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Papachristos AJ, Bin Mohamed Ebrahim ME, Fuchs TL, Gill AJ, Delbridge L, Serpell J, Sidhu SB. Beware the recurrent 'benign' multinodular goitre. ANZ J Surg 2023; 93:907-910. [PMID: 36852905 DOI: 10.1111/ans.18355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND The diagnosis of follicular carcinoma is often difficult to make on pathological analysis, as the histological distinction from follicular adenoma rests solely on the presence of capsular or vascular invasion. Even on retrospective review of the histopathology after the disease biology has declared itself as malignant, the pathological diagnosis of malignancy may not be possible to make. METHODS We report three cases in which patients were initially diagnosed with benign follicular lesions, but re-presented with locally recurrent disease and a subsequent malignant disease course. RESULTS We describe a rare entity of follicular thyroid carcinoma that demonstrates a locally recurrent and eventually metastatic disease phenotype, despite persistently benign pathological findings. CONCLUSION We highlight that if local recurrence occurs in discrete anatomical tissue planes, or in the thyroid bed following open total thyroidectomy for 'benign multinodular goitre', the possibility of this rare presentation of follicular thyroid carcinoma should be considered.
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Affiliation(s)
- Alexander J Papachristos
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Talia L Fuchs
- Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Leigh Delbridge
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Jonathan Serpell
- Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Stan B Sidhu
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Bin Mohamed Ebrahim ME, Singla A, Yao J, Laurence JM, Wong G, Lau H, Lee T, Yuen L, Lim WH, Pleass H. Outcomes of live renal donors with a history of nephrolithiasis; A systematic review. Transplant Rev (Orlando) 2023; 37:100746. [PMID: 36587468 DOI: 10.1016/j.trre.2022.100746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
The clinical outcomes of kidney donors with a prior history of nephrolithiasis are poorly defined. We conducted a systematic review assessing the post-donation clinical outcomes of kidney donors with a history of nephrolithiasis. Electronic databases (Ovid and Embase) were searched between 1960 and 2021 using key terms and Medical Subject Headings (MeSH) - nephrolithiasis, renal stones, renal transplantation and renal graft. Articles included conference proceedings and journal articles and were not excluded based on patient numbers. Primary outcome was donor stone-related event. Secondary outcomes were renal function upon follow-up or post-operative nephrectomy complications. In summary, 340 articles were identified through database search. We identified 14 studies (16 cohorts) comprising 432 live donors followed up for a median of 26 months post live kidney donation. Six donors donated the stone-free kidney whilst 23 live donors had bilateral stones. Mean stone size was 4.2 ± 1.4 mm (1-16) with average follow up duration of 21.1 months (1-149). Twelve studies provided primary outcome (n = 138 patients) and eight (n = 348) for secondary outcomes. One donor had a stone-related event upon follow up. A total of 195 patients had eGFR <60 upon follow up. However, they were not significantly different when compared to renal function of live donors that didn't have pre-donation nephrolithiasis. Many of the studies couldn't provide long term follow up, coupled with limited data regarding the nature of the pre-donation stone disease. In conclusion, this systematic review shows that we have very limited information upon which to base recommendation regarding pre-donation risk of post-donation complications. Longer term follow up is required and lifelong follow up with live donor registries will aid further understanding.
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Affiliation(s)
- Mohamed Eftal Bin Mohamed Ebrahim
- Department of Surgery, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia.
