Glucagonoma presenting as necrolytic migratory erythema in a long-standing type II diabetic patient

We report a case of glucagonoma in a 60-year old diabetic lady who was seen by a dermatologist for a superficial erythematous skin eruption with flaccid bullae over both legs of recent onset. These findings warranted further investigations that revealed a pancreatic mass lesion involving the distal body and tail with three metastatic deposits within the right lobe of the liver. Distal pancreatectomy and splenectomy were performed and histological examination of the excised specimen confirmed the diagnosis of pancreatic glucagonoma with liver metastasis. Blood sugar levels became more controlled postoperatively. The skin lesion disappeared completely six months after surgery. The lady enjoys fairly good health, and is maintained on Somatostatin analogues for control of metastasis that are stable after 18 months of follow up

Thyroiditis in a Jordanian cohort with goitre: results of fine needle thyroid aspirate

To determine the prevalence of cytologically proven thyroiditis among patients with goiter referred to Endocrine clinic at King Hussein Medical Center using fine needle thyroid aspirate and to assess thyroid status among those patients. Case study of patients who underwent fine needle aspirate thyroid biopsy for different types of goiter from January 1995 to June 2004 was conducted. Fine needle aspirate thyroid biopsy was taken using a 20cc syringe on a pistol gun apparatus under aseptic technique. All reports including the diagnoses of thyroiditis, autoimmune thyroiditis [Hashimoto's thyroiditis], lymphocytic thyroiditis, and focal thyroiditis were included. Thyroid function tests and thyroid antibodies were also reported in some patients. A total of 1934 patients underwent fine needle aspirate thyroid biopsy during the study period, 279 cases were excluded because of inadequacy of the sample, missing reports and repeated sample in some patients with the same diagnosis. Those actually included in the study were 1655 [females 1475, males 180, male: female ratio was 8:1]. Thyroiditis was reported in 323 patients [females 93.5%], giving a total prevalence of 19.5%; 11.7% for males and 20.5% for females. Hashimoto, lymphocytic and unclassified thyroiditis were found in 66.25%, 22.6% and 8.6% of the patients respectively. Hashimoto' and lymphocytic thyroiditis are the commonest causes of thyroiditis in Jordanian patients with goiter, females being affected more commonly than males. Fine needle aspirate thyroid biopsy of thyroid gland is an important tool of investigation for thyroid disorders in general and thyroiditis in patients with goiter. Long term follow up of patients with thyroiditis should be adopted