Synchronous carcinoma of the thyroid and hypopharynx; a diagnostic and management challenge

2020 ◽  
Vol 1 (1) ◽  
pp. 24-28
Author(s):  
Louise McMurran ◽  
◽  
Usman Rasul ◽  
Seok Jun Jeong ◽  
Vamsidhar Vallamkondu ◽  
...  
Keyword(s):  
Ct Scan ◽  
Thyroid Cartilage ◽  
Needle Aspiration ◽  
Neck Swelling ◽  
Pyriform Fossa ◽  
Synchronous Carcinoma ◽  
Chinese Origin ◽  
Thyroid Mass ◽  
Synchronous Cancers ◽  
The Right

A 73-year-old Chinese origin woman presented with a right neck swelling associated with recent swallowing issues and hoarseness. She had an apparent goitre and a right posterior neck swelling. An ultrasound guided fine needle aspiration demonstrated papillary thyroid carcinoma in both thyroid lobes and right neck lymphadenopathy. While awaiting total thyroidectomy and neck dissection she presented with haemoptysis. She was found to have an exophytic mass in right pyriform fossa. The CT scan confirmed an intralaryngeal extension of the thyroid mass via thyroid cartilage and metastatic disease in the lung. Unexpectedly histology showed that the tissue from the right pyriform fossa was squamous cell carcinoma and papillary carcinoma in the thyroid was confirmed. She had synchronous cancers in the thyroid and hypopharynx. Synchronous tumours are a big challenge to diagnose and to treat. In her case the CT scan was misleading. We discuss this unusual presentation of synchronous head and neck cancers and difficulty in managing them.

scholarly journals Laryngeal gout mimicking chondrosarcoma with concurrent longus colli tendinitis

2019 ◽  
Vol 12 (10) ◽  
pp. e231070
Author(s):  
Si Ying Chrisanda Lee ◽  
Yijin Jereme Gan ◽  
Julian Park Nam Goh ◽  
Yong Howe Ho ◽  
Ming Yann Lim
Keyword(s):  
Ct Scan ◽  
Thyroid Cartilage ◽  
Open Biopsy ◽  
Mri Scan ◽  
Ct Guided ◽  
Standardised Uptake Value ◽  
Positron Emission ◽  
Longus Colli ◽  
Ct Guided Biopsy ◽  
The Right

A 42-year-old man with multiple comorbidities, including gout, presented to the emergency department with severe odynophagia for 4 days with intermittent dysphagia for 1–2 months. A CT scan of the neck showed right longus colli tendinitis and partially calcified excrescences from the right thyroid cartilage which raised suspicion of a cartilaginous tumour. He underwent an MRI scan of the neck to better evaluate the thyroid cartilage findings, which showed a heterogeneous mass suspicious for a chondroid tumour. He then underwent a positron-emission tomography-CT scan which showed a fluorodeoxyglucose-avid mass containing foci of calcification involving the right thyroid cartilage and adjacent strap muscle, with high standardised uptake value of 7.7. He subsequently underwent a CT-guided biopsy and an open biopsy of the right thyroid cartilage, and the results revealed gouty tophi. To our knowledge, this is the first reported case of laryngeal gout with longus coli tendinitis, both of which are rare conditions.

scholarly journals Isolated Langerhans Cell Histiocytosis of the Thyroid in an Adult Female: One-Year Followup

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Ramon Vilallonga ◽  
Andrea Ciudin ◽  
José Manuel Fort ◽  
Juan Antonio Baena ◽  
Oscar Gonzalez ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Langerhans Cell Histiocytosis ◽  
Immunohistochemical Analysis ◽  
Needle Aspiration ◽  
Langerhans Cell ◽  
Thyroid Mass ◽  
Histologic Evaluation ◽  
One Year ◽  
The Right ◽  
Surgery Department

Thyroid gland involvement as the unique presentation of Langerhans cell histiocytosis is a rare phenomenon that can result in misdiagnosis. We report a case of Langerhans cell histiocytosis (LCH) presenting as a thyroid mass. It is a 52-year-old woman who presented an enlarged, diffusely firm, nontender, nonmobile, and not particularly nodular thyroid gland with mild compressive symptoms. Ultrasound and fine-needle aspiration showed a unique right node with benign signs. Patient was referred to our Ambulatory Surgery Department, where a hemithyroidectomy was performed. Histologic evaluation of the right thyroid gland revealed an involvement by LCH, confirmed by immunohistochemical analysis showing Langerhans cells that were positive for CD1a. LCH was a completely incidental occult finding apparent only after surgical resection and examination of the gland. Patient was evaluated, and no evidence of systemic affectation was found. LCH can rarely involve the thyroid gland in adults. Few cases have been reported in the literature. Most patients had evidence of LCH involving other anatomic sites.

