ABSTRACT
Neuroendocrine neoplasm (NEN) of the larynx consists of 0.6% of laryngeal cancer and is the second most common type after squamous cell carcinoma (SCC). Laryngeal NEN rarely secret calcitonin and should be differentiated from medullary thyroid carcinoma. It makes a diagnostic and therapeutic challenge. We describe a case of a laryngeal NEN with calcitonin hypersecretion. A 59-year-old man presented to our clinic with recurrent cough, dysphonia, hoarseness, cervical mass, and significant weight loss. Diagnostic workup showed a supraglottic mass. Biopsy of the lesion revealed large-cell neuroendocrine neoplasm. Further diagnostic workup showed elevated serum calcitonin level. The patient underwent total laryngectomy, thyroidectomy, and modified radical neck dissection. During his follow-up, new subcutaneous nodules appeared that were biopsy-proven metastases. Then adjuvant chemoradiotherapy was performed. Laryngeal NEN with hypersecretion of calcitonin is a rare entity. In patients with elevated serum calcitonin levels and head and neck tumors, it should be considered a differential diagnosis of medullary thyroid carcinoma. As the management and prognosis of these two neoplasms are entirely different.
ABSTRACT
BACKGROUND: Dynamic and static activities in dentistry cause musculoskeletal disorders, but dental students do not have sufficient awareness about the effects of ergonomic factors on their health. The aim of this study was to investigate ergonomic factors that cause pain muscle in dental students in Kerman Medical University, Iran. METHODS: This cross-sectional analysis study was carried out on dental students of the 3rd, 4th, 5th, and 6th year, in clinical practice in the School of Dentistry, Kerman University of Medical Sciences. A convenient sample of 199 students who met the inclusion criteria was selected and those willing to participate signed an informed consent form. Data were collected by means of a structured questionnaire for ergonomic factors and the presence of pain. The variables evaluated were pain, affected zones, gender, postures, and work environment. RESULTS: The present research work reveals that over 69% of the dental students complained of pain in at least one part of their body. Most individuals suffered from hand and elbow (23%) and head (19%) pain. The clinical areas where more pain was found were endodontics and pedodontics. Furthermore, it was found that a high percentage of students usually worked with their legs slightly separated, with the sole of the feet resting on the stool when working. The presence of muscular pain was higher in males in this study. Furthermore, there was a statistically significant relationship with the final Rapid Entire Body Assessment score in different body parts and the participants' demographic data (sex, age, weight, height, sports, and smoking). CONCLUSIONS: The results of this study showed that the students' sitting positions and working environments need to be improved and it seems more training is necessary in this field.
