1/8. sarcoma of the thyroid region mimicking Riedel's thyroiditis.Because sarcomas of the anterior lower neck region occur so infrequently, they are not usually considered in the differential diagnosis of Riedel's thyroiditis. Riedel's thyroiditis itself may be confused on clinical grounds alone with malignant neoplasms because of its invasive features. Sarcomatoid carcinoma is the main entity to be discarded in this regard. This is accomplished through histological examination by the finding of carcinomatous areas and/or reactivity with epithelial markers. These features also set apart sarcomatoid carcinoma from true sarcomas. This report concerns a patient with a sarcoma of the anterior lower neck region which was initially suspected to be Riedel's thyroiditis or sarcomatoid carcinoma on clinical and radiological grounds. A peroperative biopsy was interpreted by two independent pathologists as consistent with Riedel's thyroiditis. The subsequent clinical course and postmortem examination demonstrated a high grade sarcoma with metastasis to both lungs and the pleura, and invasion of adjacent neck structures. Nevertheless, some areas of the postmortem material showed a microscopic pattern similar to mediastinal fibrosis, raising the possibility of the malignant transformation of a fibrosclerotic lesion.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/8. MR findings with dynamic evaluation in Riedel's thyroiditis.We reported the findings on MRI in a patient with proven Riedel's thyroiditis. The lesion was seen as slightly heterogeneous hypointensity on both T1- and T2-weighted images and had a mild enhancement after administration of gadpentate dimeglumine (Gd-DTPA). Dynamic MR study showed gradual increase in signal intensity of the lesion. These findings were different from those of thyroid neoplasms and were considered to reflect the mixture of inflammatory cells infiltration and fibrosis of Riedel's thyroiditis.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/8. Massive thyroid tumoral embolism from a breast carcinoma presenting as acute thyroiditis.We describe an unusual case of metastatic disease to the thyroid, characterized by massive intra-arterial embolization and clinical presentation as acute thyroiditis. The patient, a 37-year-old woman with a history of breast carcinoma, presented clinically with acute thyroiditis. No nodules were palpable, and fine-needle aspiration cytology of the left lobe was performed. It showed a pleomorphic carcinoma and was followed by total thyroidectomy. histology disclosed a pleomorphic carcinoma diffusely affecting the thyroid gland. It was characterized by an extensive intra-arterial tumoral embolization. immunohistochemistry confirmed the metastatic nature of the neoplasm. This is a very uncommon form of metastatic disease to the thyroid. The ischemia and necrosis associated with the embolic process were most probably responsible for this clinical presentation. This atypical clinical and cytologic presentation may induce confusion with a primary neoplasm, mainly anaplastic thyroid carcinoma.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
4/8. High-dose radiation and the emergence of thyroid nodular disease.High-dose radiation (in excess of 2500 rads or centiGray) to the head and neck area is reputedly infrequently associated with the emergence of thyroid nodular disease. Thirty-three patients who underwent high-dose radiation and who developed thyroid nodular disease have been described. radiation was originally administered for hyperthyroidism in 11 patients, postmastectomy in five, oral cancer in three, Hodgkin's disease in three, facial hirsutism in three, hemangioma in three, cancer of the larynx in one, skin cancer in one, desmoid tumor of the neck in one, Ewing's tumor in one, and pituitary tumor in one. Treatment included radioiodine in 11, external radiation in 21, interstitial radiation in one, and combined radiation in one. Associated head and neck neoplasms included four parathyroid tumors, one osteogenic sarcoma of the maxilla, two basal cell cancers of the facial skin, and one parotid gland carcinoma. The study group consisted of five men and 26 women varying in age from 22 to 75 years, with a duration of latency of effect varying from 1.5 to 50 years. Thyroid disease consisted of 21 cancers, six adenomas, four colloid goiters, and two cases of thyroiditis resulting in four deaths caused by cancer, for a 20% mortality rate. Consideration of radiation beam behavior showed that isodose curve, penumbra effect, back scatter, and special field resulted in the thyroid gland receiving a low dose, namely under 2500 rads. Clinical factors such as an overlooked goiter, coincidental carcinoma, error in presumption of dose, and second primary malignancy were also considerations. True biologic radiation oncogenesis may have been seen in our radioiodine-treated group with hyperthyroidism as well as the group with Hodgkin's disease who underwent mantle irradiation. It is apparent that for whatever reason and by whatever means and by whatever mechanism, high-dose radiation to the head and neck area can result in significant thyroid disease, and patients undergoing such radiation should be followed with this in mind and considered for thyroid feeding on a prophylactic basis.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
5/8. Latent childhood thyroid carcinoma in diffuse lymphocytic thyroiditis.Diffuse thyroid enlargement in a child is a rare presenting symptom of thyroid carcinoma. A papillary carcinoma may be hidden in a diffuse lymphocytic thyroiditis and should be carefully searched for during surgery. Furthermore, the finding, in frozen sections, of psammoma bodies in a lymphocytic thyroiditis should raise the suspicion of an occult malignant neoplasm. A case illustrating these diagnostic difficulties in a 5-year-old child is presented.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
6/8. Thyroid-gland plasma cell neoplasm (plasmacytoma).A 61-year-old man with a primary thyroid plasmacytoma was studied. Intracytoplasmic monoclonal immunoglobulin (IgG-kappa) was demonstrated in tissue sections, using the immunoperoxidase technique. After histologic diagnosis of plasmacytoma, serum immunoelectrophoresis revealed a monoclonal component (IgG-kappa). Roentgenographic skeletal survey and bone marrow examination gave normal results. The patient received postoperative therapy with radiation and drugs. As of this writing, he is alive 20 months after diagnosis, without evidence of tumor.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
7/8. sarcoidosis with thyroid involvement, polymyalgia rheumatica and breast carcinoma. A case report.polymyalgia rheumatica developed in a 71-year-old patient within 2 years of the onset of acute sarcoidosis with biopsy-verified involvement of the thyroid, and concomitant autoimmune thyroiditis with hyperthyroid symptoms. Three years after the onset of muscle symptoms a non-metastasizing breast carcinoma was discovered and treated surgically. Neither the long interval between the onset of polymyalgia rheumatica and the discovery of the breast tumour, nor the good response of muscle symptoms to a one-year maintenance treatment with corticosteroids, was consistent with a paraneoplastic mechanism of the polymyalgia rheumatica syndrome. It was therefore hypothesized that the various disorders suffered by this patient might be related to a partly age-dependent depression of T-lymphocyte function, leading to an altered immunological reactivity to which the various clinical manifestations could be attributed. Such a hypothesis is supported by recent reports showing that in old people and in ageing experimental animals, a decrease in T-lymphocyte function and in the number of circulating T-cells occurs concomitantly with an increase in the incidence of a variety of neoplasms and autoimmune disorders.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
8/8. Actinomycotic thyroiditis in a child.The authors present a unique case of actinomycosis occurring in a 10-year-old girl who presented with a painless, noninflammatory left neck mass of 3 weeks duration. physical examination findings showed a firm, nontender mass within the left thyroid lobe, and a presumptive diagnosis of thyroid neoplasm was made. Inflammatory changes subsequently occurred and surgical drainage was performed revealing sulphur granules. Histological examination confirmed actinomycosis of the thyroid gland.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |