scholarly journals The Unusual Case of a Rapidly Enlarging Thyroid Gland in a Patient With Pendred Syndrome

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A960-A960
Author(s):  
Neal Maler ◽  
Ellis R Levin
Keyword(s):  
Thyroid Gland ◽  
Early Adulthood ◽  
Signs And Symptoms ◽  
Thyroid Function Tests ◽  
Pendred Syndrome ◽  
First Case ◽  
Patient Reported ◽  
Associated Symptoms ◽  
The Right ◽  
Left Thyroid Lobe

Abstract Pendred syndrome is a genetic condition that is characterized by sensorineural hearing loss, abnormalities of the vestibular system, and goiter. In patients with Pendred syndrome, goiter tends to develop in late childhood or early adulthood and the literature details a progressive enlargement of goiter in these individuals. Here we report the case of a 26 year old female with Pendred syndrome and congenital deafness who presented with a rapidly enlarging thyroid gland over 1 week with associated symptoms of dysphagia, dyspnea, insomnia, and diaphoresis. Thyroid function tests at the time showed no abnormalities. Diagnostic thyroid ultrasound was performed and showed enlarged, multinodular goiter and bilateral thyroid nodules measuring 1.2 cm and 1.1 cm in the right and left thyroid lobe, respectively, with TI-RADS 2 classification. The patient had a thyroid core biopsy performed showing benign appearing thyroid follicles without any evidence of malignancy. After approximately one month following the initial presentation, the patient reported resolution of her goiter and associated symptoms without intervention. To our knowledge, this is the first case in the literature detailing a rapidly enlarging goiter in a patient with Pendred Syndrome, with subsequent resolution of signs and symptoms.

Retina Injury After Dexamethasone Injection Into a Vitrectomized Eye

2020 ◽  
Vol 4 (6) ◽  
pp. 538-540
Author(s):  
Michael S. Elliott ◽  
Sandra R. Montezuma
Keyword(s):  
Macular Edema ◽  
Vitreous Hemorrhage ◽  
Signs And Symptoms ◽  
Internal Limiting Membrane ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Patient Reported ◽  
Clinically Significant ◽  
The Right ◽  
Intravitreal Dexamethasone

Purpose: This work reports a case of retinal and vitreous hemorrhage after a dexamethasone (Ozurdex, Allergan) intravitreal implant injection to treat clinically significant macular edema (ME) in a patient with moderate nonproliferative diabetic retinopathy. Methods: A 61-year-old woman who had a vitrectomy 3 years prior in the right eye underwent intravitreal dexamethasone implant injection in the right eye. Immediately after the injection, the patient noted numerous floaters, with visual acuity decline from 20/30 before injection, to counting fingers at 3 feet after injection. Dilated examination revealed the dexamethasone implant resting against the retina, just inferior to the inferior arcade. On 360° fundus examination, the retina was found to be flat and attached. Optical coherence tomography of the macula demonstrated that the dexamethasone implant was preretinal, possibly having lifted the internal limiting membrane. Results: Thirty minutes after the injection, the patient reported that her vision was starting to clear. The patient was informed about what had transpired and warned about signs and symptoms of retinal detachment. She canceled her 1-week follow-up appointment because her vision returned to baseline. By 4 weeks post injection, her vision was 20/20 without macular edema. Conclusions: This case represents the first reported instance in which retinal impact by an Ozurdex implant was observed without treatment and vision recovered to baseline.

scholarly journals Subacute Thyroiditis Associated With Liraglutide

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A957-A957
Author(s):  
Banu Erturk ◽  
Selcuk Dagdelen
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Receptor Activation ◽  
Left Lobe ◽  
Subacute Thyroiditis ◽  
Thyroid Function Tests ◽  
Free T4 ◽  
Reactive Protein ◽  
Normal Limits ◽  
The Right

