Subclinical hypothyroidism in lithium-treated psychiatric patients in Tehran, Islamic Republic of Iran

We investigated thyroid function in 46 [20 female and 26 male] psychiatric outpatients on lithium treatment by assessing triiodothyronine, thyroxine and thyroid stimulating hormone [TSH] levels. The presence of thyroid antibodies [anti-thyroid peroxidase and anti-thyroglobulin] was also assessed. Out of the 46 patients, 8 [17%] displayed overt hypothyroidism. Of the remaining patients, subclinical hypothyroidism was found in 16 patients [35%] and euthyroidism in 22 [48%]. Thyroid antibodies were present in 6 patients in the euthyroid group and 5 patients in the hypothyroid group. The Pearsor product-moment correlation results indicated positive association between TSH level and duration of lithium use and age of the patients with subclinical hypothyroidism. Duration of lithium use and age could be a reasonable indicator for screening asymptomatic patients for subclinical hypothyroidism after starting lithium treatment

Cardiac angiosarcoma; report of a case

Sarcomas are the most malignant tumors in the myocardium. Most common sarcoma is the angiosarcoma, classically located in the right atrium. Surgical resection is the primary treatment of choice for these patients. In July 2003, an 18 years old man with chest pain and dyspnea, transthoracic echocardiography demonstrated a large lobulated tumoral mass in right atrium. Cytologic examination of the pericardial effusion reported as no evidence of malignancy and chest CT scan showed cardiac dilatation with blood density and pericardial effusion. The patient underwent operation and tumor bulk was resected. Based on histological examination and immunohistochemistry, diagnosis of cardiac angiosarcoma was made and the patient received postoperative radiotherapy through parallel-opposed AP-PA cobalt beam technique. After combined modality treatment with surgery and postoperative radiotherapy, symptoms were disappeared and after 20 month follow up patient is symptom free. Despite of the ominous outcome of this malignancy an multimodality approach is worthy of consideration