Thyroid gland carcinoma causing tumor thrombus in the great veins of the neck and mediastinum is a rare condition with poor prognosis. Invasion of the internal jugular vein by thyroid gland carcinoma ...has been occasionally reported, but tumor thrombi extending to the great veins of the mediastinum are reported extremely rarely. We present a treatment approach in a case of follicular thyroid carcinoma intravascular tumor thrombus in the left internal jugular and left brachiocephalic vein.
We present the case of a 48-year-old male patient who underwent surgery for a recurrent metastatic parathyroid gland carcinoma in the patient's right paratracheal space of the neck. The patient had ...undergone surgery for lower right parathyroid gland carcinoma 28 months earlier.
The metastases were resected
with an ipsilateral central neck dissection and with the removal of the enlarged lower left parathyroid gland. After exploration of the remnant parathyroid glands we noticed that lower left parathyroid gland was macroscopically enlarged so we decided to remove it to prevent possible hypercalcemia in future and to also prevent possible recurrence of cancer or development of a new primary, considering the identical embryological origin of the lower parathyroid glands and possibility of synchronous, multiple tumors, which generally follow the same embryological origin if they occur. The patient was also treated with radiation therapy after the surgery.
With the present surgical approach to recurrent metastatic parathyroid gland carcinoma, we aimed to prevent the recurrence of cancer or development of new primary and prevent or delay hypercalcemia in the future with all severe adverse metabolic states associated with high serum calcium levels.
- The purpose of this study was to analyze the possible prognostic value of RET mutation in papillary thyroid carcinoma and its incidence in the past few decades in our population, due to the ...increasing incidence of papillary thyroid carcinoma. The present study included 180 patients operated for papillary thyroid carcinoma. The clinical and histopathologic characteristics were analyzed. Paraffin sections of the selected histologic slides were cut again and immunohistochemically stained by the Clone 3F8 P (HIER) from Novocastra (Vision Bio Systems Europe, Newcastle upon Tyne, UK) monoclonal antibody to RET oncoprotein. Univariate analysis indicated sex (p=0.01), histologic subtype (p=0.075) and capsular invasion (p=0.010) to be statistically significant predictors of lymph node metastases, whereas age (p=0.796), tumor size (p=0.556) and intraglandular dissemination (p=0.131) showed no such correlation. The presence of RET mutation (p=0.704) was not a statistically significant predictor of the tumor metastasizing potential. RET mutation (p=0.500) showed no statistically significant correlation with papillary thyroid carcinoma classifed into prognostic groups according to clinicopathologic features either. RET mutation was detected in 30% of 180 papillary thyroid carcinomas. This is the first large study demonstrating that RET mutation incidence in papillary thyroid carcinoma in Croatian population is consistent with the classic distribution of sporadic cases, despite the increased prevalence of papillary thyroid carcinoma in the past few decades.
Th e aim of the study was to determine the influence of RET, p27 and cyclin D1
on regional lymph node metastases in papillary microcarcinoma. The analysis included 70 patients
with papillary thyroid ...microcarcinoma that underwent surgery at Split University Hospital Center
between 1999 and 2001. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded
tissue by the RET, p27 and cyclin D1 antibodies. Quantification was based on the intensity and
distribution of nuclear staining, dividing tumors into those that showed expression (expressors) and
those that showed no expression (non-expressors). Univariate analysis using χ²-test and Fisher exact
test was performed with the level of statistical significance set at p<0.05. There was no statistically
significant difference in the incidence of metastases according to the expression or non-expression of
RET mutation (χ²-test: p=0.459; Fisher exact test: p=0.672). Among 25 cases with cyclin D1 expression,
6 had metastases, whereas only 2 of 45 cases with no cyclin D expression had metastases (χ²-test:
p=0.014; Fisher exact test: p=0.021), indicating that the expression of cyclin D1 is not crucial for the
development of metastases in lymph nodes. In contrast, analysis of p27 expression showed it to be
significantly associated with lymph node metastasis because 3 of 45 patients with p27 expression had
metastases, indicating a statistically significant correlation between p27 expression and lymph node
metastases (χ²-test: p=0.093; Fisher exact test: p=0.124). This study confirmed the importance of the
evaluation of RET, p27 and cyclin D1 expression and demonstrated the validity of their application in
the assessment of microcarcinoma behavior.
To assess the epidermal growth factor receptor (EGFR) correlation with histopathologic and clinical characteristics of laryngeal squamous cell carcinoma (SCC) and the impact of EGFR overexpression on ...patient survival. This retrospective study included 185 SCC patients treated at Clinical Department of ENT, Head and Neck Surgery, Split University Hospital Center between January 1, 2000 and December 31, 2009. A statistically significant correlation (
p
< 0.001) was recorded between the level of EGFR expression and SCC histopathologic grade, stage, metastasizing potential, relapsing potential, and patient survival. Kaplan–Meier survival curve yielded a statistically significant difference (
χ
2
= 75.05;
p
< 0.001) among the four patient groups with different levels of EGFR expression. The higher the level of EGFR expression, the poorer is the patient prognosis and survival. In our study, expression of EGFR as a biomarker showed a potential predictive value in laryngeal SCC.
Migratory foreign body appeared to be bird feather, caused peritonsillar and periparotid abscess in a nine-month-old infant. Patient presented painful, tender and fluctuating red neck mass on the ...left neck region II, and refusal of oral intake, with no fever. Azithromycin was introduced four days before presentation for suspected urinary tract infection. ENT examination revealed left peritonsillar abscess; ultrasound confirmed periparotid abscess, MSCT verified both diagnoses. Under general anaesthesia, we performed abscess incision, after pus drainage, small foreign body spontaneously came through the wound. After washing it with saline, it appeared like a bird feather. Subsequently, peritonsillar abscess was incised and drained. After 24-hour postoperative care on pediatric intensive care unit, the patient continued three-day parenteral antibiotic treatment on the otolaryngology department; it was discharged with a recommendation to continue seven days of oral antibiotic therapy. Suggested mechanism was ingestion of bird feather from stuffed bedding, that got trapped in the tonsillar crypt. Afterwards, it started to migrate through the neck tissue. Households with children younger than three years should not have feather stuffed clothes or beddings.
Aim of this study was to investigate the correlation of matrix metalloproteinase-9 (MMP-9) expression with histopathologic and clinical characteristics of laryngeal squamous cell carcinoma, and to ...assess the role of MMP-9 expression in patient survival. Study included 196 patients with squamous cell carcinoma of the larynx treated at ENT Department, Split University Hospital Centre, from January 1, 2000 till December 31, 2009. The level of MMP-9 expression showed a statistically significant correlation (p < 0.001) with the disease histopathologic grade, stage, metastatic potential, recurrence potential, and survival. Kaplan-Meier curve yielded a statistically significant survival difference (p < 0.001) among the three patient groups with different levels of MMP-9 expression. The survival curve clearly showed the MMP-9 expression as a predictor of survival to be significantly (p < 0.001) associated with survival. In this study, MMP-9 expression as a biological marker showed a potential predictive value in laryngeal squamous cell carcinoma.
Background: Expression of the epidermal growth factor receptor (EGFR) and human papillomavirus (HPV) DNA can serve as independent prognostic factors in squamous cell carcinoma (SCC) of the larynx. ...EGFR correlation with the course of disease and its effect on survival makes EGFR expression a negative prognostic factor, whereas HPV DNA is a positive prognostic factor.
Aim: To assess the association of EGFR expression with clinical outcome of laryngeal HPV SCC.
Materials and methods: This retrospective study included 196 SCC patients operated on at the Department of ENT, Head and Neck Surgery, Split University Hospital Center in Split, Croatia, between 1 January 2000 and 31 December 2009.
Results: The association of HPV infection and EGFR expression was found to be statistically significant, and so was the difference in survival between patient groups with different HPV to EGFR expression ratio.
Conclusions: The group of laryngeal HPV SCC patients with increased EGFR expression had shorter survival, confirming EGFR as a major component in predicting patient prognosis and survival.
