Thyroid Carcinoma in a Patient with a Coexisting Functional Adenoma

1979 ◽  
Vol 87 (6) ◽  
pp. 768-774 ◽  
Author(s):  
Andrew Blitzer ◽  
Max L. Som
Keyword(s):  
Case Reports ◽  
Lower Lobe ◽  
Follicular Carcinoma ◽  
Surgical Excision ◽  
Malignant Degeneration ◽  
Functional Area ◽  
Regional Lymph Nodes ◽  
Hot Nodule ◽  
Risk Patients ◽  
The Right

Fourteen case reports have been published in which “hot” nodules have been documented as carcinoma, with or without coexisting adenomas. The diagnosis of these lesions is difficult, since hot nodules usually represent benign disease. These carcinomas are not functional, but represent coexistence of a functional area or a malignant degeneration. Hot nodule carcinomas should be suspected in high-risk patients. A euthyroid, 31-year-old woman who, as a teenager, had radiotherapy for acne is reported. She was followed up with yearly scans for a hot nodule in the right lower lobe of her thyroid. When she was 36, a node was discovered in the right side of her neck, and carcinoma was suspected. Surgical excision revealed a papillary-follicular carcinoma adjacent to an adenoma with metastases to regional lymph nodes.

scholarly journals Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hoon Choi ◽  
Joon Pyo Jeon ◽  
Jaewon Huh ◽  
Youme Kim ◽  
Wonjung Hwang
Keyword(s):  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Case Reports ◽  
Mitral Valve Regurgitation ◽  
Catheter Insertion ◽  
Routine Practice ◽  
Hickman Catheter ◽  
Risk Patients ◽  
The Right

Abstract Background Pulmonary artery catheter insertion is a routine practice in high-risk patients undergoing cardiac surgery. However, pulmonary artery catheter insertion is associated with numerous complications that can be devastating to the patient. Incorrect placement is an overlooked complication with few case reports to date. Case presentation An 18-year-old male patient underwent elective mitral valve replacement due to severe mitral valve regurgitation. The patient had a history of synovial sarcoma, and Hickman catheter had been inserted in the right internal jugular vein for systemic chemotherapy. We made multiple attempts to position the pulmonary artery catheter in the correct position but failed. A chest radiography revealed that the pulmonary artery catheter was bent and pointed in the cephalad direction. Removal of the pulmonary artery catheter was successful, and the patient was discharged 10 days after the surgery without complications. Conclusions To prevent misplacement of the PAC, clinicians should be aware of multiple risk factors in difficult PAC placement, and be prepared to utilize adjunctive methods, such as TEE and fluoroscopy.

scholarly journals Huge true aneurysm of the facial artery treated with internal trapping and surgical excision: a case report

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Kiyoko Nakagawa ◽  
Takuji Yasuda ◽  
Natsuko Kobayashi ◽  
Kazuhiko Urabe
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Surgical Excision ◽  
Facial Artery ◽  
True Aneurysm ◽  
The Right

Abstract A report of true aneurysms is extremely rare. There are only five previous case reports of true aneurysm of the facial artery. In the previously reported cases, there was no case that underwent trapping and surgical excision. In this case report, we describe the procedure of internal trapping before the surgical excision of a huge true aneurysm of the right facial artery for a 79-year-old woman. There was no recurrence of the aneurysm during a 6-month follow-up period.

Chondroid syringoma. A review of the literature and case report

1989 ◽  
Vol 79 (11) ◽  
pp. 563-565 ◽  
Author(s):  
TG Toback ◽  
CJ Toback
Keyword(s):  
Local Recurrence ◽  
Surgical Excision ◽  
Malignant Degeneration ◽  
Surgical Removal ◽  
Review Of The Literature ◽  
Regional Lymph Nodes ◽  
Complete Excision ◽  
Subcutaneous Nodules ◽  
Chondroid Syringoma ◽  
Long Duration

