Pub Date : 2023-09-01Epub Date: 2023-08-15DOI: 10.1016/j.ijso.2023.100670
Ranjan K. Mohapatra, Snehasish Mishra, Lucia Pintilie, Lawrence Sena Tuglo
{"title":"Potentially pandemic MERS-CoV constantly circulating in the Middle East threatens the globe: Preparedness and prevention with commentaries on the ‘one health’ model","authors":"Ranjan K. Mohapatra, Snehasish Mishra, Lucia Pintilie, Lawrence Sena Tuglo","doi":"10.1016/j.ijso.2023.100670","DOIUrl":"10.1016/j.ijso.2023.100670","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100670"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41686198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.ijso.2023.100660
Eman Ali
{"title":"FDA approves first leadless dual-chamber pacing system; A breakthrough in therapy of bradycardia","authors":"Eman Ali","doi":"10.1016/j.ijso.2023.100660","DOIUrl":"https://doi.org/10.1016/j.ijso.2023.100660","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54471030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-07-26DOI: 10.1016/j.ijso.2023.100658
Dlshad Hamasaeed Ahmed , Rawa Bapir , Belan Mikaeil M. Radha , Ismaael Aghaways , Rezheen J. Rashid , Deari A. Ismaeil , Omar H. Ghalib Hawramy , Dana T. Gharib , Hemn H. Kaka Ali , Fahmi H. Kakamad , Berun A. Abdalla , Ari M. Abdullah
Introduction
Adrenal myelolipomas (AMLs) are non-functioning, benign adrenal tumors with an unknown etiology. This study aims to report a case of giant AML managed successfully by laparoscopic surgery.
Case presentation
A 43-year-old man presented with mild, dull, and non-radiating left loin pain. Physical examination and hormonal assays were normal. Imaging revealed a retroperitoneal mass (13 × 12 × 8.5cm) containing gross fat. Left laparoscopic adrenalectomy was done under general anesthesia. The postoperative period was uneventful. The patient was followed up for a duration of six months, and no recurrence was detected.
Discussion
AMLs are lipomatous tumor-like growths equally seen in both genders and are commonly incidental findings. Symptomatic AMLs are characterized by their large size, leading to the manifestation of pressure-related symptoms or abnormalities in hormonal levels. Most AMLs are associated with chronic diseases like diabetes mellitus and hypertension. The tumor is commonly diagnosed through a biochemical and imaging workup. Asymptomatic AMLs are managed conservatively, while in the presence of symptoms, surgery is usually considered. However, the open approach is regarded as the standard option, but minimally invasive approaches can be carried out due to their feasibility.
Conclusion
AMLs are rare, benign, non-functional tumors of the adrenal gland. Laparoscopy may be a safe and feasible management modality for these tumors.
