Mönckeberg sclerosis in patients with thyroid papillary carcinoma.

Background: Mönckeberg sclerosis is a form of calcification of the tunica media of small and medium size arteries. It occurs more often in the peripheral arteries of the lower limbs and it has been associated with diabetes and renal disease. Although there are a few reports of Mönckeberg sclerosis in thyroid vessels, there are no data regarding its significance in thyroid disease. Objective: The aim was to investigate the possible prognostic value of Mönckeberg sclerosis in thyroid vessels of patients with diagnosed thyroid cancer. Methods: We retrospectively studied patients with papillary thyroid cancer treated at the Theagenio Hospital of Thessaloniki from 2005 to 2021. The patients were divided into two groups based on the presence, or absence, of histopathological findings of Mönckeberg sclerosis in the thyroid vessels along with papillary thyroid cancer. Patient characteristics, histopathological details, personal history of thyroid disease, and metabolic parameters were compared between the two groups. Results: Thirty-three patients with papillary thyroid carcinoma and Mönckeberg sclerosis were identified and matched to 33 controls with papillary thyroid cancer, without evidence of Mönckeberg sclerosis. The metabolic profile of patients with Mönckeberg sclerosis was not significantly different from those who did not have Mönckeberg sclerosis. Moreover, the comparison between the two groups did not reveal any remarkable differences in terms of the aggressiveness of the disease. Conclusion: The presence of Mönckeberg sclerosis does not seem to impact on histological characteristics of patients with papillary thyroid cancer.

A unique case of aggressive uterine cancer in a 45-year-old man with persistent Müllerian duct syndrome.

OBJECTIVE: Persistent Müllerian Duct Syndrome (PMDS), one of the causes of male pseudohermaphroditism, is a rare syndrome characterized by the presence of internal female genitalia (uterus, fallopian, tubes, cervix and upper vagina) in otherwise phenotypically and normally virilized men. METHODS: We present the 4th documented case of uterine malignancy in a 45-year-old man with PMDS presenting with lower abdominal protuberance and hematuria. RESULTS: Although testicular malignancies are common in undescended testis associated with PMDS, very few cases of müllerian duct malignancies have been reported. CONCLUSIONS: Persistent mullerian duct syndrome can be associated with aggressive non-testicular malignancies, especially uterine cancer, in normally virilized males.

OBJETIVOS: El síndrome de persistencia del Conducto de Müller (SPCM), una de las causas de pseudohermafroditismo masculino, es un síndrome raro caracterizado por la presencia de genitales internos femeninos (útero, trompas de falopio, cervix y fondo vaginal) en pacientes varones fenotipicamente y con virilización normal. MÉTODOS: Presentamos el 4º caso documentado de tumor maligno uterino en un hombre de 45 años con SPCM que presenta protuberancia abdominal inferior y hematuria. RESULTADOS: Aunque los tumores malignos testiculares son frecuentes en testículos no descendidos asociados con SPCM, se han comunicado muy pocos casos de tumores malignos del conducto de Müller. CONCLUSIONES: El síndrome de persistencia del Conducto de Müller se puede asociar con tumores malignos no testiculares agresivos, especialmente cáncer uterino en hombres normalmente virilizados.

A unique case of aggressive uterine cancer in a 45-year-old man withpersistent müllerian duct síndrome / Un caso único de cáncer de útero agresivo en un varón de 45 años con síndrome de persistencia del conducto de Müller

Objective: Persistent Müllerian Duct Syndrome (PMDS), one of the causes of male pseudohermaphroditism, is a rare syndrome characterized by the presence of internal female genitalia (uterus, fallopian, tubes, cervix and upper vagina) in otherwise phenotypically and normally virilized men. Methods: We present the 4th documented case of uterine malignancy in a 45-year-old man with PMDS presenting with lower abdominal protuberance and hematuria. Results: Although testicular malignancies are common in undescended testis associated with PMDS, very few cases of müllerian duct malignancies have been reported

