11/741. radiation myelopathy with partial functional recovery: PET evidence of long-term increased metabolic activity of the spinal cord.Postoperative telecobalt irradiation was performed with a biologically effective extrapolated response dose of 165 Gy2 delivered to the spinal cord of a papillary thyroid cancer patient. Incomplete cervical transection developed, followed by a gradual functional improvement, which is still continuing 8 years after radiotherapy. Between the 6th and 8th years of the clinical course, positron emission tomography investigations demonstrated an increased 18F-deoxyglucose accumulation and (15)O-butanol perfusion, but negligible 11C-methionine uptake in the irradiated spinal cord segment. We suggest that the increased metabolism and perfusion, and the lack of detectable protein synthesis may be related to the increased energy demands of action potential conduction, due to the higher than normal density of sodium channels along demyelinated axons displaying restored conduction.- - - - - - - - - - ranking = 1keywords = thyroid (Clic here for more details about this article) |
12/741. Cribriform-morular variant of papillary carcinoma: a distinctive variant representing the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma?We describe herein four cases of an unusual sporadic thyroid tumor that shares the morphologic features of a distinctive follicular cell neoplasm previously proposed as a feasible indicator of familial adenomatous polyposis. We also review five other similar cases reported in the literature. All of the nine patients were young women, aged 16 to 30 years. Grossly, the neoplasms measured 1.5 to 5.6 cm; they were solid and solitary, except one case, which showed two tumor nodules, one in each lobe. Histologically, the lesions were encapsulated, and they exhibited an intricate blending of cribriform, follicular, papillary, trabecular, and solid patterns of growth, with morular (squamoid) areas. Cribriform structures were prominent, being formed by anastomosing bars and arches of cells in the absence of intervening fibrovascular stroma. Follicular areas were usually devoid of colloid, and the papillae were lined by columnar cells. There were focal areas of trabecular arrangement reminiscent of hyalinizing trabecular adenoma. The tumor cells were cuboidal or tall, with frequent nuclear pseudostratification and abundant eosinophilic-to-oxyphilic cytoplasm. The nuclei were usually hyperchromatic, but nuclear grooves, pale or clear nuclei, and intranuclear cytoplasmic inclusions were variably present. Morules with peculiar nuclear clearing caused by biotin accumulation were scattered in the tumors. Vascular and/or capsular invasion were noted in all of the cases except one, and lymph node metastasis was found in two cases. Immunohistochemical stains showed reactivity for thyroglobulin, epithelial membrane antigen, cytokeratins (including 34betaE12), vimentin, estrogen and progesterone receptors, bcl-2, and Rb proteins. Follow-up in seven cases showed that all of the patients were alive with no evidence of disease at 1 to 13 years after diagnosis. Thus, the behavior of this variant seems to be similar to that of conventional papillary carcinoma Because of the distinctive histologic features, we propose naming this tumor the cribriform-morular variant of papillary carcinoma.- - - - - - - - - - ranking = 5.0030769366299keywords = thyroid, nodule (Clic here for more details about this article) |
13/741. carcinoma of the thyroid gland, adenoma of the adrenal cortex and peptic ulcer: an unreported association.A 39-year-old man, operated on for duodenal ulcer, was found to have a papillary carcinoma of the thyroid, an aldosterone-producing adenoma of the adrenal cortex, and a recurrence of a peptic ulcer. The probable coincidental occurrence of these diseases in this patient is suggested. Nevertheless, careful investigation of the other endocrine glands in patients with endocrine tumors is recommended.- - - - - - - - - - ranking = 5keywords = thyroid (Clic here for more details about this article) |
14/741. Hemorrhagic cerebellar metastasis from papillary thyroid carcinoma.Papillary thyroid carcinoma has a low incidence of distant metastases. brain metastasis is extremely rare with a frequency of 0.1-1.3%. In the present series, the rate was 1.5%, only two cases had cerebral metastases in 136 patients with papillary thyroid carcinoma from January 1988 to April 1998. Cerebellar metastasis is even rarer, and solitary cerebellar metastasis has not been reported to the best of our knowledge. Two cases of papillary thyroid carcinoma with cerebellar metastases presenting as tumor hemorrhage are reported. In one patient, the lesion was in the bilateral cerebellar hemispheres with obstructive hydrocephalus. After operation, the patient had an uneventful course with recovery of her consciousness. In the other, the solitary lesion was in the left cerebellar hemisphere without obstructive hydrocephalus. After surgical treatment, the patient had a smooth course with resolution of his neurological deficit. It shows the importance of surgery in the management of a hemorrhagic cerebellar metastasis from papillary thyroid carcinoma, not only in reducing acute aggravating cerebral symptoms, but also in prolonging survival time.- - - - - - - - - - ranking = 8keywords = thyroid (Clic here for more details about this article) |
