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Spindle epithelial tumor with thymus-like element should be included in the differential diagnosis of thyroid gland cancers, particularly in medullary carcinoma, younger patients and indolent clinical presentation, because it may influence treatment and prognosis.
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Key Clinical Message: This rare diagnosis highlights the importance of anatomical and embryological knowledge in the differential diagnosis of neck masses. Abstract: A 41-year-old woman was referred to the head and neck surgery department because of a large midline neck mass at the level of the hyoid bone that was diagnostic for functioning thyroid tissue in a totally ectopic location.
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Papillary thyroid carcinoma (PTC) primarily located in the pyramidal lobe of the thyroid gland is extremely rare, therefore the clinical and pathological features are not well understood. The authors describe a case of PTC of the pyramidal lobe, in a 77-year-old woman who underwent en bloc total thyroidectomy with pyramidal lobe, hyoid bone and cervical lymph node excision. In line with the present case, current literature reports a greater presence of worse prognostic factors, namely extrathyroidal extension, advanced T stage or presence of cervical lymph node metastasis. Recently, a new classification has been suggested-Upper Neck Papillary Thyroid Cancer (UPTC)-which encompasses these carcinomas, Delphi ganglion metastases and thyroglossal duct cyst carcinomas, with potential clinical and therapeutic implications, particularly the need for orthotopic thyroidectomy. Also, the complete excision of the pyramidal lobe during thyroidectomy may influence the success of radioactive iodine therapy and the patient's follow-up surveillance.
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BACKGROUND: Cutaneous angiosarcoma (AS) of the head and neck is a rare highly aggressive tumor, often associated with difficult local control of the disease and poor prognosis. This article describes a case of multifocal cutaneous AS of the scalp, mainly addressing its difficult surgical management and challenging reconstruction and concludes with a review of the literature. METHODS: A 70-year-old Caucasian male was referred to our hospital with a growing scalp lesion initially suspected to be benign, but later diagnosed with AS. RESULTS: The patient had tumor recurrence and a difficult reconstruction for which dermal substitutes proved very useful. CONCLUSION: AS can mimic a benign lesion in its early stages. Skin substitutes, namely dermal templates, can be useful to meet the complex needs of reconstruction and oncological surveillance of patients with AS.