scholarly journals Relationship Between rhTSH Administration and Thyroid Cancer Progression: A Case Report

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A899-A899
Author(s):  
Maria G Mejia ◽  
Hospital San José de Bogotá, C ◽  
Luz Amaya Veronesi ◽  
Diana Carolina Concha
Keyword(s):  
Thyroid Cancer ◽  
Case Report ◽  
Cancer Progression ◽  
Case Reports ◽  
Bone Lesion ◽  
Thyroid Tumor ◽  
Parietal Bone ◽  
Bone Lesions ◽  
Neoplastic Progression ◽  
The Right

Abstract Introduction: The relationship between the administration of recombinant TSH (rhTSH) and the progression of thyroid cancer has been described in some case reports (1). There are scant data suggesting that rhTSH acts as a growth factor that stimulates metastatic tumor expansion. Case Report: A 55 year old male patient who 3 years ago reported an evident mass at cervical level. The ultrasound documented a large thyroid mass with an endothoracic component. The FNA reported BETHESDA IV, suspicious for follicular neoplasia. Extension studies showed lytic left parietal bone lesion and liver metastatic compromise. The pathology of the total thyroidectomy showed a follicular carcinoma with a micronodular pattern and capsular invasion, of 19x9x7 cm, vascular and esophageal involvement T4BN0M1. He was sent to radioiodine therapy with 100 MCI with previous suspension of LT4 (Preablative TGL> 300 ng / ml (<50 ng / ml) Abs-TGL 2 IU / ml (<2 IU / ml) TSH 31.3 mIU / L (0.37-4.7 mIU / L) and body scan documenting uptake of the radiotracer at the left parietal, the anterior costal grating, and liver. A second dose of iodine was applied, with 150 MCI after stimulation with thyrotropin (Preablative TGL> 300 ng / ml, Abs-TGL 1.76 IU / ml, TSH 83 mIU / L) Immediately after the administration of rhTSH, the patient described the appearance of alopecic plaques on the scalp, sensation of mass at the right upper quadrant of the abdomen and bone pain in the right rib cage and at the right hip, which progressively worsened the following days until they were incapacitating. The scan report showed a new uptake in dorsal vertebrae, the MRI showed new bone injury at the innominate bone, as well as increase in the sum of its maximum dimensions by 22%, indicative of progression. The cerebral angio-MRI showed hypervascularized metastasis at the left parietal level. Bone scintigraphy documented foci of hyper uptake in both parietals, manubrium and sternal body, 5-8 right anterior costal arches, right scapula, both humeral heads, vertebral bodies T3-T5-T7L4, right acetabulum, left proximal femur and the entire length of the right femur. The clinical and imaging worsening of the bone lesions after the application of rhTSH was striking, for this reason radiotherapy and embolization of the liver lesion was performed. The patient was not a candidate for neurosurgical management due to the vascular component of the cranial lesions. Conclusion: rhTSH is a very well-tolerated method that avoids symptoms associated with severe hypothyroidism. However, it has been associated with neoplastic progression. This is one of the few cases documented in the literature where there is a direct association between the administration of rhTSH and the progression of bone metastases. References: (1)Braga M. Ringel M. Cooper DS. Sudden Enlargement of Local Recurrent Thyroid Tumor after Recombinant Human TSH Administration. J Clin Endocrinol Metab. 2001; 86(11):5148–51.

scholarly journals Bilateral Anatomical Variation in the Formation of Trunks of the Brachial Plexus - A Case Report

2018 ◽  
Vol 35 (01) ◽  
pp. 9-13
Author(s):  
E. Lasch ◽  
M. Nazer ◽  
L. Bartholdy
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Scientific Literature ◽  
Case Reports ◽  
Anatomical Variation ◽  
Male Cadaver ◽  
Motor Nerves ◽  
The Right

AbstractThis study presents a bilateral variation in the formation of trunks of brachial plexus in a male cadaver. The right brachial plexus was composed of six roots (C4-T1) and the left brachial plexus of five roots (C5-T1). Both formed four trunks thus changing the contributions of the anterior divisions of the cervical nerves involved in the formation of the cords and the five main somatic motor nerves for the upper limb. There are very few case reports in the scientific literature on this topic; thus making the present study very relevant.

