Papillary carcinoma arising in a thyroglossal duct cyst; two case reports and review of the literature

We present in this report two cases of papillary carcinoma arising in a thyroglossal duct cyst. The first case was a 32-year-old female patient who presented with a neck mass of 5 years' duration that had recently increased in size. The patient was otherwise asymptomatic. The second patient was a 41-year-old male patient who presented with a submental mass that had been growing over the previous several months. Associated symptoms included local symptoms such as dysphagia and hoarseness and general symptoms such as fatigue and weight loss. Pathological examination revealed the presence of papillary carcinoma in the mass with presence of focus of papillary carcinoma in the thyroid bed in both cases. Periosseous invasion of the hyoid bone and involvement of the submandibular lymph nodes were observed in the second patient. The patients underwent total thyroidectomy with lymph node dissection followed by radioactive iodine therapy and are currently on thyroxin replacement.Bergamaschi R, 2007, INT REV NEUROBIOL, V79, P423, DOI 10.1016-S0074-7742(07)79019-0; Binquet C, 2006, NEUROEPIDEMIOLOGY, V27, P45, DOI 10.1159-000094380; Confavreux C, 2003, BRAIN, V126, P770, DOI 10.1093-brain-awg081; Hammond SR, 2000, J CLIN NEUROSCI, V7, P16, DOI 10.1054-jocn.1998.0107; Kantarci O, 1998, NEUROLOGY, V51, P765; KURTZKE JF, 1977, J CHRON DIS, V30, P819, DOI 10.1016-0021-9681(77)90010-8; KURTZKE JF, 1983, NEUROLOGY, V33, P1444; Langer-Gould A, 2006, ARCH NEUROL-CHICAGO, V63, P1686, DOI 10.1001-archneur.63.12.1686; Mandrioli J, 2008, J NEUROL, V255, P1023, DOI 10.1007-s00415-008-0827-5; MCDONALD WI, 2001, ANN NEUROL, V62, P865; Myhr KM, 2001, MULT SCLER, V7, P59, DOI 10.1191-135245801667968135; Pittock SJ, 2004, ANN NEUROL, V56, P303, DOI 10.1002-ana.20197; RUNMARKER B, 1993, BRAIN, V116, P117, DOI 10.1093-brain-116.1.117; SADOVNICK AD, 1993, CURR OPIN NEUROL NEU, V6, P189; WEINSHENKER BG, 1991, BRAIN, V114, P1045, DOI 10.1093-brain-114.2.1045; Yamout B, 2008, J NEUROL SCI, V270, P88, DOI 10.1016-j.jns.2008.02.00947

Predictors of bone mineral density in patients on hemodialysis

Renal osteodystrophy is a universal complication of uremia. Renal failure patients are at risk for low bone mineral density (BMD) and fractures. Parathyroid hormone (PTH) plays a pivotal role in the pathophysiology of uremic bone disease. Histomorphometric studies suggest that the maintenance of PTH levels between two and four times the upper limit of normal is associated with the lowest prevalence of two common forms of osteodystrophy: osteitis fibrosa cystica and adynamic bone disease. The purpose of this study was to investigate whether the above recommendation for PTH levels in dialysis patients corresponds to a more optimal BMD with a special emphasis on diabetic versus nondiabetic subjects. Twenty-eight patients with chronic renal failure on hemodialysis underwent measurement of PTH levels, as well as BMD at the lumbar spine, hip, and forearm. They were divided into three groups based on the mean PTH level over the 5 years prior to having BMD measured. Osteoporosis was diagnosed in 55percent of men and 87percent of women on dialysis. Predictors of BMD were gender, duration on hemodialysis, and diabetes. Our study supports the histomorphometry-based studies suggesting that the maintenance of intact PTH levels two to four times the upper limit of normal may be associated with better skeletal health in uremic patients on hemodialysis, and that the diabetic subgroup is at particular risk for low BMD.ASAKA M, 1992, CLIN NEPHROL, V38, P149; Atsumi K, 1999, AM J KIDNEY DIS, V33, P287, DOI 10.1016-S0272-6386(99)70302-1; Barnas U, 2001, AM J KIDNEY DIS, V37, P1247, DOI 10.1053-ajkd.2001.24529; BIANCHI ML, 1992, BONE, V13, P225, DOI 10.1016-8756-3282(92)90201-7; Coco M, 2000, AM J KIDNEY DIS, V36, P1115, DOI 10.1053-ajkd.2000.19812; El-Hajj Fuleihan G, 2001, PEDIATRICS, V107, P1; Fletcher S, 1997, NEPHRON, V75, P412; Fuleihan GE, 1999, NEW ENGL J MED, V340, P1840, DOI 10.1056-NEJM199906103402316; GABAY C, 1993, AM J NEPHROL, V13, P115, DOI 10.1159-000168600; Gerakis A, 2000, J NEPHROL, V13, P437; GHANNAGEYARED MH, 2000, J BONE MINER RES, V15, P1856; Goodkin DA, 2003, J AM SOC NEPHROL, V14, P3270, DOI 10.1097-01.ASN.0000100127.54107.57; HERCZ G, 1993, KIDNEY INT, V44, P860, DOI 10.1038-ki.1993.323; HRUSKA KA, 1995, NEW ENGL J MED, V333, P166; HUI SL, 1988, J CLIN INVEST, V81, P1804, DOI 10.1172-JCI113523; KANIS JA, 1994, J BONE MINER RES, V9, P1137; MALLUCHE H, 1990, KIDNEY INT, V38, P193, DOI 10.1038-ki.1990.187; MALLUCHE HH, 1992, KIDNEY INT S38, V42, P62; Marshall D, 1996, BRIT MED J, V312, P1254; MELTON LJ, 1993, J BONE MINER RES, V8, P1227; MELTON LJ, 1992, J BONE MINER RES, V7, P1005; Nisbeth U, 1999, TRANSPLANTATION, V67, P1218, DOI 10.1097-00007890-199905150-00004; NISHITANI H, 1991, CONTRIB NEPHROL, V90, P223; PEI Y, 1993, KIDNEY INT, V44, P159, DOI 10.1038-ki.1993.226; QI QL, 1995, AM J KIDNEY DIS, V26, P622, DOI 10.1016-0272-6386(95)90599-5; QUARLES LD, 1992, J CLIN ENDOCR METAB, V75, P145, DOI 10.1210-jc.75.1.145; Rix M, 1999, KIDNEY INT, V56, P1084, DOI 10.1046-j.1523-1755.1999.00617.x; Sanchez MC, 2000, AM J KIDNEY DIS, V36, P953, DOI 10.1053-ajkd.2000.19093; Schwartz AV, 2001, J CLIN ENDOCR METAB, V86, P32, DOI 10.1210-jc.86.1.32; SHERRARD DJ, 1993, KIDNEY INT, V43, P436, DOI 10.1038-ki.1993.64; WANG M, 1995, AM J KIDNEY DIS, V26, P836, DOI 10.1016-0272-6386(95)90453-0; Weinstein RS, 2000, J BONE MINER RES, V15, P621, DOI 10.1359-jbmr.2000.15.4.62122252

