Incidental association of thyroid carcinoma and squamous cell carcinoma of head and neck

PURPOSE: This study was carried out to address the dilemma of managing incidentally associated squamous cell carcinoma of the head and neck and thyroid carcinoma. MATERIALS AND METHODS: The patient group consists of 229 consecutive cases of squamous cell carcinoma of the head and neck and who were treated surgically at the Uludag University School of Medicine Department of Otolaryngology over a four-year period between 1997 and 2000. RESULTS: Among these patients, 3 had additional thyroid papillary carcinoma metastases (1.3%, 3/229) within the surgical specimens of the surgical procedures performed for squamous cell carcinoma of the head and neck. Complementary thyroidectomy was recommended but could not be performed in one of three cases because of the patient's refusal, and the primary focus of thyroid carcinoma could be found in only one of these two cases who had undergone complementary thyroidectomy. All three patients received postoperative radioactive iodine and thyroid hormone suppression, and all are free of disease after 49, 46, and 19 months of follow-up, respectively. CONCLUSIONS: Management of thyroid carcinoma found incidentally during treatment of squamous cell carcinoma of the head and neck is still debatable, and all patients must be evaluated individually with regard to its benefit. Our limited experience suggests that total thyroidectomy may not be regarded as mandatory in managing these patients.     

Bacteremia caused by Brevibacterium species in a patient with chronic lymphocytic leukemia

We report a case of bacteremia caused by Brevibacterium species which is one of the coryneform bacteria, in a patient with chronic lymphocytic leukemia. We conclude that, if a coryneform bacteria is isolated from sterile body sites, it must be carefully evaluated, and especially in immunocompromised patients, Brevibacterium species should be considered as potential pathogens.     

Is the severity of obstructive sleep apnea or the magnitude of respiratory effort associated with gastroesophageal reflux？

TO THE EDITOR In a recent issue of World Journal of Gastroenterology, Demeter et al, reported that in patients having both gastro-esophageal reflux disease (GERD) and obstructive sleep apnea (OSA), there was a positive correlation between     

Primary implant placement with evisceration in patients with endophthalmitis

PURPOSE: We report the results of 25 patients with endophthalmitis treated with evisceration with and without cornea preservation and primary orbital implants. DESIGN: Retrospective observational case series. METHODS: The records of 25 consecutive patients who underwent evisceration for endophthalmitis between June 1999 and November 2005 were reviewed. Ages ranged between three and 90 years (mean 57.6 years). The cause of endophthalmitis and bacterial agents were documented. All the patients were treated with topical, intravitreal, and intravenous antibiotics for endophthalmitis before evisceration. RESULTS: The follow-up period was between two months and 79 months (mean 25.4 months). All patients had relief from their pain and were satisfied with their cosmetic appearance and motility. Implant exposure was noted in three (12%) patients and pyogenic granuloma in one (4%) patient, which were treated successfully. Eighteen of the patients had prosthesis fitting at least eight weeks after operation. Seven patients elected to not have prosthesis. CONCLUSION: Unless the endophthalmitis is secondary to severe devastating trauma in which there is no sclera left, primary orbital implant placement with evisceration in these patients is an acceptable treatment.     

Renal amyloidosis due to pulmonary tuberculosis in a patient with Down syndrome

A pulmonary-tuberculosis-related renal amyloidosis patient with Down syndrome, who presented with nephrotic syndrome, was studied.     

A very rare case of polysplenia syndrome with congenital diffuse pulmonary arteriovenous fistulas

A five-year-old girl patient was admitted with cyanosis and dyspnea, which started from birth. She had small telangiectatic lesions on her face and cerebral arteriovenous malformation, but no family history of hereditary hemorrhagic telangiectasia. Contrast echocardiography and pulmonary angiography demonstrated diffuse pulmonary arteriovenous fistulas. The patient was diagnosed as polysplenia syndrome characterized with left atrial isomerism, interrupted inferior vena cava, azygous continuation to the superior vena cava, and hepatic veins draining to the right atrium. In contrast to the other polysplenia syndrome cases, in this patient, pulmonary arteriovenous fistulas were not associated with cavopulmonary anastomoses or liver disease.     

A different type of cardiomyopathy: ventricular noncompaction (evaluation of 8 cases)

Ventricular noncompaction, characterized by numerous, prominent ventricular trabeculations and deep intratrabecular recesses, is thought to be due to an arrest of myocardial morphogenesis. We report eight patients with ventricular noncompaction diagnosed at our center in the previous one year. Two patients had associated congenital cardiac anomalies while the others were without coexisting cardiac abnormalities. Both ventricles were involved in one patient, only the right ventricle in one, and only the left ventricle in six patients. Seven patients had initially been diagnosed as having different types of cardiomyopathies. In conclusion, based on our limited experience, we propose that during the differential diagnosis of cardiomyopathies, ventricular noncompaction should be considered.