Abstract Objective: Incretins are expressed in thyroid tissue but without clearly-known clinical significance in human. The long-term effect of GLP-1 receptor activation on the thyroid is unknown. In the literature, liragludite-related thyroiditis has not been reported yet and here we wanted to draw attention to this association. Case Summary: A 52-year-old woman with type 2 diabetes mellitus presented with thyroid tenderness, tremor and fever. Her lab results were as follows: undetectable TSH, free T4 (FT4) = 2,4 ng/dl (0.93-1.7), free T3 (FT3) = 4.4 pg/mL (2-4.4). Erythrocyte sedimentation rate (ESR) was 60 mm/hour, C-reactive protein (CRP) was 80 mg/L. Thyroid autoantibodies were negative. USG revealed that thyroid gland was in normal localization and the right lobe was 24x22x46 mm and the left lobe was 20x21x45 mm, isthmus thickness was 5 mm. The parenchyma was heterogeneous, coarsely granular, with bilateral patchy hypoechoic areas. All these findings suggested that the patient had subacute thyroiditis. When we examine the etiological factors of subacute thyroiditis in the patient, there was no history of trauma, no previous viral or bacterial illness, contrast agent exposure. But, she had only been using liraglutide for a week. Firstly liraglutide therapy was ceased and than 20 mg prednisolone and 40 mg beta-blocker therapy was initiated. At the 8 weeks’ of cessation, patient had no symptoms. Also thyroid function tests and other laboratory values were all in normal limits. Conclusions: It has been proven by previous studies that liraglutide has several effects on the thyroid gland. Liraglutide therapy might be related to subacute thyroiditis, as well.

scholarly journals Surgical Neck Emphysema Post Elective Tonsillectomy: Case Report and Literature Review

2022 ◽  
pp. 014556132110693
Author(s):  
Hassan Assiri ◽  
Yaser Ibrahim ◽  
Abdulrahman Alghulikah
Keyword(s):  
Lupus Erythematosus ◽  
Masseter Muscle ◽  
Signs And Symptoms ◽  
Neck Swelling ◽  
Systemic Lupus ◽  
Masticator Space ◽  
Air Density ◽  
Associated Symptoms ◽  
Surgical Emphysema ◽  
The Right

Neck emphysema after tonsillectomy surgery is very rare. We present a case documenting the conservative management of a post-tonsillectomy neck swelling, accompanied by crepitus. Computed tomography revealed a large air density at the region of the right masticator space and the masseter muscle, proximal to other deep neck spaces and muscles. Further investigations of her associated symptoms resulted in an additional diagnosis of systemic lupus erythematosus. We have also explored the signs and symptoms associated with such cases, along with a discussion of the literature published on surgical emphysema post-tonsillectomy.

Guided Endodontics in Root Canals with Complex Access: Two Case Reports

2021 ◽  
Vol 32 (6) ◽  
pp. 115-123
Author(s):  
Wesley Fernandes Gonçalves ◽  
Lucas da Fonseca Roberti Garcia ◽  
Daniela Peressoni Vieira-Schuldt ◽  
Eduardo Antunes Bortoluzzi ◽  
Luiz Carlos de Lima Dias-Júnior ◽  
...  
Keyword(s):  
Root Canal ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Radiographic Examination ◽  
Free Access ◽  
Filling Material ◽  
Radiographic Images ◽  
Root Canals ◽  
First Case ◽  
The Right

Abstract This article reported two clinical cases in which the guided endodontics was used to perform the access to the root canals. The first case presents a 40-year-old female with a history of pain related to the left maxillary canine. After radiographic examination, the presence of severe calcification up to the apical third of the root canal, associated with a periapical radiolucency, was noted. In the second case, an 85-year-old male was referred to our service with pain upon palpation, at the right mandibular first molar. The radiographic images revealed the presence of endodontic treatment and a fiberglass post in the distal root canal, which was associated with extrusion of the filling material and a periapical lesion. The 3D-guides were planned based on cone beam computed tomography and intraoral digital scanning, which were aligned using a specific software. Therefore, implant drills could be guided up to the root canal length required for each case. In the first case, a surgical root canal was created and the patient was free of signs and symptoms after the treatment was completed. In the second case, it was observed that the fiber post was worn by the drill, allowing free access to the filling material. It was possible to perform the endodontic reintervention in a more predictable way and in less time. In both cases, the use of the guided endodontics allowed the preservation of a large part of the dental structure. The procedures were performed faster, without the occurrence of fractures and perforations.