Tarsal Coalitions: Radiographic, CT, and MR Imaging Findings

BACKGROUND: Tarsal coalitions affect up to 13% of the population and can be a cause of chronic ankle and hindfoot pain. They can be subdivided as osseous, cartilaginous, or fibrous types, each with unique radiographic, CT, and MR imaging findings. In particular, MR imaging offers the unique ability to determine the exact type of tarsal coalition that is present as well as whether any associated soft tissue abnormalities are present. QUESTIONS/PURPOSES: The purposes of this paper were to (1) review the anatomy of the hindfoot; (2) review the radiographic, CT, and MR imaging findings of tarsal coalitions; and (3) review the imaging appearance of the specific types of tarsal coalitions. METHODS: Online searches were performed using Google Scholar with the search criteria of “tarsal coalition,” “hindfoot anatomy,” and “subtalar coalition,” and limiting the searches to papers published in the last 10 years in major radiology journals. RESULTS: The anatomy of the hindfoot is complex but essential to understand. There are various radiographic, CT, and MR imaging findings that can be consistently noted in cases of tarsal coalition. The specific types of tarsal coalition demonstrate characteristic imaging findings. CONCLUSIONS: Knowledge of the normal anatomy of the foot, in particular the hindfoot, combined with the knowledge of the imaging characteristics of different histologic subtypes of coalitions (osseous, cartilaginous, and fibrous) is essential for interpreting radiographic, CT, and MR images of the ankle and foot. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11420-013-9379-z) contains supplementary material, which is available to authorized users

Mean intrasellar pressure, visual field, headache intensity and quality of life of patients with pituitary adenoma Pressão intra-selar média, campo visual, intensidade de cefaléia e qualidade de vida em portadores de adenoma hipofisário

Intrasellar pressure (ISP) measurement technique has recently opened a new line of research in neuroendocrinology. The absolute and mean ISP values were investigated in 25 patients consecutively operated at the Brasilia University Hospital (DF). These data were correlated with serum prolactin levels, number of visual quadrant affected, tumor size, quality of life (measured through the SF-36 scale) and graded headache (measured through the HIT-6 scale). No correlation was observed. The p values were 0.887; 0.137; 0.892; 0.812 and 0.884; respectively. The HIT-6 values were inversely and moderately correlated with total RAND SF-36 and its mental and physical dimensions.<br>A técnica da medida da pressão intra-selar (PIS) abriu, recentemente, uma nova linha de pesquisa em neuroendocrinologia. O objetivo deste estudo foi aferir os valores absolutos da PIS e calcular a pressão intra-selar média (PIM) em uma população de 25 pacientes operados consecutivamente no Hospital Universitário de Brasília (DF). Não se observou correlação significativa entre a PIM e o número de quadrantes visuais comprometidos (p=0,137), área do tumor (p=0,892), nível de qualidade de vida mensurado pela escala SF-36 (p=0,812) e a presença e a intensidade da cefaléia mensurada pela escala HIT-6 (p=0,884). Contudo, o HIT-6 correlacionou-se de forma inversa e intensidade moderada com os valores de HIT-6 e suas dimensões mental e física