1/29. thyroid gland hematoma after blunt cervical trauma.Thyroid hematoma is a rare cause of airway obstruction in victims of blunt trauma. The case of a 34-year-old woman who developed orthopnea after a low-energy motor vehicle accident is described. Presenting greater than 24 hours after her accident, the patient noted dysphagia, tracheal deviation, and postural dyspnea. The diagnosis of thyroid gland hematoma was made with a combination of fiberoptic laryngoscopy, cervical computed tomography, and great vessel and carotid angiography. Invasive airway management was not required. The patient underwent a total thyroidectomy and recovered without complications.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/29. A minor salivary gland tumour presenting with dysphagia.A case is reviewed of a giant benign myoepithelioma of the soft palate presenting in an elderly female patient. Due to the large size of the lesion and its mass effect the patient developed dysphagia with subsequent significant weight loss. The clinico-pathological features of this rare tumour are described and the literature reviewed.- - - - - - - - - - ranking = 0.8keywords = gland (Clic here for more details about this article) |
3/29. Unusually aggressive rectal carcinoid metastasizing to larynx, pancreas, adrenal glands, and brain.Rectal carcinoids are slow-growing tumors. They metastasize when their size is more than 2 cm. Common sites of metastasis are the liver, lungs, and bones. Metastases to thyroid, pancreas, kidneys, adrenal glands, pituitary glands, posterior fossa, and spleen are very rare. We present the case of a 79-year-old white man with dysphagia and left vocal cord paralysis from a rapidly growing mass in his neck. Needle biopsy suggested thyroid anaplastic carcinoma, and the patient underwent total laryngectomy, total thyroidectomy, and left radical neck dissection. pathology showed undifferentiated carcinoid of the larynx. biopsy of a rectal mass suggested poorly differentiated carcinoma. Postoperatively the patient developed cardiac arrhythmias and died after 5 weeks. autopsy showed a 5-cm carcinoid of the rectum with extensive vascular invasion extending into the perirectal fat. There was metastatic disease to both lungs, liver, pancreas, both adrenal glands, peritoneum, subcutaneous tissues of thorax and abdomen, ribs, vertebrae, skull, and the leptomeninges of the cerebrum. Rectal carcinoids may present a variable histologic picture. Poorly differentiated tumors can present with widespread metastases and have poor prognosis. Extensive surgery may not improve the survival of patients with this pattern of unusually aggressive carcinoid.- - - - - - - - - - ranking = 1.4keywords = gland (Clic here for more details about this article) |
4/29. Ectopic lingual thyroid as unusual cause of severe dysphagia.Ectopic lingual thyroid is an uncommon embryological aberration characterized by the presence of thyroid tissue located in a site different from the pretracheal region as in the normal. lingual thyroid is the most frequent ectopic location of the thyroid gland, although its clinical incidence varies between 1:3000 and 1:10,000. We present the case of a 26-year-old woman who presented severe dysphagia caused by a mass located on the base of the tongue in the midline. An endoscopic partial removal of the ectopic tissue allowed her to rapidly regain her swallowing capacity. The literature regarding the incidence and diagnosis of lingual thyroid is reviewed and the possibilities of treatment discussed.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
5/29. Esophageal intramural pseudodiverticulosis: review of symptoms including upper gastrointestinal bleeding.BACKGROUND: Esophageal intramural pseudodiverticulosis (EIP) is a rare condition manifested by multiple, flask-shaped outpouchings in the wall of the esophagus, which represent dilated excretory ducts of esophageal mucous glands. STUDY: Five patients with EIP were evaluated with regard to symptoms and concomitant diseases, as well as endoscopic, radiologic, and manometric findings. RESULTS: Primary clinical symptoms reported by the five patients (three men and two women; age range, 59-72 years) were increasing dysphagia ( n = 3), upper gastrointestinal bleeding ( n = 1), and no symptoms ( n = 1). Concomitant diseases were chronic alcoholism ( n = 3), diabetes mellitus ( n = 1), and reflux esophagitis ( n = 1). Primary diagnosis was made endoscopically in all cases. Endoscopic findings other than pseudodiverticula were esophageal webs ( n = 2) and proximal esophageal stenoses ( n = 4). The typical radiologic findings were detectable in two patients, pathologic manometric findings were seen in only one patient. The authors treated the concomitant diseases and performed endoscopic dilatations of esophageal stenoses. One case with initial bleeding from an associated web is described in detail. According to our knowledge, this is the first publication of a case of EIP-associated bleeding. CONCLUSION: Esophageal intramural pseudodiverticulosis is a differential diagnosis in cases of dysphagia and/or esophageal strictures if no other causes are found. The authors think that endoscopy is the method of choice for establishing the diagnosis.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
6/29. lingual thyroid. A case report.We describe an unusual clinical case in which a non functional cervical thyroid coexisted with a functional ectopic lingual thyroid. A twenty-year-old woman was referred for hypothyroidism treated with L-thyroxin related to a basilingual tumor diagnosed 8 years previously. Oropharyngeal examination showed a spherical basilingual tumor 2.5 cm in diameter. Laboratory findings during treatment with 50 microgram of L-thyroxin daily showed: TSH 6,280 microIU/ml (N: 4,4 to 3.6), FT3 4,2 pmol/l (N: 3.3 to 5.1), and FT4 15.4 pmol/l (N: 10,5 to 25,5). Antithyroid antibodies were absent. Cervical ultrasonography showed a small hypoechogenic, heterogeneous orthotopic thyroid gland confirmed by cervical computed tomography thyroid. An I(123) scan revealed uptake above the chin on the profile, and no significant uptake is the area of the normal thyroid. The lack of iodine uptake by the cervical thyroid remains unexplained. In conclusion, this report of an ectopic thyroid location in unusual because of the coexistence of non functional cervical thyroid and of a partially functional lingual thyroid tissue. The pathogenesis of this association remains unclear.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
