ABSTRACT
Pulmonary mucoepidermoid carcinoma (PMEC) is rare and challenging to diagnose. Its association with paraneoplastic syndromes is poorly described. It is also uncommon for a patient with lung cancer to present with multiple paraneoplastic syndromes. We report a case of a patient with metastatic high-grade PMEC associated with three paraneoplastic syndromes, namely, humoral hypercalcemia of malignancy, ectopic ACTH syndrome, and paraneoplastic leukemoid reaction.
ABSTRACT
BACKGROUND: Head and neck malignancies often present as firm, solid nodal masses. However, malignancies arising from Waldeyer's Ring may give rise to cystic lymph nodes. METHODS: A 57-year-old man was referred for left-sided neck swelling of 2 weeks' duration. A CT scan revealed an enlarged cystic cervical node at level 5A/B and he underwent excision biopsy. RESULTS: Histology reported nodal fibrosis with melanophages. Further examination revealed a black nodule on his back where he had wide excision and the histology confirmed pigmented epithelioid melanocytoma. CONCLUSION: Cervical lymphadenopathy can rarely be due to an upper back lesion, such as pigmented epithelioid melanocytoma. Thus, routine clinical examination of the upper back should be performed in patients with cervical lymphadenopathy.
Subject(s)
Head and Neck Neoplasms/pathology , Lymphadenopathy/pathology , Melanosis/pathology , Nevus, Pigmented/pathology , Skin Neoplasms/pathology , Humans , Lymph Node Excision , Male , Middle AgedABSTRACT
We report a patient with Graves' disease who remained persistently hyperthyroid after a total thyroidectomy and also developed de novo Graves' ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion. LEARNING POINTS: It is important to investigate for other causes of primary hyperthyroidism when thyrotoxicosis persists after total thyroidectomy.TSH receptor antibody may persist after total thyroidectomy and may potentially contribute to the development of de novo Graves' ophthalmopathy.
