ABSTRACT
Medullary thyroid carcinoma is a rare tumour that is anatomically located in the thyroid gland but is functionally a neuroendocrine tumour. It is usually a disease of older age group but manifests in a young patient in familial form. It is derived from parafollicular c cells and has a predilection for lymph node metastasis. It is associated with slow growth in thyroid gland with early nodal metastasis. Serum calcitonin is useful as a preoperative marker of disease burden and prognosis. In the preoperative period serum levels of calcitonin can guide regarding the need for compartment wise lymph node dissection and the possibility of distant metastasis. It is used as a tool of surveillance in the postoperative period. The levels of serum CEA and calcitonin and their doubling time is a useful guide in the detection of early recurrence or distant metastasis. Imaging modality useful for diagnosis is USG in a majority of patients. Thus, the initial diagnosis and preoperative assessment of medullary thyroid carcinoma is similar to other forms of thyroid cancer but further management of disease differs significantly form other forms of differentiated thyroid carcinoma or even anaplastic carcinoma. Prognosis however differs according to age, gender, presence or absence of lymph node metastasis at presentation, metastatic disease at presentation and levels of biochemical markers.
ABSTRACT
Eccrine angiokeratomatous hamartoma is a rare newly defined vascular lesion of the skin, the first case of which was reported in 2006 (Kanitakis J, Ly A, Claudy A. Eccrine angiokeratomatous hamartoma: a new variant of eccrine hamartoma with angiokeratoma. J Am Acad Dermatol 2006; 55: S104-6). On web Literature Search, Only three previously documented cases of the lesions were found. A 1.5-year-old female child presented with a painless lesion on her right leg since birth which has been gradually increasing in size and recently developed central ulceration. Histological examination of the excised lesion confirmed the diagnosis. This is the first of the cases to be reported in paediatric age-group (<2 years).
