A Rare Case of Metastatic Uterine Leiomyosarcoma to the Thyroid Gland

Uterine leiomyosarcomas are malignant tumors that have a grim prognosis. These neoplasms have a high metastatic potential. Limited literature exists on leiomyosarcoma metastasizing to the thyroid. This case emphasizes the importance of considering metastasis as a possible cause for thyroid swelling in patients with a history of malignancy.

Mystery of love, goiter and death in flu pandemic

Ivan Mestrovic (1883-1962), a Croatian sculptor and architect, portrayed his close friend Marija Banac (born Racic) with a goiter. She died from flu in 1918 in Rome, just few days apart from her brother Edi Racic and his fiancée. In the tragic memory of the Racic family that disappeared in the burst of a terrible pandemic, Mestrovic built a church and mausoleum in Cavtat near Dubrovnik.

Was Tiepolo's wife affected by Graves' disease?

Tiepolo (1696-1770) was an Italian Rococo painter and printmaker, and is now considered to be one of the most important members of the 18th-century Venetian school. The muse that lent her face to Cleopatra and inspired many Tiepolo's works was his beloved wife, Maria Cecilia Guardi. Because of her appearance, we cannot rule out that she suffered from Graves' disease, an autoimmune condition that is characterized by goiter, exophthalmos and restlessness.

Acute thyroid swelling after fine needle aspiration-a case report of a rare complication and a systematic review

BACKGROUND

Thyroid fine needle aspiration (FNA) is the procedure of choice in the management of thyroid nodules. Acute thyroid swelling after FNA is a rare complication and is reported in a finite number of literatures. To the best of our knowledge, only seven reported cases exist in literatures. This study describes an addition case with an acute thyroid swelling after FNA, as well as puts forward a new hypothesis of this phenomenon.

CASE PRESENTATION

The case is presented of a 30-year-old female with an acute thyroid swelling after FNA, with funicular hypoechoic lesions in thyroid gland. The size of thyroid was 1.5-fold enlarged in the unilateral thyroid gland. No complains of pain or other discomforts with her and no signs of hemorrhage were found along the passage of the fine needle. The episode was recovered spontaneously.

CONCLUSIONS

An acute thyroid swelling is a rare complication of FNA. A hypothesis of anaphylactic reaction was suggested in our study. Physicians should pay more attention of this phenomenon and more information is needed to support our hypothesis.

A goitrous model for Bartolomeo Vivarini (1432-1499)

INTRODUCTION

Bartolomeo Vivarini (Venezia 1432c.-Venezia 1499c.) was an Italian painter during the Renaissance. The artist was widely influenced by Andrea Mantegna, whose opera was characterized by personages with anatomical details meticulously described.

MATERIALS AND METHODS

Some of the most valued paintings of Bartolomeo Vivarini were analyzed. Purpose of the present article is to describe these artworks focusing on female personages represented with thyroid swelling.

RESULTS

A recurring female model in Vivarini's artworks is portrayed with a goitrous neck. This might display a real prevalence of thyroid diseases among young women in the Renaissance age (e.g. postpartum thyroiditis).

CONCLUSIONS

Representation of goiter in the artworks of Vivarini and Mantegna reflects the increased anatomic accuracy and knowledge developed in art since Renaissance and Baroque.

African statue with goiter

INTRODUCTION

Representations of thyroid swelling, intended as an enlarged anterior neck in the artworks of various periods are sporadically reported in the literature.

MATERIALS AND METHODS

An African statue belonging to the African Yoruba culture has been analysed.

RESULTS

Members of Ogboni Society in Yoruba culture used this statues to represent a real subject and to communicate between the living and dead.

CONCLUSION

The statue reported seems to represent a case of real goiter.

