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Podzimek J, Fruth K, Jecker P. High-resolution ultrasound of thyroglossal cysts with special emphasis on the detection of cystic portions above the hyoid within the tongue base. ULTRASOUND (LEEDS, ENGLAND) 2025; 33:20-26. [PMID: 39555164 PMCID: PMC11563548 DOI: 10.1177/1742271x241241783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/28/2024] [Indexed: 11/19/2024]
Abstract
Background Thyroglossal duct cysts (TGDCs) within the tongue base represent a challenge for the surgeon and are often the cause of recurrence. Purpose This study aimed to evaluate diagnostic performance of high-resolution ultrasound in TGDCs within the tongue base, compared to intraoperative findings. Furthermore, accuracy with which the detection of thyroid tissue in parts of the thyroglossal duct cyst was possible was investigated. Methods A total of 50 patients with TGDCs were examined by high-resolution ultrasound. Every thyroglossal cystic lesion was examined for the presence of solid thyroid tissue with colour-coded duplex sonography and evaluated according to American Thyroid Association (ATA) guidelines. Ultimately, 45 of the 50 patients underwent surgery (Sistrunk procedure). Results In 38/50 patients (76%), TGDCs were seen in their typical distal location inferior to the hyoid. Four patients (8%) had the thyroglossal duct cyst superior and inferior to the hyoid. The TGDC remnants only in the tongue base were recognised in 16% of cases (8 patients). Histological specimens revealed thyroid tissue within the TGDCs in 23 of the 45 patients (49%). Thyroid tissue was diagnosed preoperatively in 15 patients (65%) X 2(1, N = 23) = 2.13, p = 0.144. One patient exhibited suspicious features for thyroid cancer, which was confirmed histologically as papillary thyroid carcinoma. Conclusion High-resolution ultrasound represents quick, safe and reliable imaging for TGDCs on both sides of the hyoid bone (inferior and superior) with an impact on surgical planning. Furthermore, thyroid tissue within TGDCs can be revealed preoperatively and assessed for suspicious features.
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Affiliation(s)
- Jiri Podzimek
- Department of ENT, Head and Neck Surgery and Plastic Surgery, Klinikum Bad Salzungen, Bad Salzungen, Germany
| | | | - Peter Jecker
- Department of ENT, Head and Neck Surgery and Plastic Surgery, Klinikum Bad Salzungen, Bad Salzungen, Germany
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Assaf A, Barboura M, Karaja S, Khaddour S, Maoud N, Dadah N. A large thyroglossal duct cyst with atypical features in a 73-year-old male: A case report. Int J Surg Case Rep 2024; 124:110421. [PMID: 39405753 PMCID: PMC11525108 DOI: 10.1016/j.ijscr.2024.110421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Revised: 10/04/2024] [Accepted: 10/08/2024] [Indexed: 11/03/2024] Open
Abstract
INTRODUCTION Thyroglossal duct cysts (TGDCs) are congenital anomalies arising from incomplete obliteration of the thyroglossal duct (TGD), typically presenting in childhood. While rare in the elderly, they can occur in adulthood and may remain asymptomatic until complications such as infection or malignant transformation arise. PRESENTATION OF CASE A 73-year-old male presented with progressively enlarging left-sided neck swelling over 15 years. Clinical and radiological evaluation confirmed the diagnosis of a TGDC. Surgical excision was performed via the Sistrunk procedure, with post-operative histopathology confirming the pre-operative diagnosis of TGDC. The patient recovered well with no complications or recurrence. DISCUSSION Clinical presentation of TGDC is typically an anterior neck enlargement or a non-tender midline neck mass, moving with swallowing, related to the hyoid bone. The typical differential diagnosis of TGDCs include cystic and midline neck masses. Atypically, our patient had a lateral cystic mass which was immobile with swallowing. CONCLUSION This case highlights the importance of considering TGDCs as a differential diagnosis in elderly patients despite their rarity. TGDCs may present with complications or atypical features of TGDCs which require more evaluation. Surgical intervention, specifically the Sistrunk procedure, remains the optimal management strategy for TGDCs, offering excellent outcomes and reducing the risk of recurrence.
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Affiliation(s)
- Ahed Assaf
- University of Hama College of Human Medicine, Hama, Syria
| | - Mousa Barboura
- University of Hama College of Human Medicine, Hama, Syria
| | - Saja Karaja
- University of Hama College of Human Medicine, Hama, Syria.
| | | | - Nour Maoud
- University of Hama College of Human Medicine, Hama, Syria
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D'Agostino C, Block L, Smith A, Weintraub S, Rose S, Coletti DJ, Khamis N. Enhancing point-of-care ultrasound (POCUS) utilization in primary care: A thyroid POCUS training course for internal medicine residents. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:1082-1086. [PMID: 39016344 DOI: 10.1002/jcu.23767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/20/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND POCUS is valuable in primary care, yet outpatient-specific point-of-care ultrasound (POCUS) curriculum integration into internal medicine (IM) residency is limited. We addressed this gap by developing a thyroid POCUS workshop for IM residents. AIM Develop and implement an educational curriculum to integrate thyroid POCUS into an IM residency program and evaluate the impact on resident knowledge, perceived skills, and attitudes. SETTING The study was conducted in a resident primary care clinic at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Residency Program in Internal Medicine at North Shore University Hospital and Long Island Jewish Medical Center. PARTICIPANTS All 108 IM residents (PGY1-3) in one program participated in the study during their ambulatory clinic block. PROGRAM DESCRIPTION Residents participated in a 1-hour workshop involving a didactic session and two breakout groups: one for hands-on practice and another for case-based discussions with image review. PROGRAM EVALUATION Residents completed pre- and post-session surveys assessing knowledge, perceived skills, and attitudes toward thyroid POCUS. These data showed statistically significant increases in all assessed areas. DISCUSSION Integrating thyroid POCUS into an IM residency curriculum significantly improved resident knowledge, attitudes, and perceived skills related to these exams. Residents valued this learning experience and expressed intentions to incorporate it into their future practice.
