Citation Information :
Mohan N, Chia YY, Ng CF, Iyer GN, Tan HK, Tan NC, Radhziah S. Lymph Node Metastasis from Papillary Thyroid Carcinoma or Tuberculous Lymphadenitis: A Diagnostic Dilemma. Int J Head Neck Surg 2017; 8 (3):121-124.
Background: Papillary thyroid carcinoma commonly presents with nodal metastases. The recommended treatment modality is total thyroidectomy with lateral neck dissection, i.e., a rather invasive surgical procedure with associated complications.
Aim: A rare case of coexistence of papillary thyroid carcinoma (PTC) and tuberculous cervical lymphadenitis in a patient that presented as a diagnostic and management dilemma intraoperatively is reported.
Case report: We hereby report a case of a Chinese female, who presented with a goiter and associated painful right lateral neck swellings. After preoperative investigations were done, the initial diagnosis was PTC with nodal metastases. However, the enlarged lymph nodes were eventually found out to be secondary to tuberculous infection through polymerase chain reaction (PCR) done on the surgical specimens.
Conclusion: In a small subset of patients with PTC, cervical lymphadenopathy is secondary to tuberculosis rather than nodal metastases. If preoperative and intraoperative investigations could be utilized to diagnose tuberculous lymphadenitis, lateral neck dissection could potentially be avoided.
Clinical significance: This clinical entity of coexistence of PTC and tuberculous cervical lymphadenopathy has only been minimally reported in the literature. In our patient, it was even more clinically significant as the enlarged lymph nodes were in close proximity to the innominate vessels, and thus required the potential need of a sternal split if the innominate vessels were injured in the process of surgery. In future, further studies would be recommended to determine the best approach for the management of concomitant PTC and tuberculous lymphadenitis, and future patients could benefit in terms of avoiding the complications associated with a potentially unnecessary invasive surgery.
Ito T, Saito H, Kishine N, Takeda T, Mizushima K. Preoperatively diagnosed case with co-existence of papillary thyroid carcinoma and cervical tuberculous lymphadenitis. Int J Surg Case Rep 2015 Aug;15:74-77.
Kim SM, Jun HH, Chang HJ, Chun KW, Kim BW, Lee YS, Chang HS, Park CS. Tuberculosis cervical lymphadenopathy mimics lateral neck metastasis from papillary thyroid carcinoma. ANZ J Surgery 2014 Jul;86(6):495-498.
Özkan Z, Akyiðit A, Sakallioðlu Ö, Gül Y, Solmaz Ö, Yaþar G, Polat C, Kanat BH. Diagnostic challenge in papillary thyroid carcinoma with cervical lymphadenopathy, metastasis, or tuberculous lymphadenitis. J Craniofac Surg 2013 Nov;24(6):2200-2203.
Soh EY, Clark OH. Surgical considerations and approach to thyroid cancer. Endocrinol Metab Clin North Am 1996 Mar;25(1):115-139.
Roh JL, Park CI. Sentinel lymph node biopsy as guidance for central neck dissection in patients with papillary thyroid carcinoma. Cancer 2008 Oct;113(7):1527-1531.
Noguchi S, Murakami N, Yamashita H, Toda M, Kawamoto H. Papillary Thyroid Carcinoma. Arch Surg 1998 Mar;133(3): 276-280.
Yoon JH, Kim JY, Moon HJ, Youk JH, Son EJ, Kim EK, Han KH, Kwak JY. Contribution of computed tomography to ultrasound in predicting lateral lymph node metastasis in patients with papillary thyroid carcinoma. Ann Surg Oncol 2011 Jun;18(6):1734-1741.
Andrabi SMS, Bhat MH, Farhana B, Saba S, Andrabi RS, Shah PA. Tuberculous cervical lymphadenitis masquerading as metastatis from papillary thyroid carcinoma. Int J Endocrinol Metab 2012 Summer;10(3):569-572.
Lai KK, Stottmeier KD, Sherman IH, McCabe WR. Mycobacterial cervical lymphadenopathy. Relation of etiologic agents to age. JAMA 1984 Mar;251(10):1286-1288.