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.

scholarly journals Fibrous Meningioma with Skull Invasion

2019 ◽  
Vol 10 (04) ◽  
pp. 707-710
Author(s):  
Shinya Ichimura ◽  
Kento Takahara ◽  
Koji Fujii
Keyword(s):  
Present Report ◽  
Bone Lesion ◽  
Parietal Bone ◽  
Matrix Metalloproteinase 2 ◽  
Gadolinium Enhancement ◽  
Bone Invasion ◽  
Weighted Magnetic Resonance Imaging ◽  
The Right ◽  
Intraosseous Lesion ◽  
Aggressive Clinical Behavior

AbstractIn patients with meningiomas, the presence of skull invasion is known to be a predictor of aggressive clinical behavior, which may negatively influence patient outcomes. In the present report, we discuss a case of fibrous meningioma with skull invasion. A 42-year-old woman was referred to our department presenting with hyperostosis in the right parietal bone. T1-weighted magnetic resonance imaging with gadolinium enhancement revealed prominent enhancement of the intraosseous lesion and dura mater. Following the removal of the tumor body and bone lesion, we performed immunohistochemical staining for osteopontin (OPN), matrix metalloproteinase- 2 (MMP2), and integrin β-1 (CD29). The tumor body was immunoreactive for OPN and CD29, but not MMP2, whereas, the bone lesion was immunoreactive for all the three antigens. The present case suggests that OPN, MMP2, and CD29 play key regulatory roles in bone invasion.

scholarly journals Trastuzumab-Based Combination Chemotherapy in Patients with Human Epidermal Growth Factor Receptor-2-Positive Metastatic Carcinoma ex Pleomorphic Adenoma

2018 ◽  
Vol 11 (3) ◽  
pp. 835-841 ◽  
Author(s):  
Yohei Arihara ◽  
Kazuyuki Murase ◽  
Kohichi Takada ◽  
Naotaka Hayasaka ◽  
Shogo Miura ◽  
...  
Keyword(s):  
Epidermal Growth Factor Receptor ◽  
Case Report ◽  
Growth Factor ◽  
Combination Chemotherapy ◽  
Case Reports ◽  
Growth Factor Receptor ◽  
Carcinoma Ex Pleomorphic Adenoma ◽  
Her2 Positive ◽  
Epidermal Growth ◽  
The Right

Background: Carcinoma ex pleomorphic adenoma (CXPA) is a rare histologic subtype of lacrimal gland and submandibular gland cancer. Currently, there is no standard treatment for metastatic CXPA, although some case reports have explored the role of targeted agents in chemotherapy. A few histopathologic analyses have shown that some of these tumors overexpress human epidermal growth factor receptor-2 (HER2), suggesting a potential role for HER2-based therapy. We report here two cases of metastatic CXPA that were treated with trastuzumab-based chemotherapy (IRB approved) with rapid and significant responses. Case Report 1: A 66-year-old male was diagnosed as HER2-positive CXPA of the right lacrimal gland with multiple bone and lymph node metastases. Combination chemotherapy with trastuzumab (Tmab) and nanoparticle albumin-bound paclitaxel (nabPTX) was initiated. A rapid response was confirmed, and after seven cycles of treatment, CR(complete response) was achieved. Case Report 2: A 67-year-old female was diagnosed with HER2 positive CXPA of the right submandibular gland. Multiple pulmonary metastatic lesions were detected after surgery, and combination chemotherapy with Tmab and nab-PTX was initiated. A rapid partial response (PR) was confirmed, and she eventually became disease-free. Conclusion: In the absence of definitive clinical trials, which are unlikely to be performed due to the rarity of HER2-positive CXPA, therapeutic information must be obtained from case reports. Some reports, such as this one, have suggested a potential utility of trastuzumab-based chemotherapy.

scholarly journals Variant Termination of The Right Testicular Vein A Case Report

2018 ◽  
Vol 4 (1) ◽  
pp. 36-37
Author(s):  
Abdi HM Syed ◽  
Sanjay Sah
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Case Reports ◽  
Vena Cava ◽  
Medical Sciences ◽  
Testicular Vein ◽  
The Right

