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Interesting Presentation of Renal Cell Carcinoma-Metastasis to the Thyroid Cartilage
P220
Otolaryngology– Head and Neck Surgery August 2005
Scientific Posters
ear for cochleostomy and entire active electrode array was inserted into the cochlea using Nucleus 24 Contour. To prevent post-operative infection, intra-operative topical antibiotics (Gentamicin) soaked in tempolaris muscle strips were loosely parked in the middle ear and mastoid. The postoperative course was uneventiful without wound infection. Results: The initial mapping using ACE speech coding strategy was performed on August 1st, 2003. The post-operative evaluation included sound detection threshold, MTS test, open-set sentence test and tone test. Conclusion: Patients with post-irradiated deafness can benefit from cochlear implant. To our knowledge, this is the first case of cochlear implant for post-irradiated nasopharyngeal carcinoma reported in the English literature.
P069
remote history of nephrectomy of unkown pathology per the patient’s history. Results: A 65 year old patient with a remote history of nephrectomy. He presented to his physician with a six month history of hoarseness without associated symptoms. Physical exam revealed mobile vocal cords without mucosal lesions. A CT scan was obtained revealing a mass expanding the thyroid cartiage. FNA was performed revealing markers consistent with metastatic renal cell carcinoma. A total laryngectomy was performed. Intraoperatively, the specimen revealed no gross involvement of the laryngeal mucosa or vocal cords. The metastasis was limited to the thyroid cartilage only. Conclusion: Metastasis to the head and neck region occur in approximately 15% of patients, but rarely to the larynx. This case is the first reported in the literature demonstrating renal cell carcinoma metastasis limited to the thyroid cartilage.
Multiple Scalp Cylindroma (Turbin Tumor) with Malignant Degeneration
Objectives: The patient’s clinical history will be reviewed to demonstrate the presentation of this infrequent diagnosis. Previously reported cases will be examined to allow for comparison of prognosis. Methods: Case report and limited review of the literature on the topic of cylindroma. Results: A patient with multiple scalp-based masses presented with a recurrent parotid swelling after undergoing superficial parotidectomy and postoperative radiation. Biopsy of the parotid region was consistent with an undifferentiated carcinoma while the scalp lesions revealed the diagnosis of cylindroma. Radical wide local re-excision was performed obtaining negative margins. Within six months, two of the previously stable dermal nodules (scalp and neck) demonstrated clinical change and revealed findings consistent with poorly differentiated carcinoma. Conclusion: Cylindroma is an uncommon lesion referred to as “Turbin tumor.” Malignant degeneration, as we report in this case, requires that these patients be followed closely for change in previously stable nodules. Treatment philosophies vary for addressing patients with numerous stable lesions.
P070 Interesting Presentation of Renal Cell CarcinomaMetastasis to the Thyroid Cartilage Jeremy C Roebuck, MD (presenter); Amy Clark Hessel, MD Houston TX; Houston TX
Objectives: Presentation of an interesting case of renal cell carcinoma with metastasis limited to the thyroid cartilage. Methods: Case Report of a patient with renal cell carcinoma metastasis to the thyroid cartilage. The patient had a
P071 Endometrial Adenocarcinoma Metastatic to the Thyroid Presenting Like Anaplastic Thyroid Cancer Natasha Pollak, MD (presenter); Gregory J Renner, MD; Ronald Miick, MD; Shellaine Frazier, DO Columbia MO; Columbia MO; Columbia MO; Columbia MO
Objectives: Metastases of uterine cancers to the head and neck are extremely rare. We report what we believe to be the first documented case of endometrial adenocarcinoma metastasizing to the thyroid gland as the first presentation of any regional or distant disease. Methods: An 80 year old woman was referred to the otolaryngology service with a 3 week history of a large, rapidly growing mass in the low right anterior neck. A fine needle aspiration biopsy reported atypical thyroid epithelial cells suspicious of neoplasia. The mass appeared to originate from and involve the thyroid gland. Her clinical presentation was consistent with anaplastic thyroid carcinoma. In view of the rapid growth and progressing symptoms of dysphagia and airway obstruction, a tracheostomy was planned. A partial tumor debulking was necessary in order to place the tracheostomy. An open biopsy established the diagnosis of moderately differentiated endometrial adenocarcinoma. The patient had undergone a hysterectomy 5 years prior for primary endometrial adenocarcinoma, and was free of recurrence or metastasis up to this point. Results: The thyroid tumor histology and immunostains corresponded well with her prior endometrial malignancy, indicating that the thyroid mass was a metastasis from the endometrial primary. She was treated with radiotherapy and was without evidence of disease six months post treatment. Conclusion: This case report broadens the differential diagnosis of rapidly enlarging thyroid masses to include metastasis from gynecologic primary malignancies. So far, ra-
POSTERS
Richard Orin Wein, MD (presenter) Ridgeland MS
Otolaryngology– Head and Neck Surgery August 2005
Scientific Posters
ear for cochleostomy and entire active electrode array was inserted into the cochlea using Nucleus 24 Contour. To prevent post-operative infection, intra-operative topical antibiotics (Gentamicin) soaked in tempolaris muscle strips were loosely parked in the middle ear and mastoid. The postoperative course was uneventiful without wound infection. Results: The initial mapping using ACE speech coding strategy was performed on August 1st, 2003. The post-operative evaluation included sound detection threshold, MTS test, open-set sentence test and tone test. Conclusion: Patients with post-irradiated deafness can benefit from cochlear implant. To our knowledge, this is the first case of cochlear implant for post-irradiated nasopharyngeal carcinoma reported in the English literature.