Objetivos: El síndrome de persistencia del Conducto de Müller (SPCM), una de las causas de pseudohermafroditismo masculino, es un síndrome raro caracterizado por la presencia de genitales internos femeninos (útero, trompas de falopio, cervix y fondo vaginal) en pacientes varones fenotipicamente y con virilización normal. Métodos: Presentamos el 4º caso documentado de tumor maligno uterino en un hombre de 45 años con SPCM que presenta protuberancia abdominal inferior y hematuria. Resultados: Aunque los tumores malignos testiculares son frecuentes en testículos no descendidos asociados con SPCM, se han comunicado muy pocos casos de tumores malignos del conducto de Müller. Conclusiones: El síndrome de persistencia del Conducto de Müller se puede asociar con tumores malignos no testiculares agresivos, especialmente cáncer uterino en hombres normalmente virilizados

Double primary non-small cell lung cancer with synchronous small cell lung cancer N2 nodes: a case report.

Synchronous multiple primary lung cancer (SMPLC) is rare and very hard to distinguish from metastatic disease. Recent studies indicate the presence of this entity in the lung, with no mention to the involvement of the mediastinum. An extremely rare case of a 68-year-old male with double primary non-small cell lung cancer (NSCLC) in the left upper lobe and N2 positive nodes for small cell lung cancer (SCLC) is presented. Modern diagnostic criteria as well as aggressive curative strategies are encouraged, in order to achieve better survival rates for such patients.

A rare case report of a primary large-cell neuroendocrine carcinoma of the breast with coexisting Paget disease.

Neuroendocrine carcinomas are malignancies deriving from neuroendocrine cells existing in various sites of the body, most commonly in the lungs and gastrointestinal tract. Primary neuroendocrine carcinomas of the breast are extremely rare, and their diagnosis is confirmed by positive neuroendocrine markers. We describe a case of a 46-year-old woman with a palpable mass in her left breast for the previous 3 months. The tumor was resected and a primary large-cell neuroendocrine tumor of the breast was confirmed by histopathologic examination. Paget disease of the nipple was noted as well.

Fine-needle aspiration cytology of salivary gland tumours: a 10-year retrospective analysis.

INTRODUCTION: The aim of this study was to evaluate the sensitivity, specificity, diagnostic accuracy, positive predictive value (PPV) and negative predictive value (NPV) of fine-needle aspiration cytology (FNAC) of salivary gland tumours performed at a tertiary cancer hospital over a time period of 10 years. MATERIALS AND METHODS: A retrospective analysis was carried out between 1995 and 2004 to review the cases of patients with salivary gland tumours who had undergone pre-operative FNA and for whom definite histology was either by tru-cut biopsy or by histopathological examination of the operative specimen. RESULTS: A total of 107 cases of salivary gland tumours were treated during that period, but only 82 cases diagnosed by FNAC could be correlated with histological and clinical data and were considered for this study. The sensitivity, specificity, diagnostic accuracy, PPV and NPV were estimated considering 54 benign and 28 malignant cases. Sensitivity was 90% (28/31), specificity was 98% (54/55), diagnostic accuracy was 95.1% (82/86), PPV was 96% and NPV was 94%. DISCUSSION: This study confirms that FNA cytology is a technique that offers high sensitivity, specificity and diagnostic accuracy in salivary gland tumour diagnosis.

Recurrent glabellar mucous cyst: a rare postrhinoplasty complication.

INTRODUCTION: The appearance of postrhinoplasty mucous cysts is a very rare complication, affecting mostly the nasal dorsum, along with the lines of a nasal osteotomy. There have been also descriptions of other rare locations like the nasal tip, the medial canthus, and the paranasal area. CASE: We present for the first time the appearance of a recurrent mucous cyst in the glabellar area, away from any intervention field during a rhinoplasty. Ectopic free mucosal graft implantation during surgical treatment, herniation of mucosa through intranasal incisions, or improper clearing of mucous epithelial remnants and bony or cartilage parts during the operation are the most accepted theories for the formation of mucous cysts after rhinoplasty. Until now, there have been published 19 cases of postrhinoplasty mucous cysts, with the nasal dorsum being the most affected side. The glabella, as a site away from any line of osteotomy in an usually performed rhinoplasty, has never been before reported as a region of mucous cyst formation. CONCLUSION: The patient is still under periodical control, and 68 months postoperatively, there is no evidence of a recurrence.

