Clinical Overview > Condition/ Syndrome > Granuloma
You are looking at 1 - 4 of 4 items
Search for other papers by Anna Popławska-Kita in
Google Scholar
PubMed
Search for other papers by Marta Wielogórska in
Google Scholar
PubMed
Search for other papers by Łukasz Poplawski in
Google Scholar
PubMed
Search for other papers by Katarzyna Siewko in
Google Scholar
PubMed
Search for other papers by Agnieszka Adamska in
Google Scholar
PubMed
Search for other papers by Piotr Szumowski in
Google Scholar
PubMed
Search for other papers by Piotr Myśliwiec in
Google Scholar
PubMed
Search for other papers by Janusz Myśliwiec in
Google Scholar
PubMed
Search for other papers by Joanna Reszeć in
Google Scholar
PubMed
Search for other papers by Grzegorz Kamiński in
Google Scholar
PubMed
Search for other papers by Janusz Dzięcioł in
Google Scholar
PubMed
Search for other papers by Dorota Tobiaszewska in
Google Scholar
PubMed
Search for other papers by Małgorzata Szelachowska in
Google Scholar
PubMed
Search for other papers by Adam Jacek Krętowski in
Google Scholar
PubMed
Summary
Papillary thyroid gland carcinoma is the most common type of malignancy of the endocrine system. Metastases to the pituitary gland have been described as a complication of papillary thyroid cancer in few reported cases since 1965. We report the case of a 68-year-old female patient with a well-differentiated form of thyroid gland cancer. Despite it being the most common malignant cancer of the endocrine system, with its papillary form being one of the two most frequently diagnosed thyroid cancers, the case we present is extremely rare. Sudden cardiac arrest during ventricular fibrillation occurred during hospitalization. Autopsy of the patient revealed papillary carcinoma of the thyroid, follicular variant, with metastasis to the sella turcica, and concomitant sarcoidosis of heart, lung, and mediastinal and hilar lymph nodes. Not only does atypical metastasis make our patient’s case most remarkable, but also the postmortem diagnosis of sarcoidosis makes her case particularly unusual.
Learning points:
-
The goal of presenting this case is to raise awareness of the clinical heterogeneity of papillary cancer and promote early diagnosis of unexpected metastasis and coexisting diseases to improve clinical outcomes.
-
Clinicians must be skeptical. They should not fall into the trap of diagnostic momentum or accept diagnostic labels at face value. Regardless of the potential mechanisms, clinicians should be aware of the possibility of the coexistence of thyroid cancer and sarcoidosis as a differential diagnosis of lymphadenopathy.
-
This case highlights the importance of the diagnostic and therapeutic planning process and raises awareness of the fact that one uncommon disease could be masked by another extremely rare disorder.
Search for other papers by Khaled Aljenaee in
Google Scholar
PubMed
Search for other papers by Osamah Hakami in
Google Scholar
PubMed
Search for other papers by Colin Davenport in
Google Scholar
PubMed
Search for other papers by Gemma Farrell in
Google Scholar
PubMed
Search for other papers by Tommy Kyaw Tun in
Google Scholar
PubMed
Search for other papers by Agnieszka Pazderska in
Google Scholar
PubMed
Search for other papers by Niamh Phelan in
Google Scholar
PubMed
Search for other papers by Marie-Louise Healy in
Google Scholar
PubMed
Search for other papers by Seamus Sreenan in
Google Scholar
PubMed
Search for other papers by John H McDermott in
Google Scholar
PubMed
Summary
Measurement of glycated haemoglobin (HbA1c) has been utilised in assessing long-term control of blood glucose in patients with diabetes, as well as diagnosing diabetes and identifying patients at increased risk of developing diabetes in the future. HbA1c reflects the level of blood glucose to which the erythrocyte has been exposed during its lifespan, and there are a number of clinical situations affecting the erythrocyte life span in which HbA1c values may be spuriously high or low and therefore not reflective of the true level of glucose control. In the present case series, we describe the particulars of three patients with diabetes who had spuriously low HbA1c levels as a result of dapsone usage. Furthermore, we discuss the limitations of HbA1c testing and the mechanisms by which it may be affected by dapsone in particular.
Learning points:
-
Various conditions and medications can result in falsely low HbA1c.