Lazarus AA, Thilagar B. Tuberculous lymphadenitis. Dis Mon 2007 Jan;53(1):10-15.
Lau SK, Wei Wl, Hsu C, Engzell UC. Efficacy of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenopathy. J Laryngol Otol 1990 Jan;104(1):24-27.
Artenstein AW, Kim JH, Williams WJ, Chung RC. Isolated peripheral tuberculous lymphadenitis in adults: current clinical and diagnostic issues. Clin Infect Dis 1995 Apr;20(4):876-882.
Ahuja AT, Ying M. Sonographic evaluation of cervical lymph nodes. Am J Roentgenol 2005 May;184(5):1691-1699.
do Rosario PW, Fagundes TA, Maia FF, Franco AC, Figueiredo MB, Purisch S. Sonography in the diagnosis of cervical recurrence in patients with differentiated thyroid carcinoma. J Ultrasound Med 2004 Jul;23(7):915-920.
Lee KC, Tami TA, Lalwani AK, Schecter G. Contemporary management of cervical tuberculosis. Laryngoscope 1992 Jan;102(1):60-64.
Abbara A, Davidson RN, Medscape. Etiology and management of genitourinary tuberculosis. Nat Rev Urol 2011 Dec;8(12):678-688.
Haldar S, Bose M, Chakrabarti P, Daginawala H, Harinath B, Kashyap R, Kulkarni S, Majumdar A, Prasad HK, Rodrigues C, et al. Improved laboratory diagnosis of tuberculosis—the Indian experience. Tuberculosis 2011 Sep;91(5):414-426.
Derby LD, Low DW. Laser treatment of facial venous vascular malformations. Ann Plast Surg 1997 Apr;38(4):371-378.
Ethunandan M, Mellor TK. Haemangiomas and vascular malformations of the maxillofacial region-a review. Br J Oral Maxillofac Surg 2006 Aug;44(4):263-272.
Kane WJ, Morris S, Jackson IT, Woods JE. Significant hemangiomas and vascular malformations of the head and neck: clinical management and treatment outcomes. Ann Plast Surg 1995 Aug;35(2):133-143.
Jackson IT, Carreno R, Potparic Z, Hussain K. Hemangiomas, vascular malformations, and lymphovenous malformations: classification and methods of treatment. Plast Reconstr Surg 1993 Jun;91(7):1216-1230.
Kohout MP, Hansen M, Pribaz JJ, Mulliken JB. Arteriovenous malformations of the head and neck: natural history and management. Plast Reconstr Surg 1998 Sep;102(3):643-654.
Han MH, Seong SO, Kim HD, Chang KH, Yeon KM, Han MC. Craniofacial arterio-venous malformation: preoperative embolization with direct puncture and injection of n-butyl cyanoacrylate. Radiology 1999 Jun;211(3):661-666.
Kim JY, Kim DI, Do YS, Lee BB, Kim YW, Shin SW, Byun HS, Roh HG, Choo IW, Hyon WS, et al. Surgical treatment for congenital arteriovenous malformation: 10 years’ experience. Eur J Vasc Endovasc Surg 2006 Jul;32(1):101-106.
Luo QF, Zhao FY. The effects of Bleomycin A5 on infantile maxillofacial haemangioma. Head Face Med 2011 Jul;7:11.
Umezawa H, Suhara Y, Takita T, Maeda K. Purification of bleomycin. J Antibiot (Tokyo) 1966 Sep;19(5):210-215.
Lopez-Larraza D, De Luca JC, Bianchi NO. The kinetics of DNA damage by bleomycin in mammalian cells. Mutation Res 1990 Sep;232(1):57-61.
Yura J, Hashimoto T, Tsuruga N, Shibata K. Bleomycin treatment for cystic hygroma in children. Nihon Geka Hokan 1977 Sep;46(5):607-614.
Pascarella L, Bergan JJ, Yamada C, Mekenas L. Venous angiomata: treatment with sclerosant foam. Ann Vasc Surg 2005 Jul;19(4):457-464.
Mimura H, Kanazawa S, Yasui K, Fujiwara H, Hyodo T, Mukai T, Dendo S, Iguchi T, Hiraki T, Koshima I, et al. Percutaneous sclerotherapy for venous malformations using polidocanol under fluoroscopy. Acta Med Okayama 2003 Oct;57(5):227-234.
