Background: Primary Carcinoma of EAC is a rare disease accounting for less than 2% of head and neck cancers and has an annual incidence of around 1 per million populations. EAC carcinoma in post-irradiated nasopharyngeal carcinoma (NPC) patients occurs with an incidence of approximately 0.15%. It arises from the external ear and spreads to the temporal bone and surrounding sites. Although its rarity, it is a life threatening disease with practically a poor constant prognosis. Primary EAC carcinoma can occur with no specific symptoms. Aggressive surgery with postoperative radiation remain the usual treatment until now. We report a rare case of a squamous cell carcinoma (SCC) of EAC revealed by a progressive hearing loss as first presentation of the disease in a post-irradiated woman for NPC.Results: a 47-year-old female with a past medical history of nasopharyngeal carcinoma treated with chemoradiation therapy, presented for repeated left-sided purulent ear discharge and progressive hearing loss. Otoscopic examination revealed a tissue mass filling the left EAC. CT scan revealed a soft tissue density process filling the EAC, encroaching upon the tympanic cavity and coming into contact with the handle of the malleus with no ossicular lysis nor EAC walls erosion. The biopsy of the mass was consistent with EAC SCC. The patient underwent lateral temporal bone resection with homolateral superficial parotidectomy and selective neck dissection and completed by an adjuvant external radiation therapy (RT). Conclusion:Post-irradiation EAC SCC has similar symptoms and invades similar regions as its primary counterpart. This entity is usually discovered in the early stage in post-irradiated EAC SCC patients comparing to the primary EAC SCC. Aggressive surgical treatment is strongly recommended, but adjuvant radiotherapy for early stage EAC SCC should be provided cautiously to prevent further radiation induced complications.

Background: Primary Carcinoma of external auditory canal (EAC) is a rare disease accounting for less than 2% of head and neck cancers and has an annual incidence of around 1 per million populations. EAC carcinoma in postirradiated nasopharyngeal carcinoma (NPC) patients occurs with an incidence of approximately 0.15%. It arises from the external ear and spreads to the temporal bone and surrounding sites. Although its rarity, it is a life threatening disease with practically a poor constant prognosis. Primary EAC carcinoma can occur with no specific symptoms. Aggressive surgery with postoperative radiation remains the usual treatment until now. We report a rare case of a squamous cell carcinoma (SCC) of EAC revealed by a progressive hearing loss as first presentation of the disease in a post-irradiated woman for NPC. Results:A 47-year-old female with a past medical history of nasopharyngeal carcinoma treated with chemo radiation therapy, presented for repeated leftsided purulent ear discharge and progressive hearing loss. Otoscopic examination revealed a tissue mass filling the left EAC. CT scan revealed a soft tissue density process filling the EAC, encroaching upon the tympanic cavity and coming into contact with the handle of the malleus neither with no acicular lyses nor EAC walls erosion. The biopsy of the mass was consistent with EAC SCC. The patient under went lateral temporal bone resection with homolateral superficial parotidectomy and selective neck dissection and completed by an adjuvant external radiation therapy [RT]. Conclusion:Post-irradiation EAC SCC has similar symptoms and invades similar regions as its primary counterpart. This entity is usually discovered in the early stage in post-irradiated EAC SCC patients comparing to the primary EAC SCC. Aggressive surgical treatment is strongly recommended, but adjuvant radiotherapy for early stage EAC SCC should be provided cautiously to prevent further radiation induced complications.

Background: Follicular thyroid cancer (FTC) is a well-differentiated thyroid cancer that accounts for 15-20% of all Thyroid cancers. It is more likely to manifest as a distant metastasis than PTC as it tends to spread hematogenously with bones being the second most common site of metastasis after lungs.We report an unusual case of an occult FTC revealed by caudaequinasyndrome secondary to spinal metastasis as a first clinical manifestation of the disease.Results: An 81 year old female presented to neurosurgery clinic with paraplegia and sphincteric dysfunction.Dorso-lumbo-sacral CT and MR imagingshowed an ill-limited expansilelytic tissue processinvolving L4, L5 and S1 vertebrae,extendinginto spinal canal with an invasion of caudaequina nerves. Biopsy'sresults wereconsistent with spinal metastasis of FTC.The patient was referred to the ENT department where a total thyroidectomy was carried out, and the primary tumor pathology was consistent with FTC. Conclusion:Caudaequinasyndrome secondary to spinal metastasis is very uncommon as an initial finding of FTC without any previous symptoms of malignancy.Early diagnosis and prompt management of the primary carcinoma and the metastatic lesion may extend long-term survival and allow a favorable prognosis. Thyroidectomy with radioactive iodine ablation increases the 10-year survival in patients with metastatic disease.

Background: Squamous cell carcinoma (SCC) arising from the nasal vestibule is a rare condition accounting for about 1% of head and neck malignancies. SCC develops as a result of exposure to sunlight and ultraviolet radiation, toxic agents, scars, compromised immune status, and genetic defects.It is characterized by several particularities concerning clinical presentation, staging and treatment. Through this case presentation, we report an unusual mode of revelation of a SCC of the collumella,eventually, we discuss through a brief review of the literature its various staging and management features. Case presentation:We report a rare case of cutaneous squamous cell carcinoma of thecollumella in a 43-year-old Moroccan male who presented at first for an abscess of the columella of 10 days duration. After incision-drainage of the abscess, the histological examination of the biopsy specimen revealed cutaneous SCC. Complete surgical resection and bilateral lymph node dissection were performed. Reconstruction of columella defect was accomplished by a forehead flap after confirming disease-free surgical margins. Later, the patient underwent radiation therapy. There were no signs of recurrence or metastases at 3 years postoperatively. Conclusion:despite being superficial and accessible, SCC's diagnosis may be late due to its unspecific clinical presentation which causes an enormous problem of surgical management, because the removal of these tumors emerging in the face and the reconstruction of the extensive mutilations that follow, result in disastrous aesthetic outcomes and social consequences. Hence, the need to recognize symptoms in order to diagnose early for a better management and less damages.

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