Primary thyroid leiomyosarcoma: a diagnostic and therapeutic challenge

2021 ◽  
Vol 14 (4) ◽  
pp. e236399
Author(s):  
Mohammed Talha Bashir ◽  
Tom Bradish ◽  
Usman Rasul ◽  
Muhammad Shakeel
Keyword(s):  
Smooth Muscle ◽  
Thyroid Cancer ◽  
Cervical Lymphadenopathy ◽  
Rare Condition ◽  
Ultrasound Scan ◽  
Thyroid Lobe ◽  
Mesenchymal Tumour ◽  
History Of ◽  
Left Thyroid Lobe ◽  
Malignant Mesenchymal Tumour

Leiomyosarcoma is a malignant mesenchymal tumour of smooth muscle origin. It is extremely rare as a primary thyroid cancer with only 33 cases previously described in the literature. We present the case of a 69-year-old Caucasian man who presented with a 5-month history of left cervical lymphadenopathy and a suspicious mass in the left thyroid lobe on ultrasound scan. Left hemithyroidectomy confirmed the diagnosis of leiomyosarcoma. A review of current understanding and approaches to management of this rare condition are discussed.

Thyroid lobectomy for removal of a fish bone

1990 ◽  
Vol 104 (6) ◽  
pp. 511-512 ◽  
Author(s):  
A. Al. Muhanna ◽  
K. A. Abu Chra ◽  
H. Dashti ◽  
A. Behbehani ◽  
N. Al-Naqeeb
Keyword(s):  
Foreign Body ◽  
Acute Inflammation ◽  
Fish Bone ◽  
X Rays ◽  
Thyroid Lobe ◽  
Axial Tomography ◽  
Thyroid Lobectomy ◽  
Computed Axial Tomography ◽  
History Of ◽  
Left Thyroid Lobe

AbstractA 42-year-old female Jordanian patient presented with a history of sudden painful dysphagia following swallowing of a fish bone. Though soft tissue X-rays showed a foreign body in the neck, repeated oesophagoscopies failed to reveal it. Computed axial tomography was done and showed a fish bone embedded in the left thyroid lobe. Left thyroid lobectomy was carried out and the fish bone was seen within the lobe surrounded by an area of acute inflammation.

scholarly journals Kimura’s Disease: A Rare Cause of Unilateral Tonsillar Enlargement

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Prakash Khanal ◽  
Agya Shrestha
Keyword(s):  
Histopathological Examination ◽  
Cervical Lymphadenopathy ◽  
Neck Region ◽  
Rare Condition ◽  
Surgical Excision ◽  
Kimura’S Disease ◽  
Inflammatory Disorder ◽  
Serum Ige ◽  
History Of ◽  
High Index Of Suspicion

Introduction. Kimura’s disease is a rare inflammatory disorder of unknown cause, commonly seen in young Asian males. Case Report. A 61-year-old male patient presented with a history of right tonsillar mass and cervical lymphadenopathy. The patient underwent hematological investigation and imaging followed by resection of tonsillar mass. Based on histopathological and subsequent immunohistochemistry reports, the case was diagnosed as Kimura’s disease of the tonsil. Discussion. Kimura’s disease commonly presents as painless subcutaneous masses in the head and neck region or cervical lymphadenopathy. Kimura’s disease presenting as a tonsillar mass is a very rare condition. Patients usually have peripheral eosinophilia and elevated levels of serum IgE. The diagnosis is based on the clinical and histopathologic findings in a biopsy of the mass and/or lymph node along with elevated peripheral eosinophil and serum IgE level. Conclusion. The clinical presentation of Kimura’s disease is highly variable. Kimura’s disease should be considered as a differential diagnosis in patients presenting with a tonsillar mass. A high index of suspicion along with histopathological examination helps in the early diagnosis and management. Surgical excision is the treatment of choice.

scholarly journals An unusual case of cervical leiomyosarcoma in an adoloscent girl