Abdominal actinomycosis after reparative surgery for cholecystogastric fistula in an immunosuppressed patient

2021 ◽  
Vol 14 (7) ◽  
pp. e243445
Author(s):  
Maria Carolina Fra ◽  
Massimo Brenna ◽  
Caroline Di Benedetto ◽  
Marco De Monti
Keyword(s):  
Ct Scan ◽  
Laboratory Tests ◽  
Needle Aspiration ◽  
Immunosuppressed Patient ◽  
Ct Guided ◽  
Abdominal Actinomycosis ◽  
Patient Reported ◽  
Daily Dose ◽  
The Right ◽  
Ultrasound Features

A male patient, aged over 75 years, was referred to the emergency room for pain in his right hypochondrium. This pain, which persisted for approximately 3 days, radiated to his right flank and right iliac quadrant and worsened after meals. The patient reported no nausea, vomiting, diarrhoea, fever or recent traumatic events. Blood laboratory tests, ultrasonography, an MRI and a CT scan were performed, leading to the diagnosis of a mass in the Morrison’s pouch with ultrasound features of adipose tissue compatible with a liposarcoma, infiltrating the liver and the right kidney. Subsequent CT-guided needle aspiration and a histological examination led to the diagnosis of actinomycosis. The patient was initially treated with a daily dose of 18 million IU of benzylpenicillin for 4 weeks and subsequently prescribed the oral administration of 3 g/day of amoxicillin for 11 months. A monitoring CT scan was performed after 1, 5, 8 and 12 months, and a CT scan re-evaluation confirmed that the mass had completely healed.

Adenoid Cystic Carcinoma of the Larynx Presenting as a Thyroid Mass and Brief Literature Review

2017 ◽  
Vol 61 (3) ◽  
pp. 237-241 ◽  
Author(s):  
Sadegh Shirian ◽  
Maryam Maghbool ◽  
Azita Aledavood ◽  
Shahrzad Negahban ◽  
Bijan Khademi ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Adenoid Cystic Carcinoma ◽  
Thyroid Cartilage ◽  
Three Dimensional ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Thyroid Transcription Factor 1 ◽  
Direct Invasion ◽  
Adenoid Cystic ◽  
Thyroid Mass

Background: Adenoid cystic carcinoma (ACC) of the larynx and trachea is very rare. Case: A 45-year-old man with ACC of the larynx presenting as a thyroid mass is reported in this study. Physical examination revealed a large solid thyroid nodule in the left lobe without any lymphadenopathy. A technetium thyroid scan showed multinodular goiter with cold nodules in the left lobe, isthmus, and functioning nodules in the right lobe. A large thyroid mass originating from the left side of the larynx, mostly the left vocal cord and the infraglottic part, was seen using enhanced magnetic resonance imaging after rupture of the thyroid cartilage on the left side. Ultrasound-guided fine needle aspiration smears and cell blocks of the thyroid nodule showed highly cellular smears composed of large tissue fragments, three-dimensional clusters, and sheets of neoplastic cells with slightly enlarged round and hyperchromatic nuclei. Immunohistochemical study showed that the cell block expressed C-kit and CK 7 on the cribriform growth pattern of the tumoral cells. However, protein expression of thyroglobulin and thyroid transcription factor-1 was not detectable. Conclusion: To approach a thyroid nodule, direct invasion or metastatic tumors of other organs must be borne in mind.

scholarly journals Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kamel A. Gharaibeh ◽  
Arnaldo Lopez-Ruiz ◽  
Tauqeer Yousuf
Keyword(s):  
Ct Scan ◽  
Psoas Abscess ◽  
Psoas Muscle ◽  
Needle Aspiration ◽  
Imaging Studies ◽  
Lower Quadrant ◽  
History Of ◽  
Undifferentiated Adenocarcinoma ◽  
Poorly Differentiated ◽  
The Right

Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations.

scholarly journals Cysticercosis presenting as Neck Swelling: A Rare Case diagnosed on Ultrasound Report

2017 ◽  
Vol 7 (2) ◽  
pp. 122-124
Author(s):  
Manoj G Chandak ◽  
Shivlal M Rawlani ◽  
Rakhi M Chandak
Keyword(s):  
Rare Case ◽  
Subcutaneous Tissue ◽  
Present Report ◽  
Thyroid Cartilage ◽  
Taenia Solium ◽  
Rare Event ◽  
Great Difficulty ◽  
Neck Swelling ◽  
Submandibular Region ◽  
The Right

ABSTRACT Introduction Cysticercosis is a condition that occurs when humans are infested by the larvae of Taenia solium, acting as an intermediate host instead of definitive occurrence in neural and extra-neural forms. The latter commonly involves subcutaneous tissue, skeletal muscles, and eyes. Aims and objectives Oral cysticercosis is a rare event, and it represents great difficulty for clinical diagnosis. In present report we report a case of cysticercosis in the right submandibular region where it presented as a large, soft cystic swelling and tried to explain the clinical sign & symptom of oral cysticercosis. We emphasize on the importance of ultrasonographic and routine microscopic examinations for the diagnosis of even apparently innocuous lesions in submandibular regions. Results This is a very rare case of oral cysticercosis showing neck swelling extended from the lower border of the mandible to the thyroid cartilage. The diagnosis was made by sonography and confirmed by gross and microscopic examination of cysticercosis cellulosae. In ultrasonography, there was well-defined cystic lesion with hyperechoic eccentric tiny nodules. How to cite this article Chandak RM, Chandak MG, Rawlani SM. Cysticercosis presenting as Neck Swelling: A Rare Case diagnosed on Ultrasound Report. J Contemp Dent 2017;7(2):122-124.

scholarly journals Solitary Fibrous Tumor of the Larynx and Anterior Neck

2019 ◽  
Vol 34 (1) ◽  
pp. 64-67
Author(s):  
Guinevere S. Pabayos ◽  
Armando M. Chiong
Keyword(s):  
Solitary Fibrous Tumor ◽  
Thyroid Cartilage ◽  
Upper Airway ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Anterior Neck ◽  
Neck Masses ◽  
Airway Opening ◽  
Fibrous Tumor ◽  
The Right

Whether benign or malignant, laryngeal and neck masses may involve the upper airway and obstruct breathing. While surgically-resectable malignancies are generally extirpated with adequate margins of normal tissue, benign lesions are usually excised conservatively. However, even benign masses may behave malignantly, necessitating more aggressive surgical resection. We present one such case.   CASE REPORT   A 35-year-old man from Cotabato City consulted due to difficulty of breathing.  He had a six-year history of progressively enlarging anterior neck mass with intermittent dyspnea, foreign body sensation, progressive dysphagia and hoarseness over the last three months. Physical examination revealed a well-defined, 5 x 6 cm smooth, firm, non-tender anterior neck mass that moved with deglutition.  Rigid endoscopy showed a right supraglottic mass with bulging of the right glottic and subglottic area, with a less than 10% airway opening. (Figure 1A) Both arytenoids were visibly mobile, but glottic closure was impaired. (Figure 1B) Tracheostomy and suspension laryngoscopy with biopsy yielded inconclusive results (fibromuscular tissue) and fine needle aspiration cytology (FNAC) of the anterior neck mass only revealed blood and colloid. Contrast computed tomography of the neck showed a well-marginated, hypodense, thick-walled, heterogeneously enhancing mass in the right laryngeal fossa measuring 2.86 x 1.78 cm with a larger extension anteriorly measuring 4.66 x 2.52 cm.  Effacement of the epiglottis and aryepiglottic fold was noted.  The hyoid and thyroid cartilage were intact, and the thyroid gland was normal.  (Figure 2A, B)   Because of inconclusive histopathological and cytological results, an incision biopsy of the anterior neck mass was performed.  Histopathological evaluation revealed spindle cell mesenchymal proliferation, and immunohistochemical stains showed positive immunoreactivity for CD34, with a weakly positive S-100 and negative SMA, favoring a solitary fibrous tumor.  