7/29. Intramural pseudodiverticulosis of the esophagus.Esophageal intramural pseudodiverticulosis (EIPD) is a rare condition seen in the elderly, with a male-to-female ratio of 3:2. Multiple small outpouchings occur in the submucosa of the esophageal wall, caused by dilation of the excretory ducts of the mucus glands. This disorder may be associated with gastroesophageal reflux, motility disorders, candidiasis, or other conditions. inflammation, resulting in periductal fibrosis and compression of the duct orifices, may be a causative factor. Usually, EPID presents with progressive dysphagia related to esophageal stenosis or strictures in the great majority of patients. Radiologic examination is more sensitive than endoscopy in detecting these tiny saccular diverticula in the esophageal wall. They often are noted to disappear after esophageal dilation, but may persist asymptomatically in some patients. We report two cases of dysphagia associated with reflux and candida infection in elderly patients. The diagnosis of EIPD was made, and both patients were treated successfully. A review of the available literature suggests that EIPD may be missed easily because of subtle endoscopic and radiologic changes, but that once diagnosed, conservative management leads to satisfactory control of the symptoms.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
8/29. Successful outcome after surgical management in two cases of the "painful variant" of Hashimoto's thyroiditis.OBJECTIVE: To describe two cases of the rare "painful variant" of Hashimoto's thyroiditis (HT) that were refractory to medical management and in which surgical intervention provided the definitive treatment. methods: We thoroughly review the clinical history as well as the laboratory, imaging, and surgical pathology data in these cases, and follow-up of the clinical response over time is provided. The relevant literature is also discussed. RESULTS: A 56-year-old woman, who had remotely undergone a left hemithyroidectomy and had been diagnosed with HT, sought further assessment because of neck pain and edema. Treatment with corticosteroids was partially successful but led to the development of Cushing's syndrome. A 32-year-old man had pain and swelling of the thyroid and was diagnosed with HT shortly thereafter. Levothyroxine treatment was unsuccessful. Both patients underwent thyroidectomy. Chronic lymphocytic thyroiditis (HT) with a variable degree of fibrosis was found on assessment of pathology specimens. The patients remained asymptomatic after the surgical procedure and did not require any further anti-inflammatory therapy. CONCLUSION: In selected cases, surgical treatment may become necessary for effective and permanent control of symptoms and local signs in painful HT. Access to experienced endocrine surgeons is important in order to avoid postoperative complications because the thyroid gland may be small or fibrosed in this rare variant of HT.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
9/29. lingual thyroid carcinoma: a case report and review of the literature.Ectopic thyroid tissue may reside anywhere along its embryologic path of descent. Most ectopias manifest as simple thyroglossal duct cysts in conjunction with a normally developed thyroid gland in its usual thyroid cervical bed. lingual thyroid is a rare developmental abnormality characterized by the failure of the thyroid gland, or remnants, to descend from its embryologic site of origin at the foramen cecum to its usual pretracheal position. carcinoma arising in a lingual thyroid is even more unusual with fewer than 30 cases reported in the literature. We report the second case of lingual papillary thyroid carcinoma and review the clinical features, natural history, diagnosis, and treatment of lingual thyroid carcinoma.- - - - - - - - - - ranking = 0.4keywords = gland (Clic here for more details about this article) |
10/29. Metastatic spread of occult papillary carcinoma of the thyroid to the parapharyngeal space: a case report.Metastasis from thyroid carcinomas to the parapharyngeal space is very rare. A forty-year-old male presented with progressive dysphagia and enlargement in the right upper neck. Examination showed medial displacement of the right palatine tonsil and the lateral oropharyngeal wall. A firm, submucosal mass measuring 4 x 3 cm was palpated. Computed tomography revealed a hypodense and heterogenic parapharyngeal mass with a calcified border. The mass was totally removed by a transcervical approach. Although frozen-section diagnosis was a benign lesion, histopathologic evaluation showed metastasis of papillary thyroid carcinoma to the parapharyngeal lymph nodes. Total thyroidectomy and bilateral selective neck dissection were performed, after which the tumor turned out to be papillary microcarcinoma (0.8 x 0.8 cm) in the right upper lobe of the thyroid gland. No locoregional recurrences or distant metastasis were observed during a three-year follow-up. The differential diagnosis of parapharyngeal masses should include metastatic thyroid carcinomas, for which a lymphatic route has been suggested between the thyroid gland and the parapharyngeal lymph nodes.- - - - - - - - - - ranking = 0.4keywords = gland (Clic here for more details about this article) |
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