1/8. Retroperitoneoscopic adrenalectomy in a residual of neuroblastoma.The authors report a case of retroperitoneoscopic adrenalectomy in a child with neuroblastoma previously treated by chemotherapy. Usually the presence of malignant tumours is a contraindication to retroperitoneoscopic surgery. A restaging of the tumor was done by retroperitoneoscopy. The residual adrenal gland was excised by mini-invasive surgery of the retroperitoneal space. The histopathologic examination confirmed the presence of a residual neuroblastoma in the adrenal gland. This case report shows a possible of a new indication for the retroperitoneoscopy.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/8. Severe myopathy and psychosis in a patient with Cushing's disease macroadenoma.Cushing's disease is most commonly caused by a corticotrope adenoma of the pituitary. Between 50 and 70% of patients with spontaneous hypercortisolism have ACTH-producing pituitary adenomas. The tumors are usually microadenomas with approximately 20% of patients with the disease showing no evidence of tumor on CT-scans or MR imaging of their pituitary glands. In contrast to patients with ectopic ACTH production, plasma ACTH concentrations in patients with spontaneous disease are generally within the normal range. We describe here a patient with a pituitary macroadenoma that showed evidence of necrosis on MRI. The patient had an atypical clinical presentation with plasma ACTH levels considerably higher than that seen in patients with non-ectopic ACTH-secretory syndrome, markedly elevated urine free cortisol, lack of phenotypical signs of hypercortisolism such as wide purplish striae, and whose most prominent and distressing symptom was severe myopathy that resulted in the patient becoming bed-ridden. Psychosis was another striking feature in this patient who during his hospital course developed multiple opportunistic infections that contributed to his demise.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
3/8. sella turcica metastasis from follicular carcinoma of thyroid.A case of metastasis to the sella turcica from a follicular adenocarcinoma of the thyroid gland is presented. Metastasis to this site is rare and review of the literature reveals only 12 cases of metastatic thyroid carcinoma involving the sella turcica and pituitary gland. The optimal treatment strategy is still to be determined. A 43-year-old woman presented with headache, nausea, visual impairment and galactorrhea. An MRI scan of the cranium revealed an enhancing destructive sellar lesion. The patient underwent transsphenoidal removal of the lesion to alleviate visual loss. The histological features of the sellar tumor were identical to those of a follicular adenocarcinoma partially removed from the thyroid gland 22 months earlier. Total thyroidectomy followed by three courses of iodine-131 ablation enhanced with synthetic thyrotropin and thyroid hormone suppression therapy was instituted. The post-operative course was satisfactory with improved vision and ceased galactorrhea. This case was successfully treated with a combination of surgical removal, iodine-131 ablation and hormone suppression therapy, which resulted in disease control duration of four years. sella turcica metastases of thyroid carcinoma are exceedingly rare and currently there are no established therapeutic guidelines.- - - - - - - - - - ranking = 1.5keywords = gland (Clic here for more details about this article) |
4/8. Stereotactic radiosurgery for recurrent pleomorphic adenoma invading the skull base--case report--.A 38-year-old man presented with a recurrent pleomorphic adenoma in the parapharyngeal space invading the skull base 19 years after the first operation for a parotid gland tumor. Stereotactic radiotherapy was performed to control the tumor growth using a marginal dose of 8 Gy and maximum dose of 18 Gy with care taken to minimize the dose to nearby structures. The symptoms were reduced within a few months. magnetic resonance imaging over 5 years showed that the tumor was controlled with no regrowth. Stereotactic radiotherapy is a therapeutic option for the treatment of pleomorphic adenomas.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