Facial skin metastasis due to small-cell lung cancer: a case report.

INTRODUCTION: Cutaneous metastases in the facial region occur in less than 0.5% of patients with metastatic cancer. They are an important finding and are not often the first sign leading to diagnosis. CASE PRESENTATION: We describe the case of a 64-year-old male patient who presented with dyspnea, pleuritic pain, loss of weight and a nodule on his left cheek. A chest X-ray revealed a left upper lobe mass with mediastinal lymphadenopathy. Excision biopsy of the facial nodule revealed small-cell lung carcinoma. Palliative chemo-radiotherapy was administered and the patient survived for 12 months. CONCLUSION: A high index of suspicion is necessary for the early detection of facial cutaneous metastases. Appropriate treatment may prolong patient survival.

Endoscopic resection of giant lipoma mimicking colonic neoplasm initially presenting with massive haemorrhage: a case report.

Lipomas of the colon are benign tumors that rarely occur. Their size ranges from 2 mm to several cm. They are usually asymptomatic but occasionally they present with clinical manifestations depending on tumor size, localization and complications, which often lead to diagnostic difficulty. A 40-year-old man presented with massive rectal haemorrhage. During colonoscopy a giant polyp of over 50 mm in its bigger diameter, with a thick stalk of 2 cm, located in the transverse colon, was revealed. Endoscopic resection was performed with success. Histologic examination demonstrated a giant lipoma. In this report discussion over endoscopic resection of colonic lipomas mimicking neoplasms is also performed.

Non-AIDS Kaposi's sarcoma in the head and neck area.

Kaposi's sarcoma is classified into 4 types: classic (sporadic), African (endemic), iatrogenic (transplant recipients), and epidemic (acquired immunodeficiency syndrome [AIDS]-associated). This article aims to feature a comprehensive review of non-AIDS Kaposi's sarcoma, including literature review and report of 3 cases. Case material was from our hospital's archive. Literature review was conducted via electronic and manual medical database searches. Biological aspects, diagnostic difficulties, investigation protocols, and management modalities are discussed.

Value of the cervical compartments in the surgical treatment of papillary thyroid carcinoma.

In the treatment of papillary thyroid carcinoma (PTC), supplementary lymph node dissection (LND) is not well standardized. The purpose of this study was to evaluate the significance of the cervical compartments in the lymphatic spread of PTC and the impact of modified radical neck dissection (MRND) as an additional surgical procedure to thyroid resection. From 1999 to 2002, LND of the central compartment (compartment A) was performed in 39 patients. Among this group, additional MRND of the ipsilateral compartment (compartment B) and the contralateral compartment (compartment C) was performed in 29 and 15 patients respectively, who met the selection criteria. The mean number of nodes resected was 11 (5-22) in compartment A, 23 (8-37) in compartment B, and 22 (10-31) in compartment C. Histopathologic findings revealed node invasion of compartment A in 25 patients (64.1%), of A and B in 20 patients (51,2%) and of A, B, and C in 13 patients (33.3%). From the 25 patients with metastases in compartment A, 80% (20 patients) already had metastases in compartment B and 52% (13 patients) had metastases in all three compartments. All patients free of metastasis (M0) in compartment A were also metastasis free in both lateral compartments. Postoperative whole-body scanning I(131) in M0 patients showed no uptake at all. Mapping of the cervical anatomy in compartments seems to be a useful taxonomy for clarifying the lymphatic spread of PTC. Patients having PTC without metastasis in compartment A are almost certainly disease free at the time of operation. Lymph node metastasis in the central compartment appears to be a valuable indicator of lymphatic invasion of the lateral compartment and a strong indication for performance of a unilateral or bilateral MRND to complete the surgical removal of tumor.