Intracranial abscess is a serious, life-threatening condition with a dire prognosis. Although the advent of the antibiotic era has drastically reduced the incidence of the disease, predisposing factors such as untreated ear infections, poor personal hygiene, significant trauma with violation of the sterile cranial environment as well as existing co-morbidities such as an immunocompromised state make intracranial abscess a horrifying reality. Ear infections, in particular, are notorious for being the origin of roughly 50% of cerebellar abscesses.1 Chronic suppurative otitis media (CSOM) is one of the leading causes of brain abscess. Shaw and Russell2 reviewed 47 cases of cerebellar abscess and showed that 93% were caused by CSOM; the most common mechanism of entry into the brain parenchyma being direct extension. Chronic infection in the middle ear space could erode through the tegmen tympani and into the temporal lobe or through the tegmen mastoidei into the cerebellum. Neurological symptoms may be delayed as the abscess ‘grows’ in areas around the cerebellum that are regarded as ‘silent’, until vital areas such as those responsible for coordination and balance are violated. We describe a case of cerebellar abscess secondary to CSOM and discuss the possibility of performing ear surgery with simultaneous drainage of a contiguous abscess through a transmastoid approach in cases of chronic suppurative otitis media with intracranial complications.
Human ; Male ; Young Adult ; EAR DISEASES ; OTITIS ; Otitis Media, Suppurative ; OTITIS MEDIA-COMPLICATIONS, suppuration, SURGERY ; CHRONIC EAR DISEASE ; pain ; Headache

OBJECTIVE: To present a case of pleomorphic adenoma arising from heterotopic salivary gland tissue in a supraclavicular lymph node.

METHODS:
DESIGN: Case report
SETTING: Tertiary government hospital
PATIENT: One

RESULTS: A 38-year-old female consulted with a six month history of an enlarging right supraclavicular mass. Fine needle aspiration biopsy was negative for malignant cells. No primary tumor could be demonstrated elsewhere. Excision biopsy was performed and final histopathology revealed pleomorphic adenoma surrounded by a normal lymph node. Atypical tumor cells and mitoses were not found.

CONCLUSION: Criteria were met for diagnosing heterotopic salivary gland in a supraclavicular lymph node which subsequently developed into pleomorphic adenoma. The rare location of the lesion as well as the unusual histopathological result of pleomorphic adenoma arising from a lymph node merited submission of this case report.

Human ; Female ; Adult (a Person 19-44 Years Of Age) ; Neoplasms ; Neoplasm Metastasis ; Adenoma ; Salivary Glands ; Lymph Nodes