RESUMO
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.
RESUMO
Purpose: Brown tumors, also known as cystic fibrosa, are rare, benign, osteolytic, fibrotic lesions of the bones that occur secondary to hyperparathyroidism. They are caused by increased osteoclastic activity leading to an abnormal bone metabolism. Case Description: Here, we present the case of a 58-year-old male, who presented with painful bony lesions, initially attributed to metastatic disease. After biochemical workout, imaging and biopsy, the nature of the lesions was revealed. We discuss the differential diagnosis and clinical management of the disease. Conclusion: Patients with brown tumors should be assessed in the differential diagnosis of bony lesions and should always be tested for hyperparathyroidism. An early diagnosis is crucial for the successful treatment of such patients.
RESUMO
Neuroendocrine tumors are a heterogenous group of rare neoplasms with different morphological features, immunophenotype, molecular profile, and clinical presentation. They can derive from any neuroendocrine cell throughout the body, but the majority of NENs is developed in the gastrointestinal tract. They can be divided into two groups, based on hormone secretion, functioning and non-functioning NENs. The first group is characterised from the secretion of specific substances, defining the clinical manifestations. Functional NENs can be divided into carcinoid tumors, with serotonin overproduction, and functional GEP NEN's (mostly located in pancreas) that may secrete insulin, VIP, gastrin, glucagon or somatostatin. Non-functioning NENs, comprise approximately 85% of NEN's. As these tumors lack specific symptoms, they come to clinical attention later, when they have a large size or metastases. Apart from the specific biomarkers that functional NENs are producing, there are some general markers that are produced from all NENs and play a major role in the diagnosis, prognosis and follow up of these patients. These are chromogranin (CgA), neuron-specific enolase (NSE) and 5-hydroxyindolic acetic acid (5-HIAA).