Tuberculosis of the thyroid

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To present a case of thyroid tuberculosis and to discuss its clinical presentation, differential diagnoses and management.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Case Report<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Patient:</strong> One<br /><strong>RESULTS:</strong> A 55-year-old farmer presented with an 8-month progressively enlarging anterior neck mass, and fine needle aspiration biopsy yielded grossly turbid straw-colored aspirate admixed with blood with microscopy showing scattered inflammatory cells and macrophages set against a colloid background. After total thyroidectomy, hispathology revealed parenchymal infiltration by multiple aggregates of plump spindled to epitheloid cells forming granulomas with interspersed multinucleated giant cells, central caseation necrosis and surrounding fibrosis with chronic inflammatory infiltrates. The nodal masses also showed prominent germinal centers with interspersed epitheloid cells and foamy macrophages. Final diagnosis was chronic granulomatous inflammation consistent with tuberculosis.<br /><strong>CONCLUSION:</strong> Tuberculosis (TB) of the thyroid is a rare occurrence that can present as inflammation, infection or tumor formation of the thyroid gland. Diagnosis depends on identification of the tubercle from tissues and aspirates by acid fast staining and TB culture. Treatment consists of multiple drug therapy for tuberculosis but thyroidectomy may be an option if the thyroid gland is severely diseased.</p>

Naso-glabello-frontal advancement reconstruction for chondroid syringoma of the nasal tip

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To   present   a   naso-glabello-frontal   advancement modification of   the   dorsal advancement  (Rintala)  flap  for reconstruction  of  an  unusual  case  of  chondroid  syringoma occurring at the nasal tip.<br /><strong>METHODS:</strong><br /><strong>  Design:</strong> Case Report<br /><strong>  Setting:</strong> Tertiary Government Training hospital<br /><strong>  Patient:</strong> One<br /><strong>RESULTS:</strong> A 23-year-old man who presented with a nasal tip mass initially diagnosed as a benign adnexal tumor underwent excision and reconstruction with a naso-glabello-frontal advancement flap modification of the dorsal advancement flap with median brow lift. The procedure resulted in nasal tip reconstruction with minimal scars, including a horizontal upper medial brow margin scar  that  eventually  became  less  apparent.  Final  histopathology  revealed  a  rare  benign  mixed tumor, chondroid syringoma.<br /><strong>CONCLUSION:</strong> The naso-glabello-frontal advancement flap is a one-stage procedure that can be used to reconstruct such a cutaneous nasal defect after tumor excision. The modification observes nasal aesthetic subunits and may have a better aesthetic outcome than traditional rotational or advancement flaps.</p>