Abstracts / International Journal of Pediatric O108

inflammation, erythema, and external drainage. In this patientpopulation respiratory symptoms are frequently part of the initialpresentation, and respiratory failure due to cyst mass effect is oftenfatal in newborns. The case presented here is unusual in terms ofage at presentation (4 days), type of infecting bacteria (GBS), rapidcyst enlargement, and prominent respiratory symptoms (pre-viously unreported in cysts inferior to hyoid bone). Although rare,TGDCs should be included in the differential diagnosis ofcongenital neck masses or unexplained respiratory compromisein neonates, especially when the presentation includes positional,intermittent, or progressively worsening obstructive respiratorysymptoms. As this case illustrates, infection of these cysts iscommon but does not always manifest with visible neckinflammation and swelling. With rapid diagnosis the potentiallyfatal complications of TGDCs can be avoided in neonatal patients.

doi:10.1016/j.ijporl.2009.11.022

Rapidly progressing palatal pleomorphic adenoma in anadolescent

Sami P. Moubayed, Fahad AlSaab, Sam J. Daniel *

Department of Otolaryngology, Head and Neck Surgery, Montreal

Children’s Hospital, McGill University, Montreal, QC, Canada

Minor salivary gland neoplasms are rare in children. Only 5% ofpleomorphic adenomas of the minor salivary glands have beenreported in patients under 20 years of age. We report a case of a 13-year-old female who presented with a rapidly growing hard palatalmass, confirmed to be a myoepithelial cell-rich pleomorphicadenoma with cytological atypia. Pleomorphic adenomas shouldbe included in the differential diagnosis of rapidly growing palatalmasses in children and adolescents. Surgical excision is curative,and long-term follow-up is indicated as recurrence is frequent.

doi:10.1016/j.ijporl.2009.11.023

Lemierre’s syndrome after modified radical mastoidectomy:An unusual variant caused by Citrobacter freneli

Prakash Adhikari *, Rajendra P. Guragain, Chop Lal Bhusal,Rabindra B. PradhanangaDepartment of ENT and Head and Neck Surgery, TU Teaching Hospital,

Maharajgunj, Kathmandu, Nepal

Lemierre’s syndrome is characterised by an oropharyngealinfection leading to secondary septic thrombophlebitis of theinternal jugular vein. Most of the cases are caused by Fusobacterium

necrophorum. Here, we report an unusual variant of Lemierre’ssyndrome developed after modified radical mastoidectomy. Therewas right sigmoid sinus and right internal jugular vein thrombosisalong with multiple abscess foci seen in bilateral lung with rightpyopneumothorax. The organism isolated from chest foci wasCitrobacter freneli. We also briefly review the literature ofLemierre’s syndrome.

doi:10.1016/j.ijporl.2009.11.024

Parapharyngeal space neuroglial heterotopia with tumoral

differentiation

Joseph Y. Chan a,*, Chris K.C. Lai b, Victor J. Abdullah a,Micheal C.F. Tong c, C.A. vanHasselt c

a Department of Ear, Nose and Throat, United Christian Hospital, Hong

Kong, Chinab Department of Anatomical Cellular Pathology, Prince of Wales

Hospital, Hong Kong, Chinac Department of Otorhinolaryngology, Head and Neck Surgery, The

Chinese University of Hong Kong, Hong Kong, China

torhinolaryngology 74 (2010) 107–110

Introduction: Neuroglial heterotopia is a rare condition in whichmature neuroglial tissue is found in the body other than in thecentral nervous system. Nasal glioma is neuroglial heterotopia inthe nasal cavity. We report an extremely rare case of heterotopicneuroglial tissue in the temporal bone with tumoral trans-formation. Case report: Our patient was a 1-year-old Chinese girl.She was born with a left facial swelling. CT and MRI revealed aheterogeneous mass with cystic component occupying theparapharyngeal space. The upper airway was significantlycompromised by the mass which extended into the middlecranial fossa. A combined approach to its resection wasundertaken by ENT and neurosurgeons which was uneventfulwith all cranial nerves in its vicinity preserved. Intraoperativefindings confirmed the absence of direct communicationbetween the mass and the brain. Pathological examinationconfirmed mature neural tissue with tumoral differentiation.Conclusion: Heterotopic neuroglial tissue is a rare condition inthe temporal bone. Ganglioglioma formation within the hetero-topic neuroglial tissue is an even rarer condition. Careful pre-operative investigations and planning is the key to successfuland complete excision of the abnormal tissue whilst preservingnormal function.

doi:10.1016/j.ijporl.2009.11.025

Congenital esophageal duplication cyst: A rare cause of infantilestridor and a diagnostic challenge

V. Kumar a,*, A.P. Singh a, R. Meher a, A. Raj a, S.K. Aggarwal b

a Department of Otolaryngology and Head, Neck surgery, Maulana Azad

Medical College and Lok Nayak Hospital, New Delhi, Indiab Department of Pediatric Surgery, Maulana, Azad Medical College and

Lok Nayak Hospital, New Delhi, India

Duplication cyst of the cervical esophagus represents a rarecongenital anomaly. The children with esophageal duplication cystusually present with respiratory distress or as asymptomaticthoracic mass found on incidental chest X-ray. We here present acase of a 3-month-old male infant who presented with noisybreathing and progressive respiratory distress and with no otherabnormality. After laryngoscopy, barium esophagography and MRIstudy, congenital esophageal duplication cyst was diagnosed.Transcervical excision of the cyst was done using a harmonicscalpel. Histopathological examination of the specimen confirmedthe diagnosis. The patient remains asymptomatic after one year offollow up.

doi:10.1016/j.ijporl.2009.11.026