{"title":"Laparoscopic removal of a giant adrenal myelolipoma: A case report with review of the literature","authors":"Dlshad Hamasaeed Ahmed , Rawa Bapir , Belan Mikaeil M. Radha , Ismaael Aghaways , Rezheen J. Rashid , Deari A. Ismaeil , Omar H. Ghalib Hawramy , Dana T. Gharib , Hemn H. Kaka Ali , Fahmi H. Kakamad , Berun A. Abdalla , Ari M. Abdullah","doi":"10.1016/j.ijso.2023.100658","DOIUrl":"10.1016/j.ijso.2023.100658","url":null,"abstract":"<div><h3>Introduction</h3><p>Adrenal myelolipomas (AMLs) are non-functioning, benign adrenal tumors with an unknown etiology. This study aims to report a case of giant AML managed successfully by laparoscopic surgery.</p></div><div><h3>Case presentation</h3><p>A 43-year-old man presented with mild, dull, and non-radiating left loin pain. Physical examination and hormonal assays were normal. Imaging revealed a retroperitoneal mass (13 × 12 × 8.5cm) containing gross fat. Left laparoscopic adrenalectomy was done under general anesthesia. The postoperative period was uneventful. The patient was followed up for a duration of six months, and no recurrence was detected.</p></div><div><h3>Discussion</h3><p>AMLs are lipomatous tumor-like growths equally seen in both genders and are commonly incidental findings. Symptomatic AMLs are characterized by their large size, leading to the manifestation of pressure-related symptoms or abnormalities in hormonal levels. Most AMLs are associated with chronic diseases like diabetes mellitus and hypertension. The tumor is commonly diagnosed through a biochemical and imaging workup. Asymptomatic AMLs are managed conservatively, while in the presence of symptoms, surgery is usually considered. However, the open approach is regarded as the standard option, but minimally invasive approaches can be carried out due to their feasibility.</p></div><div><h3>Conclusion</h3><p>AMLs are rare, benign, non-functional tumors of the adrenal gland. Laparoscopy may be a safe and feasible management modality for these tumors.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"57 ","pages":"Article 100658"},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46561819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a case of emergency laparoscopic omental patch repair in a patient with super-super obesity (body mass index of 64.7) who presented with upper gastrointestinal perforation.
Case presentation
A 52-year-old male patient with difficulty moving his body due to abdominal pain was transported to the emergency department. Contrast-enhanced computed tomography revealed duodenal bulb wall thickening and increased fat stranding in the surrounding tissue. Free air was also observed under the liver and on its surface. Therefore, diagnostic laparoscopy was performed because of a suspected upper gastrointestinal perforation.
Clinical discussion
Because the weight limit of the surgical bed was 150 kg and the width was insufficient, even when two beds were placed side-by-side, the patient's fixation on the bed was unstable, and the surgery was performed on a regular hospital bed. A 5-mm full-thickness perforation of the duodenal bulb wall was confirmed, and omental patch repair was performed. Because the bed was regular, securing the visual field without changing the patient's position was difficult. There were also limitations on the movement of the ports; therefore, seven ports were used. Postoperatively, bile-like drainage was observed from the surgical drain. However, upper gastrointestinal contrast imaging on the 14th day after the surgery revealed no contrast leakage.
Conclusion
The patient recovered well and was discharged on the 31st day after the surgery.
{"title":"A case report of laparoscopic omental patch repair in a patient with super-super obesity and a duodenal perforation","authors":"Takaaki Murata , Nobuo Yamaguchi , Yutaro Shimomoto , Yuto Igarashi , Yuma Suno , Tomoki Nishida , Katsunori Miyake , Naoko Isogai , Ryuta Fukai , Hiroyuki Kanomata , Rai Shimoyama , Jun Kawachi","doi":"10.1016/j.ijso.2023.100657","DOIUrl":"10.1016/j.ijso.2023.100657","url":null,"abstract":"<div><h3>Introduction</h3><p>We report a case of emergency laparoscopic omental patch repair in a patient with super-super obesity (body mass index of 64.7) who presented with upper gastrointestinal perforation.</p></div><div><h3>Case presentation</h3><p>A 52-year-old male patient with difficulty moving his body due to abdominal pain was transported to the emergency department. Contrast-enhanced computed tomography revealed duodenal bulb wall thickening and increased fat stranding in the surrounding tissue. Free air was also observed under the liver and on its surface. Therefore, diagnostic laparoscopy was performed because of a suspected upper gastrointestinal perforation.</p></div><div><h3>Clinical discussion</h3><p>Because the weight limit of the surgical bed was 150 kg and the width was insufficient, even when two beds were placed side-by-side, the patient's fixation on the bed was unstable, and the surgery was performed on a regular hospital bed. A 5-mm full-thickness perforation of the duodenal bulb wall was confirmed, and omental patch repair was performed. Because the bed was regular, securing the visual field without changing the patient's position was difficult. There were also limitations on the movement of the ports; therefore, seven ports were used. Postoperatively, bile-like drainage was observed from the surgical drain. However, upper gastrointestinal contrast imaging on the 14th day after the surgery revealed no contrast leakage.</p></div><div><h3>Conclusion</h3><p>The patient recovered well and was discharged on the 31st day after the surgery.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"57 ","pages":"Article 100657"},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49206227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-07-13DOI: 10.1016/j.ijso.2023.100650
