scholarly journals An aggressive case of Warthin-like variant of papillary thyroid carcinoma (PTC)

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S51-S51
Author(s):  
M Ali ◽  
S Thomas
Keyword(s):  
Hashimoto Thyroiditis ◽  
Neck Mass ◽  
Good Prognosis ◽  
Braf V600e ◽  
Chronic Lymphocytic Thyroiditis ◽  
Lymphoplasmacytic Infiltrate ◽  
Left Neck ◽  
Post Operation ◽  
Molecular Aberrations ◽  
Extensive Lymph Node

Abstract Introduction/Objective Warthin-like variant of PTC is a rare subtype of PTC, characterized by papillary growth lined with oncocytic neoplastic cells and lymphocytic rich stroma in the stalks of the papillae. It is frequently associated with Hashimoto thyroiditis and has good prognosis due to lower risk of metastasis. An association with BRAF V600E mutation has been reported. Here we report an aggressive case of Warthin-like variant of PTC. Methods/Case Report A 33-year-old Hispanic female presented with a progressively expanding neck mass, difficulty swallowing, voice hoarseness, and neck pain. Ultrasound showed a 3.8 cm left thyroid nodule which on biopsy was positive for PTC. Laboratory tests were positive for anti-peroxidase and anti-thyroglobulin antibodies. A total thyroidectomy was performed. Grossly, the left thyroid lobe nodule was well-circumscribed, unencapsulated, and firm with solid homogenous gray-tan cut surface. Microscopically, the nodule consisted of large eosinophilic cells demonstrating characteristic PTC nuclear features, arranged in papillary structures with the cores packed with prominent lymphoplasmacytic infiltrate consistent with Warthin-like variant of PTC (figure). Separate sub-centimeter foci of PTC with similar features were identified in a background of chronic lymphocytic thyroiditis. Central and left neck dissection showed extensive lymph node metastasis which had features similar to the primary tumor but with less pronounced lymphoplasmacytic cores. The patient is currently 6-month post operation and is receiving iodine ablative therapy. Results (if a Case Study enter NA) NA Conclusion Molecular analysis of the tumor may aid in identifying molecular aberrations responsible for the aggressive nature in this case and potentially guide treatment.

A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options

2021 ◽  
pp. 000348942199503
Author(s):  
Jerome Zhiyi Ong ◽  
Alex Chengyao Tham ◽  
Jian Li Tan
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Traumatic Event ◽  
Botulinum Toxin Injection ◽  
Treatment Options ◽  
Neck Mass ◽  
Good Prognosis ◽  
Common Symptom ◽  
Management Options ◽  
Omohyoid Muscle

Objective: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition. Data Sources: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020. Review Methods: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed. Results: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively. Conclusion: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography establishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

scholarly journals Extracranial invasion of a recurrent, transformed anaplastic pleomorphic xanthoastrocytoma: a case report

2018 ◽  
Vol 45 (S1) ◽  
pp. S2-S3
Author(s):  
K.D. Langdon ◽  
D. Krivosheya ◽  
M.O. Hebb ◽  
B. Wehrli ◽  
L.C. Ang
Keyword(s):  
Posterior Fossa ◽  
Jugular Foramen ◽  
Jugular Bulb ◽  
Neck Mass ◽  
Pleomorphic Xanthoastrocytoma ◽  
Braf V600e ◽  
Rare Tumour ◽  
Who Grade ◽  
Original Tumour ◽  
The Right

Pleomorphic xanthoastrocytoma (PXA) is a rare tumour comprising <1% of all primary central nervous system tumours and the majority (~98%) occur supratentorially. We report on a 40-year-old female with a past medical history of a rare posterior fossa/cerebellar PXA who presented with a right-sided neck mass, decreased shoulder power and longstanding right tongue deviation with right-sided hemi-atrophy. The patient had prior tumour debulking. Recent MRI demonstrated an enhancing posterior fossa mass extending to the skull base at the jugular foramen and another mass in the upper neck along the jugular bulb with displacement and encasement of the right common carotid artery down to C5. Resection of the neck mass reveals an anaplastic PXA. The tumour has close approximation with adjacent peripheral nerves and is positive in 2 lymph nodes. Comparison with the original tumour molecular and immunohistochemical profiles reveals a conserved BRAF V600E mutation but the transformed malignant glioma now expresses dot-like EMA positivity and ATRX is completely lost (mutated). Transformation of a PXA (WHO Grade II) into an anaplastic PXA (WHO Grade III) has been well documented, but extracranial extension is extraordinarily rare. We report herein the first documented case of a posterior fossa PXA that underwent malignant transformation and extracranial invasion to the parapharyngeal space.