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Affiliation(s)
| | - Lauren Block
- Department of Medicine, Northwell Health, New Hyde Park, New York, USA
| | - Alexander Smith
- Department of Medicine, Northwell Health, New Hyde Park, New York, USA
| | - Spencer Weintraub
- Department of Medicine, Northwell Health, New Hyde Park, New York, USA
| | - Sage Rose
- Department of Counseling & Mental Health Professions, Hofstra University, Hempstead, New York, USA
| | - Daniel J Coletti
- Department of Medicine, Northwell Health, New Hyde Park, New York, USA
| | - Nehal Khamis
- Department of Advanced Studies in Education/Master of Education for Health Professions Program, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Population Health, Hofstra University, Hempstead, New York, USA
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Yanar C, Cetinoglu I, Sengul Z, Caliskan O, Taner Unlu M, Aygun N, Uludag M. Coexistence of Thyroglossal Cyst and Thyroid Disease in Adults: Surgical Outcomes From A Single Center. SISLI ETFAL HASTANESI TIP BULTENI 2024; 58:291-297. [PMID: 39411044 PMCID: PMC11472196 DOI: 10.14744/semb.2024.99390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2024] [Accepted: 09/28/2024] [Indexed: 10/19/2024]
Abstract
Objectives Thyroglossal cysts (TGCs) usually present during childhood and before the age of 30, however, they can also be seen in adults, even in advanced age. Nodular thyroid disease is also common in adults. In the literature, there is an ongoing debate regarding the differences in clinical presentation, gender, and postoperative recurrence of TGC between children and adults. In this study, we aimed to process the data of adult patients who underwent surgery for TGC in our clinic, along with the data on concurrent thyroid disease and thyroid surgery. Methods The data of patients over 18 years old who were operated on for TGC at the General Surgery Clinic of Sisli Hamidiye Etfal Training and Research Hospital between 2018 and 2024 were retrospectively evaluated. Results A total of 16 patients with a mean age of 43.94±12.98 (21-67) years, were included in the study (11 F/5 M). The diagnosis of TGC was made in 12 patients (75%) by ultrasonography (USG), in 1 patient (6.25%) by computed tomography, in 1 patient (6.25%) by magnetic resonance imaging (MRI), and in 2 patients (12.5%) incidentally intraoperatively. 13 patients (81.25%) underwent the Sistrunk procedure, and 3 patients (18.75%) underwent cyst excision. Among the 16 TGC patients, papillary thyroid cancer in the cyst was detected in one patient (6.25%) preoperatively. During preoperative evaluation, nodular thyroid disease was found in 12 patients (75%). Of these, papillary thyroid cancer was detected in 3 patients (18.75%) preoperatively. Of the TGC group, 3 (18.75%) underwent thyroidectomy for thyroid malignancy, and five (31.25%) underwent additional thyroid surgery for nodular thyroid disease. The patients were followed for a mean of 22.63±18.32 months (3-67 months), and no recurrence of TGC was observed during the follow-up period. Conclusion In patients with TGC, thyroid diseases and the requirement for thyroidectomy due to benign or malignant thyroid disease are not uncommon. Patients with TGC should be evaluated for thyroid disease before surgical treatment. While the Sistrunk procedure is the standard surgical technique in the treatment of TGC, in adults, if the cyst terminates below the hyoid bone, total cyst excision without removing the central portion of the hyoid bone may be sufficient.
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Affiliation(s)
- Ceylan Yanar
- Address for correspondence: Ceylan Yanar, MD. Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye Phone: +90 538 721 35 54 E-mail:
| | | | - Zerin Sengul
- Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Ozan Caliskan
- Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Mehmet Taner Unlu
- Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Nurcihan Aygun
- Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Mehmet Uludag
- Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
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Junn A, Zhang A, Mantilla-Rivas E, Barrera MC, Episalla NC, Sentosa J, Oh AK, Boyajian MJ, Rogers GF. Pharyngeal Arches, Chapter 2: Ear and Neck Abnormalities. J Craniofac Surg 2024:00001665-990000000-01871. [PMID: 39221927 DOI: 10.1097/scs.0000000000010577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024] Open
Abstract
The pharyngeal arches are the foundation of face and neck development. Impaired development of these embryologic structures can result in craniofacial abnormalities. Surgeons who manage head and neck pathology will invariably encounter conditions associated with aberrant pharyngeal arch anatomy, and a thorough understanding of the normal development of these structures is paramount to accurate diagnosis and treatment. This manuscript is the second of a four-part series written for plastic surgeons, focusing on the abnormal development of pharyngeal arches leading to pathologic ear and neck anomalies seen in clinical practice.
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Affiliation(s)
- Alexandra Junn
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC
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6
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Rao A, Hanagud B, Chandrashekarappa S, Shetty S, Ramachandrappa S, Wali M. Thyroglossal duct cyst in the superior mediastinum. Indian J Thorac Cardiovasc Surg 2024; 40:594-596. [PMID: 39156061 PMCID: PMC11329461 DOI: 10.1007/s12055-024-01686-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 08/20/2024] Open
Abstract
Thyroglossal duct cysts (TGDCs) are congenital anomalies that originate from the embryonic thyroglossal duct. Here, we present an atypical case of a thyroglossal cyst of the superior mediastinum with a small cervical extension. A male patient presenting with vague symptoms of retrosternal discomfort and cough was evaluated with computed tomography (CT) thorax. It was revealed to be a mediastinal mass. An excision biopsy of the mass under general anesthesia revealed it to be a thyroglossal duct cyst. TGDC of the mediastinum is extremely rare. To the best of our knowledge, this is the first case reported in a patient of Indian origin and the fifth such case reported worldwide.
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Affiliation(s)
- A. Rao
- JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - B. Hanagud
- JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - S. Chandrashekarappa
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - S. Shetty
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - S. Ramachandrappa
- Department of CTVS, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - M. Wali
- Department of CTVS, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
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7
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Hu X, Yu L, Wu Y, Xiang F. Solid splenic lymphangioma: Unveiling an atypical presentation in lymphatic system malformations. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:964-966. [PMID: 38813899 DOI: 10.1002/jcu.23733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/25/2024] [Accepted: 04/28/2024] [Indexed: 05/31/2024]
Abstract
We present a case study detailing the occurrence of splenic lymphangioma in a 9-year-old girl. The multimodal imaging revealed a significant mass, a finding subsequently validated through histopathological examination. This case underscores the importance of considering splenic lymphangioma as a rare but notable differential diagnosis for solid masses observed in imaging studies.