scholarly journals Parapharyngeal schwannomma: a case report

2020 ◽  
Vol 6 (4) ◽  
pp. 799
Author(s):  
Manjunath K. ◽  
Amardeep Singh ◽  
Smitha V.
Keyword(s):  
Thyroid Cartilage ◽  
Age Distribution ◽  
Young Male ◽  
Neck Region ◽  
Neck Swelling ◽  
Neurogenic Tumors ◽  
Cervical Approach ◽  
Swallowing Difficulty ◽  
The Right ◽  
Slow Growing

<p class="abstract">Schwannomas are uncommon neurogenic tumors that are typically benign, slow growing, and asymptomatic. Upto 45% of schwannomas arise from the head and neck region, the sites of origin are: face, scalp, intracranial cavity, orbit, nasal and oral cavities, parapharyngeal space, middle ear, mastoid, larynx, and medial and lateral regions of the neck.  The age distribution is 30 to 70 years and male:female 3:1. Symptoms and signs are neck swelling (54%), pain (11%), cranial nerve palsy (10%), oropharyngeal swelling (8%), dysphagia (6%) and trismus, otalgia (11%). This case is being presented because it is the rare case of neck swelling.  A young male patient aged 22 yrs, presented with complains of swelling in right side of neck since 6 months. Patient also complains of difficulty in swallowing, difficulty in breathing and change in voice since 4 months. On examination of neck, a diffuse swelling noted at right level III neck, extending from the superior border of thyroid cartilage up to the level of hyoid bone.  Horizontally the swelling was extending from mid thyroid cartilage till the anterior border of sternocleidomastoid muscle. On examination of swelling, a pink smooth globular mass seen pushing the right aryepiglottic fold anteriorly obscuring the laryngeal inlet. No pooling of saliva. elective tracheostomy was done, through lateral cervical approach, mass was excised in toto and extubated after 7 days.</p>

scholarly journals EKSTIRPASI LIPOMA LIDAH DENGAN PENDEKATAN MANDIBULOTOMI

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Olivia C. P. Pelealu
Keyword(s):  
Oral Cavity ◽  
Ct Scan ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Pathological Examination ◽  
Fine Needle ◽  
Needle Aspiration Biopsy ◽  
The Right

Abstract: Lipoma is rarely found in the oral cavity. Actually, lipoma is a benign tumor but it will create an operational procedure problem if its size is big and it grows in a difficult location. This tumor is usually found at the age of 40 – 60 years, more frequently in men, but the same for all races. Clinically, lipoma occurs as a mass with a smooth surface, yellowish to orange in color, and painless. The diagnosis of a lipoma is confirmed by using a CT scan that shows an irregular globular radioluscent mass with a clear border that seperates it from the surrounding tissues. The definite diagnosis should be based on a fine needle aspiration biopsy (FNAB) and a pathological examination. The management of an oral cavity lipoma is through an operation. We reported a case of a lipoma on the right side of the tongue of a 56-year-old male. The tumor was extirpated with a mandibulotomy approach, in which the mandible is cut to widen the operation field without removing the mandible bone. Keywords: lipoma, tongue, mandibulotomy, extirpation.     Abstrak: Lipoma merupakan tumor yang jarang terjadi dalam kavum oris. Lipoma merupakan tumor jinak namun akan menimbulkan masalah bila berukuran besar dan tumbuh di lokasi yang sulit untuk dilakukan operasi. Tumor ini sering ditemukan pada usia 40-60 tahun, lebih sering pada laki-laki, dan sama untuk semua ras. Secara klinis lipoma tampak sebagai massa dengan permukaan licin, berwarna kekuningan sampai jingga, dan tidak nyeri. Diagnosis untuk lipoma dilakukan dengan CT scan yang memperlihatkan massa ireguler globuler, radiolusen, dan ireguler, serta berbatas jelas dari jaringan sekitarnya. Diagnosis pasti ditegakkan dengan fine needle aspiration biopsy (FNAB) dan pemeriksaan patologi. Penanganan lipoma dalam kavum oris yaitu dengan operasi. Kami melaporkan kasus seorang laki-laki berusia 56 tahun dengan lipoma lidah. Tumor tersebut diekstirpasi dengan pendekatan mandibulotomi, dimana mandibula dipotong untuk meluaskan lapangan pandang operasi tanpa mengangkat tulang mandibula. Kata kunci: lipoma, lidah, mandibulotomi, ekstirpasi.