Intrathyroidal Parathyroid Cancer Presenting as a Left Neck Mass

Thyroid ◽  
1998 ◽  
Vol 8 (7) ◽  
pp. 597-599 ◽  
Author(s):  
DONALD G. CRESCENZO ◽  
MOHSEN SHABAHANG ◽  
DAVID GARVIN ◽  
STEPHEN R.T. EVANS
Keyword(s):  
Neck Mass ◽  
Parathyroid Cancer ◽  
Left Neck

A phase II prospective study of selumetinib in children with recurrent or refractory low-grade glioma (LGG): A Pediatric Brain Tumor Consortium (PBTC) study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10504-10504 ◽  
Author(s):  
Jason R. Fangusaro ◽  
Arzu Onar-Thomas ◽  
Tina Young-Poussaint ◽  
Shengjie Wu ◽  
Azra H Ligon ◽  
...  
Keyword(s):  
Phase Ii ◽  
Pediatric Brain Tumor ◽  
Braf V600e Mutation ◽  
Low Grade Glioma ◽  
Braf V600e ◽  
Low Grade ◽  
Optic Pathway ◽  
Grade 3 ◽  
Molecular Aberrations

10504 Background: A greater understanding of the Ras-MAP kinase-signaling pathway in pediatric low-grade glioma (LGG) paired with the availability of potent selective inhibitors has enhanced the ability to target this pathway with therapeutic intent. Methods: The PBTC conducted a multi-institutional phase II study (NCT01089101) evaluating selumetinib (AZD6244, ARRY-142886), a MEK I/II inhibitor, in children with recurrent/refractory LGG assigned to 6 strata and treated at 25 mg/m2/dose PO BID for up to two years. Here we present the data from three of these strata. The remaining strata are still accruing patients. Results: Stratum I included children with non-NF-1 and non-optic pathway recurrent/refractory pilocytic astrocytoma (PA) harboring BRAF aberrations (BRAF V600e mutation or the BRAF-KIAA 1549 fusion). Eight of 25 (32%) patients achieved a partial response (PR) with 2-year PFS of 66+/-11%. Two of 7 (29%) patient tumors with a BRAF V600e mutation and 6/18 (33%) with a BRAF KIAA-1549 fusion had a PR. Stratum 3 enrolled NF-1-associated LGG. Tissue for tumor BRAF evaluation was not required for eligibility. Ten of 25 (40%) achieved PR with a 2-year PFS of 96+/-4%. Only one patient progressed while on treatment. Stratum 4 included children with non-NF-1 optic pathway/hypothalamic LGG. Tissue for tumor BRAF evaluation was not required for eligibility. Two of 16 (12.5%) had a PR with a 2-year PFS of 65+/-13%. The BRAF aberration status of the responders in strata 3 and 4 is mostly unknown. All responses were confirmed centrally and seven patients remain on treatment. The most common toxicities were grade 1/2 CPK elevation, diarrhea, hypoalbuminemia, elevated AST and rash. Rare grade 3/4 toxicities included elevated CPK, rash, neutropenia, emesis and paronychia. Conclusions: Selumetinib was effective in treating children with recurrent/refractory LGG, including those with NF-1 associated LGG and PA harboring BRAF V600e mutation or BRAF-KIAA 1549 fusion. Larger prospective studies are necessary to determine the future, specific role of this agent in treating children with LGG harboring specific molecular aberrations. Clinical trial information: NCT01089101.

scholarly journals Unusual Pharyngo-Esophageal Dysphagia Caused by a High-Riding Right Brachiocephalic Artery