scholarly journals Solitary Fibrous Tumor of Neck Mimicking Cold Thyroid Nodule in 99m Tc Thyroid Scintigraphy

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Oya Topaloglu ◽  
Bekir Ucan ◽  
Taner Demirci ◽  
Muyesser Sayki Arslan ◽  
Guleser Saylam ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Nodule ◽  
Solitary Fibrous Tumor ◽  
Surgical Removal ◽  
Thyroid Function Tests ◽  
Thyroid Scintigraphy ◽  
Thyroid Lobe ◽  
Spindle Cells ◽  
Fibrous Tumor ◽  
Left Thyroid Lobe

A 68-year-old man had a rapidly growing, painless neck mass, thought to be nodular goiter. Ultrasonography showed a giant, heterogeneous mass occupying the middle and superior poles and protruding outside of the left thyroid lobe. The results of the thyroid function tests were normal. Thyroid scintigraphy revealed a large hypoactive nodule in the left thyroid lobe. Complete surgical removal of tumor was performed and macroscopically demonstrated a well-demarked lesion outside the thyroid gland. Microscopically, the lesion was composed of fibroblast-like spindle cells in a patternless architecture and extensive stromal hyalinization. Immunohistochemistry showed positive reaction for CD34 in spindle cells and diffuse bcl-2 staining. The pathology was confirmed as solitary fibrous tumor. In the follow-up period after surgery, thyroid scintigraphy showed normal left thyroid lobe. Solitary fibrous tumor originated from or associated with thyroid gland is extremely rare. According to our knowledge, this is the first reported solitary fibrous tumor presenting like a cold thyroid nodule. This pathology must be considered for differential diagnosis of neck masses in the thyroid region.

scholarly journals MON-468 Hypoechoic Nodule Is Not Always the Bad Guy: Lessons Learned from a Patient with Subacute Painful Thyroiditis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Pakaworn Vorasart ◽  
Chutintorn Sriphrapradang
Keyword(s):  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Thyroid Function ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Thyroid Function Tests ◽  
The Right ◽  
Hypoechoic Nodule ◽  
Painful Thyroiditis

Abstract Introduction: The diagnosis of subacute painful thyroiditis (SAT) is primarily based on clinical manifestations (thyroid tenderness and diffuse goiter). Suppressed TSH, elevated erythrocyte sedimentation rate (ESR) and low thyroid uptake help confirm the diagnosis. Thyroid ultrasonography and fine-needle aspiration biopsy (FNAB) are rarely necessitated. SAT produces a typical sonographic findings of ill-defined heterogeneously hypoechoic areas, which is difficult to differentiate from thyroid carcinoma. We herein report a patient with SAT who was initially diagnosed as malignancy. Case Presentation: A 36-year-old female had pain and swelling at the left thyroid gland for 3 weeks. A left thyroid nodule was diagnosed by her primary care physician. Ultrasonography revealed a poorly defined hypoechoic nodule measuring 2.5x1.1x1.5 cm at the mid pole of the left thyroid gland, for which biopsy was recommended. The nodule showed peripheral vascularity and no calcification. No suspicious cervical lymphadenopathy was detected. Histologic analysis from core biopsy found findings consistency with follicular neoplasm. Thyroid function tests were within normal range. She was treated with ibuprofen as management of thyroid pain and referred for surgery. However, the repeated ultrasonography was performed by endocrinologist in the next 2 weeks and found an interval reduction in size of hypoechoic lesion. FNAB was performed due to the risk of infiltrative malignancies. Cytologic analysis was compatible with SAT. ESR was slightly elevated. Surgery was cancelled and she was treated with ibuprofen. Two weeks later, she reported that the left thyroid pain and swelling had subsided. However, she developed thyroid pain associated with glandular tenderness and swelling of the right thyroid. On sonographic examination, the right lobe, which was previously normal was now similarly affected. Thyroid function showed thyrotoxicosis. The patient was given a further course of beta-blocker, ibuprofen and prednisolone for 2 weeks and recovered well. On follow-up at 2 months, the patient developed biochemical hypothyroidism and received levothyroxine replacement. The lesions in the thyroid gland were not visualized in the 6-month follow-up sonography. Conclusion: The ultrasonographic features of the thyroid during the acute stage of SAT may mimic thyroid carcinoma. Awareness of the sonographic findings and interval changes of SAT lesions may helpful for proper diagnosis and treatment of SAT.

