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At least 343 records · Page 19Linked to original sources
PubMed1999

[Monosymptomatic hyperthyroidism and TSH-producing adenoma: successful therapy with octreotide].

HISTORY AND FINDINGS: Magnetic resonance imaging (MRI) of the central nervous system was performed on a 72-year-old woman who was hyperthyroid without suppression of the thyroid-stimulating hormone (TSH) and had complained of a recent onset of headaches. MRI demonstrated a space-occupying lesion, 1 cm in diameter, in the anterior pituitary. The clinical symptoms were marked by a long-standing monosymptomatic illness of rapidly changing mood swings with depressive and manic phases. INVESTIGATIONS: Endocrinological-biochemical tests showed hyperthyroidism (fT3 10.55 pmol/l and fT4 39 pmol/l) but no TSH suppression (TSH: 2.9 microU/ml). Octreotide scintigraphy documented an activity-rich area in the anterior pituitary and the upper anterior mediastinum. Mediastinal MRI revealed a 5 cm space-occupying mass lying on the right atrium. 131I scintigraphy identified the mass as a retrosternal goitre. TREATMENT AND COURSE: As an operation on the anterior pituitary would have carried a high risk for the patient who was in a poor general condition and she had refused to be operated, treatment with octreotide, a long-acting somatostatin analogue, was initiated. This achieved a euthyroid state with partly suppressed TSH, and the patient's emotional swings ceased. CONCLUSION: If hyperthyroidism coexists with non-suppressed TSH levels, a TSH-producing hypophyseal adenoma should be considered in the differential diagnosis despite its rarity. Octreotide administration is an effective and safe treatment and is the method of choice, especially when there are contraindications to surgical resection of the anterior pituitary.

Adenoma↗
PubMed1989

The radiology of the right superior intercostal vein.

The right superior intercostal vein is visualised on CT examination as a circular opacity laterally at the right aspect of the vertebral body at the T4-T5 level. In venographic examination the RSIV appears to be formed by the confluence of the venous channels, the right second, third and fourth intercostal veins. In superior vena cava obstruction the RSIV is an important collateral pathway: the flow through the vein depends on the site of the obstruction, anterograde if the obstruction is superior or parallel to the level of the vena azygos, and retrograde if the obstruction is below the vena azygos.

Goiter, Substernal↗
PubMed1985

[Endoscopic ultrasonic study of the esophagus].

Endoscopic ultrasonotomography opens a sonographic window to the organs of the mediastinum. With this technique all segments of the oesophagus can be sonographically investigated. Endosonographic investigations on 11 patients with oesophageal tumors and 3 patients with oesophageal varices showed that the diagnosis of oesophageal carcinoma and differentiation between malignant tumors and benign changes are possible. The spread of the tumor in the horizontal and vertical planes can be accurately determined with endoscopic ultrasonography. In addition, paraoesophageal lymph node metastases, as well as other lesions in the mediastinum, can be diagnosed. Ultrasonography of the oesophagus can be simplified by leaving out the optical system.

Carcinoma, Squamous Cell↗
PubMed1983

[Critique of goiter epidemiology. I. Goiter size].

Comparison of three methods for demonstration of thyroid enlargement in 92 patients showed that the sensitivity of sonographic volumetrics (93%) and palpation (91%) is superior to radiography (45%). Sonography has the disadvantage of lack of quantitative demonstration of retrosternal goitre. Palpation and chest radiograph had the disadvantage of a frequency of false positive findings in 8.7 and 10.9%.

Adult↗
PubMed2006

Negative-pressure pulmonary edema after resection of mediastinum thyroid goiter.

Negative-pressure pulmonary edema (NPPE) is an uncommon but life-threatening complication of acute or chronic upper airway obstruction; however, there are few reports of NPPE after giant goiter resection. We report a case with severe NPPE induced by the resection of a mediastinum thyroid goiter. The patient was successfully treated by non-invasive positive airway ventilation (NPPV).

Adenocarcinoma, Papillary↗
PubMed1975

Palpation thyroiditis (multifocal granulomatour folliculitis).

Disseminated inflammatory lesions constituting a multifocal granulomatous folliculitis in the thyroid are described. These lesions were present in the majority (greater than 83%) of thyroids removed surgically because of thyroid or nonthyroid (carcinoma of the larynx) disease. They also were found at autopsy in patients who died while hospitalized but not in those who died at home. An identical lesion was produced experimentally in dogs by vigorously squeezing their thyroids. The human folliculitis is believed to result from traumatic injury or rupture of isolated thyroid follicles caused by palpation of the gland (palpation thyroiditis). Palpation thyroiditis may have little, if any, clinical importance. The remote possibility that it might be associated with iatrogenically produced metastasis of thyroid carcinoma is being investigated.

Adenoma↗
PubMed1984

Diagnostic imaging in mediastinal thyroid tumor.

Various diagnostic imagings in nine patients with mediastinal goiters were presented. The clinical manifestations of these patients were various, from totally asymptomatic to severe dyspnea. Six of the nine patients underwent surgical intervention, three were follicular adenomas and three were nodular goiters. A chest radiograph (positive in seven out of nine patients) provided the most valuable initial localization of a goiter mass to the anterior, middle, or posterior compartment. Esophagograms (performed in four patients) showed compression of esophagus by the mediastinal mass. I-131 scintigraphy (performed in seven patients) was capable of detection of functional (in three patients) vs nonfunctional status of thyroid status (in four patients). Angiography (performed in five patients), characterized by anatomic continuity with cervical thyroid gland, calcifications, well-defined border of masses and/or contrast enhancement, offered important roles to direct a diagnosis of intrathoracic goiter. The computed tomography becomes increasingly important because all mediastinal goiters are not radioiodine avid.

Adenoma↗
PubMed1986

Severe thyrotoxicosis caused by an ectopic intrathoracic goiter.

The case of a 71-year-old woman with severe thyrotoxicosis due to an ectopic multinodular intrathoracic goiter is described. Previously reported cases with intrathoracic ectopic thyroid tissue were either nontoxic, or, if thyrotoxic, were a direct continuation of the tissue of the normally located gland. This mass was proved to be of thyroid origin using Tc-99m sodium pertechnetate scanning.

Aged↗
PubMed1995

Hyperthyroidism after radiographic contrast in a patient with separate cervical and intrathoracic multinodular goiters.

The authors report a case of multinodular goiter in both cervical thyroid and aberrant intrathoracic thyroid tissue which was associated with thyrotoxicosis after the use of radiographic contrast material. The role of correlative imaging in assessment of cervical and anterior mediastinal masses and the phenomenon of iodine-induced thyrotoxicosis are also discussed.

Aged↗