Mohammad Jawed Quereishi, ArunSundar MohanaSundaram , Avishek Koley, Dionisio Lorenzo Lorenzo-Villegas, Md Aminul Islam
{"title":"Female house surgeon stabbed to death: High time for a multi-pronged action plan to prevent and manage violence against Health care workers","authors":"Mohammad Jawed Quereishi, ArunSundar MohanaSundaram , Avishek Koley, Dionisio Lorenzo Lorenzo-Villegas, Md Aminul Islam","doi":"10.1016/j.ijso.2023.100650","DOIUrl":"10.1016/j.ijso.2023.100650","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"57 ","pages":"Article 100650"},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44625346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-07-20DOI: 10.1016/j.ijso.2023.100653
Amartya Dahal, Yadvinder Singh, Ajmat Ansari, Robin Man Karmacharya, Satish Vaidya, Swechha Bhatt
Introduction and importance
Diaphragmatic eventration is a rare disorder with partial or complete thinning of diaphragmatic musculature. The fibroelastic hemidiaphragm, which is pliable, moves paradoxically upward during inspiration resulting in restrictive pulmonary function. It occurs as a result of congenital defect in the diaphragm or secondarily due to phrenic nerve injury. Most patients remain asymptomatic for a long duration—the disease is therefore underdiagnosed. However, in cases of clinical suspicion, chest radiography should be performed, which can be further confirmed by chest computed tomography (CT).
Case presentation
We present a case of a 67-year-old male with a right sided diaphragmatic eventration presenting as severe coughing for two months. Surgical plication of right hemidiaphragm was done in multilayer with percutaneous dynamic stabilization (PDS) yielding good outcome.
Clinical discussion
The decision on performing a surgical repair of the defect depends upon the extent of the complications. Symptomatic patients with compromised respiratory, cardiovascular or gastrointestinal function usually require the plication of the diaphragm.
Conclusion
Despite the rarity of the disease, clinicians must always evaluate the patient for diaphragmatic eventration to ensure early repair of the defect.
{"title":"Eventration of diaphragm of unknown cause: A case report","authors":"Amartya Dahal, Yadvinder Singh, Ajmat Ansari, Robin Man Karmacharya, Satish Vaidya, Swechha Bhatt","doi":"10.1016/j.ijso.2023.100653","DOIUrl":"10.1016/j.ijso.2023.100653","url":null,"abstract":"<div><h3>Introduction and importance</h3><p>Diaphragmatic eventration is a rare disorder with partial or complete thinning of diaphragmatic musculature. The fibroelastic hemidiaphragm, which is pliable, moves paradoxically upward during inspiration resulting in restrictive pulmonary function. It occurs as a result of congenital defect in the diaphragm or secondarily due to phrenic nerve injury. Most patients remain asymptomatic for a long duration—the disease is therefore underdiagnosed. However, in cases of clinical suspicion, chest radiography should be performed, which can be further confirmed by chest computed tomography (CT).</p></div><div><h3>Case presentation</h3><p>We present a case of a 67-year-old male with a right sided diaphragmatic eventration presenting as severe coughing for two months. Surgical plication of right hemidiaphragm was done in multilayer with percutaneous dynamic stabilization (PDS) yielding good outcome.</p></div><div><h3>Clinical discussion</h3><p>The decision on performing a surgical repair of the defect depends upon the extent of the complications. Symptomatic patients with compromised respiratory, cardiovascular or gastrointestinal function usually require the plication of the diaphragm.</p></div><div><h3>Conclusion</h3><p>Despite the rarity of the disease, clinicians must always evaluate the patient for diaphragmatic eventration to ensure early repair of the defect.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"57 ","pages":"Article 100653"},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42706382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-07-26DOI: 10.1016/j.ijso.2023.100655
Tamassi Bertrand Essobiyou , Samuel Salem Laurent Ouedraogo , Pegwende Rachid Cedric Diendere , Albert Kossi Labou , Mohamed Issa , Kodjo Abossisso Sakiye
Introduction
and importance: Encapsulating peritonitis is a chronic and rare condition of the peritoneum. Most often secondary, it can occur idiopathically without any predictive factor. The diagnosis is often delayed and the management is not codified. The authors report a case of encapsulating peritonitis in a patient in a hospital in Togo. Their case highlights the diagnostic difficulties that can arise with encapsulated peritonitis.