15/741. Cytologic diagnosis of a solitary brain metastasis from papillary carcinoma of the thyroid. A case report.BACKGROUND: Papillary carcinoma of the thyroid metastasizes to the brain in rare instances. In published series and case reports of metastatic papillary thyroid carcinoma, diagnosis of central nervous system (CNS) metastases has been determined by histologic methods. We present a case of papillary carcinoma metastatic to brain diagnosed by cytologic methods. CASE: A 43-year-old female, initially diagnosed at age 12 with papillary carcinoma of the thyroid metastatic to regional lymph nodes and lung, presented with head aches of increasing frequency and severity. A computed tomography scan confirmed a 1-cm nodule in the right inferior frontal lobe of the brain. For clinical reasons, the patient was followed with serial imaging for five years. At age 48 there was significant progression of the CNS disease, and the patient underwent stereotactic biopsy with drainage of cyst fluid. Cytologic examination of the cyst fluid and immunocytochemical studies confirmed the typical features of papillary thyroid carcinoma, including papillary clusters of cells with finely granular chromatin, micronucleoli, nuclear grooves and an associated psammoma body. CONCLUSION: Neurocytology is a useful technique in the examination of cystic lesions of the brain and may be the sole technique for determination of diagnosis.- - - - - - - - - - ranking = 8.0030769366299keywords = thyroid, nodule (Clic here for more details about this article) |
16/741. Tall cell variant of papillary carcinoma coexisting with chronic lymphocytic thyroiditis. A case report.BACKGROUND: Recent studies have shown a correlation between lymphocytic thyroiditis and papillary carcinoma of the thyroid. It is thought that autoimmune thyroiditis could be a risk factor for the development of thyroid carcinoma, mainly for the papillary variant. CASE: A 59-year-old female presented with a history of enlargement in the neck and five months of dysphagia. Clinical examination showed generalized expansion and an increase in the hardness of the thyroid gland. Hormonal outline showed subclinical hypothyroidism with serum levels of TSH slightly elevated (5 micrograms/dL; range, 0.25-4). thyroglobulin antibodies and thyroperoxidase titers were moderately positive. Given these results, a diagnosis of chronic thyroiditis was made. Thyroid ultrasound scan showed diffuse gland irregularity and the presence of a solitary nodule (2.3 cm in diameter) localized in the right lobe. Fine needle aspiration biopsy (FNAB) of the nodule was performed under ultrasound guidance. CONCLUSION: Although clinical and laboratory results supported the diagnosis of autoimmune thyroiditis only, FNAB of the nodular lesion provided evidence of a rare case of papillary carcinoma, tall cell variant, confirmed by histologic results.- - - - - - - - - - ranking = 12.00615387326keywords = thyroid, nodule (Clic here for more details about this article) |
17/741. Metastatic thyroid carcinoma of the mandibule.A case of metastatic papillary carcinoma to the mandible is presented. Though relatively rare, metastatic tumours of the mandible should be included in the differential diagnosis of the tumours in the parotid region. For the primary site; being in the cervicofacial region, the thyroid gland must be considered by the head and neck surgeon.- - - - - - - - - - ranking = 5keywords = thyroid (Clic here for more details about this article) |
18/741. Cytological and immunocytochemical evaluation of thyroid and breast masses in patients with a previous neoplasm: case reports.The diagnosis of secondary tumours represents one of the most important fields in the application of fine needle aspiration cytology (FNAC). We studied two patients, one with a history of breast cancer and one with a previous tumour of the thyroid, who showed a second mass, in the thyroid and in the breast, respectively, during follow up. The aim of our study was to evaluate if cytology, performed on FNAC smears, may distinguish a metastatic lesion from a second primary tumour, or if further immunocytochemistry should be performed. Our data demonstrate that, while cytology may be indicative of a second primary tumour, the histotype should be confirmed by immunocytochemical staining.- - - - - - - - - - ranking = 6keywords = thyroid (Clic here for more details about this article) |
19/741. Tall cell variant of papillary carcinoma arising from ectopic thyroid tissue in the trachea.Ectopic thyroid tissue within the submucosa of the trachea is a rare cause of upper airway obstruction. Primary neoplasms arising from such thyroid nests are rare. This report describes a case of tall cell variant of papillary carcinoma arising from ectopic thyroid tissue in the trachea.- - - - - - - - - - ranking = 7keywords = thyroid (Clic here for more details about this article) |
20/741. hyperthyroidism due to papillary carcinoma of the thyroid--a case report.A rare case of papillary carcinoma of the thyroid producing hyperthyroidism is presented. A young patients presented seven years after a thyroid operation with metastatic disease in the cervical lymph nodes and a history of deteriorating vision in the left eye. He also had a lesion in the base of the skull which could not be established to be metastasis from the thyroid cancer. There was clinical and biochemical evidence of hyperthyroidism. Radionuclide scan revealed uptake in the residual thyroid tissue and patchy uptake by the cervical lymph nodes. The patient underwent a complete thyroidectomy and radical neck dissection of the left side and 'berry-picking' of the lymph nodes on the right side. Although the patient became euthyroid post-operatively, his general condition deteriorated and he rapidly lost vision in both eyes before any ablative therapy could be instituted for the tumour in the base of the skull. The patient was lost to follow-up.- - - - - - - - - - ranking = 16keywords = thyroid (Clic here for more details about this article) |
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