RESUMO
An adult male variable kingsnake (Lampropeltis mexicana) was presented for examination due to a three-week history of anorexia and obvious body deformities. On objective examination the animal was in poor condition, and on palpation, an intracoelomic mass was noted approximately in the distal third of the body, cranial to the cloaca. In agreement with the owner, an exploratory celiotomy was planned and performed and the mass was surgically removed. Modified Wright-Giemsa stain impression smears were taken, which were consistent with an undifferentiated tumour. Histological examination revealed the presence of a solid proliferation composed of highly tubular anaplastic cells and abundant multinucleated cells. The neoplastic cells were positive for cytokeratin (AE1/AE3), but not for vimentin. Periodic acid-Schiff (PAS) staining revealed the presence of large granular cells, which can be identified as the characteristic cells of the efferent ducts. Based on the morphological and immunohistochemical findings, the diagnosis of extratesticular anaplastic carcinoma was made. To the authors' knowledge, this type of neoplasm has never been reported in the male genital apparatus of snakes.
RESUMO
BACKGROUND: Anaplastic thyroid carcinoma is a rare, rapidly progressive, and highly aggressive tumor. It has a global annual incidence of 1-2 per million people. It mostly affects older adults and women. The median survival duration after diagnosis does not exceed 6-8 months. CASE PRESENTATION: A 60-year-old female patient of mixed race (Honduran) presented to the local medical service with dysphonia that had started approximately 2 months earlier, accompanied by orthopnea that had started 1 month earlier. On physical examination, a soft mass was palpated within the anterior neck region; it was approximately 4 cm in diameter, painless, and mobile on swallowing, and had irregular margins. Ultrasound and computed tomography of the neck were performed. Subsequently, fine needle aspiration biopsy was performed. The histological diagnosis was anaplastic thyroid carcinoma (stage IVB). She underwent total thyroidectomy and chemotherapy. She is currently in her fifth year of remission after diagnosis and remains under oncologic surveillance. DISCUSSION: Anaplastic thyroid carcinoma demonstrates a lethal behavior. Approximately 18% survive for more than a year after diagnosis, and 0-10% survive for 5 years. Different pretherapeutic prognostic factors may affect survival, including age < 70 years, the absence of distant metastases, and complete local resection. CONCLUSION: Conventional treatment improves the quality of life of the patient, but the results are not encouraging for the medium and long term. Only a few patients manage to exceed the average life expectancy of 3-6 months, despite undergoing the currently available therapeutic regimen.
Assuntos
Carcinoma Anaplásico da Tireoide , Neoplasias da Glândula Tireoide , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Carcinoma Anaplásico da Tireoide/diagnóstico por imagem , Carcinoma Anaplásico da Tireoide/terapia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , UltrassonografiaRESUMO
INTRODUCTION: Riedel´s thyroiditis is a thyroid inflammation with invasive fibrosis. CASE REPORT: Female 84 years old, studied by dysphagia to liquids and dysphonia, with cervical mass poorly demarcated and immobile. Computed Tomography (CT) (CT) showed tumor that diverted the trachea and esophagus compressed. Fine Needle Aspiration (FNA) obtained cells with atypia. Thyroidectomy was performed, appreciating a stony tumor which included the right recurrent laryngeal nerve. Given the high suspicion of thyroid malignancy tracheostomy it was performed. The pathology report as fibrosing Riedel thyroiditis. DISCUSSION: This is the less common type of chronic thyroiditis. Etiology is unknown. The normal thyroid parenchyma is replaced by fibrous connective tissue. Clinically usually a hard mass, fast growing, why is confused with thyroid carcinoma and Hashimoto's thyroiditis. It´ss more common in women and is usually bilateral. The CT or MRI (Magnetic Resonance Imaging) help assess the extent. Puncturing the mass could give us the diagnosis but is often difficult. Treatment to relieve symptoms or rule out malignancy is surgery. The prognosis is usually good. CONCLUSIONS: Riedel´s thyroiditis is an entity with histopathologic diagnosis essential
Assuntos
Humanos , Tireoidite/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Carcinoma Anaplásico da Tireoide/diagnóstico , Tireoidectomia , Tireoidite/cirurgia , Tireoidite/patologia , Tomografia Computadorizada por Raios X , Diagnóstico DiferencialRESUMO
