This report describes the experience gained by the diagnosis and management of this patient. It emphasises the importance of clinical vigilance so that proper treatment may be instituted in a timely manner.

We encountered a patient with a tongue base lymphoma that we initially diagnosed as a lingual tonsil in view of its benign appearance. We established the correct diagnosis of Waldeyer ring lymphoma by histology. This case led us to conduct a study of all cases of Waldeyer ring lymphoma that had been treated at our center during a 10-year period. We retrospectively examined our case records and found 35 such cases. From this group, we excluded 5 cases because of incomplete data. Thus our final study group was made up of 30 patients—14 males and 16 females, aged 14 to 76 years (mean: 51.6; median 54). The primary presenting signs and symptoms were dysphagia (n =17 [57%]), a neck mass (n = 7 [23%]), nasal symptoms (n = 5 [17%]), and pain (n = 1 [3%]). Only 4 patients (13%) had B symptoms. A total of 20 patients (67%) presented with tonsillar involvement, 8 (27%) with nasopharyngeal involvement, 1 (3%) with tongue base lymphoma, and 1 with anterior tongue involvement. Most patients (77%) presented at an early stage. Histologically, 25 patients (83%) had high-grade diffuse large B-cell lymphoma, 4 (13%) had T-cell lymphoblastic lymphoma, and 1 (3%) had follicular lymphoma. Twenty-one patients (70%) were treated with chemotherapy, 4 (13%) received adjuvant chemotherapy with either radiotherapy or surgery, 3 (10%) resorted to other forms of treatment (primarily traditional remedies), and 2 (7%) declined treatment altogether. There were 14 patients (47%) alive at the end of the study period.

Inflammatorypseudotumor (IPTJ isa rare, locally aggressive, benign neoplasm ofunknown etiology.It isuncommon in theheadand neckregion,particularly in theparanasal sinuses. We presentan unusual case ofIPTofthemaxillary sinus and orbit in a 27-year-old woman who presented with cheek swelling, right orbital swelling, double vision, andassociatedfeverand trismus. Computed tomography identified a mass with radiologic features suggestive of a malignancy of the maxillary sinus and orbit; the mass extended into the infratemporal fossa, parapharyngeal space, anterior antral wall, andsurrounding softtissue. A diagnosis of IPT wasestablishedon the basisofhistologic and immunohistochemical analysis, which identified a proliferation of blandspindle cells and a mixed inflammatory cell infiltrate. Despite its aggressive appearance, IPT isassociated with agoodprognosis. Ourpatient was treated successfully witha combination ofsurgery, steroid therapy, and methotrexate. Chemotherapeutic agents are generally reserved for recalcitrant cases.

The response to 8 mg of intratympanic dexamethasone used as a salvage therapy for idiopathic sudden sensorineural hearing loss was inadequate. A higher dosage of intratympanic dexamethasone might be required to achieve better outcomes.