Siniluoto TM, Svendsen PA, Wikholm GM, Fogdestam I, Edström S. Percutaneous sclerotherapy of venous malformations of the head and neck using sodium tetradecylsulphate (sotradecol). Scand J Plast Reconstr Surg Hand Surg 1997 Jun;31(2):145-150.
Berthelsen B, Fogdestam I, Svendsen P. Venous malformations in the face and neck. Radiologic diagnosis and treatment with absolute ethanol. Acta Radiol Diagn (Stockh) 1986 Mar-Apr;27(2):149-155.
Orlando JL, Caldas JG, Campos HG, Nishinari K, Wolosker N. Outpatient percutaneous treatment of deep venous malformations using pure ethanol at low doses under local anesthesia. Clinics (Sao Paulo) 2010 Sep;65(9):837-840.
Sachin K, Rashmi S, Manish S, Siddhartha W, Uday L. Haemangiomas and venous malformations of the head and neck: A retrospective analysis of endovascular management in 358 patients. Indian J Plast Surg 2013 Jan;46(1): 109-116.
Alakailly X, Kummoona R, Quereshy FA, Baur DA, Gonzalez AE. The use of sodium tetradecyl sulphate for the treatment of venous malformations of the head and neck. J Maxillofac Oral Surg 2015 Jun;14(2):332-338.
Yamaki T, Nozaki M, Sakurai H, Takeuchi M, Soejima K, Kono T. Prospective randomized efficacy of ultrasound-guided foam sclerotherapy compared with ultrasound-guided liquid sclerotherapy in the treatment of symptomatic venous malformations. J Vasc Surg 2008 Mar;47(3):578-584.
Imbesi SG, Green DA, Cho A, Pakbaz RS. MR angiographicguided percutaneous sclerotherapy for venous vascular malformations: a radiation dose-reduction strategy. AJNR Am J Neuroradiol 2016 Feb;37(2):205-209.
Muir T, Kirsten M, Fourie P, Dippennar N, Ionescu GO. Interalesional bleomycin injection (IBI) treatment for haemangiomas and congenital vascular malformations. Pediatr Surg Int 2004 Jan;19(12):766-773.
Spence J, Krings T, terBrugge KG, da Costa LB, Agid R. Percutaneous sclerotherapy for facial venous malformations: subjective clinical and objective MR imaging follow-up results. AJNR Am J Neuroradiol 2010 May;31(5):955-960.
Folayan M, Owotade F, Adejuyigbe E, Sen S, Lawal B, Ndukwe K. The timing of eruption of the primary dentition in Nigerian children. Am J Phys Anthopol 2007 Dec;134(4): 443-448.
Feraru IV, Raducanu AM, Feraru SM, Herteliu C. The sequence and chronology of the eruption of permanent canines and premolars in a group of Romanian children in Bucharest. OHMD 2011;10(4):193-198.
Singh S, Sharma A, Sandhu N, Mehta K. The prevalence of malocclusion and orthodontic treatment needs in school going children of Nalagarh, Himachal Pradesh, India. Indian J Dent Res 2016 May-Jun;27(3):317-322.
Amado JN, Sierraa AM, Gallon A, Alvarez C, Baccettic T. Relationship between personality traits and cooperation of adolescent orthodontic patients. Angle Orthod 2008 Jul;78(4):688-691.
Ansai T, Miyazaki H, Katoh Y, Yamashita Y, Takehara T, Jenny J, Cons NC. Prevalence of malocclusion in high school students in Japan according to the dental aesthetic index. Comm Dent Oral Epidemiolol 1993 Oct;21(5):303-305.
Danaei SM, Amirrad F, Salehi P. Orthodontic treatment needs of 12- 15 year old students in Shiraz, Islamic Republic of Iran. East Mediterr Health J 2007 Mar-Apr;13(2):326-334.
Onyeaso CO, BeGole EA, Orthodontic treatment need in an accredited orthodontic centre in North America: a pilot study. J Contemp Dent Pract 2006 May;7(2):87-94.
