The clinical aspect of the disease is similar to that of biliary lithiasis and the diagnosis is easily made by the characteristic spontaneous opacification of the gall bladder on plain abdominal X-rays. Complications such as acute cholecystitis, pancreatitis or obstructive jaundice can also be present. Although some cases of conservative pharmaceutical treatment as well as cases of spontaneous disappearance of limy bile have been reported, surgical treatment remains the treatment of choice.
Patient: Female, 27Final Diagnosis: Invasive thyroglossal duct cyst papillary carcinomaSymptoms: Painless cervical enlargementMedication: —Clinical Procedure: Sistrunk’s procedureSpecialty: SurgeryObjective:Rare diseaseBackground:Thyroglossal duct cyst is a common congenital anomaly of the thyroid gland, usually found centrally. The presence of malignancy occurring in a thyroglossal duct cyst is a rare condition, accounting only for 1% of all cases of thyroglossal duct cyst. This report is of a rare case of papillary carcinoma arising in a thyroglossal duct cyst and includes a review of the literature.Case Report:A 27-year-old female patient was referred to our department with a painless cystic mass in the neck. After initial physical examination and endocrinology investigations, a fine needle aspiration (FNA) of the cyst was performed. Cytology showed a papillary neoplasm. The patient underwent total thyroidectomy and surgical excision of the thyroglossal duct cyst (the Sistrunk’s procedure). Histopathology of the surgical excision specimen showed a thyroglossal duct cyst with a maximum diameter of 7.5 cm containing a primary invasive papillary carcinoma, measuring 1.5 cm in diameter that infiltrated into the cyst wall. The remaining thyroid gland was normal.Conclusions:Thyroglossal duct carcinoma, most commonly papillary carcinoma, is a rare condition that should be considered in patients presenting with cystic midline neck masses. Surgery and complete excision is the main treatment and the optimal patient management includes multidisciplinary consultation in order to improve survival. The diagnosis of malignancy is made postoperatively, as in the present case.
We report a case of a 70-year-old man with renal cell carcinoma and metastasis to the pancreas. Symptomatic patients usually present with obstructive jaundice, abdominal pain, or GI bleeding. The diagnosis usually occurs in asymptomatic patients during followup for renal cell carcinoma. It usually befalls slowly from 2 to 18 years after the onset of the primary tumor of the kidney. A 70-year-old man presented in our department with weight loss, anorexia, and elevated blood glucose, having a large tumor on the head of the pancreas treated successfully by pancreatoduodenectomy. Three years after his treatment, the patient is doing well and without recurrence of the tumor. In conclusion, metastasis of renal cell carcinoma to the pancreas is a rare neoplasm accounting for 0.25–3% of all pancreatic tumors.
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