Thyroglossal Duct Cyst Carcinoma With Synchronous Thyroid Papillary Carcinoma: A Case Report and Literature Review.

Thyroglossal duct cysts (TGDC) are one of the most common congenital anomalies in the neck. Malignant transformation of these cysts is rare and synchronous involvement of the thyroid gland is even rarer. We report a case of synchronous occurrence of carcinoma in the thyroglossal duct cyst and thyroid gland and review the relevant literature. A 24-year-old woman who presented with a midline cervical mass, clinical examination, and complementary study was suggestive of a thyroglossal cyst with papillary carcinoma on fine-needle aspiration biopsy (FNAB) synchronous with thyroid papillary carcinoma with no cervical ganglion metastases documentation. Sistrunk's procedure plus total thyroidectomy was performed. With the clinical resemblance of benign and malignant cysts and the limitations of imaging techniques to distinguish between them, FNAB might be of use. Surgical treatment is warranted for the treatment of thyroglossal duct cyst carcinoma, but controversy still exists as to the extent of the surgical intervention. Sistrunk's procedure seems to be considered the gold standard when there is no evidence of thyroid involvement. However, in the presence of concomitant thyroid carcinoma, total thyroidectomy and cervical lymphadenectomy for evident node metastases are required. In the case of synchronous thyroglossal and thyroid carcinoma, most authors recommend pursuing both radioiodine therapy and hormone ablation. Thyroglossal duct cyst carcinoma is an uncommon feature that can arise from clusters of thyroid cells found within the cyst as in the present case. When confronted with this diagnosis it is fundamental to take into consideration the possibility of synchronous lesions as well as the extent of local and distance disease, since it has a direct influence on the choice of treatment provided to the patient. As there was a synchronous presence of papillary carcinoma in both the thyroglossal cyst and the thyroid gland, both the Sistrunk procedure and total thyroidectomy were performed, and radioiodine therapy was pursued as well as hormone ablation.

Primary Hyperaldosteronism: A Rare Cause of Malignant Hypertension with Thrombotic Microangiopathy in a Kidney Transplant Recipient.

Thrombotic microangiopathy (TMA) is a rare disease that presents with haemolysis and organ damage. The kidney is one of the main affected organs, and TMA is associated with serious complications and increased mortality. In transplanted patients, TMA is even less common and has a variety of possible causes, including thrombotic thrombocytopenic purpura (TTP) and haemolytic-uremic syndrome (HUS), infections, drugs, autoimmune disease, tumours, and malignant hypertension. Transplant-related causes, such as antibody-mediated rejection, calcineurin inhibitors, and viral infections, need to be considered as well. The authors report a rare case of TMA in a kidney transplant recipient, whose investigation revealed malignant hypertension secondary to primary hyperaldosteronism.

Effect of innovative technology using staves and micro-oxygenation on the odorant and sensory profile of aged wine spirit.

The aged wine spirit is a beverage with great aromatic complexity. Their volatile compounds with odorant power coming from the distillate and from the wood used in its ageing, and the interactions that take place in the process, enhanced by oxygen, all contribute to this complexity. Due to time and cost inherent of ageing wine spirits in wooden barrels, research has sought to develop more sustainable alternatives to do it. In this context, the present study compares, the effect of traditional (wooden barrel) and alternative system (stainless steel tank with dipped staves and micro-oxygenation), on the odorant and sensory profile of a wine spirit, using Limousin oak and chestnut wood, after 12 months of ageing. The results suggest that the ageing process is accelerated by the alternative ageing technology and the chestnut wood, and the corresponding wine spirits presented characteristics of greater sensory evolution and strong wood compounds extraction.

[Conservative surgery in pancreatic solid pseudo papillary tumor]. / Cirurgia conservadora no tumor sólido pseudopapilar do páncreas.

We report the case of a 18-year-old girl having a solid pseudopapillary pancreatic tumor. The patient underwent local enucleation of the tumor located on pancreatic head and remained free of recurrence on the 5th year of follow up. Surgical management is discussed.

[Splenic metastasis in ovary serous adenocarcinoma]. / Metástases esplénicas no adenocarcinoma seroso do ovário.

Splenic metastasis is rare, and is usually associated with disseminated malignancy. The primary tumours more frequently related with splenic metastasis are lung, breast, gynaecologic, specially ovary tumours, colon, rectum and melanoma. Isolated secondary splenic disease is rare, but it is described, often associated to ovary cancer. We report a 55 years old women with parenchymal splenic metastases of serous ovary cystadenocarcinoma in the 5th follow up year. This patient had positive peritoneal washings chytology but not macroscopic disease. We discuss the secondary splenic involvement of ovary cancer, dissemination route, prognosis and role of splenectomy as treatment modality in this unusual recurrence site in ovary cancers.

[Laparoscopic cholecystectomy: day case procedure]. / Colecistectomia laparoscópica: cirurgia de ambulatório.

We describe a retrospective analysis of 105 patients who underwent day-case laparoscopic cholecystectomy to evaluate the safety of this procedure. Selection criteria included surgical indications and admission/exclusion criteria for day-case surgery. We analysed: causes of overnight stay and readmission, need of medical or nursing care after discharge, degree of patient satisfaction and insatisfaction reasons. This study has demonstrated a low rate of overnight stay and readmission and a high degree of patient satisfaction for this procedure. We concluded that in selected patients, laparoscopic cholecystectomy as a day-case surgery is a safe procedure.