RESUMEN
The case of a recurrent phosphaturic mesenchymal tumour of the maxillary sinus 10 years after the first surgical excision is reported. The neoplasm first presented with paraneoplastic osteomalacia causing a pathological femur fracture. A right maxillary sinus tumour was identified and treated thereafter. The patient had no local symptoms and serum electrolytes returned to normal after surgical removal of the tumour. However, 10 years later, the patient's urine Ca and P levels increased and an octreoscan detected a new tumour in the right maxillary sinus. Early diagnosis prevented the effects of the paraneoplastic activity of the neoplasm. This case emphasises the importance of specific, close follow-up, because the neoplasm rarely produces local signs indicating its position. To our knowledge, this is the first reported case of a late relapse presenting without relevant symptoms (local pain or swelling or pathological fractures).
Asunto(s)
Calcio/metabolismo , Hipofosfatemia/diagnóstico , Neoplasias del Seno Maxilar/diagnóstico , Recurrencia Local de Neoplasia/diagnóstico , Osteomalacia/metabolismo , Fosfatos/metabolismo , Fósforo/metabolismo , Densidad Ósea , Diagnóstico Precoz , Femenino , Fracturas del Fémur/etiología , Fracturas del Fémur/metabolismo , Fracturas Espontáneas/etiología , Fracturas Espontáneas/metabolismo , Humanos , Hipofosfatemia/etiología , Hipofosfatemia/metabolismo , Seno Maxilar/patología , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/metabolismo , Recurrencia Local de Neoplasia/metabolismo , Osteomalacia/etiología , Osteomalacia/prevención & controlRESUMEN
UNLABELLED: Multidisciplinary approach to follicular thyroid carcinoma with giant mandibular and multiple sites metastases. Case report Metastatic tumors generally have poor prognosis, with short survival period and rarely indication to surgical treatment. In case of thyroid-differentiated cancer with distant metastases, prognosis is usually better, because of the possibility of treating metastasis by Radio Ablation by 131Iodine, after surgery. We report the case of a 65 years old woman, presenting with a giant mandibular metastasis from follicular thyroid carcinoma, originating from a cervico-mediastinal nonfunctioning goiter, with lung metastases. After the diagnostic work-up, she underwent left hemi-mandibulectomy, reconstruction by the placement of a precustomized titanium plate with condylar prosthesis and total thyroidectomy. Subsequently the Patient was treated by Radio Ablation by 131 Iodine, in four consecutive sessions. She is alive with no progression of the neoplasm after forty-six months follow-up. Even in advanced differentiated thyroid carcinoma, surgery should be taken into consideration, to treat the patient by complementary therapies and to improve the prognosis in term of survival. KEY WORDS: Advanced differentiated thyroid carcinoma, Metastatic differentiated thyroid carcinoma.