 observations de leucémie à plasmocytes (1 cas de leucémie à plasmocytes primitive et 4 cas de leucémie à plasmocytes secondaire) survenus en 9 ans à l’hôpital Farhat Hached de Sousse (Tunisie). A travers ces observations, nous décrivons les caractéristiques cliniques, paracliniques, pronostiques et thérapeutiques de cette pathologie. &nbsp

Primary papillary carcinoma of the thyroglossal duct in a 14-year-old female: case report and review of the literature

Thyroglossal duct carcinoma is a rare pathologic entity. The surgeon's main concern is whether to perform thyroidectomy or not. In this paper, we report another case of thyroglossal papillary duct carcinoma in a 14-old girl suspected preoperatively and confirmed postoperatively on the histological analysis of resected specimen by a Sistrunk procedure. Therapeutic strategy was completed by a total thyroidectomy with radioactive iodine therapy and suppressive levothyroxine therapy. In the absence of clear guidelines, the management of thyroglossal duct carcinoma is depending on the clinical situation and the experience of the team of surgeons

Cervicofacial lymphatic malformations: diagnosis and management

Abstract Background Lymphatic malformations are rare benign tumors that result from congenital and acquired alterations of the lymphatic vessels. They occur most commonly on the head and neck region. The aim of this study is to describe clinical profiles of lymphatic malformations of the head and neck (LMHN) as well as to study therapeutic modalities through our series and review of the literature. Results This is a retrospective record-based descriptive study conducted in the ENT and the Radiology departments over a 17-year period. Our study included twelve patients, aged between 8 months and 52 years. Two swellings were present at birth and had not been prenatally diagnosed in both cases. One patient was affected by TRISOMY 21. All patients consulted for a painless mass of the head or neck. Seven masses were located in the suprahyoid region and five in the infrahyoid region. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) were realized to establish the diagnosis and assess the extent of the lesions. Surgical excision was performed in 7 patients. It was complete in 6 patients. Five patients were treated with sclerotherapy. The sclerosing agents used were Aetoxisclerol 2%, hypertonic saline, and absolute alcohol. One patient had a reversible paresis of the left mental nerve after surgery. An excellent response to sclerotherapy with complete resolution was obtained in 3 cases with no recurrence of the disease. Conclusions Surgical excision has been the management option of choice for LMHN. The recent advances in sclerotherapy make it safe and effective as a primary treatment modality for these lesions