Background: As per the ICMR registry, thyroid cancer is shown to be an emerging cancer in India, especially in Chennai and Bengaluru. Of the various types of thyroid cancers, follicular thyroid cancer is the second most common well-differentiated thyroid cancer and constitutes about 10% of all thyroid malignancies. It is often diagnosed between the ages of 40 years and 60 years. Females are affected three times more often than males, making it the sixth most common malignancy in females. It is more commonly found among the people living in iodine deficient endemic areas. Appropriate early surgical treatment can reduce the risk of metastasis and recurrence. A neglected goiter can occasionally present with large dimensions and thereby increase the risk of carcinoma.
Purpose: To study a unique case of an exophytic thyroid mass that was inadequately managed earlier with nodulectomy. The mass gradually manifested in the form of exophytic follicular thyroid carcinoma.
Methods: Our study is a retrospective, explanatory case report of a unique exophytic thyroid follicular carcinoma. The objective of this case report is to highlight the need for a proper assessment and management of any thyroid neck swellings.
Results: Our patient had presented with a huge thyroid mass with a history of being inadequately managed earlier. Investigations were carried out that revealed it to be an exophytic thyroid mass with features of invasive follicular carcinoma on histopathological examination. The earlier inadequate surgical treatments had paved the way for the cancer to spread and invade the subcutaneous tissues and the skin.
Conclusion: Our case report is unique as although follicular thyroid carcinoma is the second most common cancer of the thyroid gland, its manifestation in the form of an exophytic thyroid mass is unheard. A comprehensive literature search on PUBMED/MEDLINE was carried out for the literature on exophytic follicular thyroid carcinoma, but we were unable to find any literature on the same. The inability of healthcare access, lack of patient\'s concern, denial of appropriate treatment, and inadequate assessment/treatment of the thyroid swellings (as in this case) can result in an exophytic thyroid mass which could be carcinogenic, e.g., follicular carcinoma as in this case.
We report a case of 39-year-old male with persistent epistaxis post-functional endoscopic sinus surgery (FEES) with septoplasty. Digital subtraction angiography (DSA) revealed the pseudoaneurysm of septal branch of an anterior ethmoidal artery (AEA) that was occluded by glue (interventional therapy).
Rhinoscleroma is a well-documented entity. However, rhinoscleroma associated with lymphadenopathy is a rare clinical entity. Here, we report a case of rhinoscleroma with cervical lymphadenopathy of Rosai–Dorfman histiocytosis in a 57-year-old female patient who presented to us with a history of nasal obstruction of 1-year duration and neck swelling of 2 months duration along with constitutional symptoms such as malaise.
How to cite this article:
Venkateswaran J, Lad P, Sawaimoon S, Soman C, Bhatia S, Samuel P. Isolated Langerhans Cell Histiocytosis of the Thyroid Gland: A Rare Case. Int J Head Neck Surg 2018; 9 (3):110-112.
Langerhans cell (LC) histiocytosis (LCH) is a rare disease predominantly affecting children and young adults, with an annual incidence between 4 and 5.4 per million individuals. Involvement of the thyroid by LCH is very rare, even in a multifocal disease. It can easily be confused on clinical grounds with other more common entities such as undifferentiated carcinoma, lymphoma, lymphocytic thyroiditis, chronic granulomatous thyroiditis, and cystic degeneration of multinodular goiter. Histology remains the most sensitive diagnostic modality. Immunohistochemical studies are extremely helpful in confirming the histologic impression because LCs are positive for S-100 protein and CD1a, and both markers can be used to assess formalin-fixed, paraffin-embedded tissue sections. Electron microscopy is also helpful by allowing identification of the pathognomonic Birbeck granules but not essential for diagnosis. Single-organ involvement in LCH is associated with excellent survival close to 100%. We report a rare case of isolated thyroid gland involvement by LCH.
Arteriovenous malformations (AVMs) are a congenital lesion which can present in any period of life. They are slow-growing lesions. The most common site is the brain. Extracranial lesions are quite rare. They can be treated by surgical excision or by endovascular therapy. Here, we report a case of AVMs of the prevertebral space.