2021 ◽  
Vol 45 (1) ◽  
pp. 79-82
Author(s):  
Ki Hoon Park ◽  
Sora Baek ◽  
Eun Kyoung Kang
Keyword(s):  
Filling Defect ◽  
Neck Mass ◽  
Solid Food ◽  
Brachiocephalic Artery ◽  
Food Bolus ◽  
Videofluoroscopic Swallowing Study ◽  
Esophageal Dysphagia ◽  
Left Neck ◽  
The Right ◽  
Cervical Area

High-riding right brachiocephalic and subclavian arteries are often asymptomatic and rare vascular variations. We present a patient with high-riding right brachiocephalic and subclavian arteries that caused compressive pharyngeal and cervical esophageal dysphagia. An 82-year-old woman presented to our hospital with dysphagia that worsened with solid food. A pulsatile lump was observed on the right neck side. A videofluoroscopic swallowing study showed a deviated food bolus movement anterolaterally from the normal vertical pharyngoesophageal transition, with a filling defect in the lower pharynx through the upper esophagus. Neck computed tomography (CT) showed high-riding right brachiocephalic and subclavian arteries and a tortuous right common carotid artery located adjacent to the trachea in the cervical area. The cervical midline structures were deviated to the left neck side. A neck mass with vascular variation should be considered as a cause of dysphagia that worsens with solid food; CT should be considered to determine its cause.

scholarly journals Sonography of Primary Cervical Neuroblastoma in the Infant

2021 ◽  
Vol 4 ◽  
pp. 2
Author(s):  
Keeley C. Justice ◽  
Spencer M. Kriss ◽  
Daron G. Davis
Keyword(s):  
Young Child ◽  
Lymph Nodes ◽  
Surgical Resection ◽  
Patient Management ◽  
Neck Mass ◽  
Pathologic Examination ◽  
Left Neck ◽  
Improve Patient Management ◽  
Improve Patient ◽  
Sonographic Imaging

A palpable neck mass in a newborn or young child is overwhelmingly benign but can require additional evaluation to exclude the rare malignant etiology. We present a 10-month-old female with a non-tender, non-erythematous firm nodule in the left neck initially suspected to be enlarged lymph nodes. Sonographic imaging was concerning for a diagnosis of neuroblastoma confirmed by surgical resection and pathologic examination. The sonographic characteristics associated with neuroblastoma are important to recognize to accurately diagnose the neoplasm and improve patient management.

scholarly journals The effects of vitamins and trace minerals on chronic autoimmune thyroiditis

2014 ◽  
Vol 83 (2) ◽  
pp. 167-172
Author(s):  
Małgorzata Włochal ◽  
Marcin A. Kucharski ◽  
Marian Grzymisławski
Keyword(s):  
Thyroid Gland ◽  
Hashimoto’S Thyroiditis ◽  
Essential Element ◽  
Hashimoto Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Chronic Lymphocytic Thyroiditis ◽  
Thyroid Cells ◽  
Thyroglobulin Antibodies ◽  
Chronic Autoimmune Thyroiditis

Hashimoto’s thyroiditis (HT), also known as chronic lymphocytic thyroiditis is one of the most frequent types of inflammation of the thyroid gland. The prevalence of the overt HT is about 2% but it is believed that Hashimoto thyroiditis is more frequent than expected. Hashimoto’s thyroiditis is characterized by dysfunction of the immune system, which leads to impaired tolerance of own tissues and increased production of autoantibodies against the thyroid cells. Thyroid peroxidase antibodies (anti-TPO), thyroglobulin antibodies (anti-Tg) and/or TSH receptors antibodies are the principal markers of the disease. The essential element of the treatment of HT is the supplementation of L-thyroxine. In Hashimoto’s disease, like in many other autoimmune diseases, researchers attempted to support pharmacological treatment by adequate nutrition. The aim of this paper was to review the existing literature on the levels of antioxidants (vitamin A, C, E, selenium, zinc) and vitamin D in patients with HT, as well as the influence of the nutritional supplementation of the above mentioned elements on the metabolism of the thyroid gland hormones and the level of anti-thyroid peroxidase (anti-TPO) antibodies.

scholarly journals Hashimoto’s Thyroiditis Autoimmune Disease: Background and Current Status, Update Overview of Biotechnological and Biomedical Fields and Future Trends for 3D Models

