Exophytic and fungating papillary thyroid carcinoma: A rare and complex presentation of a well-differentiated malignancy

@#Papillary thyroid carcinoma is the most common well-differentiated thyroid malignancy accounting for more than 80 to 90% of all thyroid tumors. It has an overall excellent prognosis owing to advances in screening via imaging and ultrasound-guided fine-needle aspiration biopsy, which have facilitated early detection, diagnosis, and surgical treatment followed by adjuvant radioactive iodine therapy. Exceptionally rare cases of papillary thyroid tumors may present with enormous growth due to delayed consultation and, thus, late diagnosis, posing a challenge to definitive management, quality of life, overall survival, and prognosis. We report a case of a 35-year-old woman who presented with a 4-year history of a bleeding exophytic and fungating anterior neck mass. Computed tomography showed a fungating mass arising from the left thyroid lobe that measured 14.1 x 14.0 x 11.1 cm with areas of necrosis and hemorrhage, left internal jugular vein thrombus formation, and compression of the left internal carotid artery. The mass causes a displacement of the trachea to the right side and multiple bilateral cervical lymphadenopathies. The patient was fully aware, and she consented to undergo wide excision, total thyroidectomy, neck dissection, and pectoralis major muscle flap reconstruction. However, she went into arrest intraoperatively attributed to massive pulmonary embolism. Papillary thyroid cancer is well known for its excellent prognosis. However, outcomes may not be favorable and can even be fatal in advanced and extensive cases. Although fungating papillary cancers are rare, they remain more common in the developing countries, where early detection and access to healthcare remains limited. They also represent a big challenge to surgeons. Even if the outcome was not good, we opted to report this case as there were many learning points. If only patients with good and excellent outcomes are reported in the literature, it will overestimate the treatment success of these complex cases.

Pyogenic Granuloma Of Upper Lip: A Case Report

Pyogenic granuloma is a common tumor-like growth of the oral cavity that is supposed to be non-neoplastic in nature. It is a reactional response to minor trauma or chronic irritation and due to hormonal changes. Clinically oral pyogenic granuloma is a smooth or lobulated exophytic lesion on a pedunculated or sessile base, which is mostly haemorrhagic. Although pyogenic granuloma is a non-neoplastic growth in the oral cavity, proper diagnosis, prevention, management and treatment is very important. This case report draws attention towards the uncommon location of the pyogenic granuloma on the upper lip. Surgical excision was done because of the cosmetic disfigurement and discomfort to the patient.

Central plexiform ameeloblastoma with exophytic growth a rare case report with review of literature.

Ameloblastomas are predominantly benign, intra-osseous odontogenic tumors and mucosal involvement is a rare secondary phenomenon, occurring only after a long period of intra-osseous growth and bone expansion. This article presents a case report of an eleven year old male patient with a large plexiform ameloblastoma which invaded the soft tissues, presented as an exophytic growth in the mandibular anterior region with radiographic feature of a large unilocular radiolucenc y and displaced mandibular left central incisor. The management comprised of surgical removal of ameloblastoma under local anesthesia along with extraction of displaced mandibular left central incisor.

A Case of Exophytic Squamous Cell Carcinoma of the Stomach / 대한소화기내시경학회지

Squamous cell carcinoma of the stomach has been reported to occur at a younger age and have a worse prognosis than gastric adenocarcinoma. Even though squamous cell carcinoma of the stomach has several different clinical characteristics, it is difficult to distinguish it from gastric adenocarcinoma by radiological or endoscopical methods without a histopathological confirmation. Primary squamous cell carcinoma of the stomach is a rare type of cancer. To date, only six cases have been reported in Korea. Gastric cancer seldom grows exophytically and there are no reports of squamous cell carcinoma of the stomach with exophytic growth in Korea. We report a case of pure squamous cell gastric cancer with exophytic growth with a brief review of the relevant literature.

A case of gastrointestinal stromal tumor of the stomach showing exophytic growth / 대한내과학회지

Gastroinstestinal stromal tumors (GISTs) are defined as a group of KIT (CD117) positive mesenchymal tumors. Approximately 70% of those tumors are found in the stomach followed in order by the small bowel, colon and rectum, esophagus. The common clinical presentation of GISTs varies according to the size and location of the tumors, ranging from massive gastrointestinal bleeding to vague abdominal pain. We detected a GIST of the stomach incidentally during chest-computed tomography examination of a 68-year-old-woman. Esophagogastroduodenoscopy showed an 8 cm sized protruded lesion with normal mucosal covering on the posterior wall of the gastric body, and endoscopic ultrasonography showed a cystic mass originating in the fourth layer of the stomach. The patient was treated with a subtotal gastrectomy. Immunohistochemical studies on the surgical resection specimen showed CD117(+) and CD34(+). The final diagnosis was a GIST of the stomach showing exophytic growth.