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Affiliation(s)
- Xiaoqing Hu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lan Yu
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Wu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feixiang Xiang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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8
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Latino F, Tafuri F. The role of physical activity in the physiological activation of the scholastic pre-requirements. AIMS Neurosci 2024; 11:244-259. [PMID: 39431273 PMCID: PMC11486611 DOI: 10.3934/neuroscience.2024016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 08/08/2024] [Accepted: 08/14/2024] [Indexed: 10/22/2024] Open
Abstract
Physical activity during the developmental age is an indispensable tool for the physical and mental growth of children. Thanks to physical activity, individuals have the opportunity to improve their physical efficiency and promote better health, establish relationships with the environment and with others, and develop cognitive processes. Therefore, the aim of this study is to investigate the relationship between physical activity and the development of scholastic prerequisites among kindergarten children. 52 children (aged 4-5) participated in either a classroom-based physical activity program (60'/3 days per week) or regular lessons. At the beginning and end of the intervention programs, a set of standardized motor evaluation tests and the Observational Questionnaire for the Early Identification of Learning Disabilities (IPDA) were administered. As a result, a meaningful Time x Group interaction for the IPDA Variable was observed. The aforementioned development denotes a noteworthy advancement within the treatment group (p < 0.001). Conversely, no substantial modification was noted in the control group. The findings derived from this study provide a foundational support to the concept that physical activity integrated into classroom settings is an effective strategy to improve both scholastic prerequisites and academic performance.
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Affiliation(s)
- Francesca Latino
- Department of Psychology and Education, Pegaso University, 80100 Naples, Italy
| | - Francesco Tafuri
- Heracle Lab Research in Educational Neuroscience, Niccolò Cusano University, 00166 Rome, Italy
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9
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Yonghan W, Jian M, Shujing W, Jie L. Diagnosis of an epidermoid retroperitoneal cyst via ultrasound: A case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:794-799. [PMID: 38600675 DOI: 10.1002/jcu.23674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/12/2024]
Abstract
Retroperitoneal cysts (RPCs) are rare types of cyst in the retroperitoneal space that are frequently misdiagnosed as gynecological tumors. This case report details, an epidermoid RPC, identified through 2D ultrasound, with attempts to visualize its rendered images using 3D ultrasound. A 39-year-old female patient was admitted to the hospital following the detection of a pelvic mass during a routine physical examination. Initially, the lesion was suspected to be an ovarian tumor, but subsequent ultrasound investigations suggested an epidermoid RPC. This diagnosis was later confirmed by pelvic magnetic resonance imaging. The definitive diagnosis was made following laparoscopic exploration and pathological examination. This case is shared to analyze the ultrasound characteristics of epidermoid RPCs.
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Affiliation(s)
- Wei Yonghan
- Department of Ultrasound, First People's Hospital of Nanning, Nanning, China
| | - Mo Jian
- Department of Gynecology, First People's Hospital of Nanning, Nanning, China
| | - Wei Shujing
- Department of Ultrasound, First People's Hospital of Nanning, Nanning, China
| | - Li Jie
- Department of Ultrasound, First People's Hospital of Nanning, Nanning, China
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10
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Zhen-Li, De-Dai, Chen HK, Zhou XK. Asymptomatic Gouty Tophi in Thyroid Cartilage: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613231205540. [PMID: 37942800 DOI: 10.1177/01455613231205540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Abstract
Gouty tophi is a disease characterized by the long-term deposition of monosodium urate crystals in joints or cartilages. The most commonly affected site is the first metatarsophalangeal joint, and gouty tophi in the head and neck region are relatively rare. This article reports a case involving an elderly male with asymptomatic gouty tophi in the thyroid cartilage. The patient had a history of gout for over 10 years and presented with a painless thyroid mass that had been present for at least 3 years. He had not received systemic treatment. Preoperative contrast-enhanced cervical CT results indicated a high likelihood of gouty tophi. Postoperative pathology confirmed the mass to be consistent with gouty nodules. Following the procedure, the patient was treated symptomatically with non-busulfan tablets and colchicine. No recurrence was observed at the 1-year follow-up. This report highlights the need to consider gouty tophi in cases of prolonged gout history and abnormal imaging findings in the head and neck region. Appropriate management, including urate-lowering therapy and surgery, if necessary, can lead to optimal outcomes and prevent recurrences. Further research is warranted to enhance understanding and clinical management of this uncommon regional manifestation of gout.
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Affiliation(s)
- Zhen-Li
- Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - De-Dai
- Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Hui-Kuan Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Xin-Kai Zhou
- Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China
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Rigas G, Skalias A, Filentas A, Tsantila I, Blioskas S. An Unusual Case of a Papillary Thyroid Carcinoma Arising in a Branchial Cyst. EAR, NOSE & THROAT JOURNAL 2023:1455613231207819. [PMID: 37872779 DOI: 10.1177/01455613231207819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Affiliation(s)
- Georgios Rigas
- Department of Otorhinolaryngology-Head and Neck Surgery, 424 General Military Hospital, Thessaloniki, Greece
| | - Antonis Skalias
- Department of Otorhinolaryngology-Head and Neck Surgery, 424 General Military Hospital, Thessaloniki, Greece
| | - Athanasios Filentas
- Department of Otorhinolaryngology-Head and Neck Surgery, 424 General Military Hospital, Thessaloniki, Greece
| | - Ioanna Tsantila
- Department of Pathology, 424 General Military Hospital, Thessaloniki, Greece
| | - Sarantis Blioskas
- Department of Otorhinolaryngology-Head and Neck Surgery, 424 General Military Hospital, Thessaloniki, Greece
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Chen GY, Li T. Simultaneous thyroglossal duct cyst with parathyroid cyst: A case report. World J Clin Cases 2023; 11:7248-7252. [PMID: 37946755 PMCID: PMC10631413 DOI: 10.12998/wjcc.v11.i29.7248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Thyroglossal duct cysts (TDC) are common congenital deformities. Most of them are cysts formed by the thyroglossal ducts that do not disappear and degenerate in the early embryonic stage. TDC exists alone and is rarely complicated by other congenital embryonic malformations. Only a few reports of TDC with branchial cleft cysts, thyroid cancer, thyroid hematoma, and epidermoid cysts have been reported. Therefore, we report a patient with TDC and parathyroid cyst (PC), a rare disease that has never been reported. CASE SUMMARY A 47-year-old woman presented to clinic in April 2021 with a neck tumor which she had noticed 5 d earlier. We perfected the relevant examinations, such as ultrasound and computed tomography, and resected the tumor. After surgical treatment, the pathology revealed a cervical thyroglossal duct cyst and a left lobe parathyroid cyst. The patient was followed up for 1 year without significant recurrence. CONCLUSION We report a patient with a simultaneous TDC and a PC to explore the correlation between the two congenital anomalies.