P069
remote history of nephrectomy of unkown pathology per the patient’s history. Results: A 65 year old patient with a remote history of nephrectomy. He presented to his physician with a six month history of hoarseness without associated symptoms. Physical exam revealed mobile vocal cords without mucosal lesions. A CT scan was obtained revealing a mass expanding the thyroid cartiage. FNA was performed revealing markers consistent with metastatic renal cell carcinoma. A total laryngectomy was performed. Intraoperatively, the specimen revealed no gross involvement of the laryngeal mucosa or vocal cords. The metastasis was limited to the thyroid cartilage only. Conclusion: Metastasis to the head and neck region occur in approximately 15% of patients, but rarely to the larynx. This case is the first reported in the literature demonstrating renal cell carcinoma metastasis limited to the thyroid cartilage.
Multiple Scalp Cylindroma (Turbin Tumor) with Malignant Degeneration
Objectives: The patient’s clinical history will be reviewed to demonstrate the presentation of this infrequent diagnosis. Previously reported cases will be examined to allow for comparison of prognosis. Methods: Case report and limited review of the literature on the topic of cylindroma. Results: A patient with multiple scalp-based masses presented with a recurrent parotid swelling after undergoing superficial parotidectomy and postoperative radiation. Biopsy of the parotid region was consistent with an undifferentiated carcinoma while the scalp lesions revealed the diagnosis of cylindroma. Radical wide local re-excision was performed obtaining negative margins. Within six months, two of the previously stable dermal nodules (scalp and neck) demonstrated clinical change and revealed findings consistent with poorly differentiated carcinoma. Conclusion: Cylindroma is an uncommon lesion referred to as “Turbin tumor.” Malignant degeneration, as we report in this case, requires that these patients be followed closely for change in previously stable nodules. Treatment philosophies vary for addressing patients with numerous stable lesions.
P070 Interesting Presentation of Renal Cell CarcinomaMetastasis to the Thyroid Cartilage Jeremy C Roebuck, MD (presenter); Amy Clark Hessel, MD Houston TX; Houston TX
Objectives: Presentation of an interesting case of renal cell carcinoma with metastasis limited to the thyroid cartilage. Methods: Case Report of a patient with renal cell carcinoma metastasis to the thyroid cartilage. The patient had a
P071 Endometrial Adenocarcinoma Metastatic to the Thyroid Presenting Like Anaplastic Thyroid Cancer Natasha Pollak, MD (presenter); Gregory J Renner, MD; Ronald Miick, MD; Shellaine Frazier, DO Columbia MO; Columbia MO; Columbia MO; Columbia MO
Objectives: Metastases of uterine cancers to the head and neck are extremely rare. We report what we believe to be the first documented case of endometrial adenocarcinoma metastasizing to the thyroid gland as the first presentation of any regional or distant disease. Methods: An 80 year old woman was referred to the otolaryngology service with a 3 week history of a large, rapidly growing mass in the low right anterior neck. A fine needle aspiration biopsy reported atypical thyroid epithelial cells suspicious of neoplasia. The mass appeared to originate from and involve the thyroid gland. Her clinical presentation was consistent with anaplastic thyroid carcinoma. In view of the rapid growth and progressing symptoms of dysphagia and airway obstruction, a tracheostomy was planned. A partial tumor debulking was necessary in order to place the tracheostomy. An open biopsy established the diagnosis of moderately differentiated endometrial adenocarcinoma. The patient had undergone a hysterectomy 5 years prior for primary endometrial adenocarcinoma, and was free of recurrence or metastasis up to this point. Results: The thyroid tumor histology and immunostains corresponded well with her prior endometrial malignancy, indicating that the thyroid mass was a metastasis from the endometrial primary. She was treated with radiotherapy and was without evidence of disease six months post treatment. Conclusion: This case report broadens the differential diagnosis of rapidly enlarging thyroid masses to include metastasis from gynecologic primary malignancies. So far, ra-
POSTERS
Richard Orin Wein, MD (presenter) Ridgeland MS