Epidermal inclusion cyst in the thyroid gland.

Epidermal inclusion cysts (EIC) are common benign lesions of the skin, ovaries, and testicles. However, their occurrence in thyroid gland is rare. We reported a case in which a 57-year-old male patient with history of nontoxic uninodular goiter presented with dysphonia and dysphagia. The cytology of ultrasound guided fine needle aspiration of the thyroid nodule revealed epidermal cyst. Despite the benign presentation. The patient underwent lobectomy to relieve his clinical symptoms and the surgical pathology exam confirmed the diagnosis of benign thyroid cyst, consistent with EIC of the thyroid.

Primary peritoneal carcinoma metastasizing to breast: a single case report and literature review from clinic to biology.

Primary peritoneal carcinoma (PPC) is a type of rare malignant epithelial tumor. Metastasis from PPC to breast has been rarely reported. PPC originates de novo from the peritoneal tissues rather than invasion or metastasis from adjacent or remote organs. PPCs have been implicated in many cases of carcinomas of unknown primary origin. It is similar to ovarian cancer (OvCa), because it shares the same common embryonic origin, the coelomic epithelium (mesodermal origin). The mechanism of oncogenesis remains elusive. In this article, we report a rare case of PPC in a patient 10 years after total abdominal hysterectomy and bilateral salpingooophorectomy for uterine leiomyoma, which was widely spread in the abdomen and metastasized to the colon, liver and distant organs including breast. The treatment is similar to that of primary ovarian cancer. We also reviewed the primary peritoneal cancer metastatic to breast and discuss the possible mechanisms and biology of primary peritoneal cancer, using experimental and animal model.

Tuberculous empyema presenting as a persistent chest wall mass: case report.

Empyema necessitatis is an empyema that spreads outside of the pleural space involving the chest wall. Tuberculosis is the most common cause. It occurs in both immunocompetent and immunocompromised patients. Due to the long latency period and the paucity of symptoms, diagnosis can be challenging. Clinicians must have a high awareness of this disease, especially in patients from endemic regions. The disease is treatable with surgical and medical interventions. Failure to diagnose can lead to grave consequences for both the individual patient and public health. This is particularly true in endemic regions where controlling the spread of TB is challenging. We report a rare presentation of pulmonary tuberculosis in an otherwise healthy 72-year-old USA immigrant from Thailand. He presented with a painless, chronic chest wall swelling with minimal systemic symptoms. Imaging revealed empyema necessitatis. Histopathology could not give a definitive diagnosis because the tissue was too necrotic. Despite negative acid-fast staining, sputum cultures were positive for tuberculosis. The case presentation is followed by a brief review of the current relevant literature. This case highlights the importance of clinical suspicion and increased awareness for this silent but serious infection.

Cytomegalovirus infection presenting as a colonic mass in a patient with acquired immunodeficiency syndrome.

Cytomegalovirus (CMV) infection of the gastrointestinal tract occurs in both immunocompromised and immunocompetent hosts. Often presenting as ulcerative lesions, CMV infection rarely presents as a mass lesion in the gastrointestinal tract. We present a case of a discrete colonic mass caused by CMV infection in a patient with acquired immunodeficiency syndrome (AIDS). This case illustrates that an infectious process such as CMV should be considered along with malignancy as the etiology of a mass lesion present in the gastrointestinal tract of patients with AIDS.

Cardiac aspergillosis in patients with acquired immunodeficiency syndrome: a case report and review of the literature.

Cardiac aspergillosis is uncommon in patients with acquired immunodeficiency syndrome (AIDS) in the absence of open heart surgery. We report a unique case of a 62-year-old man with AIDS who developed Aspergillus pancarditis with Aspergillus vegetations on mitral valve without evidence of pulmonary aspergillosis. There was extensive embolization to the brain and multiple foci of Aspergillus infection in kidneys and adrenal glands. There are only 10 documented cases of cardiac aspergillosis in the literature (1966-2003) in severely immunocompromised AIDS patients with CD4 T-lymphocyte counts ranging from 10 to 121 cells/muL. The cardiac aspergillosis could result from invasive pulmonary aspergillosis, either by hematogenous dissemination or by direct invasion, and skin Aspergillus infection can be carried through the bloodstream to the right heart in intravenous drug abusers. Most of the reported cases of cardiac aspergillosis were diagnosed at autopsy. Mortality among AIDS patients with cardiac aspergillosis is 100%, despite appropriate therapy.