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Affiliation(s)
- Geng-Yu Chen
- Department of Thyroid and Breast Surgery, The Forth Hospital of Jinan City, Jinan 250021, Shandong Province, China
| | - Tong Li
- Department of Thyroid and Breast Surgery, The Forth Hospital of Jinan City, Jinan 250021, Shandong Province, China
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Shi C, Lu N, Yong YJ, Chu HD, Xia AJ. Parathyroid carcinoma: Three case reports. World J Clin Cases 2023; 11:5934-5940. [PMID: 37727485 PMCID: PMC10506032 DOI: 10.12998/wjcc.v11.i25.5934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/14/2023] [Accepted: 08/01/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Parathyroid carcinoma (PC) is a rare, slow-growing malignant tumor and a rare cause of primary hyperfunctioning of the parathyroid, with a highly variable clinical course, depending on the aggressiveness of the individual tumor and the degree of hypercalcemia. CASE SUMMARY The aim of this report is to summarize the diagnosis and treatment of three cases of PC and to review and conclude aspects regarding the three collected cases with reference to other relevant cases to explore the value of ultrasound in the diagnosis of PC. All three patients had hypercalcemia, consisting of a high serum calcium level and a high level of parathyroid hormone that was > 2-fold (even > 30-fold) of the normal upper limit. The ultrasonographic findings of the parathyroid gland showed that the glands were all > 30 mm, and the internal echo was uneven. All patients underwent surgery. PC in three cases was confirmed by routine histopathology and immunohistochemistry. CONCLUSION As clinical signs and laboratory results are nonspecific, it is difficult to diagnose PC preoperatively, so imaging examinations are often needed.
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Affiliation(s)
- Ce Shi
- Department of Ultrasound, Yantaishan Hospital, Yantai 264003, Shandong Province, China
| | - Ning Lu
- Department of Pathology, Yantaishan Hospital, Yantai 264003, Shandong Province, China
| | - Yan-Jie Yong
- Department of Ultrasound, Yantaishan Hospital, Yantai 264003, Shandong Province, China
| | - Hai-Di Chu
- Department of Thyroid Surgery, Yantaishan Hospital, Yantai 264003, Shandong Province, China
| | - Ai-Jun Xia
- Department of Ultrasound, Yantaishan Hospital, Yantai 264003, Shandong Province, China
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14
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Hu J, Wang F, Xue W, Jiang Y. Papillary thyroid carcinoma with nodular fasciitis-like stroma - an unusual variant with distinctive histopathology: A case report. World J Clin Cases 2023; 11:5797-5803. [PMID: 37727715 PMCID: PMC10506009 DOI: 10.12998/wjcc.v11.i24.5797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/12/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Papillary thyroid carcinoma (PTC) is regarded as a fairly common endocrine malignancy, which can be divided into different multiple variants due to wide morphologic differences. The majority of PTC variants have been reported, but PTC with nodular fasciitis-like stroma (NFS) is a rare pathological variant and has been infrequently reported in the relevant literature. This condition involves abundant reactive stromal components rich in spindle cells, which may account for 60%-80% of the tumor along with a typical papillary carcinoma. CASE SUMMARY A 44-year-old man presented with a 4-mo history of a palpable mass over the anterior aspect of the left neck, the tumor demonstrated gradual enlargement but was painless during the 4 mo prior to discovery. Thyroid function test results were normal. Physical examination showed an enormous and firm nodular mass in the left lobe of the thyroid gland extending to the level of the hyoid bone. Ultrasonography of the neck revealed a well-defined heterogeneous lesion measuring around 5.0 cm × 4.0 cm with a hypoechoic complex nodule, decreased vascularity and speckles of microcalcification. The patient underwent left thyroidectomy with central compartment lymph node dissection. Final histopathological examination confirmed the diagnosis of PTC with extensive fibromatosis-like stroma combined with typical PTC. The patient was asymptomatic at the 3-mo follow-up. CONCLUSION PTC-NFS is a rare pathological variant and its diagnosis and prognosis may be similar to typical papillary carcinoma.
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Affiliation(s)
- Jun Hu
- Department of Thyroid Surgery, The First People’s Hospital of Changzhou, Changzhou 213003, Jiangsu Province, China
| | - Fei Wang
- Department of Thyroid Surgery, The First People’s Hospital of Changzhou, Changzhou 213003, Jiangsu Province, China
| | - Wei Xue
- Department of Thyroid Surgery, The First People’s Hospital of Changzhou, Changzhou 213003, Jiangsu Province, China
| | - Yong Jiang
- Department of Thyroid Surgery, The First People’s Hospital of Changzhou, Changzhou 213003, Jiangsu Province, China
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15
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Liang ZW, Gao WL. ADAMTS3 and FLT4 gene mutations result in congenital lymphangiectasia in newborns: A case report. World J Clin Cases 2023; 11:5179-5186. [PMID: 37583869 PMCID: PMC10424027 DOI: 10.12998/wjcc.v11.i21.5179] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/24/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Congenital lymphangiectasia is a rare disease characterized by dilated interstitial lymphatic vessels and cystic expansion of the lymphatic vessels. Congenital lymphangiectasia can affect various organ systems; however, it frequently occurs in the lungs accompanied with unexplained pleural effusion. Further, it might not be diagnosed during prenatal examination owing to the absence of pronounced abnormalities. However, after birth the newborn rapidly develops respiratory distress that quickly deteriorates. Genetic variations in proteins controlling the development of lymphatic vessels contribute to the pathophysiology of this disease. We report a rare case of heterozygous mutation of ADAMTS3 and FLT4 genes, which have not been reported previously. CASE SUMMARY We analysed the case of a neonate who had presented with only pleural effusion at a late gestational age and eventually died due to its inability to establish spontaneous breathing after birth. An autopsy revealed lymphangiectasia of the organ systems. Further, whole exome sequencing revealed heterozygous mutations of the lymphangiogenesis-controlling genes, ADAMTS3 and FLT4, and Sanger verification revealed similar lesions in the mother with no symptoms. CONCLUSION Considering the presented case, obstetricians should observe unexplained foetal pleural effusion, and perform pathology analysis and whole exome sequencing for a conclusive diagnosis and prompt treatment.
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Affiliation(s)
- Zhu-Wei Liang
- Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Wan-Li Gao
- Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
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16
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Tan SW, Misron K, Tengku Kamalden TMI. Large Thyroglossal Duct Cyst Presenting in Adulthood: A Case Report and Literature Review. Cureus 2023; 15:e37084. [PMID: 37168144 PMCID: PMC10166281 DOI: 10.7759/cureus.37084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
Thyroglossal duct cyst (TGDC) is one of the most prevalent congenital midline cervical anomalies which commonly appear during childhood. It has a typically slow-growing presentation with small- or moderate-sized swelling. Here, we described our experience in managing a case of TGDC with an extraordinary clinical course and size, with further evidence from a literature review. A 35-year-old gentleman presented later in adult life with a large midline neck mass of 9.3 x 9.0 x 10.7 cm reaching up to the level of mandible superiorly and sternal notch inferiorly. His history and physical examination, along with fine needle aspiration cytology (FNAC) and CT scan, were suggestive of TGDC. He successfully underwent a Sistrunk operation for TGDC without any morbidity. Postoperatively, he recovered well without evidence of recurrence during follow-up. Large TGDC is always a challenge to clinicians. Correlating the clinical features and imaging is crucial to decide the appropriate surgical treatment.
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17
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Liao Y, Li YJ, Hu XW, Wen R, Wang P. Benign lymphoepithelial cyst of parotid gland without human immunodeficiency virus infection: A case report. World J Clin Cases 2023; 11:931-937. [PMID: 36818610 PMCID: PMC9928695 DOI: 10.12998/wjcc.v11.i4.931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/13/2022] [Accepted: 01/10/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Benign lymphoepithelial cyst (BLEC) of the parotid gland is a rare benign embryonic-dysplastic cystic tumor in the anterolateral neck that occurs most commonly in human immunodeficiency virus (HIV)-positive adults and rarely in non-acquired immune deficiency syndrome patients. The main presentation is a slow-growing, painless mass, and secondary infection may cause acute inflammatory symptoms.
CASE SUMMARY A 44-year-old Chinese male patient presented with a 1-year history of a mass in the left side of the neck. On physical examination, a mass similar in size and shape to a quail egg was found in the left parotid gland. The mass was tough, without tenderness, and easily moveable. The results of HIV tests, including antibody and nucleic acid tests and CD4+ T cell examination, were negative. Imaging examination revealed a left parotid gland mass. The patient underwent surgical treatment, and BLEC was diagnosed based on postoperative pathology. After 2 years of follow-up, the patient survived well without related discomfort.
CONCLUSION The detailed characteristics of a BLEC in a patient without HIV infection contribute to an improved understanding of this rare disease.
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Affiliation(s)
- Yan Liao
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Yan-Jie Li
- Department of Critical Care Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Xian-Wen Hu
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Rui Wen
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Pan Wang
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
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18
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Chen W, Zhou Y, Xu M, Xu R, Wang Q, Xu H, Chen J, Li X. Congenital second branchial cleft anomalies in children: A report of 52 surgical cases, with emphasis on characteristic CT findings. Front Pediatr 2023; 11:1088234. [PMID: 36937970 PMCID: PMC10020344 DOI: 10.3389/fped.2023.1088234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Objective The objectives of this study was to review the clinical features and surgical treatment outcomes of congenital second branchial cleft anomalies (CSBCAs) and to investigate the characteristic computed tomography (CT) findings of CSBCAs. Methods We conducted a retrospective study of 52 children who were referred to Shanghai Children's Hospital from October 2014 to December 2021 diagnosed as CSBCAs. Results There were 36 males and 16 females. Of them, 35 patients were presented as having a skin pit at birth or discharge from the skin opening on the lateral neck, and 17 patients presented with an asymptomatic or painful mass. The typical CT features of CSBCAs included isolated and homogeneously hypodense cystic lesions surrounded by a uniformly thin, smooth wall. CSBCAs were generally located at the anteromedial border of the sternocleidomastoid muscle, posterior to the submandibular gland, and lateral to the carotid sheath. All patients were treated surgically and only one case underwent ipsilateral tonsillectomy. After a median follow-up of 30 (range 4-90) months, no recurrence or complications were observed. Conclusions The CSBCAs show some characteristic CT findings, which can help clinicians diagnose and plan surgical strategies. High ligation of the lesions is sufficient for complete excision of CSBCAs.