Significance: This article confirms the importance of EGFR expression as a biomarker in laryngeal SCC.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The aim of the study was to determine epidemiological characteristics of thyroid cancer in Dalmatia and Slavonia, to analyze regional differences in its incidence, and to determine whether iodine ...intake had an impact on the incidence. This epidemiological study was based on data published by the Croatian National Cancer Registry (CNCR) in the Croatian Health Service Yearbook and CNCR Bulletin. Data on 651 thyroid cancer patients operated on in Dalmatian hospitals between 1997 and 2006 were analyzed. Control group consisted of thyroid cancer patients operated on in Slavonia (N = 498). Incidence rates recorded in Dalmatia were compared with those in Slavonia. Iodine intake was measured in elementary schoolchildren in the Split-Dalmatia and Osijek-Baranya Counties. Iodine excretion levels were measured in 131 children. In the 10-year period, the mean age-standardized incidence rate (ASR) of thyroid cancer was 9.32 per 100,000 inhabitants in Dalmatia and 6.02 in Slavonia. The difference was statistically significant (P < 0.001). Incidence rates (World ASR, European ASR, crude incidence rate and research rates) showed an increase and were significantly higher in Dalmatia than in Slavonia. Patient sex structure showed the disease to be 4 times more common in women than in men. In Dalmatia sample, women accounted for 81.4% of all patients and papillary cancer accounted for 80.03% of all thyroid cancers. Median age of new patients was 50 in Dalmatia and 48 in Slavonia. Papillary cancer accounted for 63.7% of all patients in Slavonia. Follicular thyroid cancer accounted for 20.9% of patients in Slavonia and 12.4% in Dalmatia. Epidemiological characteristics of thyroid cancer in Dalmatia were found to be consistent with the characteristics of this cancer in iodine-sufficient areas: papillary carcinoma was the most common type and the papillary to follicular ratio was 6.4:1. Follicular cancer accounted for 12.4% of the total number of patients. In Slavonia, the papillary form predominated, the papillary to follicular ratio was 3:1, and follicular cancer accounted for 20.88% of all patients. Median urinary iodine excretion in elementary schoolchildren was 23.6 microg/dL in the Split-Dalmatia County and 28.1 microg/dL in the Osijek-Baranya County. The difference was not statistically significant (P < 0.050). In conclusion, the average iodine intake levels in Dalmatia and Slavonia were not the cause of the high thyroid cancer incidence in the 1997-2006 period. Improved thyroid cancer diagnosis may be one of the causes of the increased thyroid cancer incidence in Dalmatia.
Uvod: Aspiracija stranoga tijela predstavlja značajan uzrok bolesti i smrti tijekom djetinjstva. Cilj ovoga istraživanja bio je odrediti postotak pronađenih i uspješno odstranjenih stranih tijela ...prilikom traheobronhoskopije, kao i njihovu vrstu i lokalizaciju, te utvrditi postoji li razlika u demografskim, kliničkim i radiološkim obilježjima među skupinama sa i bez stranog tijela. Bolesnici i metode: Proveli smo retrospektivnu studiju u koju je uključeno 62 ispitanika kojima je u Kliničkom bolničkom centru Split učinjena traheobronhoskopija zbog sumnje na aspiraciju stranoga tijela, tijekom razdoblja od 1.1.2010. do 31.12.2020. Prikupljeni podaci za svakog ispitanika uključivali su: dob, spol, nalaz traheobronhoskopije, radiološke nalaze i kliničke podatke. Ovisno o nalazu traheobronhoskopije, podijelili smo ispitanike u dvije skupine: skupina s pronađenim stranim tijelom (n=32) i skupina u kojoj strano tijelo nije pronađeno (n=30). Za statističku analizu koristili smo hi-kvadrat i Fisherov egzaktni test, te smo razinu statističke značajnosti postavili na P<0,05. Rezultati: Strano tijelo pronađeno je u 32 (51,6%) bolesnika kojima je učinjena traheobronhoskopija, a uspješno je odstranjeno njih 31 (96,9%). Medijan dobi u skupini sa stranim tijelom iznosio je 20,5 mjeseci (15,3-35,5 mjeseci). Najveća incidencija, njih 19 (59,4%) bila je u dobi između prve i treće godine. U skupini sa stranim tijelom (n=32) dječaci čine većinu – 22 (68,8%) u odnosu na djevojčice – 10 (31,2%), u omjeru 2,2:1. Većina stranih tijela bila je organskoga podrijetla (87,5%), a najčešće pronađeno strano tijelo bilo je kikiriki (37,5%). Strano tijelo bilo je lokalizirano podjednako u desnom glavnom bronhu (43,75%), kao i u lijevom (43,75%), u oba glavna bronha nađeno je stranih tijela u 3,1% slučajeva, a u dušniku 9,4%. Korištenje pomoćne dišne muskulature (P=0,024), auskultacijski smanjen šum disanja (P=0,001), dispneja (P=0,046), emfizem (P=0,011) i pomak medijastinuma (P=0,011) statistički su značajno češći u skupini sa stranim tijelom. Radiološki netransparentno strano tijelo bilo je prisutno u 9,4% bolesnika kojima je strano tijelo pronađeno, a kod 46,9% bolesnika imalo je uredan nalaz radiograma pluća. Zaključci: Kod djeteta s dispnejom, korištenjem pomoćne dišne muskulature, auskultacijski smanjenim šumom disanja, te emfizemom i pomakom medijastinuma na radiogramu pluća, potrebno je posumnjati na aspiraciju stranoga tijela u donjim dišnim putovima, te učiniti rigidnu traheobronhoskopiju kao dijagnostičku i terapijsku metodu.
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