Case Report
A Case Report of Anesthetic Challenges in a Patient with Eagle Syndrome
Semon Mengistu*
,
Mengistu Feye
Issue:
Volume 1, Issue 1, December 2026
Pages:
1-6
Received:
8 August 2026
Accepted:
19 August 2026
Published:
22 September 2026
Abstract: Elongation of the styloid process (ESP) was described by Pietro Marchetti in 1652 but it was not until 1937 that the clinical symptomatology of Eagle Syndrome (ES) was characterized by the otolaryngologist Watt Weems Eagle. The normal styloid process is defined as 2.5 to 3 cm although there are some reports of lengths up to 4 cm. Radiological ESP or calcified stylohyoid ligaments are relatively common but symptomatic ES remains rare and is often misdiagnosed with distinct perioperative challenges due to upper airway distortion which may make intubation difficult and vascular compression (stylocarotid syndrome) which may cause transient ischemic attack, stroke or dissection. Symptoms ranging from dysphagia and odynophagia to syncope and neurologic deficits require vigilance as demonstrated in our case of a 25-year-old male who presented with a 12-month history of intermittent analgesia for cervical pain and sensation of a foreign body in the pharynx, diagnosed with ESP and planned for styloidectomy at Hawassa University Comprehensive Specialized Hospital. This case highlights the need for a comprehensive and multidisciplinary approach to successful perioperative management, including strict preparation for difficult airways following current guidelines, continuous neurological and hemodynamic monitoring to identify cerebral ischemia, multimodal analgesia for neuropathic pain, and a smooth, controlled extubation to avoid vascular injury. Furthermore, a detailed preoperative evaluation of nutritional status, medication history, and anxiety is essential, enhancing patient safety and achieving optimal surgical results in this diagnostically complex condition.
Abstract: Elongation of the styloid process (ESP) was described by Pietro Marchetti in 1652 but it was not until 1937 that the clinical symptomatology of Eagle Syndrome (ES) was characterized by the otolaryngologist Watt Weems Eagle. The normal styloid process is defined as 2.5 to 3 cm although there are some reports of lengths up to 4 cm. Radiological ESP o...
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Case Report
Recurrent Spindle Cell Carcinoma in the Region of the Cheek: A Case Report
Tooba Noor,
Kashif Shahzad,
Muhammad Mudassar,
Samaviya Atif,
Affan Mudassar,
Naveera Waseem*
Issue:
Volume 1, Issue 1, December 2026
Pages:
7-11
Received:
30 August 2026
Accepted:
8 September 2026
Published:
22 September 2026
Abstract: Spindle cell carcinoma (SpCC) is a rare and aggressive variant of squamous cell carcinoma characterized by a distinctive spindle-cell morphology and variable epithelial differentiation. It most frequently develops in the mucosal surfaces of the upper aerodigestive tract, particularly the larynx, hypopharynx, and oral cavity. Although maxillofacial involvement can occur, recurrent SpCC involving the cheek and mandibular region represents an uncommon clinical presentation and may pose significant diagnostic and therapeutic challenges. We report a case of recurrent spindle cell carcinoma involving the cheek and mandibular region following previous treatment. The patient presented with clinical features suggestive of a recurrent malignant lesion, and radiological evaluation demonstrated tumour involvement of the affected maxillofacial region. Histopathological examination revealed a highly atypical spindle-cell proliferation with malignant cytological features, raising consideration of several differential diagnoses, including spindle cell sarcoma, malignant fibrous histiocytoma, and other mesenchymal neoplasms. Given the unusual morphology and anatomical location, immunohistochemical evaluation was performed using a broad panel of epithelial and mesenchymal markers. The immunoprofile demonstrated epithelial differentiation and supported the diagnosis of spindle cell carcinoma, allowing distinction from primary mesenchymal spindle-cell malignancies. The recurrent nature of the lesion further emphasized the aggressive biological behaviour and potential for local recurrence associated with SpCC. Management of these tumours requires careful correlation of clinical, radiological, histopathological, and immunohistochemical findings, particularly when conventional squamous differentiation is inconspicuous. This case highlights the diagnostic complexity of recurrent SpCC in an uncommon cheek and mandibular location and emphasizes the importance of maintaining a high index of suspicion when evaluating recurrent spindle-cell lesions of the maxillofacial region. Early recognition, accurate pathological diagnosis, appropriate assessment of local and regional disease, and multidisciplinary management are essential for optimizing treatment and follow-up. Awareness of this rare presentation may facilitate timely diagnosis and improve clinical decision-making in patients with recurrent maxillofacial spindle cell carcinoma.
Abstract: Spindle cell carcinoma (SpCC) is a rare and aggressive variant of squamous cell carcinoma characterized by a distinctive spindle-cell morphology and variable epithelial differentiation. It most frequently develops in the mucosal surfaces of the upper aerodigestive tract, particularly the larynx, hypopharynx, and oral cavity. Although maxillofacial ...
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