scholarly journals Papillary Microcarcinoma: AN Epidemiological, Clinical, therapeutic and Prognostic Study of 35 Cases

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Maha Hakimi ◽  
Fatimaazahra Hadid ◽  
Youssef Rochdi ◽  
Hassan Nouri ◽  
Abdelaziz Raji
Keyword(s):  
Lymph Node ◽  
Medical Records ◽  
Medical Center ◽  
Neck Surgery ◽  
Tumor Extension ◽  
Papillary Microcarcinoma ◽  
Thyroid Microcarcinoma ◽  
Therapeutic Protocol ◽  
Conservative Attitude ◽  
Iodine 131

Papillary microcarcinoma of the thyroid is defined as cancers having a diameter equal or inferior to 10 mm in the anatomopathological examination; The problematic of this pathology lies in its latent character, it is, thus, much more frequent than we thought or predicted. That is why, beyond specifying the epidemiological and clinical characteristics of papillary thyroid microcarcinoma, our ultimate goal was to determine the "gold standard" for the management of this entity. We carried out a descriptive retrospective study spread over 4 years including all cases of Papillary Microcarcinoma of the thyroid diagnosed within the department of ENT and Head and Neck Surgery of the medical center Mohammed VI in Marrakech; We collected 35 cases, and using their medical records we summarized their epidemiological, clinical and paraclinical data. None of our patients had a normal clinical examination, the palpation of our patients showed an isolated nodule in 20% of patients, the rest of our patients had clinically bilateral noticeable nodes. 80% of which were not clinically suspicious, and only three of our patients had palpable lymph nodes which was confirmed by the ultrasound, where the major suspicious character was their hypoechoic character ( 17 % were EU-TIRADS 5 ) With regard to surgical treatment, 28 of our patients (80%) underwent total thyroidectomy as a first step,4 patients underwent secondary totalization during the same operation after the extemporaneous examination came back positive for papillary microcarcinoma , 2 cases of remote loboisthmectomy after final histological examination showing papillary microcarcinoma , and one final case of totalization after extemporaneous examination of a superior right jugular lymph node with central necrosis. Neck dissection was performed in three cases. Postoperative outcomes were simple in all patients. Isotopic totalization by iodine 131 therapy was performed in four of our patients. Their indications were respectively: infiltrating tumor, extension to neighboring parenchyma, multifocality, lymph node metastasis. The survival rate of our series was 100%. The therapeutic protocol of papillary microcarcinoma is punctuated, to this day, with controversy, and faces a conservative attitude versus a radical one, it is the surgeon's duty to distinguish between the two attitudes.

scholarly journals Post-Operative Bleeding in Tonsillectomy versus Tonsillectomy with Fossa Closure in a Tertiary Military Hospital: A Cohort Study

2020 ◽  
Vol 35 (1) ◽  
pp. 36-38
Author(s):  
Niel Khangel Reyes
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Postoperative Bleeding ◽  
Neck Surgery ◽  
Military Hospital ◽  
Significant Difference ◽  
Keywords Tonsillectomy

ABSTRACT Objective: To determine the incidence of post-operative bleeding among patients who underwent tonsillectomy alone versus tonsillectomy with fossa closure at the Victoriano Luna Medical Center from January 2015 to December 2017. Methods: Design: Retrospective Cohort Study Setting: Tertiary Military Hospital Patients: Medical records of 83 patients that underwent tonsillectomy under the Department of Otorhinolaryngology – Head and Neck Surgery between January 2015 to December 2017 were retrospectively reviewed for data regarding sex, age, tonsillectomy with or without fossa closure and post-operative bleeding. Cases of tonsillectomy alone versus tonsillectomy with fossa closure were compared (particularly with respect to post-operative bleeding), tabulated and statistically analyzed using risk ratio and t-test. Results: There were 57 cases of tonsillectomy alone versus 26 cases of tonsillectomy with fossa closure. The incidence of bleeding in all cases of tonsillectomy whether tonsillectomy alone or with fossa closure was 4.8%. The incidence of bleeding was higher in cases of tonsillectomy with fossa closure at 11.5% (versus 1.8% in tonsillectomy alone). Post-operative bleeding was 0.1 times more likely to occur in patients who underwent tonsillectomy alone than those who underwent tonsillectomy with fossa closure but there was no statistically significant difference in the risk of post-operative bleeding between the two. Conclusion: Although the incidence of bleeding was higher in cases of tonsillectomy with fossa closure, our results suggest that there is no statistically significant difference in risk for postoperative bleeding between tonsillectomy alone or tonsillectomy with fossa closure. Keywords: tonsillectomy; postoperative bleeding; tonsil pillars; suturing

Cervical lymph node metastasis in thyroid microcarcinoma

2019 ◽  
Author(s):  
Mouna Bellakhdhar ◽  
Jihene Houas ◽  
Monia Ghammem ◽  
Abir Meherzi ◽  
Wassim Kermani ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma

American Academy of Otolaryngology–Head and Neck Surgery/Foundation Reg-ent Registry: Purpose, Properties, and Priorities

2021 ◽  
pp. 019459982098413
Author(s):  
Cecelia E. Schmalbach ◽  
Jean Brereton ◽  
Cathlin Bowman ◽  
James C. Denneny
Keyword(s):  
American Academy ◽  
Head And Neck ◽  
Best Practice ◽  
Medical Center ◽  
Quality Care ◽  
Academic Medical Center ◽  
Neck Surgery ◽  
Performance Measure ◽  
Head And Neck Surgery ◽  
Evidence Based