This case report pertains to a variant termination of the right testicular vein into a large lower tributary of the right renal vein, instead of opening into the inferior vena cava. Since the lower vein in which the right testicular vein opened did not join the inferior vena cava directly, therefore there is no real duplication of the right renal vein which has been found in some previous case reports. The right renal vein had its normal termination into the inferior vena cava. Embryological explanation of the anomalous termination of the right testicular vein has been given.Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, Page: 36-37

scholarly journals Can thyroidectomy be performed in secondary thyroid cancer?

2003 ◽  
Vol 11 (3) ◽  
pp. 183-183
Author(s):  
Aleksandar Diklic ◽  
Vladan Zivaljevic ◽  
Ivan Paunovic ◽  
Ksenija Krgovic ◽  
Svetislav Tatic ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Female Patient ◽  
Male Patient ◽  
Cancer Metastasis ◽  
Case Reports ◽  
Unknown Origin ◽  
Breast Cancer Metastasis ◽  
Thyroid Tumor ◽  
Lung Lobectomy ◽  
Toxic Goiter

Background: Secondary thyroid cancer is much less frequent than primary and in the majority of cases represents disseminated disease where operation on thyroid is useless or thyroid tumor is not operable, infiltrating surrounding structures. Methods: Five case reports of patients operated for secondary thyroid cancer. Results: Case 1: In male patient aged 64 years thyroidectomy was done for thyroid solid tumor 5 years after lung lobectomy for bronchogenic planocellular cancer. FNB suspected nonthyroid cancer histological analysis revealed planocellular cancer (Grimelius staining excluded medullar cancer) and multinodular goiter. Case 2: In female patient aged 65 years, thyroidectomy was done 4 years after left mastectomy with the history of long standing multinodular toxic goiter. Infiltrate remained in trachea and esophagus, histology revealed breast cancer metastasis in thyroid, confirmed with special mucin I, and estrogen receptor staining with negative thyroglobulin staining. Case 3: In female patient aged 76 years thyroidectomy was performed for metastatic lucidocellular kidney cancer in recurrent goiter (with Vimentin staining), a year after nephrectomy and 50 years after first goiter operation. Case 4: In female patient aged 58 years thyroidectomy was performed for planocellular infiltration of esophagus into the left thyroid lobe. Case 5: In female patient aged 77 years thyroidectomy was done for hemorrhage into thyrotoxic goiter, histology revealed metastasis of planocellular cancer of unknown origin into thyroid. Case 6: In male patient aged 54 years, thyroidectomy was done for thyroid metastatic lucidocellular cancer of kidney, 2 years after nephrectomy. Conclusion: Although prognosis of secondary thyroid cancer is poor, in rare cases aggressive surgery with adjuvant therapy may be successful.

scholarly journals 1271 High-Density EEG Correlates During Confusional Arousals in a Child With a Long-Lasting History Of Sleepwalking

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A483-A483
Author(s):  
A Castelnovo ◽  
N Amato ◽  
S Riccardi ◽  
M Pereno ◽  
S Miano ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Case Report ◽  
Sleep Stage ◽  
Single Case ◽  
Case Reports ◽  
Nrem Sleep ◽  
High Density ◽  
Source Power ◽  
History Of ◽  
The Right