Case presentation
a 46-year-old female patient with a history of transient abdominal pain was admitted to an emergency with acute intestinal obstruction. A laparotomy was indicated. Intraoperatively, it was discovered that there was an agglutination of coats covered by a thin membrane. The surgical procedure consisted of adhesiolysis with the release of the loops. The fibrous nature of the membrane on histology and the negativity of the etiological examinations allowed the diagnosis to be retained.
Clinical discussion
This is the result of a chronic attack on the peritoneum. In the majority of cases, it is said to be secondary because it occurs in a known evocative context. However, idiopathic cases have been reported. The disease has an insidious course making its diagnosis difficult. The disease is associated with a high mortality rate even under treatment, which reflects its severity. There is no consensus on the therapeutic management of this disease.
Conclusion
Encapsulating peritonitis is a rare and serious disease with a difficult diagnosis and complex management. There is no consensus on the therapeutic management of this disease.
{"title":"Idiopathic encapsulating peritonitis: A case report","authors":"Tamassi Bertrand Essobiyou , Samuel Salem Laurent Ouedraogo , Pegwende Rachid Cedric Diendere , Albert Kossi Labou , Mohamed Issa , Kodjo Abossisso Sakiye","doi":"10.1016/j.ijso.2023.100655","DOIUrl":"10.1016/j.ijso.2023.100655","url":null,"abstract":"<div><h3>Introduction</h3><p>and importance: Encapsulating peritonitis is a chronic and rare condition of the peritoneum. Most often secondary, it can occur idiopathically without any predictive factor. The diagnosis is often delayed and the management is not codified. The authors report a case of encapsulating peritonitis in a patient in a hospital in Togo. Their case highlights the diagnostic difficulties that can arise with encapsulated peritonitis.</p></div><div><h3>Case presentation</h3><p>a 46-year-old female patient with a history of transient abdominal pain was admitted to an emergency with acute intestinal obstruction. A laparotomy was indicated. Intraoperatively, it was discovered that there was an agglutination of coats covered by a thin membrane. The surgical procedure consisted of adhesiolysis with the release of the loops. The fibrous nature of the membrane on histology and the negativity of the etiological examinations allowed the diagnosis to be retained.</p></div><div><h3>Clinical discussion</h3><p>This is the result of a chronic attack on the peritoneum. In the majority of cases, it is said to be secondary because it occurs in a known evocative context. However, idiopathic cases have been reported. The disease has an insidious course making its diagnosis difficult. The disease is associated with a high mortality rate even under treatment, which reflects its severity. There is no consensus on the therapeutic management of this disease.</p></div><div><h3>Conclusion</h3><p>Encapsulating peritonitis is a rare and serious disease with a difficult diagnosis and complex management. There is no consensus on the therapeutic management of this disease.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"57 ","pages":"Article 100655"},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47843424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-08-02DOI: 10.1016/j.ijso.2023.100659
ArunSundar MohanaSundaram, Josef Finsterer, Dionisio Lorenzo Lorenzo-Villegas, Man Mohan Mehndiratta, Md Aminul Islam
{"title":"Unravelling two fungal meningitis outbreaks in Mexico: An urgent call for multi-faceted action","authors":"ArunSundar MohanaSundaram, Josef Finsterer, Dionisio Lorenzo Lorenzo-Villegas, Man Mohan Mehndiratta, Md Aminul Islam","doi":"10.1016/j.ijso.2023.100659","DOIUrl":"10.1016/j.ijso.2023.100659","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"57 ","pages":"Article 100659"},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42817189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-07-12DOI: 10.1016/j.ijso.2023.100651
James J. Yahaya, Emmanuel D. Morgan, Emmanuel Othieno
Introduction and importance
The infection caused by Strongyloides stercoralis (S stercoralis) is usually an asymptomatic condition particularly in immunocompetent individuals and the condition may remain unnoticed even for decades, however, strongyloidiasis is more severe in patients who are immunocompromised.
