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Cureus Sep 2023Thyrolipoma is a rare disorder marked by substantial adipose tissue growth inside the thyroid gland. Fatty tissue is frequently seen in salivary glands, thymus, breasts,...
Thyrolipoma is a rare disorder marked by substantial adipose tissue growth inside the thyroid gland. Fatty tissue is frequently seen in salivary glands, thymus, breasts, and pancreas but rarely in the thyroid gland. The fascinating and unusual illness known as thyrolipoma presents challenging diagnostic and therapeutic issues. Due to the rarity of thyrolipoma, doctors must evaluate thyroid nodules with a high index of suspicion, especially those who are radiologically and clinically worrisome. We present a study of a 50-year-old female who came with the complaint of midline neck mass for one year. On clinical examination, a diagnosis of multinodular goiter was made. Computed tomography (CT) scan was suggestive of a heterogenous enhanced thyroid mass lesion. Thus, a total thyroidectomy was performed. On histopathological examination, a final diagnosis of thyrolipoma was made. The abstract aims to provide an overview of the clinical presentation, diagnosis, and treatment options of thyrolipoma, as well as highlight the importance of early recognition and appropriate management of this rare tumor.
PubMed: 37846247
DOI: 10.7759/cureus.45310 -
Journal of Clinical Medicine Sep 2023Uncontrolled acromegaly causes increased morbidity and mortality. The analysis of acromegaly comorbidities and complications is important when establishing a standard of...
Uncontrolled acromegaly causes increased morbidity and mortality. The analysis of acromegaly comorbidities and complications is important when establishing a standard of care for the entire population of acromegaly patients. The aim of this study was to determine the frequency of comorbidities and complications of acromegaly and their dependence on the activity of the disease. A retrospective analysis of medical records from 124 patients with acromegaly was carried out, including 39 who were cured, 73 treated with somatostatin analogs and 12 newly diagnosed patients. The incidence of comorbidities and complications was very high, and those most frequently observed were arterial hypertension, multinodular goiter, lipid disorders, hypopituitarism and degenerative changes. At least one complication of acromegaly was observed in 92% of patients undergoing successful neurosurgery and in all pharmacologically treated patients. By contrast, two or more complications were observed in 77% of cured patients and in pharmacologically controlled and uncontrolled patients, 82% and 91%, respectively. Conclusions: Acromegaly is associated with a high prevalence of complications. Active acromegaly is associated with a higher incidence of complications than in treated groups. Untreated patients have more complications than treated patients. Successfully cured patients have significantly fewer complications than pharmacologically controlled patients and patients with active acromegaly.
PubMed: 37834952
DOI: 10.3390/jcm12196309 -
Journal of Medical Case Reports Oct 2023Acute suppurative thyroiditis is a rare and potentially life-threatening disease. A few cases of acute suppurative thyroiditis associated with thyrotoxicosis have been...
BACKGROUND
Acute suppurative thyroiditis is a rare and potentially life-threatening disease. A few cases of acute suppurative thyroiditis associated with thyrotoxicosis have been reported in adults. We report a case of acute suppurative thyroiditis that was associated with thyrotoxicosis.
CASE PRESENTATION
We report the case of a 49-year-old Iranian female presented with a painful neck swelling for a week. Computed tomography showed a well-defined gas-filled collection in the left thyroid lobe with an enhancing margin. The patient underwent two-phase surgery, first left thyroid abscess drainage and then total thyroidectomy. The result of histopathology examination was multinodular goiter with abscess formation without malignancy.
CONCLUSION
Abscess formation and thyrotoxicosis is a very rare condition that occurs at the same time in acute suppurative thyroiditis. Despite antibiotic therapy being the first line of treatment, surgery is also required when antibiotic therapy fails.
Topics: Adult; Humans; Female; Middle Aged; Thyroiditis, Suppurative; Abscess; Iran; Thyrotoxicosis; Anti-Bacterial Agents; Acute Disease
PubMed: 37833794
DOI: 10.1186/s13256-023-04119-1 -
International Journal of Surgery Case... Nov 2023Thyroid lipomatosis is a rare entity of thyroid gland lesions. The exact etiopathogenesis of this condition is unknown. Most patients presented with compression...