The third documented case of chondroid syringoma occurring in a toe, involving the largest tumor of the three, along with a review of the literature, has been presented. The possibility of a mixed tumor should be kept in mind when considering the differential diagnosis of a solid nodule in the skin, particularly if it is of long duration. These tumors usually will present as simple, asymptomatic, subcutaneous nodules that are shelled out easily during surgical excision. However, there is a tendency toward local recurrence that usually is attributed to incomplete surgical removal, which easily may occur because of the lobulation of the tumor. Complete excision of the primary tumor always is recommended, as diagnosis can be made only by histopathologic examination. Six reported cases revealed that the recurrence of the lesion following primary excision resulted in malignant degeneration. In nine reported cases where metastasis had occurred, the initial site of metastasis in five patients was the regional lymph nodes, and, in four patients, there was metastasis in the lung. The period of time between the removal of the primary lesion and the malignant local recurrence or metastasis has been reported to be from 1 to 4 years. Recognition of chondroid syringoma is clinically difficult because of its rarity. Its diagnosis requires histologic examination.

Rhabdomyosarcoma in 8 Horses

2011 ◽  
Vol 48 (6) ◽  
pp. 1144-1150 ◽  
Author(s):  
W. L. Castleman ◽  
D. E. Toplon ◽  
C. K. Clark ◽  
T. W. Heskett ◽  
L. L. Farina ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Incidental Findings ◽  
Case Reports ◽  
Surgical Excision ◽  
Shoulder Muscles ◽  
Limb Muscles ◽  
The Right ◽  
Pleomorphic Rhabdomyosarcoma

This multi-institutional report describes 8 cases of rhabdomyosarcoma in horses. Four neoplasms were in the tongue and other areas of the mouth or head, 2 were in the abdominal wall, and 1 each was in right shoulder muscles and heart. Four rhabdomyosarcomas that were less than 10 cm in diameter were treated by surgical excision or radiation with no recurrence. Two neoplasms greater than 10 cm in diameter in the abdominal wall and the right shoulder were considered inoperable and led to decisions to euthanize the horses. Two neoplasms were incidental findings at necropsy. All the neoplasms were classified as embryonal except for 1 pleomorphic rhabdomyosarcoma. These 8 cases were evaluated with 9 published case reports of equine rhabdomyosarcoma. For all cases, the most common sites were limb muscles (5/17) and tongue (4/17). Metastasis was reported in 4 of the previously published cases; none was found in this study.

scholarly journals Lymphadenitis “As Rosary beads” - a diagnostic challenge

2019 ◽  
Vol 44 (3) ◽  
pp. 20-23
Author(s):  
Vitorino Modesto Dos Santos ◽  
Micheline Silva Abreu De Azevedo ◽  
Katia Rejane Marques Brito ◽  
Larissa Almondes Da Luz ◽  
Kayursula Dantas Ribeiro
Keyword(s):  
Case Reports ◽  
Clinical Manifestations ◽  
Definitive Diagnosis ◽  
Medical Attention ◽  
Diagnostic Challenge ◽  
Regional Lymph Nodes ◽  
Primary Health ◽  
Primary Focus ◽  
The Right ◽  
High Index Of Suspicion

Introduction: nodular lymphangitis (NL) may be a manifestation of various infectious and non-infectious conditions, characterised by subcutaneous inflammatory nodules that extend from the site of the primary focus to the regional lymph nodes. NL usually constitutes a challenge in primary health care, and histopathological and microbiological evaluations are necessary to establish the definitive diagnosis. Methods: We report a classic case of NL that developed in the upper limb of a middle-aged man after trauma on the right thumb. The objective:  was to emphasise some aspects of the differential diagnosis in a patient with NL and to reduce the rate of misdiagnosis in the scenery of initial medical attention. Results: the clinical manifestations were non-specific, but the microbiological study revealed typical characteristics of sporotrichosis. The treatment with itraconazole (200 mg daily) for six months was successful. Conclusion: NL constitutes a challenging condition and the early diagnosis depends on a high index of suspicion. Case reports may reduce late diagnoses with unfavourable results.

scholarly journals Two case reports on Mandibular metastases

2018 ◽  
Vol 52 (3) ◽  
pp. 168-172
Author(s):  
Adesina O. Adewale ◽  
Ladeji A. Mofoluwake ◽  
Opaleye T Olamide ◽  
Salami A. Yussuf
Keyword(s):  
Case Reports ◽  
Osteolytic Lesion ◽  
Neck Region ◽  
Follicular Carcinoma ◽  
Metastatic Lesion ◽  
Parietal Bone ◽  
Lytic Lesion ◽  
Posterior Aspect ◽  
The Right ◽  
High Level

