Thyroid Hyalinizing Trabecular Tumor: A Case Series

Aim: Hyalinizing Trabecular Tumor (HTT) of the thyroid gland is an unusual and rare follicular derived neoplasm, which was first described from Carney and colleagues in 1987. We aim to present two cases of HTT diagnosed as papillary thyroid carcinomas in preoperative FNA cytological findings, although the postoperative histological examinations revealed the presence of Hyalinizing Trabecular tumors. Moreover, a short review regarding the diagnostic and clinical aspects of this rare thyroid tumor is also presented. Cases Presentation: A 30 year old and a 33 year old females were referred as having papillary thyroid carcinomas on preoperative FNA. Total thyroidectomy was offered in both. Histologic sections revealed the presence of HTT with the characteristic trabecular arrangement of polygonal/spindle cells and positive staining for MIB-1. Both patients remain disease free at a follow up of 5 years. Discussion: Although HTT diagnosis and differentiation from other thyroid tumors remains a topic of controversy, immunochemistry and molecular analysis may provide adequate information for HTT distinction from papillary thyroid carcinoma (PTC), medullary thyroid cancer (MTC) and paragaglioma. Therefore, suspicious cases based on preoperative FNA, require careful evaluation and cooperation of pathologists, endocrinologists and endocrine surgeons for optimal diagnosis and treatment. Conclusions: HTT is a rare, mostly benign neoplasm with favorable prognosis Preoperative identification of HTT is significant since its extremely low malignant potential and its favorable prognosis may lead to less extended operations and avoidance of postoperative radioiodine administration

Limited cross-border infections in patients newly diagnosed with HIV in Europe

Matti Ristola ja Jussi Sutinen kuuluvat työryhmään SPREAD ProgrammePeer reviewe

Thyroid paraganglioma: a case series of a rare head and neck tumor

Thyroid paragangliomas are rare neuroendocrine tumors. We present two cases analyzing their clinical presentation and pathology findings. A 44-year-old woman presented with a 33 mm left thyroid lobe mass. A 27-year-old male presented with a 27-mm right thyroid lobe mass and a FNA biopsy suggesting a follicular thyroid tumor. Both patients underwent total thyroidectomy. Vigorous bleeding was noted on the first case. Histologic sections revealed encapsulated tumors, whereas immunochemical stains were positive for chromogranin A, synaptophysin and NSE and negative for thyroglobulin, calcitonin, CEA and S-100. After an 18- and 12-month follow-up, respectively, both patients have no signs of local recurrence or distantmetastasis. Preoperative diagnosis of thyroid paragangliomas was never attained in this series. Immunohistochemistry is mandatory for proper differential diagnosis. For the surgeon, the operation is technically demanding mainly due to the increased vascularity and friability of the tumor

Posterior retroperitoneoscopic versus laparoscopic adrenalectomy in sporadic and MENIIA pheochromocytomas

Retroperitoneal adrenalectomy (PRA) comprises an alternative approach in the management of adrenal tumors that has been set as the treatment of choice in our Institution. We assess the impact of PRA the management of hereditary and sporadic pheochromocytomas comparing its outcomes to the laparoscopic technique, in a case-controlled setting. From May 2008 to January 2013, 17 patients [5 males and 12 females, mean age: 51 yrs (range 26-73)] with pheochromocytomas underwent PRA. Demographics, tumor characteristics, operative time, complications, hospital stay, and postoperative pain (based on VAS score at days 1 and 3) were compared to 17 selected laparoscopic patient controls [7 males and 10 females, mean age 49 yrs (range 25-64)]. 17 patients, 11 with the sporadic form and 6 with MENIIA associated pheochromocytomas, comprised the retroperitoneoscopic group. 19 pheochromocytomas with a mean size 3.7 cm (range 1.7-7.0) at a mean operative time: 105.6 min (range 60-180) were accordingly excised. In the laparoscopic group, 13 patients had sporadic pheochromocytomas, whereas 4 patients had MENIIA syndrome. Mean tumor size of the laparoscopic series was 5.1 cm (range 1.7-8.5) at a mean operative time of 137 min (range 75-195). No mortality or conversions were encountered in both groups. No blood transfusions were needed. Mean visual analog scale pain scores were significantly lower for the retroperitoneoscopic group both on days 1 and 3 [0.94 (0-3) vs 4.15 (3-6), p < 0.001 and 0.06 (0-1) vs 3.5 (2-6) p < 0.001] respectively. Mean hospital stay for the patients of the retroperitoneoscopic group was significantly better than the laparoscopic group [(2.1 +/- A 0.24 days vs 40 +/- A 0.70 days) p < 0.001]. Retroperitoneoscopic adrenalectomy is associated with excellent clinical results in the management of sporadic and hereditary pheochromocytomas. Moreover, it appears to be superior to the laparoscopic approach, because it is faster and affords the patient with less pain and shorter hospital stay