We here present the case of a 22-year-old female of Suriname ethnicity with ulcerative colitis who received treatment with mercaptopurine and infliximab.She presented herself with a severe necrotizing tonsillitis due ...We here present the case of a 22-year-old female of Suriname ethnicity with ulcerative colitis who received treatment with mercaptopurine and infliximab.She presented herself with a severe necrotizing tonsillitis due to herpes simplex virus type-1(HSV-1).Combination therapy consisting of immunomodulators and anti-tumor necrosis factor(TNF) agents is increasingly being used.Anti-TNF therapy is associated with an increased risk of developing serious infections,and especially patients receiving combination treatment with thiopurines are at an increased risk.We here show that HSV infections can cause a severe tonsillitis in immunocompromised patients.Early recognition is essential when there is no improvement with initial antibiotic therapy within the first 24 to 72 h.HSV infections should be in the differential diagnosis of immunocompromised patients presenting with a necrotizing tonsillitis and can be confirmed by polymerase chain reaction.Early treatment with antiviral agents should be considered especially if antibiotic treatment fails in such patients.展开更多
Introduction: Carcinosarcoma of the head and neck is a very rare pathology < 1%. This is a mixed tumor with epithelial and mesenchymal components. It is characterized by high recurrence, metastasis, and mortality r...Introduction: Carcinosarcoma of the head and neck is a very rare pathology < 1%. This is a mixed tumor with epithelial and mesenchymal components. It is characterized by high recurrence, metastasis, and mortality rates. Aim: The sporadic nature of carcinosarcomas of the oral cavity, sinonasal tract, larynx, and hypopharynx causes difficulties with the diagnostic and therapeutic approach. Our clinical case is an example of a rare localization of carcinosarcoma, which allows for a detailed examination thereof. Materials and methods: We present a clinical case of a 67-year-old male, admitted to the Otorhinolaryngology Clinic of University Hospital “Sv. Georgi”—Plovdiv, presenting with difficulty swallowing and a lump on the right side of the neck for several months. Computed tomography was performed and a tumor involving the right palatine tonsil was found. The tonsil was surgically removed. The histopathological findings showed a biphasic tumor with epithelial and mesenchymal components—carcinosarcoma. Results: Following monotonsillectomy, the patient was referred to radiotherapy. The local status does not indicate any progression and infiltration into soft tissue. Conclusion: Carcinosarcoma is a malignant mixed tumor with high recurrence, metastasis, and mortality rates. It is difficult to diagnose due to its non-typical location and the need for immunohistochemistry testing, which is not always possible. The therapy for carcinosarcoma of the head and neck is delivered as per protocol for treatment of squamous cell carcinoma due to the absence of a specific one.展开更多
文摘We here present the case of a 22-year-old female of Suriname ethnicity with ulcerative colitis who received treatment with mercaptopurine and infliximab.She presented herself with a severe necrotizing tonsillitis due to herpes simplex virus type-1(HSV-1).Combination therapy consisting of immunomodulators and anti-tumor necrosis factor(TNF) agents is increasingly being used.Anti-TNF therapy is associated with an increased risk of developing serious infections,and especially patients receiving combination treatment with thiopurines are at an increased risk.We here show that HSV infections can cause a severe tonsillitis in immunocompromised patients.Early recognition is essential when there is no improvement with initial antibiotic therapy within the first 24 to 72 h.HSV infections should be in the differential diagnosis of immunocompromised patients presenting with a necrotizing tonsillitis and can be confirmed by polymerase chain reaction.Early treatment with antiviral agents should be considered especially if antibiotic treatment fails in such patients.
文摘Introduction: Carcinosarcoma of the head and neck is a very rare pathology < 1%. This is a mixed tumor with epithelial and mesenchymal components. It is characterized by high recurrence, metastasis, and mortality rates. Aim: The sporadic nature of carcinosarcomas of the oral cavity, sinonasal tract, larynx, and hypopharynx causes difficulties with the diagnostic and therapeutic approach. Our clinical case is an example of a rare localization of carcinosarcoma, which allows for a detailed examination thereof. Materials and methods: We present a clinical case of a 67-year-old male, admitted to the Otorhinolaryngology Clinic of University Hospital “Sv. Georgi”—Plovdiv, presenting with difficulty swallowing and a lump on the right side of the neck for several months. Computed tomography was performed and a tumor involving the right palatine tonsil was found. The tonsil was surgically removed. The histopathological findings showed a biphasic tumor with epithelial and mesenchymal components—carcinosarcoma. Results: Following monotonsillectomy, the patient was referred to radiotherapy. The local status does not indicate any progression and infiltration into soft tissue. Conclusion: Carcinosarcoma is a malignant mixed tumor with high recurrence, metastasis, and mortality rates. It is difficult to diagnose due to its non-typical location and the need for immunohistochemistry testing, which is not always possible. The therapy for carcinosarcoma of the head and neck is delivered as per protocol for treatment of squamous cell carcinoma due to the absence of a specific one.