Abstract Introduction Sleepwalking belongs to a family of disorders (Disorders of Arousal - DOA) that are thought to derive from incomplete arousals out of Non Rapid Eye Movement (NREM) sleep. At yet, our knowledge about the specific neural dynamics occurring during clinical episodes is limited and relies on one SPECT case study, four stereo-EEG case reports/series and one single high-density electro-encephalography (hdEEG) case report. We herein describe a single case captured by hdEEG. Report of Case We collected two consecutive sleep recordings (using a 256-channel hdEEG coupled with standard video-polysomnography) of a non-medicated, otherwise healthy, 13-year-old male, with a history of recurrent daily sleepwalking episodes. We visually identified 17 behavioral events during sleep stage 3 and divided them into two groups: clear clinical episodes (n = 7) and simple movements associated with burst of delta waves (n = 10). Source power topography in the delta range (1-4 Hz) was computed using LORETA. Source images during selected episodes were compared to 30 second-windows of baseline stage 3 sleep. Comparisons were performed using statistical non-parametric mapping with supra-threshold cluster tests. Events were associated with an increase of delta power over the right frontopolar prefrontal cortex (rPFC) / Broadman area 10 (BA10) at their onset. This finding was clearly observable even when considering only clear-cut events, followed by the involvement of the right dorsolateral and medial prefrontal cortex / BA9 and of the left superior temporal gyrus/ BA 22. Conclusion We were able to replicate a recently published case report by our group, where we highlighted the putative role of rPFC and PFC and prefronto-temporal circuit in DOA episodes. Intriguingly, we observed a lateralization of this effect, with a prominent right frontal involvement. Novel research has shown a physiological asymmetry in the generation of large slow waves between the two hemispheres. An increased right-left unbalance might prime behavioral episodes in DOA patients.

Abstract 1122‐000051: Isolated Diplacusis Due to Ipsilateral Temporal Lobe Infarction: A Case Report

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Ali Kerro ◽  
Reza Bavarsad Shahripour
Keyword(s):  
Case Report ◽  
Temporal Lobe ◽  
Case Reports ◽  
Sensorineural Deafness ◽  
Screen Test ◽  
Acute Onset ◽  
First Case ◽  
Ischemic Infarct ◽  
Pubmed Search ◽  
The Right

Introduction : Double hearing or Diplacusis is a synchronous double perception of a sound and can have Binauralis or Monauralis pattern, with inner ear disorders being the main culprit [1] . Other forms of Auditory illusions have been reported as a co‐manifestation of stroke syndromes, but none as an isolated presentation [1][2] . This is a case of a 77‐year‐old male with acute onset isolated Diplacusis in a patient due to a right temporal lobe ischemic infarct. To our knowledge, this is the first case report of an isolated diplacusis due to cortical infarct. Methods : A case presentation with Pubmed search of review articles and case reports. Results : The patient had a past medical history of sensorineural deafness in his left ear. He described any sound heard as the same quality but occurring with an echo heard a fraction of a second later in his right ear. There was no decreased hearing quality or tinnitus reported in his right ear. His drug screen test was negative. His examination was only remarkable for a sensorineural hearing loss pattern on his left ear. His (NIHSS) was zero, and no other cranial nerve abnormalities were detected. His MRI was significant for a punctate restricted diffusion on the right temporal lobe, resembling an ischemic infarct (Figure). Conclusions : Isolated diplacusis can present as acute ischemic stroke in the temporal lobe. Further studies are needed to understand its pathophysiology.

scholarly journals Two-Year Outcome of Aflibercept for the Treatment of Choroidal Neovascularization in Punctate Inner Choroidopathy

2019 ◽  
Vol 10 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Luis Arrevola ◽  
María Almudena Acero ◽  
María Jesús Peral
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Choroidal Neovascularization ◽  
Single Case ◽  
Case Reports ◽  
Oral Prednisone ◽  
Case Series ◽  
Punctate Inner Choroidopathy ◽  
Single Case Report ◽  
The Right

Punctate inner choroidopathy (PIC) is a rare inflammatory chorioretinopathy that predominantly affects young myopic women. Visual prognosis is generally good, but occurrence of choroidal neovascularization (CNV) is common and may be vision threatening. Case reports and short case series support the effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) agents (ranibizumab and bevacizumab) for CNV associated with PIC given their anti-angiogenic and anti-inflammatory effects. Evidence concerning aflibercept, a more recent intravitreal anti-VEGF, is limited to a single case report. In this case report, we illustrate the case of a 43-year-old myopic woman presenting with visual acuity loss and distortion in the right eye over the last 5 days in whom CNV associated with PIC was diagnosed. Treatment with 1 injection per month of intravitreal aflibercept for 2 months and full-dose oral prednisone for 1 week, being tapered afterwards, improved visual acuity and resolved CNV, with benefits lasting up to 24 months.

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