Case presentation
The patient is a 56-year old male who presented with nine months history of episodes of abdominal pain, nausea loss of appetite, and chronic diarrhea. His diarrhea had mucus and trace blood. His oesophagogastroduodenoscopy (OGD) revealed erythematous, hypertrophied, and ulcerating lining mucosa of the duodenum. The specimen sampled showed sections of the duodenum with numerous Strongyloides stercoralis larvae, some inside the crypts with associated active duodenitis.
Clinical discussion
Despite the asymptomatic nature of Strongyloides stercoralis infectious condition especially for immunocompetent patients, the infection may sometimes result into serious complications including exudative enteropathy and paralytic ileus. The clinical outcome of patients with strongyloidiasis is usually better despite severe infection may develop and it is associated with slightly increased morbidity and even mortality.
Conclusion
Diagnosis of Strongyloides stercoralis infection in individuals residing in tropical or subtropical countries who present with chronic diarrhea, abdominal pain should always be considered so as to avoid delay of diagnosis. This may help in preventing unnecessary complication such as severe anaemia, intestinal perforation or even death.
{"title":"Duodenal Strongyloides stercoralis infection in a 56-year old male: A case report","authors":"James J. Yahaya, Emmanuel D. Morgan, Emmanuel Othieno","doi":"10.1016/j.ijso.2023.100651","DOIUrl":"10.1016/j.ijso.2023.100651","url":null,"abstract":"<div><h3>Introduction and importance</h3><p>The infection caused by <em>Strongyloides stercoralis (S stercoralis)</em> is usually an asymptomatic condition particularly in immunocompetent individuals and the condition may remain unnoticed even for decades, however, strongyloidiasis is more severe in patients who are immunocompromised.</p></div><div><h3>Case presentation</h3><p>The patient is a 56-year old male who presented with nine months history of episodes of abdominal pain, nausea loss of appetite, and chronic diarrhea. His diarrhea had mucus and trace blood. His oesophagogastroduodenoscopy (OGD) revealed erythematous, hypertrophied, and ulcerating lining mucosa of the duodenum. The specimen sampled showed sections of the duodenum with numerous <em>Strongyloides stercoralis</em> larvae, some inside the crypts with associated active duodenitis.</p></div><div><h3>Clinical discussion</h3><p>Despite the asymptomatic nature of <em>Strongyloides stercoralis</em> infectious condition especially for immunocompetent patients, the infection may sometimes result into serious complications including exudative enteropathy and paralytic ileus. The clinical outcome of patients with strongyloidiasis is usually better despite severe infection may develop and it is associated with slightly increased morbidity and even mortality.</p></div><div><h3>Conclusion</h3><p>Diagnosis of <em>Strongyloides stercoralis</em> infection in individuals residing in tropical or subtropical countries who present with chronic diarrhea, abdominal pain should always be considered so as to avoid delay of diagnosis. This may help in preventing unnecessary complication such as severe anaemia, intestinal perforation or even death.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"57 ","pages":"Article 100651"},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42982807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-04-12DOI: 10.1016/j.ijso.2023.100612
Caspar J. Peterson , Jennifer M. Klasen , Lukas Bubendorf , Martin Freitag , Tarik Delko , Ioannis I. Lazaridis
Introduction and importance
Although the majority of thyroid lesions are benign, diagnostic workup including fine needle aspiration biopsy cytology is important to rule out cancerous lesions. However, cytological findings may pose challenges in interpretation because of similarities in cytomorphological features between certain thyroid nodules and parathyroid tissue. Similarly, parathyroid lesions may go unnoticed for a long period of time because they are misinterpreted as thyroid lesions and patients with parathyroid lesions are typically oligo- or asymptomatic for a long period of time.