IMPORTANCE AND IMPORTANCE
Thyroid lipomatosis is a rare entity of thyroid gland lesions. The exact etiopathogenesis of this condition is unknown. Most patients presented with compression symptoms. Radiological investigations such as neck ultrasonography (U/S) and computed tomography (CT) are crucial to evaluate and diagnose fat-containing thyroid tumors, while the definitive diagnosis is achieved by the histopathological study.
CASE PRESENTATION
A 78-year-old female patient, with a background medical history of diabetes mellitus type II and chronic kidney disease, presented to our hospital with a seven-month history of large-sized neck swelling. On physical examination, the neck mass was firm, nodular, hard in consistency, and asymmetrical. The neck swelling was associated with swallowing difficulties and minimal voice changes. Laboratory investigations were unremarkable. Neck U/S showed thyroid goiter. FNA and FNAC were also done. Then, neck CT was performed, and bilateral lobulated fat density was detected. So, a total thyroidectomy was performed, and the resected specimen was sent for histopathology studies. The postoperative period was uneventful.
CLINICAL DISCUSSION
Diffuse thyroid lipomatosis is an unusual non-neoplastic lesion. The clinical features of thyro-lipomatosis include compression symptoms. Radiological tools and cytology aid in diagnosis demonstration but the specific diagnosis is achieved by histopathology.
CONCLUSION
Due to the rare etiologic origin and unknown pathogenesis of thyrolipoma, we report the case of a 78-year-old female patient with enlarged neck swelling, found to be thyroid lipomatosis.
PubMed: 37826979
DOI: 10.1016/j.ijscr.2023.108936 -
Medicine International 2023Tuberculosis of the thyroid gland is rare, and tuberculous granulomatous inflammation of the parathyroid glands is even rarer. The present study reports a rare case of...
Tuberculosis of the thyroid gland is rare, and tuberculous granulomatous inflammation of the parathyroid glands is even rarer. The present study reports a rare case of primary hyperparathyroidism caused by tuberculous granulomatous inflammation. A 58-year-old female patient presented with generalized body pain persisting for 1 year. She had a history of recurrent renal stones (>20 times) and an incidental finding of multinodular goiter involving the parathyroid on neck ultrasound. A blood analysis revealed elevated levels of serum calcium (11.26 mg/dl) and parathyroid hormone (154.7 pg/ml). The patient underwent the resection of the affected left thyroid lobe under general anesthesia. A histopathological examination revealed parathyroid adenoma with caseating granulomatous inflammation involving the adenoma with focal lymphocytic thyroiditis of the left thyroid gland. Although granulomatous parathyroid disease with parathyroid adenoma causing hypercalcemia is an extremely rare event, it can occur. The treatment of choice is surgical resection.
PubMed: 37745150
DOI: 10.3892/mi.2023.109 -
Medicine International 2023Sarcoid-like granulomatous inflammation (SLGI) is defined as the development of non-necrotizing epithelioid granulomas in patients who do not meet the criteria for...
Sarcoid-like granulomatous inflammation (SLGI) is defined as the development of non-necrotizing epithelioid granulomas in patients who do not meet the criteria for systemic sarcoidosis. Its occurrence is known to be linked to diverse conditions, including malignancies, infections, the use of certain drugs and inorganic substances. To the best of our knowledge, the available literature to date lacks any description regarding SLGI in a paraganglioma. The present study describes the first case of SLGI in a carotid body paraganglioma (CBP). A 54-year-old female patient presented with anterior neck swelling for 27 years without any other symptoms. An ultrasonography revealed a multinodular goiter with retrosternal extension and a solid lesion on the right side of the neck measuring 40x30x22 mm, which was suggestive of a CBP. The patient underwent a total thyroidectomy, and the right-side cervical mass was resected via another longitudinal incision. A histopathological examination of the thyroid specimen revealed findings of a multinodular goiter. Sections from the right-side cervical mass confirmed the diagnosis of CBP accompanied by multiple, well-formed, small-medium sized, non-necrotizing epithelioid granulomas associated with multinucleated giant cells, indicative of SLGI. Non-necrotizing epithelioid cell granulomas (as with SLGIs), identical to those observed in sarcoidosis, may rarely be observed in patients who do not meet the criteria of systemic sarcoidosis; however, they have been observed in association with various neoplasms. It is thus crucial to distinguish them from actual sarcoidosis, as misdiagnoses may lead to severe consequences. The presence of SLGIs accompanying a paraganglioma is an extremely rare phenomenon. Due to this, it is difficult to conclude if it confers a better prognosis or not.