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Arnaud Martino Capuzzo
Keyword(s):  
Thyroid Tissue ◽  
Disease Process ◽  
Hashimoto Thyroiditis ◽  
3D Models ◽  
Current Status ◽  
Thyroid Peroxidase ◽  
Chronic Lymphocytic Thyroiditis ◽  
Laboratory Findings ◽  
Thyroid Cells ◽  
Immunological Mechanisms

Hashimoto thyroiditis, also known as chronic autoimmune thyroiditis or chronic lymphocytic thyroiditis, is an autoimmune illness in which thyroid cells are damaged by immunological mechanisms involving cells and antibodies. Thyroid peroxidase and/or thyroglobulin autoantibodies in the serum are biochemical indicators of the condition, with females having a higher incidence than males and increasing with age. It’s the leading cause of hypothyroidism in affluent countries. Inadequate dietary iodine intake, on the other hand, is the most common cause of hypothyroidism worldwide. The development of antithyroid antibodies that target the thyroid tissue, causing gradual fibrosis, is the pathogenesis of Hashimoto thyroiditis. The diagnosis can be difficult, and as a result, the problem is frequently not detected until late in the disease process. The most prevalent laboratory findings are raised TSH and low thyroxine (T4) levels, as well as enhanced antithyroid peroxidase (anti-TPO) antibodies. The pathogenesis, diagnosis, and management of Hashimoto thyroiditis are discussed in this article.

Renal Clear Cell Carcinoma Appearing as a Left Neck Mass

1996 ◽  
Vol 75 (9) ◽  
pp. 620-622 ◽  
Author(s):  
Michael A. Boggess ◽  
T. Oma Hester ◽  
Sanford M. Archer
Keyword(s):  
Cell Carcinoma ◽  
Head And Neck ◽  
Soft Tissues ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Female Genital Tract ◽  
Neck Mass ◽  
Renal Clear Cell Carcinoma ◽  
Primary Tumors ◽  
Left Neck

Malignant clear cell tumors of the head and neck are uncommon. Primary tumors may arise from the salivary glands, thyroid gland, or parathyroid glands, while metastatic tumors most commonly arise from the lungs, kidneys, and female genital tract. Renal cell carcinoma is the third most common metastatic tumor to the bone and soft tissues of the head and neck. Despite this, there have been few reported cases of renal clear cell carcinoma metastases to the neck. Here we report a unique case of an otherwise asymptomatic young woman with a left neck mass as the first clinical sign of advanced renal clear cell carcinoma.

scholarly journals Combined Tumors in Hematolymphoid Neoplasms: Case Series of Histiocytic and Langerhans Cell Sarcomas Arising From Low-Grade B-Cell Lymphoma

2019 ◽  
Vol 12 ◽  
pp. 2632010X1987841 ◽  
Author(s):  
Stephanie L Skala ◽  
Jing C Ye ◽  
Jennifer Stumph ◽  
William R Macon ◽  
Frances R Quinones ◽  
...  
Keyword(s):  
B Cell ◽  
Case Series ◽  
B Cell Lymphoma ◽  
Neck Mass ◽  
Histiocytic Sarcoma ◽  
Langerhans Cell ◽  
Lymphocytic Leukemia ◽  
Low Grade ◽  
Left Neck ◽  
Combined Tumors

We report an index case of histiocytic sarcoma arising in a 70-year-old patient with long-standing chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The patient presented in 2017 with painful, enlarging swelling of the left neck. He had remote history of cutaneous squamous cell carcinoma with no sign of recurrence, and his CLL/SLL was thought to be in remission. Computed tomography showed mild splenomegaly and multifocal lymphadenopathy including a 3-cm left neck mass. Biopsy of the left neck mass showed CLL/SLL with associated histiocytic sarcoma. Flow cytometry demonstrated a B cell neoplasm with CLL/SLL phenotype. Despite radiation therapy, he expired 3 months after presentation. Two similar cases (CLL/SLL and histiocytic sarcoma, follicular lymphoma and Langerhans cell sarcoma) from another institution are also illustrated. The pathological features of combined tumors in lymphoid neoplasms, a general framework to the work-up to determine interrelatedness of tumor components, and the clinical relevance are discussed.

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