scholarly journals Clozapine-induced myocarditis: Two case reports and review of clinical presentation and recognition

2018 ◽  
Vol 8 (6) ◽  
pp. 303-308 ◽  
Author(s):  
Bryan K. Sackey ◽  
Troy A. Moore ◽  
Nicole L. Cupples ◽  
Cynthia A. Gutierrez
Keyword(s):  
Psychotic Disorders ◽  
Case Reports ◽  
White Male ◽  
Case Fatality ◽  
Signs And Symptoms ◽  
Primary Diagnosis ◽  
Reactive Protein ◽  
First Case ◽  
Patient Reported ◽  
Potential Risk Factors

Abstract Myocarditis is a potentially fatal cardiac disease marked by inflammation of the heart muscle. With a noted black-box warning, rates of clozapine-induced myocarditis are reportedly as high as 3%. Since the first case of clozapine-induced myocarditis was documented in 1994, more than 250 cases have been described in literature with an approximate 33% case-fatality rate. We report 2 cases of patients with primary psychotic disorders treated with clozapine, who developed signs and symptoms of myocarditis. The first was a 35-year-old white male patient with a primary diagnosis of schizoaffective disorder (bipolar type) who was initiated on clozapine after nonresponse to several therapies. On day 26, the patient was admitted to the emergency department for chest pain presenting with eosinophilia and notable elevations in several biomarkers, including troponin and C-reactive protein. The second patient was a 45-year-old black male who was initiated on clozapine for treatment-resistant schizophrenia. On day 13, the patient reported cardiac-related concerns (tachycardia) and flu-like symptoms resulting in hospitalization. Similarly, this patient demonstrated elevated biomarkers (troponin and creatine kinase). Both patients experienced resolution of symptoms after discontinuation of clozapine. Clozapine was not rechallenged for either patient. Review of literature further elucidates the relationship between clozapine and myocarditis, including potential risk factors, pathophysiology, and symptom presentation. Due to the potentially fatal nature of this condition, clinical vigilance and awareness is warranted upon initiation of clozapine through monitoring of symptoms along with cardiac and inflammatory biomarkers as indicated.

scholarly journals Giant Thyroid Abscess Related to Postpartum Brucella Infection

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Zülküf Akdemir ◽  
Erbil Karaman ◽  
Hüseyin Akdeniz ◽  
Cem Alptekin ◽  
Harun Arslan
Keyword(s):  
Thyroid Gland ◽  
Left Lobe ◽  
Magnetic Resonance Images ◽  
Suppurative Thyroiditis ◽  
Brucella Infection ◽  
First Case ◽  
Thyroid Abscess ◽  
Life Threatening ◽  
Acute Suppurative Thyroiditis ◽  
The Right