2020 ◽  
Vol 9 (12) ◽  
pp. 5121
Author(s):  
Sangeeta Pahwa ◽  
Arshdeep Kaur ◽  
Preet K. Kaur ◽  
Tavleen Kaur
Keyword(s):  
Smooth Muscle ◽  
Uterine Cervix ◽  
Adolescent Girl ◽  
Unusual Case ◽  
Rare Tumor ◽  
Reproductive Outcome ◽  
Mesenchymal Tumour ◽  
Excessive Bleeding ◽  
Malignant Mesenchymal Tumour ◽  
Primary Leiomyosarcoma

Primary leiomyosarcoma of the uterine cervix is an exceedingly rare tumor. It is malignant mesenchymal tumour of smooth muscle origin. We report a case of 15-year-old adolescent girl who presented with complain of excessive bleeding per vaginum off and on since 3-4 months and was diagnosed as leiomyosarcoma of cervix. Patient was advised further management but father refused as according to them when bleeding has stopped completely then what is the need of further treatment. In this article we want to highlight the points: what is prognosis and survival of such patient whose mass was removed completely and patient is not willing for further treatment inspite of knowing the aggressive nature of tumor and if hysterectomy is the answer what about the reproductive outcome in such young girls and what is the prospect of uterine transplant surgery.  

scholarly journals Left Hemithyroidectomy in Combined Thyroid Cancer with Previous Right Lobe Tumour Surgery: a Clinical Case

2021 ◽  
Vol 11 (1) ◽  
pp. 46-50
Author(s):  
S. P. Muzhikov ◽  
M. Iu. Eremenko
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Clinical Case ◽  
Nodular Goiter ◽  
Laryngeal Nerve ◽  
Thyroid Lobe ◽  
Papillary Cancer ◽  
Extent Of Surgery ◽  
Right Lobe ◽  
Left Thyroid Lobe

Background. Combined thyroid cancer is extremely rare. There is no unified approach currently to the choice of treatment and extent of surgery in combined cancer.Aim. A clinical case description of left hemithyroidectomy for follicular papillary cancer in a patient previously operated for follicular right lobe cancer with right recurrent laryngeal nerve injury.Materials and methods. Patient N., 48 yo, had a routine surgical admission in December 2019 with nodular goiter in left thyroid lobe. Suspicio c-r of left thyroid lobe. Condition after right hemithyroidectomy in 2002, postoperative paresis of right recurrent laryngeal nerve.Results. The patient had a routine surgery upon further examination. Morbid histology corresponded to follicular papillary cancer of left thyroid lobe.Discussion. Combined thyroid cancers are relatively poorly documented, stimulating further case studies. The chosen extent of surgery and iatrogenic injury of right recurrent laryngeal nerve in history are also distinctive of this clinical case.Conclusion. A non-standard extent of surgery is described in a clinical case of combined thyroid cancer complicated by postoperative paresis of right recurrent laryngeal nerve in history.

scholarly journals The association between diabetes and thyroid cancer risk: a hospital-based case-control study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meng Wang ◽  
Wei-Wei Gong ◽  
Feng Lu ◽  
Ru-Ying Hu ◽  
Qing-Fang He ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Family History ◽  
Case Control Study ◽  
Positive Family History ◽  
Case Control ◽  
Diabetes Duration ◽  
Family History Of Diabetes ◽  
Thyroid Cancer Risk ◽  
History Of ◽  
Control Study

Abstract Background Previous studies have indicated inconsistent relationships of diabetes with thyroid cancer risk, yet little is known in China. In this study, we aimed to investigate the associations between diabetes, diabetes duration and the risk of thyroid cancer in Chinese population. Methods A 1:1 matched case-control study was performed between 2015 and 2017 in Zhejiang Province including 2,937 thyroid cancer cases and 2,937 healthy controls. Odds ratios (ORs) with 95 % confidence intervals (CIs) for thyroid cancer were estimated in logistic regression models. Specific effects stratified by age, as well as sex, body mass index (BMI) and family history of diabetes were also examined. Results Overall, neither diabetes (OR = 0.75, 95 % CI: 0.21–2.73) nor diabetes duration (OR = 0.14, 95 % CI: 0.02–1.22 for diabetes duration ≦ 5 years; OR = 2.10, 95 % CI: 0.32–13.94 for diabetes duration > 5 years) was significantly associated with thyroid cancer. In stratified analyses, significant lower risk of thyroid cancer was observed among subjects with diabetes and shorter diabetes duration ( ≦ 5 years), but limited to those who were aged more than 40 years, female, overweight/obese and had positive family history of diabetes. Conclusions Diabetes and shorter diabetes duration were significantly associated with decreased risk of thyroid cancer in individuals characterized by older age, female sex, higher BMI and positive family history of diabetes.