| | - Animesh Singla
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Vascular Surgery, Royal North Shore Hospital, NSW 2065, Australia
| | - Jinna Yao
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; National Pancreas Transplant Unit, Westmead Hospital, Sydney, NSW 2145, Australia; Department of Urology, Westmead Hospital, Sydney, NSW 2145, Australia
| | | | - Germaine Wong
- Renal Transplant Unit, Westmead Hospital, Sydney, NSW 2145, Australia; University of Sydney, Sydney, NSW 2000, Australia
| | - Howard Lau
- Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; Western Sydney University, Sydney, NSW 2000, Australia
| | - Taina Lee
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Lawrence Yuen
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Wai H Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia; School of Medicine, University of Western Australia, Perth, WA 6009, Australia
| | - Henry Pleass
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia
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Bin Mohamed Ebrahim ME, Kulasegaran S, Leibman S, Smith G. Greater omental infarction. ANZ J Surg 2022; 92:3080-3081. [PMID: 35174609 PMCID: PMC9790466 DOI: 10.1111/ans.17545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 12/30/2022]
Affiliation(s)
- Mohamed Eftal Bin Mohamed Ebrahim
- Discipline of Surgery, Faculty of Health and MedicineUniversity of SydneySydneyNew South WalesAustralia,Acute Surgical UnitRoyal North Shore HospitalSydneyNew South WalesAustralia
| | - Suheelan Kulasegaran
- Upper Gastrointestinal Surgery, Royal North Shore HospitalSydneyNew South WalesAustralia
| | - Steven Leibman
- Upper Gastrointestinal Surgery, Royal North Shore HospitalSydneyNew South WalesAustralia
| | - Garett Smith
- Upper Gastrointestinal Surgery, Royal North Shore HospitalSydneyNew South WalesAustralia
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Bin Mohamed Ebrahim ME, Mohamed Rizvi Z, Hameed A, Laurence J, Webster A, Cavazzoni E, Lee T, Yuen L, Pleass H. Transplant Outcomes From Deceased Donors Dying With Burns Injury, a Systematic Review. Transplant Proc 2022; 54:1730-1736. [PMID: 35985876 DOI: 10.1016/j.transproceed.2022.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022]
Abstract
AIM The ever-expanding organ supply and demand gap necessitates alternate sources of organ donors. Initially thought to be a contraindication, organ procurement from nonsurvivable burns patients is possibly an additional organ donor source. We aimed to conduct a systematic review investigating the prevalence and outcomes of the use of burn victims as a source of organ donation for transplantation. METHODS Medline and EMBASE were searched between 1990 and 2020, using the following keywords: organ procurement, organ donation, organ transplantation, and burns. Studies were not excluded based on patient numbers and included both published abstracts/conference proceeding and journal articles. Studies were excluded if specific organs were not identified or if posttransplant outcomes were not recorded. Primary and secondary outcomes of interest were post-transplantation organ function and complications respectively. RESULTS Six manuscripts met study inclusion criteria. Fourteen burns donors were identified, including both donation after circulatory death and donation after brain death pathways. The total body surface area of burn ranged from 4% to 90%. A total of 4 hearts, 2 lungs, 8 livers, 1 pancreas, and 24 kidneys were transplanted with varying duration of follow-up and outcomes. CONCLUSION A very small number of studies have reported the posttransplant outcomes of organs derived from victims of burn injury, including very limited information regarding graft function in the short or long term. Hence, recommendations for the utilization of organs from victims of burn injury should remain guarded and subject to surveillance.
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Affiliation(s)
- Mohamed Eftal Bin Mohamed Ebrahim
- Department of Surgery, Royal North Shore Hospital, Sydney, Australia; Specialty of Surgery, FMH, University of Sydney, Sydney, Australia; Department of Surgery, Westmead Hospital, Sydney, Australia.
| | | | - Ahmer Hameed
- Specialty of Surgery, FMH, University of Sydney, Sydney, Australia; Department of Surgery, Westmead Hospital, Sydney, Australia; Transplant Surgery, Westmead Hospital, Sydney, Australia; Surgical Innovations Unit, Westmead Hospital, Sydney, Australia
| | | | - Angela Webster
- Renal Transplant Unit, Westmead Hospital, Sydney, Australia
| | - Elena Cavazzoni
- Intensive Care Unit, Westmead Children's Hospital, Sydney, Australia
| | - Taina Lee
- Department of Surgery, Westmead Hospital, Sydney, Australia
| | - Lawrence Yuen
- Department of Surgery, Westmead Hospital, Sydney, Australia
| | - Henry Pleass
- Specialty of Surgery, FMH, University of Sydney, Sydney, Australia; Department of Surgery, Westmead Hospital, Sydney, Australia
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Bin Mohamed Ebrahim ME, Tang M, Vukasovic M, Coggins A. Contemporary evaluation of adverse outcome risks associated with 'did not wait' emergency department presentations. Emerg Med Australas 2021; 33:932-934. [PMID: 34189849 DOI: 10.1111/1742-6723.13820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/18/2021] [Accepted: 06/11/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Did not wait (DNW) is a frequently cited ED key performance indicator. We conducted a network-based observational study of consecutive DNW presentations. METHODS Prospective cohort study of Western Sydney Local Health District with a primary outcome measure of reported 30-day all-cause mortality and secondary outcomes of demographic characteristics and representation risk. For re-presenting patients who were subsequently admitted, a manual review of electronic records and incident report systems based on a priori plan assessed each case for the length of stay and adverse outcomes. RESULTS During the study window, there were 1114 DNW presentations with 172 (15.4%) re-presentation within 72 h. The analysis of re-presented patients did not reveal adverse outcomes or prolonged length of stay. A review of available outcomes data revealed one DNW patient died within 30 days but had a previous palliative plan for terminal illness. CONCLUSION While a proportion of DNW patients re-presented within 72 h, an excess prevalence of poor outcomes were not observed.
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Affiliation(s)
- Mohamed Eftal Bin Mohamed Ebrahim
- Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew Tang
- Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia
| | - Matthew Vukasovic
- Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia
| | - Andrew Coggins
- Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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