PubMed: 37745149
DOI: 10.3892/mi.2023.107 -
Scientific Reports Sep 2023Thyroid cancer (TC) is caused by genetic factors and or their cross talk with lifestyle and environment. An important role of miRNA involvement has been identified in...
Thyroid cancer (TC) is caused by genetic factors and or their cross talk with lifestyle and environment. An important role of miRNA involvement has been identified in different human diseases alongside the cancer. The growing cloud of miRNA discoveries narrates miRNA-221 and miRNA-222 as key elements of ready arsenal in the cancer micro-niches. The aim of present study was to identify the variations of miRNA-221 and miRNA-222 expression in TC tissues and their likely association with TC. miRNA-221 and miRNA-222 were investigated for their expressional alterations in TC tissue samples and healthy thyroid tissue. Expression of miRNA-221 and -222 was analyzed through real time PCR. The relative gene expression of both the miRNA was quantified and statistically evaluated. miRNA-221 and miRNA-222 were found to be highly over expressed when compared with samples of multinodular goiter (MNG) and normal controls. Interestingly, it was also noted that miRNA-221 and miRNA-222 expression is working in a cluster in thyroid cancer patients. So, it can be concluded that the expressional alterations of miRNA-221 and -222 are playing their potential role in the development of thyroid cancer.
Topics: Humans; Tumor Microenvironment; Thyroid Neoplasms; MicroRNAs; Cross Reactions
PubMed: 37737255
DOI: 10.1038/s41598-023-42941-1 -
Frontiers in Immunology 2023Polymorphonuclear neutrophils (PMNs) are the main effector cells in inflammatory responses and play multiple roles in thyroid cancer (TC). PMNs contain and release a...
BACKGROUND
Polymorphonuclear neutrophils (PMNs) are the main effector cells in inflammatory responses and play multiple roles in thyroid cancer (TC). PMNs contain and release a plethora of mediators, including granular enzymes [e.g., myeloperoxidase (MPO), pentraxin-3 (PTX3) and matrix metalloproteinase-9 (MMP-9)], and neutrophil extracellular traps (NETs). The aim of this study was to evaluate NETs and neutrophil-derived mediators as possible biomarkers in TC patients.
METHODS
20 patients with differentiated thyroid cancer (DTC), 26 patients with dedifferentiated thyroid cancer (De-DTC), 26 patients with multinodular goiter (MNG) and 22 healthy controls (HCs) were recruited. Serum concentrations of free DNA (dsDNA), nucleosomes, citrullinated histone H3 (CitH3) and MPO-DNA complexes were evaluated as NET biomarkers. Neutrophil-related mediators such as MPO, PTX3, MMP-9, CXCL8, and granulocyte-monocyte colony-stimulating factor (GM-CSF) were measured by ELISA.
RESULTS
Serum levels of all four NET biomarkers were increased in DeDTC patients compared to HCs. CitH3 serum levels were selectively increased in both DeDTC and DTC patients compared to HCs and MNG patients. MPO-DNA complexes and nucleosomes were selectively increased only in DeDTC patients compared to HCs and MNG patients. Moreover, MPO-DNA complexes were selectively increased in DeDTC patients compared to DTC patients also. MPO circulating levels were selectively increased in the DeDTC patient subgroup compared to HCs. Circulating levels of PTX3, MMP-9 and GM-CSF were increased in DTC and DeDTC patients compared to HCs. Nucleosomes positively correlated with dsDNA, CitH3, MPO and CXCL8. MPO-DNA complexes positively correlated with dsDNA, CitH3, CXCL8, MPO and nucleosome levels. Moreover, three out of the four NET biomarkers (i.e., dsDNA, nucleosomes and MPO-DNA complexes) were increased in elderly patients compared to young patients and in patients with metastatic disease at diagnosis compared to non metastatic patients. Nucleosomes were higher in males compared to females.
