1/15. leiomyosarcoma of the thyroid gland with rapid growth and tracheal obstruction: A partial thyroidectomy and tracheostomy using an ultrasonically activated scalpel can be safely performed with less bleeding.Primary leiomyosarcoma of the thyroid gland is rare, and to the best of our knowledge only nine well-documented cases have been previously reported in the world literature. We herein report a 90-year-old female patient with primary leiomyosarcoma of the thyroid gland who showed a rapid tumor growth and tracheal obstruction. The patient was successfully treated by a partial resection of the thyroid gland using an ultrasonically activated scalpel and emergency tracheostomy. Immunohistochemically, the tumor cells showed positive reactivity to smooth muscle actin and negative reactivity to thyroglobin. Palliative surgery successfully allowed the patient to recover from the symptoms of dyspnea related to this rare disease. The use of an ultrasonically activated scalpel and tracheostomy thus allowed us to safely perform a thyroidectomy with substantially less bleeding than normal.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
2/15. False positive 131I whole body scans in thyroid cancer.Well differentiated thyroid cancer is a rare disease in the UK. It is the only cancer which, having metastasized, remains curable by radioisotope therapy with 131I. The main indication for administering repeat doses of 131I is the appearance of abnormal uptake in a whole body scan following diagnostic or therapeutic 131I administration. False positive scans, showing the presence of 131I uptake in the absence of residual thyroid tissue or metastases can occur, although they are uncommon. Unless recognized as a false positive, 131I uptake may result in diagnostic error and lead to administration of an unnecessary therapy dose. We describe a series of nine patients in whom the scans showed false positive uptake of 131I, including cases where the cause of the uptake is still uncertain. We demonstrate the common sites of false positive uptake, discuss the underlying mechanisms and suggest a systematic approach to the interpretation of whole body scans in order to prevent unnecessary treatment with 131I.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
3/15. Malignant struma ovarii: report of a case and review of the literature.Malignant struma ovarii is a very rare disease and therefore there is neither common agreement on treatment regimens nor sufficient follow-up experience. The case of a 38-year-old woman with malignant struma ovarii is described. The patient presented with a clinically silent ovarian neoplasm discovered incidentally during investigations for metrorrhagia. The ovarian mass was resected and the tumor was found to be a teratoma. Within the teratoma a papillary thyroid carcinoma of the follicular variant was found. Subsequently, in order to make follow-up of the patient possible by thyroglobulin measurement and radioiodine whole body scintigraphy, near-total thyroidectomy was performed and the thyroid was found to be normal on histology. Whole body radioiodine scintigraphy with (131)I and ablation of the thyroid remnant by the administration of 80 mCi (131)I was performed. The patient recovered uneventfully and is now well.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
4/15. Malignant struma ovarii: a case report of laparoscopic management.BACKGROUND: struma ovarii is a rare disease. Malignant transformation is even rarer. Data about its management are lacking. We describe the first reported case of a malignant struma ovarii treated and staged by laparoscopy. CASE: A 49-year-old patient was operated by laparoscopy for a right ovarian teratoma. The patient did not show symptoms of hyperthyroidism. The ovarian teratoma was removed in a plastic bag and definitive histology showed foci of papillary adenocarcinoma in a struma ovarii. The patient was then staged by laparoscopic surgery undergoing left adnexectomy, multiple peritoneal and omental biopsies, and common iliac and paracaval lymph node sampling. hysterectomy was not performed. The postoperative course was uneventful and the patient was released on the second day. thyroglobulin level was monitored and the patient is free of disease after more than 1 year. CONCLUSION: The preoperative diagnosis of malignant struma ovarii is difficult. Even with cautious evaluation of the patient, some risk of wrong diagnosis is possible. This is why a meticulous technique of laparoscopic surgery in removing the ovary is important. Laparoscopic staging may also intervene in very limited cases; the expertise to perform open staging of the patient is necessary but the postoperative course is fast.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
5/15. Nodular poorly differentiated lymphocytic lymphoma of the thyroid.A 44-year-old woman had a four-month history of enlargement of her thyroid. Evaluation revealed a rare disease: nodular, poorly differentiated lymphocytic lymphoma of the thyroid (NPDL), stage IE. A review of the literature revealed that most thyroid lymphomas are diffuse histiocytic (DH). Treatment of thyroid lymphocytic lymphoma and survival rates have been quite variable between institutions. There are no large studies to guide the physician in making a management plan to treat thyroid NPDL. Our patient was treated with a combination of chemotherapy and radiation therapy (XRT).- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
