Year 2021, Volume 5 - Issue 12

Background: Merkel cell carcinoma is a rare skin malignancy of neuroendocrine origin that is highly aggressive and frequently metastasizes. Case Presentation: We present a case of Merkel cell carcinoma in which the patient developed metastatic gastric deposits that led to his admission to the acute medical unit with signs consistent with an upper gastrointestinal bleed. Treatment options in this case were limited to palliative radiotherapy (RT) given the patient’s multimorbid state. Unfortunately, our patient deteriorated during his admission and passed away. Conclusion: There have been few reports of Merkel cell carcinoma metastasizing to the stomach. In this case, we highlight an immediately life-threatening presentation with upper gastrointestinal bleeding that required prompt endoscopic intervention. The relatively recent initiation of immunotherapy as a management option for this underlying condition introduces a shift in treatment options that were previously limited to RT and chemotherapy.

Background: Mature teratomas are common tumors in the pediatric population. They can arise in the central nervous system and often require surgical resection. They are classified as non-germinomatous germ cell tumors and their recurrence are extremely rare. Case Presentation: We are reporting the case of a 6-year-old boy who was diagnosed with mature pineal teratoma after he presented with signs of acute hydrocephalus. Histopathology did not reveal any other germ cell tumor component. He underwent a complete resection of the mass, with no adjuvant chemotherapy. Nine years post-operatively, magnetic resonance imaging results showed recurrence of the pineal tumor as a germinoma. Chemotherapy and radiotherapy resulted in significant shrinkage of the mass and resolution of the clinical symptoms. Conclusion: This case illustrates the possibility of the late recurrence of a germinoma after the complete removal of a mature intracranial teratoma. It also raises the issue of whether mature teratomas should be treated with adjuvant therapy after surgical resection to prevent their recurrence as another germ cell tumor.

Background: Extremity foreign body traumas are common injuries occurring symptoms after 10 years is a rare entity. We are presenting two cases as an example of this situation. Case Presentation: In the first case, a 30-year-old male patient was admitted to the outpatient clinic with complaints of swelling and pain in the right forearm for 3 weeks. The patient had a history of foreign body injury after punching glass 10 years ago. Physical examination of the patient revealed a 4 cm incision scar in the anteromedial of the right forearm with swelling and tenderness. Radiological evaluation revealed a 3 × 1 cm-sized foreign body resembling a glass fragment. In the second case, a 36-year-old male patient was admitted to the clinic with swelling and pain in the left foot. Examination revealed tenderness in the first webspace. The patient had a history of foot injury with a nail 24 years ago. Both patients had removal surgery and complaints regressed in the postoperative clinical follow-up. Conclusion: In these two foreign body injuries, symptoms that occurred years after injury and removal were necessary. It should be always kept in mind that foreign body injuries might cause late injuries, even years after. Therefore, these injuries should always be on mind.

Background: Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (pHPT). Mutations of the cell division cycle protein 73 homolog (CDC73) gene are associated with both sporadic and familial pHPT and PC, including hyperparathyroidism-jaw tumor (HPT-JT) syndrome. Case Presentation: A 38-year-old man presented with severe hypercalcemia and acute renal injury due to pHPT. He had a palpable left cervical mass of 50 mm, characterized by both ultrasound and 99mTc-sestamibi scintigraphy as an enlarged hyperfunctioning parathyroid gland. Histological diagnosis after parathyroidectomy was of PC. During follow-up, patient developed metastasis of the skin, mediastinal lymph-nodes, and lungs. Even after surgical excision of all detectable metastasis parathyroid hormone (PTH) remained elevated. Genetic analysis found a germline mutation (c.766_767delGT) of the CDC73 gene, which was not previously reported in PC. Conclusion: Germline CDC73 analysis may be considered in HPT-JT syndrome, familial isolated pHPT, PC, and young individuals with pHPT.

Background: Papillary thyroid cancer (PTC) accounts for 90% of the thyroid malignancies with predominance in females. Distant metastasis is usually seen in lungs and bones. The treatment of metastatic papillary cancer thyroid is total/near total thyroidectomy followed by radioactive iodine (RAI) ablation. Lung metastasis shows a good response to RAI therapy. Case Presentation: We describe a case of a 22-year-old female, referred to the nuclear medicine department after surgery for RAI ablation. The patient was diagnosed case of PTC. The first dose of 100 mCi of RAI under steroid cover was given. The post-therapy scan showed bilateral pulmonary metastasis. However, follow-up I-131 whole-body imaging after 2 years showed no evidence of functioning thyroid tissue/metastasis. Conclusion: PTC with lung metastasis has a good prognosis and better survival in young patients treated with RAI. A single dose of RAI (I-131) may cure extensive lung metastasis.