Thyroid gland infection, although rare, may be a life threatening disease. Thyroid abscess, arising from acute suppurative thyroiditis (AST), is a rare clinic condition depending on widespread use of antibiotics. Infection may involve one or both lobes and abscess formation may not be apparent until late stage of the progress of illness. Thyroid left lobe is more often affected than the right one. Brucellosis, especially obvious in endemic areas, is a widely seen zoonosis around the world. Although brucella infection can affect many organs through various complications, thyroid gland infection is rare. We aimed to present ultrasonography (USG) and magnetic resonance images (MRI) of a case with an acute thyroiditis which rapidly developed and grew fast on the left half of the neck during the first postpartum month. As far as we know from literature reviewing, our case is the first case report of a thyroid abscess arising from brucella infection which is developed in first postpartum period with images of ultrasonography and MRI.

scholarly journals The First Report of an Intraperitoneal Free-Floating Mass (an Autoamputated Ovary) Causing an Acute Abdomen in a Child

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ibrahim Uygun ◽  
Bahattin Aydogdu ◽  
Mehmet Hanifi Okur ◽  
Selcuk Otcu
Keyword(s):  
Small Intestine ◽  
Acute Abdomen ◽  
Terminal Ileum ◽  
Signs And Symptoms ◽  
Pathological Examination ◽  
Necrotic Tissue ◽  
First Case ◽  
The Right ◽  
Almost All ◽  
Thin Band

A free-floating intraperitoneal mass is extremely rare, and almost all originate from an ovary. Here, we present the first case with an intraperitoneal free-floating autoamputated ovary that caused an acute abdomen in a child and also review the literature. A 4-year-old girl was admitted with signs and symptoms of acute abdomen. At surgery, the patient had no right ovary and the right tube ended in a thin band that pressed on the terminal ileum causing partial small intestine obstruction and acute abdomen. A calcified mass was found floating in the abdomen and was removed. The pathological examination showed necrotic tissue debris with calcifications. An autoamputated ovary is thought to result from ovarian torsion and is usually detected incidentally. However, it can cause an acute abdomen.

scholarly journals Rare Metastasis of Gastric Cancer to the Thyroid Gland: A Case Report and Review of Literature

2021 ◽  
Vol 8 ◽  
Author(s):  
Zehui Wu ◽  
Tao Guo ◽  
Qiang Li ◽  
Liang Cheng ◽  
Xiaosi Hu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Thyroid Gland ◽  
Cancer Metastasis ◽  
Thyroid Nodules ◽  
Malignant Tumors ◽  
Subtotal Gastrectomy ◽  
Thyroid Function Tests ◽  
Oesophagogastric Junction ◽  
The Right ◽  
Metastasis To The Thyroid

Background: It is common for patients with gastric cancer to develop distant metastases in the liver, lung, bone, and brain. Although the thyroid also has an abundant blood supply, gastric cancer metastasis to the thyroid is uncommon. Due to the rarity of such metastasis, its clinical features are not well understood. Here, we present the case of a patient with gastric cancer metastasis to the thyroid treated at our hospital.Case Summary: We report the case of a 63-year-old female with a mass in the anterior neck and mild hoarseness for 6 months. The patient underwent proximal subtotal gastrectomy for Siewert III oesophagogastric junction cancer 6 years ago. Subsequently, she received 8 cycles of adjuvant chemotherapy. Her condition was stable until mild hoarseness developed for no apparent reason 6 months prior to presenting at our clinic. Both ultrasonography and computed tomography confirmed a heterogeneous mass in the right lobe of the thyroid gland. Blood thyroid function tests and tumor marker expression levels were normal. Thyroid malignancy was suspected, and the patient underwent a right thyroidectomy. During the surgery, a tumor was found that had invaded the right recurrent laryngeal nerve and trachea. H&E staining and immunohistochemistry results suggested that the cancer cells originated from gastric cancer. The patient was diagnosed with thyroid metastasis of gastric cancer. She refused further treatment and died within 6 months.Conclusion: Metastasis of gastric cancer to the thyroid is rare and is associated with a poor prognosis. Immunohistochemical diagnosis is essential for a conclusive diagnosis. For patients with a history of malignant tumors, the possibility of metastatic thyroid nodules should be ruled out when diagnosing thyroid nodules.

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