6/15. struma ovarii with a focus of papillary thyroid cancer: a case report and review of the literature.BACKGROUND: Malignant struma ovarii is a rare ovarian neoplasm that is usually asymptomatic and infrequently diagnosed preoperatively. A few case studies have described associated thyrotoxicosis. CASE: A 46-year-old female presented for her annual gynecologic exam during which a pelvic mass was appreciated on physical examination. Patient was asymptomatic at presentation. A follow-up ultrasound confirmed the presence of a 16-cm mass in the right adnexa. Patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathology revealed a mature cystic teratoma with features of struma ovarii, containing a single 5-mm focus of papillary cancer within the thyroid tissue. Patient subsequently had a thyroid scan that was normal with normal thyroid function. There was no evidence of metastasis. CONCLUSION: Malignant struma ovarii is a very rare disease and there are various approaches to treatment based on staging. In our review, we found a higher rate of metastasis than previously reported. recurrence was seen after an average period of 4 years. We recommend follow-up with surveillance thyroglobulin levels in cases of malignant struma ovarii for at least 10 years.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
7/15. Primary thyroid lymphoma: report of two cases.Primary thyroid lymphoma is a rare disease. Most of the patients have a history of Hashimoto's thyroiditis. Main histopathologic subtypes are either mucosa-associated lymphoid tissue (MALT) or diffuse large cell lymphomas. Treatment options are surgical resection in localised, low-grade MALT lymphomas or systemic chemotherapy in aggressive, diffuse large cell lymphomas. But, sometimes other histopathologic subtypes can be seen and therapeutic approaches must be done. We report two patients who have primary thyroid lymphoma. There was no history of Hashimoto's thyroiditis in either case, and neither of them had MALT histologic subtype. First patient a sixty four year old woman, admitted to hospital because of bilateral thyroid nodules. Histological subtype was B cell follicular lymphoma. Subtotal thyroidectomy was performed and radiotherapy was administered to the entire neck region. Second patient, a 50 year old man, presented with complaints of a left thyroid mass and dyspnoea. Total thyroidectomy was carried out and chemotherapy was given. Histological diagnosis was diffuse large B cell lymphoma. Thyroid lymphomas had heterogenous histological and clinical characteristics. In localised, non-aggressive subtypes, surgical treatment must be considered. Postoperative chemotherapy or radiotherapy may be necessary in some patients.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
8/15. A partial response in anaplastic carcinoma of the thyroid with liposomal doxorubicin.Anaplastic thyroid carcinoma is a rare disease with a poor prognosis. Surgery represents the curative treatment for limiting the disease. In the presence of locoregional disease, not suitable for surgery, and for metastastic disease, chemotherapy represents the treatment option. Single agents chemotherapy can produce some responses; doxorubicin is an active drug with a rate of partial response lower than 20%. association with cisplatin seems to be more active producing a higher rate of complete responses. Liposomal doxorubicin is a new class of anthracyclines, derived from a structural modification of doxorubicin, representing a new form of an old drug with pharmacological characteristics that facilitate a more easy elusion from immune system, a longer half-life, an increased tumor cell uptake and a reduced toxicity if compared with parental drug. Herein we report the first case of an anaplastic thyroid carcinoma treated with the use of liposomal doxorubicin. The encouraging response observed with single agent liposomal doxorubicin (70% according to RECIST criteria) deserves further investigations.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
9/15. An unusual presentation of primary lymphoma of the thyroid in a young male patient.Primary lymphoma of the thyroid gland is a rare disease that is strongly associated with chronic lymphocytic thyroiditis. We report an unusual case of 20-year-old male who presented with thyroid swelling and was diagnosed on cytology as lymphocytic thyroidtis. However, histopathologicalfindings revealed non-Hodgkin's lymphoma that was further classified as B-cell type on immunohistochemical stains. In cytology, lymphomas must be considered as a differential diagnosis in case of Hashimoto's/lymphocytic thyroiditis, subacute thyroiditis and small cell carcinoma.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
10/15. Sonographic detection of intrathyroidal branchial cleft cyst: a case report.We report here on an extremely rare case of an intrathyroidal branchial cleft cyst. Intrathyroidal branchial cleft cyst is rare disease entity and it has nonspecific findings on sonography, so the diagnosis of the lesion is very difficult. However, during aspiration, if pus-like materials are aspirated from a thyroid cyst, we should consider the possibility of intrathyroidal branchial cleft cyst in the differential diagnosis.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
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