Completion thyroidectomy, part of surgical treatment for thyroid carcinoma – experience of 2nd department of surgery, emergency county hospital in Targu Mures

Emergency County Hospital, Tirgu Mures, Romania, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: Completion thyroidectomy is the surgery practiced in order to excise the residual thyroid tissue at patients who underwent istmlobectomy or near-total thyroidectomy for a lesion considered initially benign. Completion thyroidectomy is indicated at short time post-operator after the final malignant histopathological examination result, or years away after first surgery because of benign or malignant relapses on residual thyroidian blunt. The objective of the study is to highlight the role of completion thyroidectomy in the surgical treatment of thyroid carcinoma. Materials and methods: We conducted a retrospective study at the 2nd Department of Surgery, Emergency County Hospital in Tirgu Mures, during January 2011 and December 2015. During this period were performed 602 surgeries on thyroid gland, including 28 completion thyroidectomies. We analyzed data obtained according to: the surgery before completion thyroidectomy, histopathological diagnosis resulted from istmlobectomy or near-total thyroidectomy, histopathological diagnosis resulted from completion thyroidectomy. Discussion results: In the 28 cases for which completion thyroidectomy was practiced, final histopathology was: 21 cases of follicular variant of papillary thyroid carcinoma, 1 case of Wathin-like variant of papillary thyroid carcinoma, 3 cases of multifocal papillary thyroid cancer, 1 case of poorly differentiated carcinoma, 1 case of oncocytic variant of papillary thyroid cancer, 1 case of solid variant of papillary carcinoma with poorly differentiated carcinoma component. After completing the thyroidectomy, were revealed thyroid carcinoma lesions in 5 (17,85%) of the 28 thyroidectomies. Also, 9 of the 28 completion thyroidectomies were followed by lymphadenectomy, tumor metastases being present in one case. Conclusion: Completion thyroidectomy is required as surgical treatment for patients with final malignant histopathology who underwent initially near-total thyroidectomy or istmlobectomy

A case of aplastic anemia complicated with systemic aspergillosis

University of Medicine and Pharmacy, Targu Mures, Romania, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: Aplastic anemia is a rare disease in which the bone marrow and the hematopoietic stem cells that reside there are damaged. This causes a deficiency of all three blood cell types (pancytopenia). Aplastic refers to the inability of the stem cells to generate mature blood cells. Aplastic anemia can be caused by exposure to certain chemicals, drugs, radiation, infection, immune disease, and heredity; in about half the cases, the cause is unknown. It may also occur due to a congenital inheritance or as well in the context of a constitutional predisposition. Objective: The aim of this paper is to present the case of a 17 years old boy who developed aplastic anemia in the context of using sodium metamizol at home (Algocalmin) for 10 days without medical advice. Due to poor immune system the opportunistic fungus Aspergillus takes advantage of this situation and colonizes throughout the body leading to the condition called Aspersilosis. Clinical case: We monitored the patient for a period of 33 days correspondently to the hospitalization in our Pediatric Clinic I - Hemato-Oncology Department of Targu-Mures. Results: At the admission in our clinic, the first lab tests showed: a marked leukopenia (Leu/mm3- 440, Gran. 7/mm3) and trombocytopenia (PLT/mm3- 26.000) and the peripheral blood smear showed (Segmented 0%, Eo 0%, Ba 0%, Mo 1%, Lymphocytes 99%). The final diagnose was established on the bone marrow biopsy histopathology exam. Than it was performed the Anti Aspergillus fumigatus antibody: 1/320 (NV< 1/80) because of the persisting fever. Immediately it was implemented the antibiotic, antifungal and replacement therapy with a good result. After 33 days of hospitalization the lab tests showed a marked improvement therefore: the leucocytes reached the peak of 5890/mm3,granulocytes 4090/mm3, PLT 384.000/mm3. Conclusions: Due to the fact that the aplastic anemia is secondary to the treatment with Algocalmin occurred in a previously healthy young patient, the bone marrow rehabilitation was achieved with the right treatment. After 6 months after the discharge, the patient had been declared completely cured having both aplastic anemia and systemic aspergillosis extinguished

Solid pseudopapillary neoplasm – Management of an extremely rare case of pancreatic tumor in a young patient

Introduction: Franz Tumor or the solid pseudopapillary neoplasm is a very rare form of pancreatic cancer, that can be held responsible for approximately 0.2-2% of the exocrine pancreatic tumors

Fatal Hypocalcaemia Due to Hungry Bone Syndrome with Secondary Refractory HyperParathyroidism after Parathyroidectomy: A Case Report

Hungry bone syndrome (HBS) refers to the rapid, profound, and prolonged hypocalcaemia associated with hypophosphatemia and hypomagnesaemia, and is exacerbated by suppressed parathyroid hormone (PTH) levels, which follows parathyroidectomy in patients with severe primary hyperparathyroidism (PHPT) and preoperative high bone turnover. [1