-
Dapsone can lead to falsely low HbA1c by inducing haemolysis and by forming methaemoglobin.
-
Capillary glucose measurement, urine glucose measurements and fructosamine levels should be used as alternatives to HbA1c for monitoring glycaemic control if it was falsely low or high.
Search for other papers by Alessandro Mantovani in
Google Scholar
PubMed
Search for other papers by Ilaria Teobaldi in
Google Scholar
PubMed
Search for other papers by Vincenzo Stoico in
Google Scholar
PubMed
Search for other papers by Fabrizia Perrone in
Google Scholar
PubMed
Search for other papers by Marina Zannoni in
Google Scholar
PubMed
Search for other papers by Luca Cima in
Google Scholar
PubMed
Search for other papers by Massimiliano Bruti in
Google Scholar
PubMed
Search for other papers by Lucia Mingolla in
Google Scholar
PubMed
Search for other papers by Maddalena Trombetta in
Google Scholar
PubMed
Search for other papers by Enzo Bonora in
Google Scholar
PubMed
Summary
After basal cell carcinoma, the cutaneous squamous cell carcinoma (cSCC) is the second most frequent non-melanoma skin cancer worldwide, and, classically, arises from the upper coats of the epidermis of sun-exposed areas or from skin areas constantly exposed to a chronic inflammatory stimulus. The occurrence of cSCC seems to be linked to several factors, including exposure to sunlight (or other ultraviolet radiations), immunosuppression, chronic scarring conditions and some familial cancer syndromes. Although the majority of cSCCs are adequately eradicated by surgical excision, a subgroup of cSCC may be linked with an increased risk of recurrence, metastasis and death. The incidence of type 2 diabetes mellitus is constantly increasing worldwide. Importantly, diabetes mellitus is a strong risk factor for cancers (including cutaneous tumors) and is highly related with poor cancer outcomes. At present, in the literature, squamous cell carcinoma developing in association with diabetic foot ulcers has been already reported in some reports; however, additional data are needed to make the clinicians aware of this rare, although possible, complication. Therefore, we herein report an unusual case of an elderly man with T2DM and a positive oncological history, presenting a cSCC involving the skin overlying the first toe of left foot. The growing cSCC appeared approximately 3 years after the appearance of a diabetic ulcer.
Learning points:
-
Diabetic foot ulcers are an important and severe complication of diabetes mellitus and often can result in foot amputation.
-
Chronic and non-healing diabetic foot ulcers are often observed in clinical practice.
-
Clinicians should always take into consideration the malignant degeneration (e.g., cutaneous squamous cell carcinoma) of any chronic non-healing diabetic foot ulcer in elderly T2DM individuals.
-
Timely surgical resection of a chronic, non-healing diabetic foot ulcer might preclude the development of a cutaneous squamous cell carcinoma.
Search for other papers by K Majumdar in
Google Scholar
PubMed
Search for other papers by M Barnard in
Google Scholar
PubMed
Search for other papers by S Ramachandra in
Google Scholar
PubMed
Search for other papers by M Berovic in
Google Scholar
PubMed
Search for other papers by M Powell in
Google Scholar
PubMed
Summary
Tuberculosis (TB) is an important cause of mortality and morbidity across the world. In 2–5% of all cases of systemic TB, the C is affected, with lesions reported in the meninges, cortex and ventricles. Intrasellar tuberculomas, however, are extremely rare. We report the interesting case of a young female patient who presented with secondary hypothyroidism and hyperprolactinaemia. She was treated successfully for pituitary TB. We also highlight and discuss some interesting (and hitherto unreported) endocrine issues. Radiological and histological features and treatment of pituitary TB are discussed using this case as an example.
Learning points
-
Intrasellar TB continues to be a rare presentation, but incidence and prevalence are expected to grow with increasing numbers of multidrug-resistant TB and shrinking geographical boundaries across the world.
-
Pituitary TB can present with features of a typical adenoma, but has certain radiological and histological features that help to differentiate from an adenoma.
-
Patients can present with a variety of endocrine abnormalities at different times.
-
The presence of an intrasellar mass in individuals at a high risk of developing TB, or with a previous history of systemic TB, should prompt the diagnosis of pituitary TB. In such individuals, it may be worth considering a trial of anti-tuberculous therapy, before considering surgery.
