Abdulwahid M. Salih, Deari A. Ismaeil, Rawa M. Ali, Ari M. Abdullah, Karzan M. Salih, Shko H. Hassan, Twana Omer Saeed, Ahmed H. Ahmed and 1 more
Introduction Follicular thyroid carcinoma (FTC) is a type of well-differentiated thyroid carcinoma. It has a poorer prognosis, is more metastatic, and has characteristics different from papillary thyroid carcinoma. It tends to metastasize hematogenously, usually to the bones and lungs. This study aims to present a…
Unusual Metastasis from Follicular Thyroid Carcinoma: A Case Report and Literature Review
Abdulwahid M. Salih, Deari A. Ismaeil, Rawa M. Ali, Ari M. Abdullah, Karzan M. Salih, Shko H. Hassan, Twana Omer Saeed, Ahmed H. Ahmed and 1 more
IntroductionFollicular thyroid carcinoma (FTC) is a type of well-differentiated thyroid carcinoma. It has a poorer prognosis, is more metastatic, and has characteristics different from papillary thyroid carcinoma. It tends to metastasize hematogenously, usually to the bones and lungs. This study aims to present a rare case of FTC metastasis to the peritoneum and thigh of a patient with a literature review.
Case presentationA 70-year-old patient presented with a right thigh mass. Magnetic resonance imaging of the right thigh revealed an intramedullary lesion in the femoral diaphysis. The thyroid gland was firm, with no evidence of enlargement. A computed tomography scan showed several peritoneal nodules. A core biopsy of the right upper femoral lesion and peritoneal mass was performed. Histopathologic findings and immunohistochemical analysis confirmed metastatic FTC with thyroid origin.
Literature reviewUnlike widely invasive FTC, minimally invasive FTC has a better prognosis and is less metastatic. Imaging, histopathologic examination, and immunohistochemistry can help in arriving at a diagnosis of FTC. Mutations of PPAR-γ and RAS are associated with FTC. Radioiodine treatment and suppressive therapy for the thyroid-stimulating hormone have been shown to improve survival rates of FTC, with postoperative follow-ups and treatment being important.
ConclusionMetastasis of FTC to the peritoneum is rare and could lead to a late diagnosis. Proper diagnosis with confirmatory tools such as immunohistochemistry and adequate treatment are critical.
Soran H. Tahira, Fahmi H. Kakamad, Dlsoz M. Hussein, Shorsh A. Mohammed, Rezheen J. Rshid, Karzan M. Salih, Shvan H. Mohammed, Hussein M. Hamasalih and 1 more
Introduction Behcet's disease is a rare, multisystemic disease marked by vasculitis and a triad of recurrent oral and genital mucosa ulcers, as well as relapsing uveitis and thrombophlebitis. Mediastinal fibrosis is extremely rare in Behcet's disease. Case presentation We present ultrasound and computed tomography (CT…
Behcet’s Disease Presenting with Focal Fibrosing Mediastinitis and SVC Thrombosis: A Case Report with Review of Literature
Soran H. Tahira, Fahmi H. Kakamad, Dlsoz M. Hussein, Shorsh A. Mohammed, Rezheen J. Rshid, Karzan M. Salih, Shvan H. Mohammed, Hussein M. Hamasalih and 1 more
IntroductionBehcet's disease is a rare, multisystemic disease marked by vasculitis and a triad of recurrent oral and genital mucosa ulcers, as well as relapsing uveitis and thrombophlebitis. Mediastinal fibrosis is extremely rare in Behcet's disease.
Case presentationWe present ultrasound and computed tomography (CT scan) in a 26-year male with mediastinal fibrosis and superior vena cava (SVC) thrombosis, with thrombus in left internal jugular veins (IJV) associated with Behcet’s disease.
ConclusionBehcet's disease can cause mediastinal fibrosis in rare cases. CT and MRI are efficient methods for detecting mediastinal fibrosis and superior vena cava thrombosis.