Onyeaso CO, Sanu OO. Perception of personal dental appearance in Nigeria adolescents. Am J Orthod Dentofac Orthop 2005 Jun;127(6):700-706.
Onyeaso CO. Orthodontic concern of parents compared with orthodontic treatment need assessed by Dental Aesthetic Index (DAI) in Ibaden, Nigeria. Odontostomatol Trop 2003 Mar;26(101):13-20.
Naveen Kumar B, Mohapatra A, Ramesh N, Ravishankar TL. Prevalence of malocclusion and orthodontic treatment need among 12-15 years old school children in Davangere, Karnataka, India. Pak Oral Dent J 2010;30(1):181-185.
de Oliveira CM, Sheiham A. The relationship between normative orthodontic treatment need and oral health-related quality of life. Community Dent Oral Epidemiol 2003 Dec;31(6):426-436.
de Oliveira CM, Sheiham A, Tsakos G, O'Brien KD. Oral health related quality of life and the IOTN index as predictors of children's perceived needs and acceptance for orthodontic treatment. Br Dent J 2008 Apr;204(7):1-5.
Al-Sarheed M, Bedi R, Hunt NP. Orthodontic treatment need and self perception of 11-16 year old Saudi Arabian children with a sensory impairment attending special schools. J Orthod 2003 Mar;30(1):39-44.
Kerosuo H, Al Enezi S, Kerosuo E, Abdulkarim E. Association between normative and self perceived orthodontic treatment need among Arab high school students. Am J Orthod Dentofacial Orthop 2004 Mar;125(3):373-378.
Ghijselings I, Brosens V, Williams G, Fieuws S, Clijmans M, Lemiere J. Normative and self-perceived orthodontic treatment need in 11- to 16-year-old children. Eur J Orthod 2014 Apr;36(2):179-185.
Onyeaso CO, Arowojolu MO. Perceived, desired and normatively determined treatment need among orthodontically untreated Nigerian adolescents. West Afr J Med 2003 Jan- Mar;22(1):5-9.
Jung MH. Quality of life and self-esteem of female orthognathic surgery patients. J Oral Maxillofac Surg 2016 Jun;74(6):1240.e1-1240.e7.
Abu Alhaija ES, Al-Nimri KS, Al-Khateeb SN. Self perception of malocclusion among Jordanian school children. Eur J Orthod 2005 Jun;27(3):292-295.
Kolawole KA, Otuyemi DE, Jebode SO, Unweni AA. Awareness for malocclusion and desire for orthodontic treatment need in 11-14year old Nigerian school and their parents. Aust Orthod J 2008 May;24(1):21-25.
Cucalon A 3rd, Smith RJ. Relationship between by adolescent orthodontics patients and performance on psychological tests. Angle Orthod 1990 Summer;60(2):107-114.
Southard KA, Tolley EA, Arheart KL, Hackett-Renner CA, Southard TE. Application of the Millon Adolescent Personality Inventory in evaluating orthodontic compliance. Am J Orthod Dentofacial Orthop 1991 Dec;100(6):553-561.
Kharbanda OP. What is the prevalence of malocclusion in India? Do we know orthodontic treatment needs of our country. J Indian Orthod Soc 1999 Apr-Jun;32(2):33-41.
Siddiqui TA, Shaikh A, Fida M. Agreement between orthodontist and patient perception using Index of Orthodontic Treatment Need. Saudi Dent J 2014 Oct;26(4):156-165.
Borzabadi-Farahani A, Borzabadi-Farahani A, Eslamipour F. Orthodontic treatment needs in an urban Iranian population in epidemiological study of 11-14 years old children. Eur J Paediatr Dent 2009 Jun;10(2):69-74.
Grando G, Young AA, Vedovello Filho M, Vedovello SA, Ramirez-Yañez GO. Prevalence of malocclusions in a young Brazilian population. Int J Orthod Milwaukee 2008 Summer;19(2):13-16.
Nadim R, Aslam K, Rizwan S. Frequency of malocclusion among 12 -15 years old school children in three sectors of Karachi. Pak Oral Dent J 2014 Sep;34(3):510-514.
