ABSTRACT
BACKGROUND: A 40-year-old man presented to a hospital emergency department with acute-onset, bilateral, painless swelling of the scrotum, which had developed progressively over the previous 12 h. He was physically well with no remarkable medical history, and was not taking any medication. He had no history of allergies or trauma (including insect bites to the genitalia), no urinary symptoms, and was not sexually active. INVESTIGATIONS: Physical examination, assessment of erythrocyte sedimentation rate, white blood cell count, renal function panel, urine microscopic analysis, urine cultures, transillumination, and scrotal ultrasonography. DIAGNOSIS: Acute idiopathic scrotal edema. MANAGEMENT: The patient received expectant management and treatment with an NSAID to relieve his inflammation. He was discharged from hospital and his symptoms resolved within 72 h of onset of treatment.
Subject(s)
Edema/diagnostic imaging , Genital Diseases, Male/diagnostic imaging , Scrotum/diagnostic imaging , Acute Disease , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Diagnosis, Differential , Edema/diagnosis , Edema/drug therapy , Genital Diseases, Male/diagnosis , Genital Diseases, Male/drug therapy , Humans , Male , Scrotum/drug effects , UltrasonographyABSTRACT
OBJECTIVE: The study objective was to study the impact of the diagnosis, treatment, and follow-up of differentiated thyroid cancer (DTC) on the quality of life and related issues in an urban multi-ethnic Asian population. DESIGN: A self-administered questionnaire containing the Short Form 36 Health Survey (SF-36) and assessing sociodemographic, disease, and treatment-related status was mailed to patients with DTC. MAIN OUTCOMES: One hundred fifty-two (52.4%) of 290 patients answered the questionnaire. There was a statistically significant decrease in SF-36 scores between thyroid cancer survivors and the general population in all domains except for social functioning (SF). Physical functioning (PF) was worse in those survivors who were aged 50 years or older. Mental health (MH) scores were better in those who had more than 12 years of formal education. Being employed had a positive influence on role physical (RP) and role emotional (RE) scores. Being of Malay/Indian ethnicity strongly correlated with lower scores in bodily pain (BP), SF, RE and MH domains. CONCLUSION: Although most patients with well-differentiated thyroid cancer have near normal life expectancy, our study has shown that there is a significant decrease in their quality of life, especially in the elderly and poorer educated. Returning to work should be encouraged to improve the quality of life in DTC survivors.
Subject(s)
Health Status , Survivors/psychology , Thyroid Neoplasms/mortality , Thyroid Neoplasms/psychology , Adenocarcinoma, Follicular/mortality , Adenocarcinoma, Follicular/psychology , Adenocarcinoma, Follicular/therapy , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Carcinoma, Papillary/mortality , Carcinoma, Papillary/psychology , Carcinoma, Papillary/therapy , Educational Status , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Singapore/epidemiology , Surveys and Questionnaires , Survival Rate/trends , Survivors/statistics & numerical data , Thyroid Neoplasms/therapyABSTRACT
INTRODUCTION: Identifying malignancy either preoperatively or intraoperatively can have a significant impact on the management of salivary gland tumours. We review our experience with fine needle aspiration cytology (FNAC) and frozen section (FS) for salivary gland lesions. We analyse the accuracy of both modalities and their influence on management. MATERIALS AND METHODS: Retrospective review of 114 patients who underwent salivary gland surgery, 91 with intraoperative FS and 68 with preoperative FNAC. Both sets of results were compared against each other and the final histopathological diagnosis. RESULTS: The accuracy of FS was 92.3%, with a sensitivity and specificity of 62.5% and 100%. Histologic concordance was 92.4% for benign lesions, and 100% for malignant tumours. The accuracy of FNAC was 89.7%, with a sensitivity and specificity of 100%. The non-diagnostic rate was 10.3%. Histologic concordance for FNAC was inferior to that for FS, with only 64.2% of benign lesions and 50% of malignant tumours correctly identified. FNAC did not alter the management of benign disease even when a correct diagnosis was obtained. CONCLUSION: Our results suggest that FNAC and FS are complementary in usefulness for malignant tumours. However, FNAC does not influence the management of benign lesions and routine FNAC for every patient may not be cost-effective.