scholarly journals Rare Etiology of Odynophagia in a Female Adolescent

2021 ◽  
pp. 352-358
Author(s):  
Anastasios Koutsoumourakis ◽  
Asterios Gagalis ◽  
Maria Fotoulaki ◽  
Maria Stafylidou
Keyword(s):  
Antiviral Treatment ◽  
Healing Process ◽  
Rare Condition ◽  
Female Adolescent ◽  
Mucosal Barrier ◽  
Esophageal Mucosa ◽  
Intact Immune System ◽  
History Of ◽  
Orolabial Herpes

Herpes esophagitis (HE) is a rare condition in immunocompetent adolescents. However, it commonly occurs as a primary infection in younger individuals. Herein, we report a 16-year-old female patient who had a history of fever for 5 days, odynophagia, and orolabial herpes infection for 7 days. Clusters of painful vesicles on an erythematous base on the lips, gingiva, and palate were observed on physical examination. Further, esophagogastroduodenoscopy revealed diffuse linear ulcerations in the distal esophagus. The patient then received the following treatment: intravenous (I.V.) acyclovir 5 mg/kg three times a day, I.V. omeprazole 40 mg two times a day, and acyclovir 5% cream four times a day. After 8 days of admission, the patient was discharged. A follow-up esophagogastroduodenoscopy was performed 7 weeks after discharge, and the results revealed that the esophageal mucosa had a normal appearance. The effect of antiviral treatment against HE remains unknown in these patients. Nevertheless, it is believed to accelerate the healing process in individuals with esophageal mucosal barrier damage. To the best of our knowledge, this case of a female adolescent with an intact immune system is the sixth case of herpes simplex esophagitis to be reported in the literature.

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals Bilateral Congenital Humeroradial Synostostis Presenting with Bilateral Proximal Radius Fractures: A Case Report

2021 ◽  
pp. 29-32
Author(s):  
Elsiddig E. Mahmoud
Keyword(s):  
Case Report ◽  
Elbow Joint ◽  
Parental Education ◽  
Functional Disability ◽  
Congenital Abnormalities ◽  
Rare Condition ◽  
Radius Fractures ◽  
Proximal Radius ◽  
History Of ◽  
Uncommon Condition

Congenital bilateral humeroradial synostosis (HRS) is a rare condition. It is generally divided into 2 categories. In the first group, which is mainly sporadic, additional upper limb hypoplasia typically coexists. In the second group, which is classically familial, HRS is commonly an isolated upper extremity anomaly. HRS can lead to variable degrees of functional disability. The clinical case reported here illustrates a possibly avoidable presentation of this uncommon condition. In this case report, we present a 6-week-old male who presented with bilateral radius fractures. Radiography revealed congenital HRS at both elbows. No other associated congenital abnormalities were detected, and there was no family history of similar conditions in any first-degree relatives. In cases of congenital HRS, movement at the elbow joint is not possible. Parents who are unaware of this information might try to straighten their infant’s elbows, which in turn may result in fractures of the proximal radius. Hence, early diagnosis and proper parental education could prevent fractures as a sequela of HRS.

scholarly journals P043 Fascinating phosphate: seek and you will find

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Jyoti Bakshi ◽  
Clare Batten
Keyword(s):  
Back Pain ◽  
Degenerative Change ◽  
Nasal Bone ◽  
Rare Condition ◽  
Whole Body ◽  
Excision Biopsy ◽  
Small Lesion ◽  
History Of ◽  
The Right ◽  
Fgf 23