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Affiliation(s)
- Wei Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yilong Zhou
- Department of Pediatric Otorhinolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Mengrou Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Rong Xu
- Department of Radiology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qingyu Wang
- Department of Pathology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hongming Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiarui Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoyan Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Correspondence: Xiaoyan Li
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19
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Alarfaj AA. Coexistence of thyroglossal duct cyst and second branchial cleft cyst in a young woman: A case report and literature review. Int J Surg Case Rep 2022; 95:107192. [PMID: 35598343 PMCID: PMC9127597 DOI: 10.1016/j.ijscr.2022.107192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/26/2022] [Accepted: 05/08/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Thyroglossal cysts represent 70% of congenital neck anomalies, and second branchial cleft anomalies are the most common anomalies (90%) of the branchial apparatus. However, their coexistence, especially in adults, is very rare. Presentation of case A 23-year-old woman presented with a 1-year history of lateral left neck swelling and midline swelling. Imaging and histopathological examination confirmed the diagnosis of a thyroglossal duct cyst and a second branchial cleft cyst. The Sistrunk procedure was performed for surgical excision of the masses. Discussion Only three cases of a coexisting thyroglossal duct cyst and branchial cleft have been reported. Conclusion When encountering patients, even adults, with neck lesions, clinicians must keep in mind the possibility of a coexistence of a thyroglossal duct and a branchial cleft cyst.
Thyroglossal cysts represent 70% of congenital neck anomalies. Second branchial cleft anomalies are the most common branchial apparatus anomalies. Only three cases of coexisting thyroglossal duct and branchial cleft cysts have been reported. We present a rare case of a young woman with the two cysts coexisting.
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20
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Li JY, Sun LX, Hu N, Song GS, Dou WQ, Gong RZ, Li CT. Eustachian tube teratoma: A case report. World J Clin Cases 2022; 10:316-322. [PMID: 35071534 PMCID: PMC8727263 DOI: 10.12998/wjcc.v10.i1.316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/23/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mature teratoma composed of all three basic germ cell layers of the head and neck is a rare disease. Teratomas involving the temporal bone are particularly scarce.
CASE SUMMARY A 48-year-old male patient with a history of chronic otitis of the left ear from infancy, for which he had been operated on twice, was referred to our hospital for chronic otitis, cholesteatoma and a middle ear mass. Computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed a eustachian tube teratoma, in which the anterior lower part and posterior upper part were connected by a thin membranaceous tissue. The mass was removed completely under general anesthesia by mastoidectomy. As of last follow-up (2 years post-surgery), the disease had not relapsed.
CONCLUSION Pre-operative CT and MRI are necessary for eustachian tube teratoma. Complete surgical resection provided excellent prognosis.
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Affiliation(s)
- Jin-Ye Li
- Department of Radiology, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
| | - Li-Xin Sun
- Department of Radiology, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
| | - Na Hu
- Department of Radiology, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
| | - Ge-Sheng Song
- Department of Radiology, Shandong Province Qianfoshan Hospital, Jinan 250021, Shandong Province, China
| | - Wei-Qiang Dou
- GE Healthcare, MR Research China, Beijing 100000, China
| | - Ruo-Zhen Gong
- Gong Ruozhen Innovation Studio, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
| | - Chuan-Ting Li
- Department of Radiology, Shandong Province Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China
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21
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Corvino A, Caruso M, Varelli C, Di Gennaro F, Pignata S, Corvino F, Vallone G, Catalano O. Diagnostic imaging of parotid gland oncocytoma: a pictorial review with emphasis on ultrasound assessment. J Ultrasound 2021; 24:241-247. [PMID: 32710434 PMCID: PMC8363736 DOI: 10.1007/s40477-020-00511-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022] Open
Abstract
Parotid gland oncocytoma (PGO) is a rare benign epithelial tumor that usually occurs in the elderly population. The most common clinical presentation is a painless, slow-growing, non-tender, lobulated, and mobile mass. Histologically, it is composed of monotonous sheets of epithelial cells (oncocytes) with a central scar. The cross-sectional appearance is not specific, and it overlaps with other parotid lesions. On ultrasound (US), oncocytoma appears as an ovoid, well-defined, homogeneous, and hypoechoic lesion. Cystic and hemorrhagic areas as well as intralesional fat may be observed. Doppler analysis shows intratumoral vessels, sometimes with a spoke-wheel pattern. The peak systolic flow is high (up to 100 cm/sec). Furthermore, oncocytoma is avid of FDG on a PET scan, as well as a malignant tumor. Thus, a combined clinical, imaging, and pathologic assessment is essential to establish the most accurate diagnosis and plan the best treatment. US, combined with Doppler techniques, can play an important role in suggesting the diagnosis and confirming it through percutaneous sampling. The purpose of this review is to show the imaging findings in PGO, with special emphasis on the US appearance.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", via F. Acton 38, I-80133, Naples, Italy.
- , Casal di Principe, Italy.
| | - Martina Caruso
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131, Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Varelli Institute, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Francesca Di Gennaro
- Nuclear Medicine Division, Radiology and Radiotherapy Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, 80131, Naples, Italy
| | - Saverio Pignata
- Ultrasound Unit, Ninetta Rosano Institute, via Capo Tirone 14, 87021, Belvedere Marittimo (CS), Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianfranco Vallone
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131, Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Varelli Institute, via Cornelia dei Gracchi 65, 80126, Naples, Italy
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22
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Imaging features and enhancement technique to diagnose and classify intrathoracic Lymphatic-venous malformations: A case report and literature review. Radiol Case Rep 2021; 16:1888-1894. [PMID: 34113413 PMCID: PMC8170020 DOI: 10.1016/j.radcr.2021.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/11/2021] [Accepted: 04/11/2021] [Indexed: 11/24/2022] Open
Abstract
The diagnosis and treatment of pediatric intrathoracic lymphatic-venous malformations (LVM) can be complex due to their rarity, variable presentation and confusing nomenclature in the literature. The International Society for the Study of Vascular Anomalies (ISSVA) has recently (2018) updated their classification to help guide the correct diagnosis, nomenclature and management of such cases. We present the case of a 12-month-old Caucasian female with a lymph-venous malformation (LVM) classified in the updated ISSVA classification as a combined vascular malformation (CLVM) defined as two or more vascular malformations found in one lesion, associated with an underlying “malformation of an individual named vessel”. The patient presented with tachypnea, tachycardia and fever. While all the previous cases underwent surgical treatment, our patient was successfully treated with rapamycin and sclerotherapy. Appropriate imaging can aid in the diagnosis of vascular anomalies and in the proper ISSVA classification, saving the patient the need for a biopsy and allow for proper referral to Multidisciplinary Vascular Anomalies centers. The accurate classification can identify cases that can be treated through Interventional Radiology with sclerosing agents and medical therapy as opposed to surgery.