Metastatic tumours of the oral cavity are not common. The most common site for bone metastases in the head and neck region is the mandible. Metastatic lesion of the mandible most commonly originate from the lungs in men and breast in women, and these lesions (or tumours) usually are carcinomas rather than sarcomas. We report two cases of metastatic lesions in the mandible: (1) A 19year old male with right mandibular swelling and a nodular swelling in the distal two–third of the right tibia. Radiograghs revealed sclerotic lesion with a sunburst appearance in both the jaw and tibia. Histology of the jaw lesion confirmed a metastatic osteosarcoma of the mandible. (2) A 51year old female with a right mandibular swelling with associated swelling in the anterior neck, right shoulder and right parietal region of the skull. Computerised tomography scan (CT) of the jaws showed an osteolytic lesion of the right mandible. CT scan of the brain also showed a large lytic lesion seen in the posterior aspect of the right parietal bone. Histology of the jaw mass confirmed a metastatic follicular carcinoma from the thyroid. Mandibular metastasis may be the first presenting feature of underlying occult malignancy of another primary site. Therefore, clinicians should maintain a high level of suspicion while evaluating patients with a history of cancer presenting with oral lesions. Keywords: metastatic tumours, mandible, tibia, thyroid

scholarly journals Leiomyomatosis peritonealis disseminata: a rare disease with a difficult diagnosis

2019 ◽  
Vol 12 (7) ◽  
pp. e229564
Author(s):  
Daniel Martins Jordão ◽  
João Santos Pereira ◽  
Emanuel Furtado ◽  
Isabel Cristina Ferrão
Keyword(s):  
Smooth Muscle ◽  
Left Kidney ◽  
Vena Cava ◽  
Rare Condition ◽  
Surgical Excision ◽  
Malignant Degeneration ◽  
Low Grade ◽  
Leiomyomatosis Peritonealis Disseminata ◽  
Renal Hilum ◽  
Risk Patients

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition, characterised by the proliferation of peritoneal smooth muscle nodules. LPD is a benign disease with a low rate of malignant degeneration. We describe the case of a 46-year-old, asymptomatic, woman presenting with a mass on the left renal hilum, identified by ultrasound. A CT scan showed three nodules near the left kidney, a mass anterior to the vena cava and bilateral iliac nodules. Biopsy revealed a mesenchymal low-grade tumour. The patient underwent a left nephrectomy and excision of the other masses. The histological diagnosis revealed smooth muscle nodular proliferation with no malignant features, compatible with LPD. The differential diagnosis between LPD and metastatic leiomyosarcoma is sometimes very difficult because they are clinically very similar and even on histology the diagnosis can be tricky. Treatment is conservative in most cases, with surgical excision reserved for high-risk patients.

RASA1 phenotype overlaps with hereditary haemorrhagic telangiectasia: two case reports

2020 ◽  
pp. jmedgenet-2019-106792
Author(s):  
Mostafa El Hajjam ◽  
Ahmed Mekki ◽  
Aurelien Palmyre ◽  
Melanie Eyries ◽  
Florent Soubrier ◽  
...  
Keyword(s):  
Ct Scan ◽  
Arteriovenous Malformations ◽  
Case Reports ◽  
Lower Lobe ◽  
Left Lobe ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Portocaval Shunt ◽  
Cerebral Arteriovenous Malformations ◽  
Receptor Like Kinase ◽  
The Right

Background We report two cases of RASA1-related capillary malformation-arteriovenous malformation (CM-AVM1) syndrome mimicking hereditary haemorrhagic telangiectasia (HHT).Methods and results A 28-year-old man, previously embolised for cerebral arteriovenous malformations (AVMs), presented with epistaxis and typical nasal telangiectasias of HHT. CT scan revealed a large portocaval shunt. The second patient was a 9-year-old girl presenting with cyanosis and several mucocutaneous telangiectasias, similar to those observed in typical cases of HHT. CT scan revealed a huge and complex pulmonary AVM of the right lower lobe and a hepatic AVM within the left lobe. HHT diagnosis was considered possible according to the Curaçao criteria for the two patients, with at least two criteria for each. Genetic tests did not find any mutation in the three classic genes (Endoglin, Activin receptor-like kinase 1 or Mothers against decapentaplegic homolog 4), but identified in both cases an RASA1 mutation, known to cause CM-AVM1 syndrome.Conclusions Pulmonary AVM and portocaval shunt, usually encountered in HHT, have not yet been described in the CM-AVM1 syndrome. RASA1 screening may be considered in case of HHT suspicion, particularly when mutations are not found in the usually affected genes.