Case presentation
We present the case of a 57-year-old female patient who was under observation for a hormone inactive mildly suspicious thyroid nodule for eight years before the suspected thyroid nodule was found to be a parathyroid adenoma. Repeated fine needle aspiration biopsies showed cytomorphological features of Bethesda Class III thyroid nodules and the patient was asymptomatic throughout all consultations. Finally, a pathological hip fracture and symptomatic kidney stone prompted further diagnostic work-up, confirming primary hyperparathyroidism and exposing the suspected thyroid lesion for a parathyroid adenoma. After focused parathyroidectomy the patient fully recovered.
Clinical discussion
Systematic blood sampling for Calcium and parathyroid hormone levels, which has to become part of the usual work up for suspicious thyroid nodules, may have exposed the diagnosis earlier preventing secondary complications.
Conclusion
This case highlights one of the major pitfalls in ultrasound interpretation and fine needle aspiration biopsy of the thyroid gland. Physicians need to be aware of these difficulties during the diagnostic work-up.
{"title":"Parathyroid adenoma mimicking bethesda class III follicular thyroidal lesion: A case report","authors":"Caspar J. Peterson , Jennifer M. Klasen , Lukas Bubendorf , Martin Freitag , Tarik Delko , Ioannis I. Lazaridis","doi":"10.1016/j.ijso.2023.100612","DOIUrl":"10.1016/j.ijso.2023.100612","url":null,"abstract":"<div><h3>Introduction and importance</h3><p>Although the majority of thyroid lesions are benign, diagnostic workup including fine needle aspiration biopsy cytology is important to rule out cancerous lesions. However, cytological findings may pose challenges in interpretation because of similarities in cytomorphological features between certain thyroid nodules and parathyroid tissue. Similarly, parathyroid lesions may go unnoticed for a long period of time because they are misinterpreted as thyroid lesions and patients with parathyroid lesions are typically oligo- or asymptomatic for a long period of time.</p></div><div><h3>Case presentation</h3><p>We present the case of a 57-year-old female patient who was under observation for a hormone inactive mildly suspicious thyroid nodule for eight years before the suspected thyroid nodule was found to be a parathyroid adenoma. Repeated fine needle aspiration biopsies showed cytomorphological features of Bethesda Class III thyroid nodules and the patient was asymptomatic throughout all consultations. Finally, a pathological hip fracture and symptomatic kidney stone prompted further diagnostic work-up, confirming primary hyperparathyroidism and exposing the suspected thyroid lesion for a parathyroid adenoma. After focused parathyroidectomy the patient fully recovered.</p></div><div><h3>Clinical discussion</h3><p>Systematic blood sampling for Calcium and parathyroid hormone levels, which has to become part of the usual work up for suspicious thyroid nodules, may have exposed the diagnosis earlier preventing secondary complications.</p></div><div><h3>Conclusion</h3><p>This case highlights one of the major pitfalls in ultrasound interpretation and fine needle aspiration biopsy of the thyroid gland. Physicians need to be aware of these difficulties during the diagnostic work-up.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"57 ","pages":"Article 100612"},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42902106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}