5/8. Spontaneous regression of intraoral mucosa-associated lymphoid tissue lymphoma: molecular study of a case.Mucosa-associated lymphoid tissue (MALT) lymphoma presentation in the oral cavity is very rare. Reported herein is a case of intraoral MALT lymphoma of the minor salivary gland in a 70-year-old woman with sjogren's syndrome. Unexpectedly, a spontaneous clinically and histologically confirmed regression occurred 1 month after the tumor biopsy for diagnosis. Considering that salivary MALT lymphoma is associated with sjogren's syndrome and that the chronic inflammation caused by sjogren's syndrome persisted, it is hypothesized that the tumor clone might be present in the regressed lesion. Minimal residual tumor clone identical with the primary lesion was detected using the polymerase chain reaction (PCR) clonality assay for immunoglobulin heavy chain gene (IgH) rearrangement. No recurrence was clinically evident 38 months after the diagnosis. Spontaneous regression of MALT lymphoma should be examined at the molecular level in addition to clinical and histological evaluations. When minimal residual disease is detected, close follow up is necessary for early detection of the tumor relapse.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
6/8. Sialoblastoma: a rare submandibular gland neoplasm.A sialoblastoma is a rare congenital epithelial tumor that arises in a major salivary gland. To our knowledge, only 24 cases of sialoblastoma have been previously reported in the English-language literature. We report a new case, that of a 15-month-old boy who presented with a submandibular mass. Surgical excision of the mass was undertaken. Intraoperatively, the mass appeared to be adjacent to the submandibular gland, but it had not invaded it. The mass was excised, and the submandibular gland was left in place. pathology identified the tumor as a sialoblastoma. However, pathology also revealed that residual tumor was present at the surgical margin. The patient was returned to the operating room for excision of the left submandibular gland and the level I lymph nodes. Following revision surgery, the surgical margins were negative. The patient remained disease-free at the 1-year follow-up. Despite the need for revision surgery, this case provides support for the idea that surgery alone is sufficient for curative treatment.- - - - - - - - - - ranking = 4keywords = gland (Clic here for more details about this article) |
7/8. Medullary thyroid carcinoma imaged by Tc-99m MIBI SPECT and Tl-201 chloride/Tc-99m pertechnetate subtraction SPECT.A 61-year-old man with medullary thyroid carcinoma and local invasion of the left lobe of the thyroid had Tc-99m MIBI SPECT and Tl-201 chloride/Tc-99m pertechnetate subtraction SPECT after left lobectomy of the thyroid, using a triple-headed gamma camera. Tl-201 chloride/Tc-99m pertechnetate subtraction demonstrated a large mass with high Tl-201 uptake in the left neck. Although there was intense uptake in the tumor in the left thyroid bed on Tc-99m MIBI neck SPECT, there was also uptake in both salivary glands and the right lobe of the thyroid gland. Thus, uptake in the right lobe of the thyroid gland and the salivary glands might not be differentiated from tumor invasion or metastasis from medullary cell carcinoma. Compared with MIBI SPECT, Tl-201 chloride/Tc-99m pertechnetate subtraction SPECT shows more apparent delineation of tumor uptake and may be a preferable technique.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
8/8. Primary malignant teratoma of the thyroid gland: report and discussion of two cases.BACKGROUND: teratoma of the thyroid in adults is a rare neoplasm and is usually seen in young females. Most of the thyroid teratoma are malignant. The tumor appears as a dominant mass in the thyroid gland and is often associated with local lymph node involvement. We describe our experience of primary malignant teratoma of the thyroid in two young women who were treated with aggressive chemotherapy and surgical intervention. methods: medical records of two patients treated between 1993 and 1995 were reviewed. Both patients were women (36 years old and 34 years old). The diagnosis of primary malignant teratoma of the thyroid was made on the basis of clinical, radiographic, and microscopic findings. patients were treated with aggressive combination chemotherapy consisting of alternating regimens similar to those used for high-volume germ-cell tumor patients at the University of texas M. D. Anderson Cancer Center. RESULTS: One of the patients demonstrated a partial response to chemotherapy and underwent postchemotherapy surgery for removal of residual disease. The other patient had a complete response to chemotherapy. Both patients are alive and disease free for 32- and 26-plus months. CONCLUSIONS: Primary malignant teratoma of the thyroid is sensitive to combination chemotherapy. It appears that the treatment strategy offered-aggressive induction chemotherapy with planned surgery for removal of residual disease, similar to that for patients with testicular tumors-has the potential to provide a durable, complete remission.- - - - - - - - - - ranking = 2.5keywords = gland (Clic here for more details about this article) |