RESUMEN
Tracheal obstruction and superior vena cava (SVC) syndrome are rare complications of retrosternal goiter. These two conditions present a difficult diagnostic and therapeutic challenge. Malignancy is the most common cause of SVC syndrome. Determining whether SVC syndrome is due to a benign or malignant process is imperative before instituting treatment, but this determination may be difficult. We present a case of a patient presenting with upper airway obstruction and SVC syndrome with a large mediastinal mass. The mass was determined to be a multinodular goiter. The patient was managed by surgical removal of the goiter with complete resolution of symptoms. This case illustrates the need for careful preoperative evaluation and the importance of establishing a histologic diagnosis prior to initiating treatment for SVC syndrome.
Asunto(s)
Obstrucción de las Vías Aéreas/etiología , Bocio Nodular/complicaciones , Bocio Subesternal/complicaciones , Síndrome de la Vena Cava Superior/etiología , Enfermedades de la Tráquea/etiología , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana EdadRESUMEN
The treatment of patients with differentiated carcinoma of the thyroid is a controversial subject. This article discusses the authors' approach in the clinical practice. A description of the various types of papillary and follicular carcinoma is presented. Diagnostic tests, biologic behavior, and management are reviewed.
Asunto(s)
Adenocarcinoma/cirugía , Carcinoma Papilar/cirugía , Neoplasias de la Tiroides/cirugía , Tiroidectomía/métodos , Adenocarcinoma/diagnóstico , Adolescente , Adulto , Factores de Edad , Carcinoma Papilar/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Radioisótopos de Yodo/administración & dosificación , Metástasis Linfática , Masculino , Persona de Mediana Edad , Disección del Cuello/métodos , Cuidados Posoperatorios , Dosificación Radioterapéutica , Factores Sexuales , Glándula Tiroides/patología , Glándula Tiroides/cirugía , Neoplasias de la Tiroides/diagnósticoRESUMEN
The benign lymphoepithelial lesion of the salivary glands has been labeled with multiple, confusing terms. We recommend the abandonment of the vague term of Mikulicz disease. The histopathologic findings of lymphoid infiltration, intraductal proliferation, epimyoepithelial islands, and acinar atrophy are presented. The relationship between this lesion and autoimmune diseases, including Sjögren syndrome, is noted. Difficulty of histopathologic differentiation between this lesion and malignant lymphoma can occur. The association of the benign lymphoepithelial lesion with the simultaneous presence or future development of lymphoma is discussed.