Reddy ER, Manjula M, Sreelakshmi N, Rani ST, Aduri R, Patil BD. Prevalence of malocclusion among 6 to 10 year old Nalgonda school children. J Int Oral Health 2013 Dec;5(6): 49-54.
Onyeaso CO. Prevalence of malocclusion among adolescents in Ibadan, Nigeria. Am J Orthod Dentofacial Orthop 2004 Nov;126(5):604-607.
Kaur H, Pavithra US, Abraham R. Prevalence of malocclusion among adolescents in South Indian population. J Int Soc Prev Community Dent 2013 Jul-Dec;3(2):97-102.
Lauc T. Orofacial analysis on the Adriatic islands: an epidemiological study of malocclusions on Hvar Island. Eur J Orthod 2003 Jun;25(3):273-278.
Zimmermann E, Gamborg M, Holst C, Baker JL, Sørensen TI, Berentzen TL. Body mass index in school-aged children and the risk of routinely diagnosed non-alcoholic fatty liver disease in adulthood: a prospective study based on the Copenhagen School Health Records Register. BMJ Open 2015 May;5(4):e006998.
Reece EA, Hagay Z, Roberts AB, DeGennaro N, Homko CJ, Connolly-Diamond M, Sherwin R, Tamborlane WV, Diamond MP. Fetal Doppler and behavioral responses during hypoglycemia induced with the insulin clamp technique in pregnant diabetic women. Am J Obstet Gynecol 1995 Jan;172(1 Pt 1):151-155.
Patrick J, Campbell K, Carmichael L, Natale R, Richardson B. Patterns of gross fetal body movements over 24-hour observation intervals during the last 10 weeks of pregnancy. Am J Obstet Gynecol 1982 Feb;142(4):363-371.
Ornoy A, Ratzon N, Greenbaum C, Peretz E, Soriano D, Dulitzky M. Neurobehavior of school age children born to diabetic mothers. Arch Dis Child Fetal Neonatal Ed 1998 Sep;79(2):F94-F99.
Wolf, A. Developmental evaluation on early school age children born to gestational diabetic mothers. Israel: Hebrew University; 1997.
Mulder EJ, Leiblum DM, Visser GH. Fetal breathing movements in late diabetic pregnancy: relationship to fetal heart rate patterns and Braxton Hicks’ contractions. Early Hum Dev 1995 Nov;43(3):225-232.
Schulte FJ, Michaelis R, Nolte R, Albert G, Parl U, Lasson U. Brain and behavioral maturation in newborn infants of diabetic mothers. I. Nerve conduction and EEG patterns. Neuropadiatrie 1969 Jan-Jul;1(1):24-35.
Devoe LD, Youssef AA, Castillo RA, Croom CS. Fetal biophysical activities in third-trimester pregnancies complicated by diabetes mellitus. Am J Obstet Gynecol 1994 Aug;171(2):298-303.
Dierker LJ Jr, Pillay S, Sorokin Y, Rosen MG. The change in fetal activity periods in diabetic and nondiabetic pregnancies. Am J Obstet Gynecol 1982 May;143(2):181-185.
Doherty NN, Hepper PG. Habituation in fetuses of diabetic mothers. Early Hum Dev 2000 Aug;59(2):85-93.
Kainer F, Prechtl HF, Engele H, Einspieler C. Assessment of the quality of general movements in fetuses and infants of women with type-1 diabetes mellitus. Early Hum Dev 1997 Nov;50(1):13-25.
Mulder EJ, O'Brien MJ, Lems YL, Visser GH, Prechtl HF. Body and breathing movements in near-term fetuses and newborn infants of type-1 diabetic women. Early Hum Dev 1990 Nov;24(2):131-152.
Mulder EJ, Visser GH. Growth and motor development in fetuses of women with type-1 diabetes. I. Early growth patterns. Early Hum Dev 1991 May;25(2):91-106.
Mulder EJ, Visser GH. Growth and motor development in fetuses of women with type-1 diabetes. II. Emergence of specific movement patterns. Early Hum Dev 1991 May;25(2):107-115.
