Risk factors for recurrent papillary thyroid carcinoma

OBJECTIVE: To identify risk factors associated with disease recurrence among Filipinos with papillary thyroid carcinoma (PTC).METHODS:Design: Retrospective Cohort StudySetting: Tertiary National University HospitalParticipants: 76 patients diagnosed with papillary thyroid carcinoma, classified as low and low-to-intermediate risk (2015 ATA classification) that underwent total thyroidectomy with or without neck dissection from 2010-2014 and were followed up from 10 months to 5 years. Log rank and Cox regression analyses were used to determine significant risk factors for recurrence.RESULTS: 29 (38.15%) had recurrence. On univariate analysis, age, tumor size, multifocality, extrathyroidal extension, presence of lateral neck nodes and RAI therapy were statistically associated with recurrence. However, on multivariate analysis, no clinicopathologic factor was statistically associated with recurrence.CONCLUSION: Age of >45 years, female sex, tumor size of >2 cm, multifocality, presence of microscopic extrathyroidal extension and lymph node metastasis might contribute to the recurrence of papillary thyroid cancer while post-operative radioactive ablation may have some protective effect. However, this study suggests that other factors must be included in the model to better understand the relationship between these factors and recurrence.

Extragnathic sinonasal ameloblastoma: A rare benign intranasal tumor with malignant features

@#<p><strong>OBJECTIVE:</strong> To report a case of extragnathic sinonasal ameloblastoma and discuss its clinical features, approach to diagnosis, pathology and management.<br /><br /><strong>METHODS:<br /></strong><strong>Design:</strong> Case Report<br /><strong>Setting:</strong> Tertiary Government University Hospital<br /><strong>Patient:</strong> One<br /><br /><strong>RESULTS:</strong> A 40-year-old female consulted for a rapidly enlarging right intranasal mass of four months duration associated with recurrent profuse epistaxis and nasal obstruction. Previous specimens of the mass were histopathologically interpreted as ameloblastoma versus craniopharyngioma. Examination revealed a pink, fleshy, smooth right intranasal mass with associated nasomaxillary bulge and supero-Iateral displacement of the right eye. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the nasal cavity and paranasal sinuses demonstrated a soft-tissue density occupying the entire nasal cavity with erosion but no invasion of the maxillary sinus and no intracranial extension despite erosion of the skull base. The mass was completely excised via lateral rhinotomy and the final histopathologic diagnosis was ameloblastoma.<br /><br /><strong>CONCLUSION:</strong> Extragnathic sinonasal ameloblastoma is a benign but locally aggressive variant of ameloblastoma involving the nasal cavity and/or paranasal sinuses often mimicking malignant tumors. Diagnosis is primarily based on histopathology but radiologic and intraoperative findings help distinguish it from differentials. Complete surgical excision remains the treatment of choice, and coupled with good follow up, may improve the prognosis of patients.</p>