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23
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Catelli A, Corvino A, Quarantelli M, Venetucci P. Obstructive oligospermia: the role of interventional radiology in its diagnosis and treatment. Pol J Radiol 2021; 86:e204-e207. [PMID: 34093916 PMCID: PMC8147715 DOI: 10.5114/pjr.2021.105590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/04/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE According to the latest World Health Organization guidelines (2010), oligo-sperm it is due to a sperm concentration of less than 15 million/ml of seminal fluid. The cause can be obstructive and non-obstructive. Interventional radiology allows diagnosis and, in some cases, minimally invasive treatment. CASE PRESENTATION A 28-year-old man with oligospermia (7 million/ml of seminal fluid), surgically treated 2 years ago for clinical grade III bilateral varicocele (according to Dubin's classification), was admitted to the Urology Department for suspected accidental surgical ligation of the left vas deferens. The patient underwent several diagnostic tests including phlebography of the left pampiniform plexus, bilateral vesico-deferentography. The steno-occlusion of the ejaculatory ducts was diagnosed, which was resolved through an innovative interventional radiology treatment. CONCLUSIONS Interventional radiology has played a decisive role in the diagnosis and treatment of the causes of male infertility. In our experience, it has considerable potential in the minimally invasive treatment of steno-obstructive pathologies of the vesico-deferential system.
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Affiliation(s)
- Antonio Catelli
- Department of Advanced Biomedical Sciences, University Federico II of Naples (UNINA), Naples, Italy
| | - Antonio Corvino
- Department of Motor Science and Wellness, University of Naples “Parthenope”, Naples, Italy
| | - Mario Quarantelli
- Department of Advanced Biomedical Sciences, University Federico II of Naples (UNINA), Naples, Italy
| | - Piero Venetucci
- Department of Advanced Biomedical Sciences, University Federico II of Naples (UNINA), Naples, Italy
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24
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Catelli A, Corvino A, Loiudice G, Tucci A, Quarantelli M, Venetucci P. Diagnostic imaging in the diagnosis of acute complications of bariatric surgery. Pol J Radiol 2021; 86:e102-e111. [PMID: 33758635 PMCID: PMC7976234 DOI: 10.5114/pjr.2021.104003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/21/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of study is to identify the frequency of acute complications and imaging findings at gastro-intestinal transit (GI) and computerised tomography (CT) in a group of obese patients who developed clinical suspicion of acute complications (painful and meteoric abdomen, nausea, vomiting, fever, intestinal blockage) in post bariatric surgery. MATERIAL AND METHODS We retrospectively review 954 obese patients who underwent bariatric surgery between 2013 and 2019. The study included 72 patients who developed clinical suspicion of acute complications (painful and meteoric abdomen, nausea, vomiting, fever, intestinal blockage) within 6 days of bariatric surgery of sleeve gastrectomy, gastric banding, gastric bypass with Roux loop confirmed by CT, and who underwent a gastrointestinal transit before the CT examination. RESULTS GI exam allowed visualisation of 58% of complications. Analysing the data for each surgical technique, 46 post-operative complications were found involve gastric banding. The most frequent was bandage migration (26 cases, 56 %), identified in all cases at GI transit and then confirmed on CT. CONCLUSIONS The study suggests that CT should be used to clarify all doubtful or clinically discordant GI transit exam results. The participation of a radiologist in qualification and post-operative evaluation is important for bariatric surgery patients.
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Affiliation(s)
- Antonio Catelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Naples, Italy
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, Naples, Italy
| | - Giovanni Loiudice
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Naples, Italy
| | - Anna Tucci
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Naples, Italy
| | - Mario Quarantelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Naples, Italy
| | - Pietro Venetucci
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Naples, Italy
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25
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Ozturk K, Li F, Özütemiz C, Cayci Z. Not a pearl necklace: synchronous papillary carcinoma of thyroglossal duct cyst and thyroid gland. Clin Imaging 2020; 73:111-114. [PMID: 33360837 DOI: 10.1016/j.clinimag.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/16/2020] [Accepted: 12/17/2020] [Indexed: 11/15/2022]
Abstract
We report an unusual case of synchronous papillary carcinoma of thyroglossal duct cyst (TGDC) and thyroid gland. Here, the radiology findings, surgical approach and subsequent management, and pathology of an synchronous papillary carcinoma of TGDC and thyroid gland are described.
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Affiliation(s)
- Kerem Ozturk
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN, USA.
| | - Faqian Li
- Department of Pathology and Laboratory Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA.
| | - Can Özütemiz
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN, USA.
| | - Zuzan Cayci
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN, USA.