Mulder EJ, Visser GH. Impact of early growth delay on subsequent fetal growth and functional development: a study on diabetic pregnancy. Early Hum Dev 1992 Dec;31(2):91-95.
Mulder EJ, Visser GH, Bekedam DJ, Prechtl HF. Emergence of behavioral states in fetuses of type-1 diabetic women. Early Hum Dev 1987 Jul;15(4):231-251.
Mulder EJ, Visser GH, Morssink LP, de Vries JI. Growth and motor development in fetuses of women with type-1 diabetes. III. First trimester quantity of fetal movement patterns. Early Hum Dev 1991 May;25(2):117-133.
Aberg A, Westbom L, Kallen B. Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes. Early Hum Dev 2001 Mar;61(2):85-95.
Deregnier RA, Nelson CA, Thomas KM, Wewerka S, Georgieff MK. Neurophysiologic evaluation of auditory recognition memory in healthy newborn infants and infants of diabetic mothers. J Pediatr 2000 Dec;137(6):777-784.
Nelson CA, Wewerka S, Thomas KM, Tribby-Walbridge S, deRegnier R, Georgieff M. Neurocognitive sequelae of infants of diabetic mothers. Behav Neurosci 2000 Oct;114(5):950-956.
Reece EA, Homko CJ. Infant of the diabetic mother. Semin Perinatol 1994 Oct;18(5):459-469.
Reece EA, Homko CJ. Why do diabetic women deliver malformed infants? Clin Obstet Gynecol 2000 Mar;43(1):32-45.
Rizzo T, Metzger BE, Burns WJ, Burns K. Correlations between antepartum maternal metabolism and intelligence of offspring. N Engl J Med 1991 Sep;325(13):911-916.
Rizzo TA, Metzger BE, Dooley SL, Cho NH. Early malnutrition and child neurobehavioral development: insights from the study of children of diabetic mothers. Child Dev 1997 Feb;68(1):26-38.
Schwartz R, Teramo KA. Effects of diabetic pregnancy on the fetus and newborn. Semin Perinatol 2000 Apr;24(2):120-135.
Vaarasmaki MS, Hartikainen A, Anttila M, Pramila S, Koivisto M. Factors predicting peri- and neonatal outcome in diabetic pregnancy. Early Hum Dev 2000 Jul;59(1):61-70.
Robertson SS, Dierker LJ. Fetal cyclic motor activity in diabetic pregnancies: sensitivity to maternal blood glucose. Dev Psychobiol 2003 Jan;42(1):9-16.
Accardo PJ, Blondis TA, Whitman BY. Disorders of attention and activity level in a referral population. Pediatrics 1990 Mar;85(3 Pt 2):426-431.
Ornoy A, Uriel L, Tennenbaum A. Inattention, hyperactivity and speech delay at 2-4 years of age as a predictor for ADDADHD syndrome. Isr J Psychiatry Relat Sci 1993;30(3):155-163.
Smyth TR. Impaired motor skill (clumsiness) in otherwise normal children: a review. Child Care Health Dev 1992 Sep-Oct;18(5):283-300.
Petersen MB, Pedersen SA, Greisen G, Pedersen JF, Mølsted- Pedersen L. Early growth delay in diabetic pregnancy: relation to psychomotor development at age 4. Br Med J (Clin Res Ed) 1988 Feb;296(6622):598-600.
Sells CJ, Robinson NM, Brown Z, Knopp RH. Long-term developmental follow-up of infants of diabetic mothers. J Pediatr 1994 Jul;125(1):S9-S17.
Vladareanu R, Lebit D, Constantinescu S. Ultrasound assessment of fetal neurobehaviour in high risk pregnancies. DSJUOG 2012 Apr-Jun;6(2):132-147.
Talic A, Kurjak A, Ahmed B, Stanojevic M, Predojevic M, Kadic AS, Di Renzo GC. The potential of 4D sonography in the assessment of fetal behavior in high-risk pregnancies. J Matern Fetal Neonatal Med 2011 Jul;24(7):948-954.
Bekedam DJ, Visser GH, de Vries JJ, Prechtl HF. Motor behaviour in the growth retarded fetus. Early Hum Dev 1985 Nov;12(2):155-165.
