Auricular leishmaniasis mimicking squamous cell carcinoma of the pinna.

Cutaneous leishmaniasis can occur on any exposed area of the body; however, the pinna is an exceptionally rare site for the disease. Caused by the parasite Leishmania, cutaneous leishmaniasis has a wide range of presentations and thus is very easy to misdiagnose or mistake for a neoplastic lesion. Here, we report the case of a middle-aged male patient presenting with a painful, ulcerated lesion on the left auricle initially suspected to be a malignancy with histopathology eventually revealing a diagnosis of auricular leishmaniasis. The patient received appropriate therapy and was found to be disease free at follow-up. These isolated lesions of the pinna often resemble neoplastic lesions and thus may escape diagnosis for months at a time, increasing patient stress as well as expenditure. In addition, prompt recognition may also help mitigate recurrence of the disease, making it worthwhile to include cutaneous leishmaniasis as part of the differential, especially in endemic areas.

Successful management of a difficult airway in a case of advanced thyroid cancer.

Papillary thyroid carcinoma is the most prevalent endocrine malignancy of the head and neck region. It makes up to 80% of all thyroid cancers, and has a 10-year survival rate of up to 95%. Differentiated thyroid carcinomas have good prognosis after a complete surgical extirpation as long as it is not associated with invasion of the surrounding structures. The advanced papillary thyroid carcinoma can invade the neighbouring structures of the thyroid gland, such as strap muscles, recurrent laryngeal nerve, trachea, oesophagus, larynx, pharynx, and carotids. Whenever papillary thyroid carcinoma is associated with invasion of aerodigestive tract it is difficult to excise the tumour. We report a patient with stage IV invasive papillary thyroid carcinomas as per Shin Staging system. The surgery was deferred from several hospitals considering the advanced stage of the disease with tracheal extension making it a problematic airway for both the anaesthesiologist and the operating surgeon. The patient underwent total thyroidectomy, modified radical neck dissection, tracheal resection, and primary anastomosis. Successful intubation was done with video laryngoscopy. Intermittent apnoea technique was used for ventilation during the repair of posterior tracheal wall. The patient was extubated on the table and shifted to the recovery room. The histopathologic diagnosis was reported as papillary thyroid carcinoma classic variant with tracheal invasion.

Synchronous primary diffuse large B-cell lymphoma and papillary thyroid carcinoma: A case report highlighting "Lymphoma first approach".

Papillary thyroid carcinoma (PTC) is the most common type of all thyroid carcinomas and accounts for up to 90% of all thyroid malignancies. It is the most indolent form of the disease and has an excellent prognosis. On the other hand, Primary thyroid lymphoma (PTL) is a rare entity accounting for only about 1% to 5% of all thyroid malignancies and only 2% of extranodal lymphomas. Synchronous PTC and PTL is a very rare condition and only a few cases have been reported in the literature up till now. We report one such case in a 52-year-old lady who was referred to us with goiter and progressively increasing difficulty in breathing.