1/7. Excision of a 1.9 kg goitre under local anaesthetic.A 30-year-old woman with a large goitre underwent thyroidectomy under local anaesthetic field block. A 1.9 kg goitre was resected. She was given light sedation but was able to communicate throughout the whole procedure which was performed comfortably under the local anaesthesia. She made an uneventful recovery with no complications. Local anaesthetic was chosen as the safest procedure in a remote rural Ugandan hospital which lacked close post-operative monitoring. Other benefits of using local anaesthesia are discussed.- - - - - - - - - - ranking = 1keywords = thyroid (Clic here for more details about this article) |
2/7. Malignant thyroid haemangioendothelioma in a non-endemic goitrous region, with immunohistochemical evidence of a vascular origin.A case of malignant haemangioendothelioma of the thyroid is presented in a patient resident in a non-endemic goitrous region of england. The tumour's endothelial origin was confirmed by factor viii-related antigen and ulex europaeus lectin staining.- - - - - - - - - - ranking = 5keywords = thyroid (Clic here for more details about this article) |
3/7. Thyroid cancer with skull enlargement: a lesson learned?A case of endemic goitre associated with thyroid cancer and huge enlargement of the scalp is reported in a Brazilian mulatto from an iodine deficient Central west region of the country. On admission, osteolytic metastases of follicular thyroid carcinoma were found scattered in the parietal bones. Impressive images from old files could illustrate and emphasize the hurdle-like role of poverty and inadequate social and cultural attitudes before the fight against cancer in regions with limited resources. Even in developed countries, goitres still occur in areas with iodine prophylaxis. Another concern is insufficiency of reliable data on the incidence and pattern of head and neck tumours in developing countries.- - - - - - - - - - ranking = 2keywords = thyroid (Clic here for more details about this article) |
4/7. A case of methimazole-induced hypothyroidism in a patient with endemic goiter: effects of endogenous TSH hyperstimulation after discontinuation of the drug.serum thyroid hormone and TSH concentrations were monitored in a patient with multinodular endemic goiter and severe methimazole (MMI) induced hypothyrodism up to 190 days after drug withdrawal. serum concentrations of TT3, TT4 and TSH returned to normal values at the 6th., the 140th, and the 120th. day respectively. Within the first 20 days after MMI withdrawal the increase of serum T3 levels was correlated with the observed decrease of serum TSH concentrations. Successively T3 values decreased and T4 levels progressively increased. Six months after MMI withdrawal basal serum TSH concentration was normal while an exaggerated response to TRH was observed. We think that this peculiar hormone pattern is due to iodine depletion. In this case TSH hyperstimulation increases predominantly T3 secretion demonstrating the reduced thyroidal ability to produce T4 when hyperstimulated.- - - - - - - - - - ranking = 6keywords = thyroid (Clic here for more details about this article) |
5/7. somatostatin receptor expression in the thyroid demonstrated with 111In-octreotide scintigraphy.neuroendocrine tumors with somatostatin receptor expression may be localized by 111In-octreotide scintigraphy. This study examines those thyroid conditions where 111In-octreotide uptake could be observed also in the thyroid gland. 26 consecutive patients who underwent 111In-octreotide scintigraphy for tumor localization were additionally examined for thyroid disease by sonography and 99mTc-pertechnetate scintigraphy. 12 of these patients had no significant thyroid uptake and had an euthyroid normal-sized thyroid gland 14 patients with 111In thyroid uptakes had endemic goiters, two of them with thyroid autonomy and one with Graves' disease. Thus, 111In-octreotide thyroid uptake was predominantly seen in patients with endemic goiter with or without thyroid autonomy.- - - - - - - - - - ranking = 14keywords = thyroid (Clic here for more details about this article) |
6/7. Giant goitre: a surgical scourge.The giant goitre is an interesting phenomenon almost exclusively confined to regions of endemic goitre. A majority of patients with giant goitre usually desire operation for social and cosmetic reasons. Some of them however suffer frequent attacks of intercurrent respiratory tract infection which complicates the post-operative course. About a fifth of them present with acute respiratory distress requiring emergency surgery. The peri-operative management of this disease is both formidable and hazardous. The operative time is not only longer than for a standard thyroidectomy but mortality can also be unacceptably high. In this paper the author reports his personal experience with 30 patients whose resected specimens weighed between 500g and 1750g. There was a total of six complications; one patient developed a deep haematoma which produced respiratory distress post-operatively. Five patients developed suture abscesses at intervals after the operation. There was no mortality.- - - - - - - - - - ranking = 1keywords = thyroid (Clic here for more details about this article) |
7/7. Pendred's syndrome.Although 5% of all cases of congenital deafness are caused by Pendred's syndrome, there are few reports in the literature. Seven patients with Pendred's syndrome in three families living in the same village were detected. For that reason, the syndrome is reviewed in light of the literature. The sex distribution of the patients with Pendred's syndrome and their families was recorded. We tested for thyroxine, triiodothyronine, thyroid-stimulating hormone, triiodothyronine resin uptake, and perchlorate, and performed caloric testing. In one patient, subtotal thyroidectomy was performed. In the histopathologic study, a thyroid nodule filled with colloid was found. Chromosome studies showed no anomalies in any patient. Five of the patients were deaf-mutes. We observed that the parents were cousins in all three families. These families also had healthy children, and the existence of the syndrome in both sexes points to an autosomal recessive trait.- - - - - - - - - - ranking = 3keywords = thyroid (Clic here for more details about this article) |