Cases reported "Thyroid Neoplasms"

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1/7. Computerized tomography of the glottis after intracordal autologous fat injection.

    According to the committee on speech, voice, and swallowing disorders of the American Academy of otolaryngology-head and Neck Surgery, various surgical methods such as laryngeal framework surgery, laryngeal re-innervation, and injection laryngoplasty might be used to palliate inferior laryngeal nerve paralysis. In the present case report we document the survival and exact location of the boluses of autologous fat in one patient in whom this material was used for injection laryngoplasty.
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2/7. Virilizing adrenocortical adenoma with Cushing's syndrome, thyroid papillary carcinoma and hypergastrinemia in a middle-aged woman.

    We report a rare case of virilizing adrenocortical adenoma complicated with Cushing's syndrome, thyroid papillary carcinoma and hypergastrinemia. A 45-year-old woman had a history of amenorrhea for 10 years, hypertension for 8 years, and diabetes mellitus for 3 years. physical examination showed a masculinized woman with severe hirsutism, male-like baldness, deep voice, acne in the precordia, and clitorism. plasma testosterone, DHEA-S and urinary 17-KS were high, and plasma cortisol level was it at the upper limit of the normal range, but it did not show a diurnal rhythm nor was suppressed by 2 and 8 mg of dexamethasone. Abdominal CT scan showed a left adrenal tumor (4.5 cm in size). Adrenal scintigram revealed uptake of the tracer on the left side, and plasma cortisol concentration was high in a blood sample from the left adrenal vein. Left adrenalectomy was performed. Histopathological features of resected adrenal tumor were consistent with those of adrenocortical adenoma, consisting of tumor cells with eosinophilic compact cytoplasm. Immunohistochemical staining for steroidogenic enzymes showed reactivity for P450sec, 3 beta-HSD, P450c17, P450c21 and P450c11. plasma testosterone and cortisol levels decreased to the normal range postoperatively. The patient was also found to have a papillary thyroid carcinoma and hypergastrinemia. Our patient is a rare case of virilizing adrenocortical adenoma associated with Cushing's syndrome, thyroid papillary carcinoma, and hypergastrinemia.
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3/7. Solitary fibrous tumor of the thyroid gland.

    A solitary fibrous tumor is a mesenchymal neoplasm originally described in the pleura. Subsequently, it was found to exist in many extra-pleural sites including the thyroid gland. Herein, we report a case of solitary fibrous tumor of the thyroid gland associated with symptoms of hoarseness of voice in a 45-year-old man. In this report we discuss and illustrate various aspects of this rare tumor including, the gross macroscopic appearance, the histological findings, the immunohistochemical staining properties, the differential diagnosis, and the outcome of our experience regarding fine needle aspiration technique in this particular tumor.
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4/7. Laryngeal abscess after injection laryngoplasty with micronized AlloDerm.

    OBJECTIVE: patients with unilateral vocal cord paralysis usually present with dysphonia and occasionally with swallowing problems. Operative management includes thyroplasty type I, injection laryngoplasty, arytenoid adduction, and reinnervation. Recent publications have documented the safety of micronized AlloDerm (Cymetra, LifeCell Corporation, Branchburg, NJ) for injection laryngoplasty, but we report the first documented case of a laryngeal abscess after injection laryngoplasty with Cymetra. STUDY DESIGN: Single case report of a laryngeal abscess after injection laryngoplasty with Cymetra. methods: The patient's clinical course is presented and discussed, and the pertinent literature is reviewed. RESULTS: Prompt hospital admission with intravenous antibiotics and steroids resolved this airway emergency. Follow-up visits showed a significantly improved postoperative voice with an intact airway. CONCLUSION: A review of the literature reveals that this case of a laryngeal abscess after injection laryngoplasty with Cymetra is the first of its kind. Studies have shown that the use of AlloDerm in the head and neck region is safe, but otolaryngologists need to be cognizant of potential complications when working with this material.
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5/7. A patient with primary squamous cell carcinoma of the thyroid intermingled with follicular thyroid carcinoma that remains alive more than 8 years after diagnosis.

    Primary squamous cell carcinoma of the thyroid is an extremely rare tumor with a highly aggressive clinical course. We report here on a patient with primary squamous cell carcinoma of the thyroid who remains alive more than 8 years after diagnosis. A 56-year-old man presented with a hoarse voice and a rapidly progressing mass on the right side of the thyroid gland. The patient underwent a total thyroidectomy without neck lymph node dissection. Histopathologic findings revealed primary squamous cell carcinoma combined with follicular carcinoma of the thyroid. The tumors metastasized to the cervical lymph nodes, thoracic spine and lung. He underwent 5000 rads of adjuvant radiotherapy to the neck. TSH suppressive therapy with L-thyroxine was administered alone rather than radioactive iodine therapy or chemotherapy. The patient's clinical course has been remarkable over the first 7 years; he has remained stable except for a transient paraplegia due to nerve compression. The patient underwent colectomy for the diagnosis of a colon cancer. Recent evaluation has revealed a new lesion in the lung; this was diagnosed as metastatic follicular carcinoma originating from the thyroid. High dose radioactive iodine therapy was administered, and he remains alive in stable condition.
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6/7. Invasive thymoma (a case report).

    A 10-year old Nigerian boy was admitted to hospital with a history of swelling in the neck, change of voice, dysphagia and dyspnoea of 2 weeks duration. He died on the 2nd day of admission. autopsy revealed a thymoma infiltrating the thyroid, trachea and neck muscles and transforming the tracheal lumen into a slit like space. The condition is considered worthy of record on account of its rarity and of the short clinical course terminating in death. The authors feel that the most important factor in determining the prognosis of thymoma is the presence or absence of gross invasion.
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7/7. The role of total laryngectomy in the management of intraluminal upper airway invasion by well-differentiated thyroid carcinoma.

    Intraluminal invasion of the upper airway by well differentiated thyroid carcinoma is very uncommon, and the management can be problematic. Many conservative, reconstructive-type surgical procedures have been advocated to maintain normal laryngeal function. Although voice preservation is desirable, it may not always be in the patient's best interest and radical surgery, including total laryngectomy, may be necessary. We describe three cases in which total laryngectomy was performed, and review the indicators for this procedure in the treatment of this difficult to manage condition.
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