Lymphoepithelial sialadenitis is a rare disease characterized by chronic swelling of the parotid gland. Herein, we describe a case of a 9-year-old boy with recurrent parotiditis that was diagnosed as lymphoepithelial sialadenitis via tissue biopsy.

Antibiotics were ineffective, but steroid treatment successfully alleviated glandular inflammation. We considered eosinophilic parotiditis as a differential diagnosis; however, secretion analysis of the parotid gland revealed no eosinophils. A definitive diagnosis of lymphoepithelial sialadenitis was achieved through tissue biopsy that revealed lymphoid cell infiltration of the parotid gland, glandular parenchymal atrophy, and epimyoepithelial island formation in the gland duct. Following the biopsy, the patient remained free of parotiditis and glandular swelling for 8 months.

Lymphoepithelial sialadenitis is exceedingly rare in children and presents diagnostic challenges, as clinical course, imaging studies, and blood tests often prove inconclusive. While lymphoepithelial sialadenitis is generally considered benign, malignant transformation has been reported. Therefore, when encountering cases of atypical parotiditis or swelling of the parotid glands, prompt tissue biopsy is important for accurate diagnosis and appropriate management.

In most cases, external ear canal foreign bodies are removed and treated promptly; they are rarely left untreated for a long time. Here, we report a rare case of an external ear canal foreign body discovered three years after the injury.

A 4-year-old girl visited a local otolaryngology clinic with right ear pain and discharge, and a black foreign body was found in the right external ear canal. She had been stabbed in the right ear canal with a chopstick and visited the emergency department three years previously; however, no foreign body was found. In observing the external ear canal, the foreign body was partially buried under the skin and difficult to remove in an outpatient setting; then surgery was planned under general anesthesia. A skin incision was made above the foreign body, removed after peeling from the surrounding tissue. No tympanic membrane perforation was observed, a piece of gauze with antibiotic ointment was inserted, and the surgery was completed. The gauze was removed 13 days postoperatively and wound epithelialization was well two months postoperatively.

Thalassemia is a congenital disorder that causes hemolytic anemia due to impaired hemoglobin synthesis. Thalassemia major is very rare and hematopoiesis is enhanced by prolonged hemolysis, which may be complicated by myeloid hyperplasia. The patient is a 13-year-old boy. When he was 4 years old, he was diagnosed with beta thalassemia and had been under observation since then. When he was 13 years old, bilateral buccal swelling began to appear and he was referred to our hospital. He had nasal stenosis but no respiratory impairment. In addition, he presented with bilateral otitis media with effusion and conductive hearing loss. CT scan revealed myeloid hyperplasia of the maxilla and perimeter of the auditory tube to mastoid air cells, but no obvious deformity of the auditory ossicles. We performed insertion of transtympanic ventilation tube on him, and conductive hearing loss was improved. However, hearing loss in the low frequency range remained. The curative treatment for thalassemia was a bone marrow transplant, which was performed when he was 16 years old. Even after bone marrow transplant, there is a possibility of respiratory impairment and progressive hearing loss due to increased facial myeloid hyperplasia. Therefore, long-term follow-up is necessary.