Abstract Background/Aims  A 62-year-old accountant was referred to the metabolic bone clinic with a 2 year history of thoracic back pain and a persistently raised ALP. There were no associated red flags for her back pain. She had a history of a gluteal lump, thought to be benign, for which she had declined excision. She has hypertension and had a previous navicular fracture. Medications included bendroflumethiazide and Adcal D3. She had restriction in neck movements and was tender to percussion in the thoracic spine. There was no proximal weakness or focal neurology. Systems and joint exam were unremarkable. Methods  The case is discussed below. Results  Salient abnormal results on presentation were a raised ALP of 207 and corrected calcium of 2.34. PTH was elevated at 8.2 (NR:1.6-6.9), Vitamin D 79 and a low phosphate of 0.34 (NR:0.8-1.50). Alkaline phosphatase isoenzymes showed the raised level came from bone. Protein and urine electrophoresis were normal. A bone density scan was normal, and a recent thoracic MRI showed only degenerative change. An isotope bone scan was requested and was reported to show increased activity in the nasal bone, maxilla and both orbits, raising the possibility of Paget’s disease. However, when reviewed in the Radiology meeting with a skull x-ray, the appearances were not felt to be in keeping with Paget’s. Despite physiotherapy, hydrotherapy, acupuncture and neuropathic medication the patient’s back pain continued. Her phosphate remained low and her calculated tubular reabsorption of phosphate from a 24h urine collection (TmP/GFR) was low at 0.42mmol/l (NR 0.80-1.35). She was started on phosphate replacement and calcitriol, and Adcal D3 was continued. The Fibroblast Growth Factor (FGF) 23 levels were sent and came back significantly elevated at 1380 (NR < 100). A 68Ga DOTA-TATE scan (whole body PET/CT scan), confirmed the right gluteal lump as the source of the FGF 23. The patient went on to have an excision biopsy and histology confirmed a mesenchymal tumour of the right buttock. Her phosphate replacement was gradually weaned, but on reducing the dose phosphate levels dropped and her symptoms returned. The repeat TmP/GFR was again low at 0.61, and FGF 23 levels were still raised at 204. A repeat 68Ga DOTA-TATE scan, 4 years after the first one, showed recurrence of the right gluteal lesion and a possible small lesion in the left gluteal muscle. She has been sent for further excision. Conclusion  Tumour induced osteomalacia (TIO) is a rare condition and should be considered in cases of hypophosphataemia. Classical symptoms are proximal weakness and muscle and bone pain. They are typically associated with small benign tumours (most commonly mesenchymal tumours) which may be difficult to find. Excision is curative but if small amounts of tumour remain, relapses may occur. Disclosure  J. Bakshi: None. C. Batten: None.

scholarly journals Familial Chylomicronemia Syndrome-Induced Acute Necrotizing Pancreatitis during Pregnancy

2021 ◽  
Vol 43 (03) ◽  
pp. 220-224
Author(s):  
Julia Cristina Coronado Arroyo ◽  
Marcio José Concepción Zavaleta ◽  
Eilhart Jorge García Villasante ◽  
Mikaela Kcomt Lam ◽  
Luis Alberto Concepción Urteaga ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Clinical Course ◽  
Necrotizing Pancreatitis ◽  
Rare Condition ◽  
Severe Hypertriglyceridemia ◽  
Fetal Complications ◽  
Acute Necrotizing ◽  
History Of ◽  
Important Objective

AbstractAcute pancreatitis is a rare condition in pregnancy, associated with a high mortality rate. Hypertriglyceridemia represents its second most common cause. We present the case of a 38-year-old woman in the 24th week of gestation with a history of hypertriglyceridemia and recurrent episodes of pancreatitis. She was admitted to our hospital with acute pancreatitis due to severe hypertriglyceridemia. She was stabilized and treated with fibrates. Despite her favorable clinical course, she developed a second episode of acute pancreatitis complicated by multi-organ dysfunction and pancreatic necrosis, requiring a necrosectomy. The pregnancy was ended by cesarean section, after which three plasmapheresis sessions were performed. She is currently asymptomatic with stable triglyceride levels. Acute pancreatitis due to hypertriglyceridemia represents a diagnostic and therapeutic challenge in pregnant women, associated with serious maternal and fetal complications. When primary hypertriglyceridemia is suspected, such as familial chylomicronemia syndrome, the most important objective is preventing the onset of pancreatitis.

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