Photo quiz What is your diagnosis? Diagnosis: carcinoma of the thyroglossal duct cyst

A 48-year-old woman was referred with an anterior midline neck mass which had gradually appeared without tenderness. The patient had a previous history of frequent painful swelling of the anterior part of her neck

diagnostic value of computed tomography in determining invasion to carotid arteries by head and neck malignant tumors

Awareness of invasion to the walls of the carotid arteries by malignant tumors, either tumoral mass or metastatic lymph nodes, is of great clinical importance before surgery and can change the management strategy. This study was conducted to assess the diagnostic value of computed tomography [CT] in determining invasion to carotid artery [CA] by oromaxillofacial and neck malignant tumors. CT with contrast was performed in 40 patients who has had oromaxillofacial and neck malignant tumors before surgical intervention. Abnormal CT findings in our patients were categorized into 6 types: I] tumor encasement of carotid arteries >/= 270 degrees; II] tumor encasement of carotid arteries >/= 180 degrees; III] compression and deformation of CA; IV] displacement of CA; V] ill-defined CA wall; and VI] the segmental deletion of fat or fascial planes between tumor and CA. The CT appearances of all tumors were prospectively compared with surgical findings. Abnormal CT findings in our patients included 6 with form I; 17 with type II; 2 with type III; 8 with type IV; 7 with type V; and 33 with type VI. Surgical findings showed that the tumors invaded CA vessels in 13 of 40 patients. The sensitivity, specificity, accuracy and positive and negative likelihood ratio values with 95% confidence interval for type I were 0.31, 0.93, 0.7, 4.15 and 1.3; for type II were 0.62, 0.67, 0.65, 1.8 and 1.7; for type III were 0, 0.93, 0. 63, 0 and 0.93; for type IV were 0.07, 0.74, 0.53, 0.3 and 0.8; for type V were 0.39, 0. 93, 0.69, 5.2 and 1.6; and for type VI were 1, 0.26, 0.50 and 1.35, respectively. Though many CT findings are of value in determining of CA invasion by head and neck tumors, our study demonstrated that encasement >/= 270 degree [type I], ill-defined wall of the artery [type V] and segmental deletion of fat or fascial planes between tumor and CA [type VI] are valuable in determining CA invasion by tumors. However, CT is not a definite way for the diagnosis of CA in-volvement by malignant tumoral lesions

Relation between third day LH level and ovarian response in IVF cycles

Infertility treatment has reached to prominent improvements in recent years and new methods of ART have important role in these improvements. Several factors are considered for patient's evaluation in these methods. For this purpose, we decided to evaluate the relation between third day LH with ovarian response in IVF cycles. This is a prospective study and 78 IVF candidates were chosen base on study requirements and were divided into two groups according to third day LH level. First group was consisted of 14 women with LH<3 mIU/ml, and second group was consisted of 64 women with LH>3. Patients had gone under treatment cycle base on long treatment plan with agonist gonadotropins and human gonadotropins. Then two groups were compared for number of follicle, number of retrieved oocyte, duration of ovarian stimulation, number of used gonadotropin ampules, number of resulted embryos, cancellation rate of cycles and finally pregnancy rate. Base on results and considering P value < 0.05, significant differences were not observed between the two groups in third day LH, patient age, kind of infertility, cause of infertility and duration of infertility. In other hand, two groups did not show any significance difference in ovarian response, number of follicle and retrieved oocyte, stimulation duration, number of used ampules, cancellation rate of cycles and pregnancy rate. This reveals third day LH level is not associated with success rate in IVF cycles