scholarly journals Pretibial myxedema: Paradoxical manifestation of thyroid dermopathy after i-131 ablation therapy

2020 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Chih-Tsung Hung ◽  
Bing-Sian Lin ◽  
Yi-Hsien Chen
Keyword(s):  
Ablation Therapy ◽  
Pretibial Myxedema ◽  
Thyroid Dermopathy

scholarly journals Thyroid Acropachy: Report of 40 Patients Treated at a Single Institution in a 26-Year Period

2002 ◽  
Vol 87 (12) ◽  
pp. 5435-5441 ◽  
Author(s):  
Vahab Fatourechi ◽  
Debra D. F. Ahmed ◽  
Kara M. Schwartz
Keyword(s):  
Systemic Corticosteroid ◽  
Periosteal Reaction ◽  
Single Institution ◽  
Autoimmune Thyroid ◽  
Long Term Follow Up ◽  
Pretibial Myxedema ◽  
Thyroid Dermopathy ◽  
Systemic Corticosteroid Therapy

Abstract Thyroid acropachy is an extreme manifestation of autoimmune thyroid disease. It presents with digital clubbing, swelling of digits and toes, and periosteal reaction of extremity bones. It is almost always associated with ophthalmopathy and thyroid dermopathy. During a 26-yr period at our institution, of 178 patients with thyroid dermopathy, 40 had acropachy. Clubbing associated with thyroid dermopathy (pretibial myxedema) was seen in 35 patients. Clubbing usually was not a patient complaint and was noted only by clinical observers. Four of eight patients with hand and extremity radiographs had periosteal reaction. Seven had associated extremity and joint pain; this pain was absent at long-term follow-up. Half of the patients required systemic corticosteroid therapy, 53% required transantral or transfrontal orbital decompression for severe ophthalmopathy, and 18% had the elephantiasic form of dermopathy. Cigarette-smoking rates were 81% for women and 75% for men (mean, 28 pack-years). All 13 patients who had thyroid-stimulating Ig measurement had high titers. Long-term follow-up (median, 12.5 yr) revealed that acropachy was not a complaint in follow-up visits or questionnaires. The data suggest that thyroid acropachy is an indicator of severity of ophthalmopathy and dermopathy. It is a source of clinical concern only if dermopathy is persistent and severe.

scholarly journals Pretibial myxedema: pathogenetic features and clinical aspects

2019 ◽  
Vol 65 (2) ◽  
pp. 134-138
Author(s):  
Ekaterina A. Sabanova ◽  
Valentin V. Fadeyev ◽  
Nikolai N. Potekaev ◽  
Andrey N. Lvov
Keyword(s):  
Lymphatic Drainage ◽  
Scientific Data ◽  
Clinical Aspects ◽  
Skin Changes ◽  
Anterior Tibial ◽  
Diagnostic Biopsy ◽  
Pretibial Myxedema ◽  
Preventive Examination ◽  
Thyroid Dermopathy

Pretibial myxedema (PTM) or thyroid dermopathy is a rare extrathyroidal manifestation of Graves disease. The condition is accompanied by mucinous skin changes, mainly in the anterior tibial surface. Severe forms may lead to lymphatic congestion and disability. Prolonged and intense autoimmune aggression is supposed to be necessary for PTM manifestation. However, data on the role of TSHR antibodies in the development of thyroid dermopathy are very ambiguous; evidence of IGF-1 receptor involvement in the pathogenesis was reported recently. Typically, PTM is localized on the anterior and lateral surfaces of both tibias and can be represented by diffuse, tumorous, plaque-like, or elephantiasic forms. Currently, early diagnostics involves regular preventive examination of the pretibial area. A diagnostic biopsy is indicated only in complex cases. Maintaining euthyroidism, smoking cessation, preventing injuries, and avoiding tight shoes that disturb lymphatic drainage are measures reducing the risk of PTM in GD patients. Currently, there are no accepted clinical guidelines for the diagnosis and treatment of thyroid dermopathy. This review provides the recent scientific data on etiopathogenesis and management of patients with PTM.

The Contemporary Role of Resection and Ablation in Colorectal Cancer Liver Metastases

2020 ◽  
Vol 04 (03) ◽  
pp. 291-302
Author(s):  
Mariam F. Eskander ◽  
Christopher T. Aquina ◽  
Aslam Ejaz ◽  
Timothy M. Pawlik
Keyword(s):  
Colorectal Cancer ◽  
Portal Vein ◽  
Surgical Oncology ◽  
Portal Vein Ligation ◽  
Safe Alternative ◽  
Colorectal Cancer Liver Metastases ◽  
Liver Remnant ◽  
New Era ◽  
Ablation Therapy

AbstractAdvances in the field of surgical oncology have turned metastatic colorectal cancer of the liver from a lethal disease to a chronic disease and have ushered in a new era of multimodal therapy for this challenging illness. A better understanding of tumor behavior and more effective systemic therapy have led to the increased use of neoadjuvant therapy. Surgical resection remains the gold standard for treatment but without the size, distribution, and margin restrictions of the past. Lesions are considered resectable if they can safely be removed with tumor-free margins and a sufficient liver remnant. Minimally invasive liver resections are a safe alternative to open surgery and may offer some advantages. Techniques such as portal vein embolization, association of liver partition with portal vein ligation for staged hepatectomy, and radioembolization can be used to grow the liver remnant and allow for resection. If resection is not possible, nonresectional ablation therapy, including radiofrequency and microwave ablation, can be performed alone or in conjunction with resection. This article presents the most up-to-date literature on resection and ablation, with a discussion of current controversies and future directions.

Graves' autoantibodies to extrathyroidal TSH receptor: Their role in ophthalmopathy and pretibial myxedema

1987 ◽  
Vol 116 (1_Suppl) ◽  
pp. S344-S347 ◽  
Author(s):  
C. M. Rotella ◽  
F. Alvarez ◽  
L. D. Kohn ◽  
R. Toccafondi
Keyword(s):  
Tsh Receptor ◽  
Pretibial Myxedema
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