CONCLUSION
MPO-DNA complexes, nucleosomes and, to some extent, CitH3 levels seem to correlate with malignancy and severity of progressive TC. Moreover, serum concentrations of PMN-related mediators (MPO, PTX3, GM-CSF) were increased in TCs compared to MNG and HCs.
Topics: Aged; Female; Male; Humans; Neutrophils; Extracellular Traps; Matrix Metalloproteinase 9; Nucleosomes; Granulocyte-Macrophage Colony-Stimulating Factor; Thyroid Neoplasms; Histones; Adenocarcinoma
PubMed: 37705974
DOI: 10.3389/fimmu.2023.1167404 -
International Medical Case Reports... 2023Agranulocytosis is a rare but fatal side effect of antithyroid drugs (ATDs) with incidence reported at 0.1%-1%. Agranulocytosis is defined as a granulocyte count...
BACKGROUND
Agranulocytosis is a rare but fatal side effect of antithyroid drugs (ATDs) with incidence reported at 0.1%-1%. Agranulocytosis is defined as a granulocyte count <500 cells/μL following the use of ATDs and is an absolute contraindication to the use of these drugs; in this case, radioactive iodine (RAI) or surgery are therapeutic options.
CASE PRESENTATION
A 28-year-old female patient was on follow-up at our clinic after she presented with anterior neck swelling of 4 years. The patient was started on propylthiouracil (PTU) and propranolol based on clinical symptoms of hyperthyroidism and low thyroid stimulating hormone (TSH) levels. After taking the ATDs for 7 months, she came to the clinic for her regular follow-up. At this point, she was declared euthyroid and booked for surgery. Investigations were sent and the complete blood count (CBC) result showed leucopenia with agranulocytosis, even though she was completely asymptomatic. The offending ATD was immediately discontinued. The patient was kept inpatient for monitoring, and lugol's iodine and propranolol were initiated. Eight days after discontinuing the ATD, the CBC profile was determined once again, showing normalized total leukocyte, as well as, absolute neutrophil count. Eventually, the multinodular goiter (MNG) was managed with subtotal thyroidectomy.
CONCLUSION
Despite the fact that agranulocytosis is an extremely rare side effect of ATDs, most often PTU; it is a potentially fatal complication when it occurs. Patient education at the time of prescription should not be overlooked, and systematic programs should be put in place. The baseline granulocyte count should be determined and monitored on a regular basis.
PubMed: 37701536
DOI: 10.2147/IMCRJ.S424053 -
International Journal of Surgery Case... Sep 2023Laryngeal carcinoma represents the 22nd most common cancer worldwide. Thyroid metastasis from laryngeal cancer is extremely rare. Overall, thyroid gland involvement by...
INTRODUCTION
Laryngeal carcinoma represents the 22nd most common cancer worldwide. Thyroid metastasis from laryngeal cancer is extremely rare. Overall, thyroid gland involvement by metastatic carcinoma represents about 1.1-2.1 % among thyroid malignant diseases.
PRESENTATION OF CASE
A male in his 70s came to our Otolaryngology Unit with a laryngeal squamous cell carcinoma (cT3). Total laryngectomy and bilateral neck dissection were performed. Histological examination revealed a pT3 carcinoma with sub-massive metastasis of the Delphian node. The patient underwent close follow-up. After eight months, neck examination revealed a suspected nodule in the right thyroid lobe. A right thyroid lobectomy was performed, and histological assessment revealed a nodule with squamous carcinoma metastasis in the superior pole of the thyroid lobe. The remaining thyroid tissue was affected by multinodular macrofollicular goitre. The patient underwent adjuvant therapy. One year after the second surgery, he showed no signs of recurrence.
DISCUSSION
Thyroid gland metastasis from laryngeal carcinoma is a very rare occurrence. In literature, we found only three articles that describes thyroid metastasis in overall 7 patients affected by laryngeal squamous cell carcinoma. Positive Delphian lymph node is usually related to poor prognosis: in 2007 a study reported tumour recurrence in 15 out of 25 patients with metastatic Delphian lymph node within the first two years of surgery.
CONCLUSION
Thyroid gland metastasis from laryngeal carcinoma is rare; so close follow-up of oncologic patients is mandatory and, most of all, the positive Delphian node should not be underestimated for its predictive value.
PubMed: 37659157
DOI: 10.1016/j.ijscr.2023.108736