scholarly journals PSEUDOTUMOR TUBERKULOSIS HATI DIAGNOSIS MELALUI BIOPSI ASPIRASI JARUM HALUS

2013 ◽  
Vol 2 (2) ◽  
Author(s):  
Poppy M. Lintong
Keyword(s):  
Ct Scan ◽  
Metastatic Cancer ◽  
Abdominal Cavity ◽  
Needle Aspiration ◽  
Diagnostic Tools ◽  
Focal Lesions ◽  
Normal Limits ◽  
Cell Aggregations ◽  
Upper Abdominal ◽  
The Right

Abstract: Nowadays, the role of Fine Needle Aspiration Biopsy (FNAB) in the evaluation of focal lesions in the liver, especially nodular hepatocellular carcinoma, is well developed. As one of the diagnostic tools, FNAB is very important in making a preoperative diagnosis to prevent unneeded hepatectomy. Although a CT scan or USG can detect a tubercular lesion in the abdo-minal cavity, this imaging is not always specific, and still needs microbiologic and histo-pathologic examinations for further confirmation. We reported a case of a 45-year-old female with a tumor in the right upper abdominal cavity. She had undergone a USG twice with two different results: the first one was a hepatoma, and the second one was a benign nodule of the liver. The AFP test was within normal limits (2.6 mg/ul). FNAB showed a tubercular granuloma consisting of epitheloid cell aggregations and Langhans datia cells, with a background of necrotic tissues, connective tissue fibrils, and normal hepatocytes. Localized tuberculosis as a clinical entity producing large nodules is exceedingly rare, even in endemic areas. These pseudotumors often resemble metastatic cancer, clinically and radiographically. By using FNAB we can detect liver tuberculosis that clinically manifests as a tumor. Key words: FNAB, liver tuberculosis, pseudotumor.     Abstrak: Saat ini peranan biopsi  aspirasi jarum halus  dalam        hal menilai kelainan-kelainan fo-kal pada hati sudah berkembang, terutama pada nodul karsinoma hepatoseluler. Biopsi aspirasi jarum halus pada hati  sebagai salah satu sarana diagnostik  sangat berguna untuk menegakkan diagnosis preoperatif sehingga dapat  menghindari tindakan hepatektomi yang tidak perlu. Meskipun pemeriksaan computerized tomography scan (CT-scan) dan ultrasonography (USG) pada hati dapat mendeteksi lesi tuberkulosis dalam rongga perut, namun  pencitraannya tidak selalu spesifik sehingga membutuhkan konfirmasi pemeriksaan mikrobiologi dan histopatologi. Dilaporkan kasus  seorang wanita berusia 45 tahun dengan tumor pada perut kanan atas. Telah dilakukan dua kali pemeriksaan USG: yang pertama hasilnya suatu hepatoma dan yang kedua suatu nodul jinak pada hati. Pemeriksaan alpha-feto protein (AFP) dalam batas normal (2,6 mg/ul). Kemudian dilakukan pemeriksaan biopsi aspirasi jarum halus dengan hasil menunjukkan granuloma tuberkulosis dari agregat sel-sel epiteloid yang tersusun dalam granuloma dan sel-sel datia Langhans dengan latar belakang fokus-fokus nekrosis, fibril jaringan ikat serta sel-sel hati normal. Tuberkulosis terlokalisir pada hati  yang secara klinik menimbulkan nodul besar, sangat jarang terjadi, sekalipun pada daerah endemik. Pseudotumor seperti ini sering menyerupai  metastatik kanker secara klinik dan radiologik. Melalui pemeriksaan biopsi aspirasi jarum halus dapat dikonfirmasi suatu tuberkulosis hati yang klinisnya memberi manifestasi seperti tumor. Kata kunci: biopsi  aspirasi jarum halus, tuberkulosis hati, pseudotumor.

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