Clinicopathological and Radiological Study of Thyroid Swelling

Thyroid swelling is the most common swelling among the endocrine disorder. It can affect any age group. USG neck will help to diagnose the solid and cystic lesions. The treatment is surgical excision. FNAC is a good diagnostic tool to minimize the incidence of thyroidectomy. FNAC is cost effective, reliable and OPD procedure. Final diagnosis can only be made by HPE postoperatively. The aim of this study is to find out the relative occurrence of various pathological conditions presenting as midline thyroid swellings and clinicopathological and radiological examination of the thyroid swellings. A one and half year prospective study which was carried out from October 2016 to April 2018 in ENT department of MMIMSR, Mullana, Ambala. Informed written consent was taken from all the patients. A complete clinical, radiological, cytological an HP Examination was done. Total 50 patients were included in the study. Complete clinical data of the patient was gathered from medical records. The maximum number of patients in present study was found in an age group of 31-40 years (34%). There was female predominance with female to male ratio of 7.3:1. Most of the patients belonged to rural background i.e. 42 (84%) patients. Most of the patients present with Left sided neck swelling i.e. 18 (36%) patients. Ultrasound revealed that non neoplastic lesions were present in 44 (88%) patients and 6 (12%) patients had neoplastic lesions. FNAC showed that non neoplastic lesions were present in 38 (76%) patients and 12 (24%) patients had neoplastic lesions. On HPE, non neoplastic and neoplastic lesions were present in 36 (72%) and 14 (28%) patients respectively. Colloid goiter was the most common among the non neoplastic lesions in 29 (58%) patients. Papillary carcinoma was the most common malignant disease in 4 (8%) patients. Thyroid swelling was most commonly seen during the 3rd and 4th decade of life, with a female preponderance. Most common benign thyroid swelling is Colloid goiter and papillary carcinoma was the most common malignant disease. Histopathology is considered as a gold standard.

A Retrospective Study to Assess the Role of Using Fine Needle Aspiration Cytology and Frozen Section in the Diagnosis of Thyroid Swelling

The most cost-effective test is fine needle aspiration cytology (FNAC). Many surgeons use intraoperative frozen section to confirm the FNAC findings and to guide the extent of thyroid surgery. Though it is a valuable tool in the diagnosis of the thyroid lesion and determining the extent of thyroid surgery, still in certain cases diagnosis can be incorrect or inconclusive, so histopathology of the excised specimen remains the most reliable test. The purpose of this study will be to compare the result attained by FNAC and frozen section of the thyroid to the final histopathological diagnosis, in order to establish their role in thyroid surgery today. A retrospective study with a total of 140 patients who underwent thyroid surgery at the ENT department, of a tertiary hospital in coastal Karnataka. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for FNAC and frozen section. The sensitivity, specificity, positive predictive rate, and negative predictive rate of frozen section was found to be 66.7%, 88.4%,76.6%, 82.4% respectively for detecting malignancy. This was found to be higher than the results of FNAC for the same which were 64.4%, 77.8%, 64.4%, 77.8% respectively. As the sensitivity of FNAC is similar to frozen section in detecting malignant cases, FNAC is a good tool for screening the patient for determining malignancy in thyroid, but frozen section is more specific in confirming the malignancy.

Thyroid Swelling: A Common Phenomenon in Art?

Representations of thyroid swelling, intended as an enlarged anterior neck region, in the artworks of various periods are sporadically reported in the scientific literature, and different intents may be hypothesized. A comprehensive review of the international literature was performed on PubMed, Embase, and ResearchGate with the aim to analyze the modalities of representation of thyroid swelling through the ages by different artistic movements. Thyroid swelling is frequently represented in the artworks of many stylistic periods and seems to be a known condition even by the earliest cultures. Thyroid swelling may be considered a common finding among forms of art distant in time and style. It is not always possible to define whether thyroid swelling is a realistic representation or a detail added by the author. Although the function of the gland was discovered only at the end of the 19th century, thanks to the artworks of authors in many cultures, it is nowadays possible to formulate hypotheses about the distribution of thyroid diseases over the centuries.

Isolated Langerhans Histiocytosis in Thyroid: Thyroidectomy or Chemotherapy?

Langerhans cell histiocytosis (LCH) is a rare disorder of mononuclear phagocytic system whose clinical presentation varies from the localised involvement of a single bone to a widely disseminated disease. Langerhans cell histiocytosis rarely involves the thyroid gland and isolated involvement of thyroid is even rarer. We report a case of an eight-year-old male child diagnosed with Langerhans cell histiocytosis limited to thyroid gland with review of literature. Should thyroidectomy be done or proceed with chemotherapy? Our case report raises this question with a note on the role of 18 fluoro deoxy glucose positron emission tomography-computed tomography in the management of the same.