Abdulwahid M. Salih, Lana R.A. Pshtiwan, Ari M. Abdullah, Aras J. Qaradakhy, Fahmi H. Kakamad, Halkawt Omer Ali, Karzan M. Salih, Hawbash M. Rahim and 3 more
Abstract Introduction Fibroadenomas are the most frequent cause of palpable breast lumps in young women. Although it’s a benign lesion, malignancy can occur in extremely rare cases; this risk is higher in complex fibroadenomas and in patients with a family history of the disease. The aim of the current study is to…
Carcinoma in Situ Raised from Fibroadenoma: A Case Series of a Rare Combination
Abdulwahid M. Salih, Lana R.A. Pshtiwan, Ari M. Abdullah, Aras J. Qaradakhy, Fahmi H. Kakamad, Halkawt Omer Ali, Karzan M. Salih, Hawbash M. Rahim and 3 more
IntroductionFibroadenomas are the most frequent cause of palpable breast lumps in young women. Although it’s a benign lesion, malignancy can occur in extremely rare cases; this risk is higher in complex fibroadenomas and in patients with a family history of the disease. The aim of the current study is to report a case series of rare combination of two breast tumors (carcinoma in situ within fibroadenoma).
MethodsThis is a retrospective case series study. The cases were managed in a single private center specific for breast diseases. They were evaluated and treated during the four previous years (January 2018-May 2022). It included all patients who had a fibroadenoma with malignant changes.
ResultsThe study included nine cases. The mean age was 41 years ranged from 31 to 51 years. Six cases were ductal carcinoma in situ within fibroadenoma and three cases were lobular carcinoma in situ.
ConclusionAlthough fibroadenomas are the most common benign breast mass, it is rarely associated with malignant transformation.
Hiwa O. Baba, Aso S. Muhialdeen, Abdulwahid M. Salih, Yadgar A. Saeed, Ismael Y. Abdullah, Aras J. Qaradakhy, Karzan M. Salih, Soran H. Tahir and 4 more
Introduction Reoperation is the most challenging task in thyroid surgery because of the high risk of complications. This study aims to demonstrate the efficacy of a modified thyroidectomy technique in decreasing associated complications to almost zero in recurrent thyroidectomy. Methods This single-group cohort study…
Redo Thyroidectomy Modified Technique to Eliminate Complications: A Cohort Study
Hiwa O. Baba, Aso S. Muhialdeen, Abdulwahid M. Salih, Yadgar A. Saeed, Ismael Y. Abdullah, Aras J. Qaradakhy, Karzan M. Salih, Soran H. Tahir and 4 more
IntroductionReoperation is the most challenging task in thyroid surgery because of the high risk of complications. This study aims to demonstrate the efficacy of a modified thyroidectomy technique in decreasing associated complications to almost zero in recurrent thyroidectomy.
MethodsThis single-group cohort study enrolled consecutive patients who had a recurrent thyroidectomy. The procedures were done by high-volume surgeons using a modified thyroidectomy technique, which included the following steps: 1) Preserving parathyroid glands before searching for the recurrent laryngeal nerve; 2) Expecting the recurrent laryngeal nerve in any area of the neck until it is found; 3) Initiating dissection in the suprasternal notch and moving to the tracheoesophageal groove; 4) If the nerve was not found in the suprasternal notch, the search would continue at the nerve's expected entrance to the cricoid cartilage.
ResultsIn total, 195 cases with redo thyroidectomy were enrolled in this study. Female patients (173, 88.7%) were predominant compared to males (22, 11.3%). The most common ultrasonographic finding was multinodular goiter in 138 cases (70.7%). Most of the cases underwent total thyroidectomy (160, 82%), and thyroid lobectomy was performed in 35 cases (18%). In all the cases that underwent total thyroidectomy, both recurrent laryngeal nerves were explored, and the concerned lateral recurrent laryngeal nerve was seen during the thyroid lobectomies. There was no injury to recurrent laryngeal nerves, and only 15% of the cases suffered from temporary hypocalcemia.
ConclusionRecurrent thyroidectomy without significant complications is possible when conducted by high-volume surgeons, and a modified technique is used.
