RESUMO
Isolated presentation of endometriosis of the inguinal canal is infrequent, and the clinical and imaging findings may be misleading in such patients. We describe an otherwise healthy female with isolated inguinal endometriosis presenting as a hydrocele of the canal of Nuck. Surgeons should consider such unusual presentations and obtain imaging and histological evaluations in doubtful instances. Complete excision was curative in our patient with no evidence of recurrence.
RESUMO
BACKGROUND: Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited intestinal polyposis syndrome with an incidence of about 1/8300 births and accounts for about 1% of all colorectal cancers. It has a spectrum of extra-intestinal manifestations including thyroid carcinoma which occur in 1-2% of affected. The cribriform morular variant (CMV) is a rare but distinct histological subtype of papillary thyroid carcinoma (PTC) associated with FAP. Most of the reported cases describe the above entity in the background of well-established FAP. We report a case where both entities presenting simultaneously in a previously undiagnosed patient with FAP without a family history of polyposis. CASE PRESENTATION: A 24 year old Asian female presented to the surgical clinic with a goitre of eight months duration and recent onset of altered bowel habits with features of anaemia. She was previously healthy and there was no family history of adenomatous polyposis, colorectal carcinoma or thyroid neoplasms. Colonoscopy revealed large bowel polyposis and fine needle aspiration of thyroid revealed a smear suspicious for malignancy. She underwent total thyroidectomy which revealed CMV PTC. Histology was characterized by a prominent cribriform pattern of growth with interspersed cell clusters arranged as morules along with papillary structures which are the key features of this subtype. CONCLUSION: Diagnosis of CMV warrants ruling out of underlying FAP, irrespective of family history or gastrointestinal symptoms.
Assuntos
Polipose Adenomatosa do Colo/complicações , Carcinoma/etiologia , Neoplasias da Glândula Tireoide/etiologia , Polipose Adenomatosa do Colo/diagnóstico , Adulto , Carcinoma/diagnóstico , Carcinoma/patologia , Carcinoma Papilar , Feminino , Humanos , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Adulto JovemRESUMO
Bleeding duodenal diverticulum is a rare cause of gastrointestinal bleeding, which sometimes can be massive and life threatening. We report one such case and the management, with a successful outcome. Different diagnostic techniques and management options available are also discussed.