[Thyroglossal duct cyst carcinoma: The rational behind performing a total thyroidectomy]. / Prise en charge du carcinome papillaire du kyste du tractus thyréoglosse: Intérêt de la thyroïdectomie totale.

Thyroglossal duct cysts are a common developmental abnormality but carcinoma within is rare. A 68 year old male patient was diagnosed with a thyroglossal duct cyst (TGDC) which on imaging studies demonstrated suspicious features within the cyst alone. Fine needle aspiration cytology was suspicious of papillary thyroid cancer. A Sistrunk's procedure (SP) was performed and demonstrated papillary carcinoma within. A decision to perform a total thyroidectomy (TT) and central compartment neck dissection was made. Final histological analysis showed no disease within the thyroid gland or in the neck nodes. The presence of cancer suspected within the TGDC by relevant diagnostic modalities may necessitate treatment to the thyroid gland and neck in addition to a Sistrunk's procedure as part of a definitive treatment policy due to the high incidence of associated thyroid malignancy. In our institution, in patients presenting with thyroglossal duct cyst carcinoma and are at high risk for having thyroid cancer, we perform both SP as well as TT and central compartment neck dissection.

Les kystes du tractus thyréoglosse (KTT) sont fréquents et leur dégénérescence est rare. Nous rapportons le cas d'un patient de 68 ans avec un diagnostic de KTT et une imagerie démontrant des caractéristiques suspectes au sein du kyste. La ponction cytologique réalisée était suspecte de carcinome papillaire sur KTT. La procédure de Sistrunk (PS) a été réalisée et a confirmé la présence du cancer papillaire au sein du kyste. La décision de réaliser une thyroïdectomie totale (TT) associée à un curage du compartiment central cervical a été retenue. L'examen histologique a montré l'absence de lésions suspectes dans la glande thyroïde ainsi qu'au niveau des ganglions cervicaux. La suspicion de cancer au sein du KTT révélée par des modalités de diagnostic pertinentes peut nécessiter un traitement chirurgical de la glande thyroïde ainsi que des ganglions cervicaux, en plus de la procédure de Sistrunk, dans le cadre d'une politique de traitement définitif en raison de la forte incidence de malignité au sein de la glande thyroïde. Dans notre institution, chez les patients présentant un carcinome du KTT qui sont à risque élevé d'avoir un cancer de la thyroïde associé, nous réalisons la PS, une thyroïdectomie totale ainsi qu'un curage du compartiment central cervical.

Lobular capillary haemangioma of the nasal cavity during pregnancy.

OBJECTIVE: We report a pregnant patient with a rapidly growing mass within the nasal cavity, which required pre-operative super-selective embolisation and subsequent removal under general anaesthesia after childbirth. We also discuss the clinical, radiological and histological characteristics of lobular capillary haemangioma, and its treatment. METHOD: Case report and literature review. RESULTS: Lobular capillary haemangioma is a benign lesion originating in the vascular tissue of skin, mucosa, muscles, glands and bone. These lesions grow rapidly. Nasal localisation is rare. Microtrauma and pregnancy are the most commonly proposed aetiological factors. Reported incidence during pregnancy ranges from less than 2 per cent to approximately 5 per cent. The management of a pregnant woman with such a lesion may be complex, and depends on the severity of symptoms and the status of the pregnancy. Complete surgical excision, with or without pre-operative embolisation, is the treatment of choice. CONCLUSION: This uncommon lesion should be considered in any pregnant patient with a mass in the mouth or nasal cavity.

Detection of macrophage migration inhibitory factor (MIF) in human cholesteatomas and functional implications of correlations to recurrence status and to expression of matrix metalloproteinases-3/9, retinoic acid receptor-beta, and anti-apoptotic galectin-3.

OBJECTIVES: To investigate whether the expression of the macrophage migration inhibitory factor (MIF) 1) is detectable, 2) changes in relation to recurrence and infection status, and 3) relates to the levels of expression of growth regulators/differentiation markers, including galectin-1, -3, and -8, retinoid acid receptors (RAR)]-alpha, -beta, and -gamma, binding sites for sarcolectin, and invasion markers (cathepsins -B and -D, and matrix metalloproteinases [MMP]-2, -3, and -9) in human cholesteatomas. STUDY DESIGN: An analysis of 56 cholesteatomas resected by the same surgeon using canal wall up and canal wall down surgical procedures. METHODS: The immunohistochemical levels of expression of MIF and the proteases were quantitatively determined (using computer-assisted microscopy) on routine histologic slides by specific antibodies, and statistically correlated to parameters of the other markers determined previously in conjunction with data on apoptosis/proliferation. RESULTS: MIF expression was detected. It was significantly higher in the epithelium (P =.002) and vessels (P =.04) of the connective tissues (but not in the connective tissue itself) of recurrent as opposed to non-recurrent cholesteatomas. The MIF expression is significantly correlated (P =.006) to the RAR beta expression in non-infected cholesteatomas, and to MMP-3 (P <.01) and anti-apoptotic galectin-3 (P =.01) in infected cholesteatomas. The level of MIF expression was also correlated significantly to MMP-9 (P = 0.003), RAR beta (P <.001), and galectin-8 (P =.003) expression in the cholesteatomas regardless of their infection status. CONCLUSIONS: MIF expression in human cholesteatomas is related to the levels of biologic aggressiveness reflected in their recurrence status and MMP expression, and to the differentiation status reflected in their galactin and RAR beta expressions. Together with galectin-3, it could cooperate to form an anti-apoptotic feedback loop.