Cioni G, Prechtl HF. Preterm and early postterm motor behaviour in low-risk premature infants. Early Hum Dev 1990 Sep;23(3):159-191.
Seme-Ciglenecki P. Predictive value of assessment of general movements for neurological development of highrisk preterm infants: comparative study. Croat Med J 2003 Dec;44(6):721-727.
Abo-Yaqoub S, Kurjak A, Mohammed AB, Shadad A, Abdel-Maaboud M. The role of 4-D ultrasonography in prenatal assessment of fetal neurobehaviour and prediction of neurological outcome. J Matern Fetal Neonatal Med 2012 Mar;25(3):231-236.
Athanasiadis AP, Mikos T, Tambakoudis GP, Theodoridis TD, Papastergiou M, Assimakopoulos E, Tarlatzis BC. Neurodevelopmental fetal assessment using KANET scoring system in low and high-risk pregnancies. J Matern Fetal Neonatal Med 2013 Mar;26(4):363-368.
Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, Carmina E, Chang J, Yildiz BO, Laven JS, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012 Jan;97(1):28-38.e25
Sirmans SM, Pate KA. Epidemiology, diagnosis and management of polycystic ovary syndrome. Clin Epidemiol 2014; 6:1-13.
Fauser BC, Diedrich K, Bouchard P, Domínguez F, Matzuk M, Franks S, Hamamah S, Simón C, Devroey P, Ezcurra D, et al. Contemporary genetic technologies and female reproduction. Human Reproduction Update 2011 Nov;17(6):829-847.
Balen A, Conway G, Kaltsas G. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod 1995 Aug;10(8):2107-2111.
Azziz R, Sanchez L, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab 2004 Feb;89(2):453-462.
Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at longterm follow-up: a retrospective cohort study. Clin Endocrinol (Oxf) 2000 May;52(5):595-600.
Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril 2007 Jun;87(6): 1369-1376.
Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome. In: Givens JHF, Merriman G, editors. The polycystic ovary syndrome. Cambridge, MA: Blackwell Scientific; 1992. p. 377-384.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004 Jan;81(1):19-25.
Azziz R, Carmina E, DeWailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, et al. Position statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 2006 Nov;91(11):4237-4245.
Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR. Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod 2013 May;28(5):1361-1368.
Badawy A, Elnashar A. Treatment options for polycystic ovary syndrome. Int J Womens Health 2011 Feb;3:25-35.
ACOG Committee on Practice Bulletins—Gynecology. ACOG Practice Bulletin No 108: Polycystic ovary syndrome. Obstet Gynecol 2009 Oct;114(4):936-949.
Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril 2008 Mar;89(3): 505-522.
Balen AH. Ovulation induction in the management of anovulatory polycystic ovary syndrome. Mol Cell Endocrinol 2013 Jul;373(1-2):77-82.
Berridge DL, Winter TC. Saline infusion sonohysterography: technique, indications, and imaging findings. J Ultrasound Med 2004 Jan;23(1):97-112.
Allison SJ, Horrow MM, Kim HY, Lev-Toaff AS. Salineinfused sonohysterography: tips for achieving greater success. Radiographics 2011 Nov-Dec;31(7):1991-2004.
O'Neill MJ. Sonohysterography. Radiol Clin North Am 2003 Jul;41(4):781-797.
Bonnamy L, Marret H, Perrotin F, Body G, Berger C, Lansac J. Sonohysterography: a prospective survey of results and complications in 81 patients. Eur J Obstet Gynecol Reprod Biol 2002 Apr;102(1):42-47.
Lindheim SR, Adsuar N, Kushner DM, Pritts EA, Olive DL. Sonohysterography: a valuable tool in evaluating the female pelvis. Obstet Gynecol Surv 2003 Nov;58(11):770-784.
Lindheim SR, Sprague C, Winter TC. Hysterosalpingography and sonohysterography: lessons in technique. AJR Am J Roentgenol 2006 Jan;186(1):24-29.
Jeanty P, Besnard S, Arnold A, Turner C, Crum P. Air-contrast sonohysterography as a first step assessment of tubal patency. J Ultrasound Med 2000 Aug;19(8):519-527.