Objective (1) To describe the patient and membership cohort captured by the otolaryngology-based specialty-specific Reg-ent registry. (2) To outline the capabilities of the Reg-ent registry, including the process by which members can access evidence-based data to address knowledge gaps identified by the American Academy of Otolaryngology–Head and Neck Surgery/Foundation and ultimately define “quality” for our field of otolaryngology–head and neck surgery. Methods Data analytics was performed on Reg-ent (2015-2020) Results A total of 1629 participants from 239 practices were enrolled in Reg-ent, and 42 health care specialties were represented. Reg-ent encompassed 6,496,477 unique patients and 24,296,713 encounters/visits: the 45- to 64-year age group had the highest representation (n = 1,597,618, 28.1%); 3,867,835 (60.3%) patients identified as Caucasian; and “private” was the most common insurance (33%), followed by Blue Cross/Blue Shield (22%). Allergic rhinitis–unspecified and sensorineural hearing loss–bilateral were the top 2 diagnoses (9% each). Overall, 302 research gaps were identified from 17 clinical practice guidelines. Discussion Reg-ent benefits are vast—from monitoring one’s practice to defining otolaryngology–head and neck surgery quality, participating in advocacy, and conducting research. Reg-ent provides mechanisms for benchmarking, quality assessment, and performance measure development, with the objective of defining and guiding best practice in otolaryngology–head and neck surgery. To be successful, patient diversity must be achieved to include ethnicity and socioeconomic status. Increasing academic medical center membership will assist in achieving diversity so that the quality domain of equitable care is achieved. Implications for Practice Reg-ent provides the first ever registry that is specific to otolaryngology–head and neck surgery and compliant with HIPAA (Health Insurance Portability and Accountability Act) to collect patient outcomes and define evidence-based quality care.

scholarly journals Prediction of central compartment lymph node metastasis in papillary thyroid microcarcinoma

2014 ◽  
Vol 81 (2) ◽  
pp. 282-288 ◽  
Author(s):  
Yinlong Yang ◽  
Chengze Chen ◽  
Zimiao Chen ◽  
Jiachun Jiang ◽  
Yizuo Chen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Central Compartment ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma

Lymph Node Infarction

2003 ◽  
Vol 127 (1) ◽  
pp. 60-63 ◽  
Author(s):  
James A. Strauchen ◽  
Lorraine K. Miller
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Malignant Lymphoma ◽  
Immunohistochemical Study ◽  
Cell Lymphoma ◽  
Medical Center ◽  
Academic Medical Center ◽  
B Cell Lymphoma ◽  
Antigen Expression ◽  
Formalin Fixed Paraffin Embedded

Abstract Context.—The etiology of lymph node infarction may be difficult or impossible to determine by histologic examination. Lymph node infarction is followed by malignant lymphoma in some but not all patients. The role of immunohistochemistry in the evaluation of lymph node infarction is not well defined. Although it is widely believed that necrotic tissue is not suitable for immunohistochemical study, this view may be inaccurate. Objective.—To determine whether lymphoid antigens are preserved in infarcted lymph nodes and to determine the utility of immunohistochemical staining in the evaluation of lymph node infarction. Design.—Retrospective immunohistochemical study of infarcted lymph nodes using archival formalin-fixed, paraffin-embedded tissue. Setting.—Academic medical center. Patients.—Eleven adult patients with lymph node infarction retrieved from pathology files. Main Outcome Measures.—Results of immunohistochemistry, diagnosis of lymphoma. Results.—Preservation of lymphoid antigens was observed in 4 of 6 cases of lymph node infarction associated with malignant lymphoma, including 3 of 5 cases of diffuse large B-cell lymphoma and 1 case of peripheral T-cell lymphoma. Nonspecific staining was not encountered. In 1 case, in which an infarcted lymph node showed a benign pattern of lymphoid antigen expression, lymphoma has not developed after 5 years. Conclusion.—Lymphoid antigens are frequently preserved in cases of lymph node infarction, and immunohistochemical study of infarcted lymph nodes may provide clinically useful information.

Clinical Analysis of Pediatric Thyroid Cancer: A Single Medical Institution Experience of 18 Years

2019 ◽  
Vol 128 (12) ◽  
pp. 1152-1157 ◽  
Author(s):  
Hyung Kwon Byeon ◽  
Sang Bin Kim ◽  
Hyeon Seok Oh ◽  
Hong Kyu Kim ◽  
In Hak Choi ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Medical Center ◽  
Disease Recurrence ◽  
Clinical Analysis ◽  
Lateral Lymph Node ◽  
Node Metastasis ◽  
Pediatric Thyroid Cancer

Objective: The incidence of pediatric thyroid cancer is relatively low compared to the disease in adults. This study aims to present the data in our institution on pediatric thyroid cancer patients, with particular emphasis on the risk factors of recurrence together with treatment outcomes. Subjects and Methods: Between January 2000 and July 2018, patients <20 years who were diagnosed with thyroid carcinoma and primarily treated with surgery at a major large-volume tertiary medical center specializing in thyroid cancer were enrolled. A total of 83 patients were eligible for this study. Results: The majority of the studied patients were girls and adolescents (age ≥13 years). Papillary thyroid carcinoma (PTC) was the most common pathology (n = 74). PTC tumors >1 cm showed higher rate of lymph node metastasis and extrathyroidal extension than tumors ≤1 cm. All patients survived with nine PTC patients who displayed treatment failure. Age, tumor size, multifocality, lateral lymph node metastasis, and postoperative thyroglobulin levels were significant prognosticators for disease recurrence. Conclusion: Pediatric thyroid cancer is relatively rare and should be considered a specific disease entity with respect to the thyroid cancer in adults, since there are several distinctive characteristics.

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