Introducción: el Cáncer tiroideo se caracteriza por su baja incidencia, comportamiento maligno infrecuente y baja mortalidad. La mayoría de ellos procede de bocios multinodulares de larga duración por lo que es muy importante tener en cuenta factores que constituyen riesgos potenciales como: tiempo de establecimiento de la enfermedad, tamaño, así como las características particulares personales y la evolución de la entidad en cada caso. Si tenemos en cuenta el gran avance tecnológico que constituye la Biopsia Aspirativa con Aguja Fina (BAAF), que nos permite no solamente evitar su transformación neoplásica maligna, sino que también podemos prolongar la vida con la calidad que humanamente se requiere que es en definitiva la meta principal de la Salud Pública Cubana. Objetivo: destacar la importancia del adecuado seguimiento evolutivo del Bocio multinodular como elemento significativo en la prevención de su transformación maligna. Presentación del caso: Paciente femenina de 80 años de edad con aumento de volumen de la región anterior del cuello y antecedentes patológicos personales de Bocio Multinodular (BMN) con tratamiento inconstante e irregular de años de evolución, quien no solamente pudo haber mejorado la calidad de su vida sino que no la hubiera truncado, considerando las condiciones atenuantes en la forma de presentación que tuvo su caso. Al examen físico: Aumento de la región anterior del cuello, palpándose masa de superficie irregular, consistencia firme, dolorosa, de aproximadamente 6x5 cm que había aumentado considerablemente en los últimos meses sin fecha precisada. La paciente fue ingresada por el gran agobio respiratorio y la toma del estado general, pudiéndose realizar únicamente la Biopsia Aspirativa con Aguja Fina (BAAF). Desde su ingreso presenta evolución tórpida con incremento del compromiso respiratorio requiriendo la práctica de la traqueotomía que sólo ayuda como medida de soporte al estadio terminal de esta enfermedad neoplásica maligna. (Carcinoma Anaplásico del Tiroides). A pesar de ello la paciente fallece y los familiares autorizan la necropsia. Conclusiones: los BMN deben tener seguimiento evolutivo que permita precisar una tiroidectomía a tiempo como prevención en enfermedades benignas del Tiroides, por los cambios malignos que pueden producirse cuando la glándula es irradiada. La tiroidectomía a tiempo permite evitar no solamente la transformación maligna que puede producirse, sino también previene las metástasis que ocurren en los Carcinoma Anaplásicos.
Introduction: the thyroid carcinoma is characterized by low incidence, low malignant behaviour as well as low mortality. The most of they are developed from multinodular goitres of long duration so is important to be into account the risk factors such as: time of the establishment of the disease, size and the particular and personal characterists and the evolution of the each case. If we take into account the great technological advance of the BAAF from its performance in the past century to be united to the National Health System of our country ,we have to say that the multinodular goitres in any group of age are easily manageable and accessible which may us to avoid the malignant transformation besides we can do that the life continues with the quality humanely requested . Finally, this is the first goal of the Cuban Public Health. Objective: to highlight the importance of an appropriate follow-up of multinodular goitre as a significant element in the prevention of its multinodular malignant transformation. Case presentation: an 80 year- old, female patient presents an increase of the volumen of the anterior section of the neck, with pathologic antecedents of a multinodular goitre which the evolution has been characterized by an irregular and non systematic treatment along of years .She could have better quality of life as well as to avoid to death taking into account the wild conditions of that disease was presented herself. Physical examination: It has been observed an increase of the anterior area of the neck. On palpation ,it was felt a mass of irregular surface , painful and of a hard consistency with 6x5cms. approximately that had increased notably in the course of the last months . On the admission, the patient presented a serious respiratory process and poor general status so we only achieved a Fine Needle Aspirative Biopsy (FAAB).She continuos with reapiratory compromised so a surgical racheotomy was ejecuted that only help her as a way of supporting in the patient terminal stage in this malignant disease (Anaplastic Carcinoma of Thyroid). Despite the recommended procedure the patient died. The family accepted the autopsy. Conclusions: the multinodular goitres have to exam periodically in order to just may to do the tiroidectomy as the preventive measure in benign diseases of thyroid and avoid the malignant changes that could occurred when the gland is irradiated.The tiroidectomy ejecuted at just time avoid the malignant transformation as well as the metastasis in Anaplastic Carcinoma Thyroid.