Neurosyphilis, which is caused by Treponema pallidum, is a rare sexually transmitted disease involving the central nervous system (CNS). Among all the sub-categories, spinal syphilitic gumma is extremely rare. In previous literature, limited cases of spinal syphilitic gumma have been reported, most of which underwent surgery treatment. In this study, we reported a 46-year-old man, who presented with 5-day numbness of bilateral lower limbs, lower back pain, and irregular defecation. Magnetic resonance imaging (MRI) revealed a homogeneous peripheral enhancement and intramedullary nodule at the T7 level with extensive thoracic cord edema. Combining with laboratory examination results, the syphilitic gumma was considered. One month after the administration of penicillin G, the symptoms vanished. Six months later, MRI indicated no intramedullary nodule.

No abstract

Introduction:Ectopic thyroid occurs due to aberrant development of the thyroid gland during its migration to the pretracheal region. Intrapulmonary ectopic thyroid is extremely rare and its benign transformation (microfollicular adenoma) has never been reported. This paper reports a case of ectopic thyroid microfollicular adenoma in the lung mimicking metastatic pelvic tumors.Patient concerns:A 76-year old female presented to our hospital because of transient unconsciousness. Pelvic ultrasound (US) and chest computed tomography (CT) showed pelvic tumors and pulmonary nodules.Diagnosis and interventions:The patient underwent pelvic tumors resection and CT-guided fine-needle aspiration cytology (FNAC) at the largest pulmonary nodule. Pathological description revealed bilateral ovarian serous cystadenoma and endometrioma in pelvic, and ectopic thyroid microfollicular adenoma in lung. In view of the patient's age and physical conditions, it is unanimously decided by the physicians and the family members of the patient to closely follow up this benign pulmonary lesion.Outcomes:During the 12-month follow-up, no pelvic tumor recurrence or metastasis was found. CT review of pulmonary nodules showed no remarkable changes. The patient was asymptomatic and euthyroid after being discharged from the hospital.Conclusion:Ectopic thyroid microfollicular adenoma in the lung is extremely rare and can be easily mistaken for pulmonary metastases from other sites. The case reported in this paper highlights that ectopic intrapulmonary thyroid tumor should not be overlooked.

The combined diagnostic value of BV and sPLA2-IIa appeared as a desirable detection method for malignant and benign SPNs.

Objective To establish a prediction model of malignancy for solitary pulmonary nodules (SPNs) on the basis of imaging, clinical characteristics and tumor marker levels. Methods Totally, 341 cases of SPNs were enrolled in this retrospective study, in which 70% were selected as the training group ( n = 238) and the rest 30% as the verification group ( n = 103). The imaging, clinical characteristics and tumor marker levels of patients with benign and malignant SPNs were compared. Influencing factors were identified using multivariate logistic regression analysis. The model was assessed by the area under the curve (AUC) of the receiver operating characteristic curve. Results Differences were evident between patients with benign and malignant SPNs in age, gender, smoking history, carcinoembryonic antigen (CEA), neuron-specific enolase, nodule location, edge smoothing, spiculation, lobulation, vascular convergence sign, air bronchogram, ground-glass opacity, vacuole sign and calcification (all P < 0.05). Influencing factors for malignancy included age, gender, nodule location, spiculation, vacuole sign and CEA (all P < 0.05). The established model was as follows: Y = −5.368 + 0.055 × age + 1.012 × gender (female = 1, male = 0) + 1.302 × nodule location (right upper lobe = 1, others = 0) + 1.208 × spiculation (yes = 1, no = 0) + 2.164 × vacuole sign (yes = 1, no = 0) −0.054 × CEA. The AUC of the model with CEA was 0.818 (95% confidence interval, 0.763–0.865), with a sensitivity of 64.80% and a specificity of 84.96%, and the stability was better through internal verification. Conclusions The prediction model established in our study exhibits better accuracy and internal stability in predicting the probability of malignancy for SPNs.