scholarly journals Isсhemic change in bronchus stump after lung cancer resection

2020 ◽  
Vol 179 (3) ◽  
pp. 33-39
Author(s):  
S. A. Plaksin ◽  
L. I. Farshatova ◽  
A. L. Lisichkin
Keyword(s):  
Main Bronchus ◽  
Lung Resection ◽  
Bronchopleural Fistula ◽  
Lower Lobe ◽  
Lobe Bronchus ◽  
Doppler Flowmetry ◽  
Bronchial Wall ◽  
Risk Patients ◽  
The Right ◽  
Right Lower Lobectomy

The OBJECTIVE of the study was to assess the changes in blood supply of the bronchus stump following lung resection with lymph node dissection.METHODS AND MATERIALS. Bronchial microcirculation was studied in 8 patients during pneumonectomy of the wall of the main bronchus using laser Doppler flowmetry method. In this paper, we present our observations of postoperative necrotic ischemic bronchitis after lobectomy with associated formation of bronchopleural fistula of the main bronchus and the failure of the stump of the lobular bronchus.RESULTS. Mobilization of the bronchus decreased microcirculation rate to (3.3±0.3) conventional units (c. u.), or to 74.5 %; lymphatic dissection further reduced microcirculation rate to (2.6±0.2) c. u., or to 60.2 %. An additional twisted suture was found to worsen ischemia. The normalized value of the amplitude decreased during the second minute of the dissection of the bronchus, indicating hypoxia. A 61-year-old patient with diabetes showed damage to the wall of the main bronchus 0.6 cm in size 7 days after undergoing the right lower lobectomy with lymphatic dissection. On the 19th day after the same procedure, the same patient developed an insolvency of the stump of the lower lobe bronchus, which was classified as a manifestation of ischemia. Postoperative ischemic bronchitis can occur in a true ischemic or an ulcerative necrotic form, and it can be diagnosed using a macroscopic picture in the context of fibrobronchoscopy. It occurs in (2.5–3.2) % of patients who underwent lung resections for cancer with lymphatic dissection.CONCLUSION. Ischemia of the bronchial wall during its mobilization plays a significant role in the etiology of bronchopleural fistula. Lymphatic dissection worsens microcirculation of the bronchial wall. Ischemic necrotic bronchitis can lead to formation of the bronchopleural fistula outside of the stump. High-risk patients require additional coverage of the bronchus stump with muscle or fat tissue.

scholarly journals Intrapulmonary solitary fibrous tumour: a case report

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Akie Horikiri ◽  
Hiroyoshi Tsubochi ◽  
Natsuki Mizukoshi ◽  
Ryota Myobatake ◽  
Hidetaka Sakurai ◽  
...  
Keyword(s):  
Immunohistochemical Staining ◽  
Wedge Resection ◽  
Lower Lobe ◽  
Surgical Excision ◽  
Good Health ◽  
Solitary Fibrous Tumour ◽  
Thoracic Cavity ◽  
Solitary Fibrous Tumours ◽  
S 100 ◽  
The Right

Abstract Solitary fibrous tumours (SFTs) mainly originate from the visceral pleura and may protrude to the thoracic cavity, but intrapulmonary SFTs are extremely rare. We describe a rare case of SFT arising in the right lung of an 83-year-old man who underwent surgical excision. Chest computed tomography (CT) revealed a 10-mm tumour in the lower lobe of the right lung. The size of tumour gradually increased and reached 17 mm 2 years after the first radiologic examination. Considering the possibility of malignancy, wedge resection of the right lower lobe was performed via video-assisted thoracic surgery. Microscopically, the tumour consisted mainly of spindle-shaped cells. Immunohistochemical staining indicated the tumour was positive for CD34, STAT6, vimentin and bcl-2, but negative for cytokeratins, D2–40 and S-100. Based on the histological findings, the tumour was diagnosed as SFT. The patient has been in good health for 6 months since the surgery.

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