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26
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Corvino A, Catalano O, de Magistris G, Corvino F, Giurazza F, Raffaella N, Vallone G. Usefulness of doppler techniques in the diagnosis of peripheral iatrogenic pseudoaneurysms secondary to minimally invasive interventional and surgical procedures: imaging findings and diagnostic performance study. J Ultrasound 2020; 23:563-573. [PMID: 32436181 PMCID: PMC7588580 DOI: 10.1007/s40477-020-00475-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/06/2020] [Indexed: 12/11/2022] Open
Abstract
The pseudoaneurysm (PA) is a perfused sac directly connecting with the arterial lumen by an interruption of the vessel wall continuity, more commonly secondary to trauma or iatrogenic causes. Aim of our study was to determine the accuracy and usefulness of Doppler techniques in the diagnosis of peripheral iatrogenic PAs secondary to minimally invasive procedures. From a three year prospective research, 20 Duplex Ultrasound (DUS) studies in as many patients presenting with periarterial pulsating mass clinically suspected for PA secondary to minimally invasive procedures were selected. The PA final diagnosis was confirmed by angiography in 12 patients (60% cases), by computed tomography angiography in 5 patients (25%), by surgery in 2 patients (10%), and by magnetic resonance angiography in 1 patient (5%). The vessels involved by PA formation were: common femoral artery in 8 cases (40%); superficial femoral artery in 4 cases (20%); brachial artery in 3 cases (15%); popliteal artery in 2 cases (10%); superficial temporal artery (STA) in 2 cases (10%); dorsal medial digital artery of the foot in 1 case (5%). Our study confirmed the usefulness of doppler techniques in the diagnosis of peripheral iatrogenic PAs. Specifically, a sensitivity of 90-95%, a specificity of 100% and predictive values of 100% (VPP) and 83-90% (VPN) were reported. The radiologist must always suspect a PA in the differential diagnosis of lesions contiguous to an artery vessel. This is to prevent potential complications such as e.g. massive haemorrhage. In this order, DUS allows a careful selection of patients who require to undergo in-depth imaging methods or surgical therapy, thus contributing to a significant reduction of contrast medium and exposure to ionizing radiation.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", Via F. Acton 38, 80133, Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Giuseppe de Magistris
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
| | - Francesco Giurazza
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Niola Raffaella
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianfranco Vallone
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131, Naples, Italy
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27
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Corvino A, Campanino MR, De Rosa N, Corvino F, Gisonni P. Left-sided omental infarction without torsion: report of a case with radiologic-pathologic correlation. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020; 51:117. [DOI: 10.1186/s43055-020-00235-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
Abstract
Background
Omental infarction is a rare disease that affects the entire omentum or a segment of the greater omentum. It presents as acute abdominal pain mainly in the right lower quadrant or right flank. Left-sided omental torsion is infrequent and it is rarely preoperatively diagnosed.
Omental infarction is a differential diagnosis in the acute abdomen. As most cases of omental infarction can be adequately diagnosed via computed tomography, a conservative treatment strategy for patients without complications should be considered in order to avoid any unnecessary surgical intervention.
Case presentation
We herein report a case of a surgically proved left-sided infarction of the greater omentum presenting with abdominal pain, tenderness of the left flank. Specifically, we describe the ultrasound (US) and computed tomography (CT) findings of this rare disease providing a radiological-pathological correlation of them. To date, there are few similar correlation reports in literature.
Conclusions
Although the classical treatment of omental infarction is surgery, more recently the conservative management has been suggested. Thus, we believe that the knowledge of the characteristic imaging findings is essential for establish a correct preoperative diagnosis, which can avoid unnecessary surgical intervention.
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Catelli A, Venetucci P, Castaldo A, loiudice G, Tarulli FR, Carpiniello M, De Angelis M, Corvino A. Calcium pyrophosphate deposition disease: The role of imaging in their detection and in differential diagnosis of crystal arthropathies. Radiol Case Rep 2020; 15:1773-1776. [PMID: 32774579 PMCID: PMC7403887 DOI: 10.1016/j.radcr.2020.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 02/06/2023] Open
Abstract
Calcium pyrophosphate deposition disease is characterized by the deposition of pyrophosphate crystals in various joint structures. Calcium pyrophosphate deposition disease can be linked to underlying metabolic disorders such as hemochromatosis, hyperparathyroidism, hypophosphatemia, hypomagnesaemia, and hypothyroidism, all of which increase the risk of calcium pyrophosphate deposition. We present the case of a 55-year-old male who underwent diagnostic examination for the onset of recurrent joint pain in the right knee.
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Affiliation(s)
- Antonio Catelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Pietro Venetucci
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Anna Castaldo
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Giovanni loiudice
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | | | | | | | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, Naples, Italy
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Ma JJ, Zhang B. Diagnosis of an actively bleeding brachial artery hematoma by contrast-enhanced ultrasound: A case report. World J Clin Cases 2020; 8:3835-3840. [PMID: 32953861 PMCID: PMC7479570 DOI: 10.12998/wjcc.v8.i17.3835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/16/2020] [Accepted: 07/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Active bleeding due to arterial injury following the acupuncture can sometimes represent a life-threatening complication. Only few reports of an actively bleeding hematoma diagnosed by contrast-enhanced ultrasound, which enables the depiction of vascular, have been reported.
CASE SUMMARY Here, we report the case of a 75-year-old woman, who presented with sudden swelling, ecchymosis, and pain in the upper left limb. She underwent an acupuncture treatment of traditional Chinese medicine followed by a deep shoulder massage 2 d before admission to hospital. A few hours after the massage, her left upper arm was red, swollen and progressively aggravated. Ultrasonography showed a large hematoma (11.2 cm × 3.5 cm × 3.4 cm) beside the left brachial artery. Color Doppler ultrasound revealed that blood flow signals of the arteries branched into the hematoma. The contrast-enhanced ultrasound showed microbubbles from the brachial artery passing into the hematoma, diffused within the hematoma with the local surge of red blood cells, and disappearing after approximately 17 s. The microbubbles were likely due to bleeding from the arteries. After pressure bandaging treatment, the hematoma became smaller (3.1 cm × 1.7 cm) and organized according to ultrasonography performed 20 d later.
CONCLUSION This case highlights the ultimate importance of contrast-enhanced ultrasound for the diagnosis of an actively bleeding hematoma.
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Affiliation(s)
- Jiao-Jiao Ma
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
| | - Bo Zhang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
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Catelli A, Loiudice G, Corvino A, Castaldo A, Bracale UM, Quarantelli M, Venetucci P. Amplatzer vascular plug IV in the treatment of high flow renal arteriovenous fistula: Case considerations. Radiol Case Rep 2020; 15:1442-1445. [PMID: 32642014 PMCID: PMC7334554 DOI: 10.1016/j.radcr.2020.05.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 01/22/2023] Open
Abstract
Renal arteriovenous fistula is classified into idiopathic, acquired and congenital. Endovascular therapy has become the gold standard compared to surgery. We present the embolization procedure of a renal fistula postbiopsy in a 57-year-old female patient through the use of St. Jude Medical Amplatzer vascular Plug IV. Although numerous embolizing agents are available, plug type IV has numerous advantages in terms of procedure times, speed of embolization and precision of the occlusion, but with a relative increase in costs.
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Affiliation(s)
- Antonio Catelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Giovanni Loiudice
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, I-80133 Naples, Italy
| | - Anna Castaldo
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | | | - Mario Quarantelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Pietro Venetucci
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
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