Renal involvement in cases of spindle epithelial tumor with thymus-like differentiation: a case report and review of the literature

Background: Spindle epithelial tumor with thymus-like differentiation [SETTLE] is a very rare neoplasm of the thyroid first described by Chan and Rosai in 1991. Renal involvement usually occurs as part of a disseminated metastatic picture. SETTLE is believed to arise from branchial pouch or thymic remnants and shows primitive thymic differentiation

Presentation: A 41-year-old male presented with a thyroid mass in 2005. The patient underwent a total thyroidectomy followed by radiation therapy. Pathology concluded papillary thyroid cancer. In 2011, the patient was admitted with worsening cough. CT showed lung involvement, multiple mediastinal lymph nodes, and a left renal mass. A biopsy established the diagnosis of SETTLE. Four cycles of platinum chemotherapy were given. In 2014, the patient was referred to Urology with progressive flank pain and hematuria. CT showed a progression of the renal mass, and results of an U/S guided biopsy of the kidney were consistent with SETTLE. An elective radical nephrectomy was performed in late 2016 to relieve symptoms. The patient is currently being followed as an outpatient

Conclusion: Due to the rare nature of SETTLE, algorithms for the diagnosis, treatment, and outcomes are not established. Although SETTLE presents as a low-grade malignancy, this case, as well as other reported cases with a long follow-up duration, suggested that it can metastasize many years after initial diagnosis. More data is needed to elucidate the risk and prognosis of renal metastasis in SETTLE

Multiple types of coloboma in an otherwise healthy patient: a case report

Purpose: this study aimed to report a case of a unilateral lenticular coloboma super imposed over bilateral iris and optic nerve coloboma in a healthy patient, colobomas are rare congenital malformation of the neuroectodermal tissue of the optic cup

Materials and Methods: this case of medically free patient who complained of poor vision since early childhood that has progressed in the last five years. Patient underwent thorough and complete ophthalmic investigation

Results: fundus photography revealed inferior optic nerve colobomas in both eyes and no uveal colobomas. On slit lamp examination, bilateral inferior iris coloboma were noted. Systemic examination was unremarkable. Patient was otherwise healthy

Conclusion: our report showed the need of more studies to be done in order to have a better understanding of the prevalence, management and genetics related to this condition in our population