Extrathyroid implantation or dissemination of thyroid tissue secondary to a thyroid procedure is rare. Most of these belonged to thyroid carcinoma with metastatic potential and uncommon for benign pathologies.
We report the case of a 31-year-old female who was identified to have multiple subcutaneous implantation of thyroid tissue 5 years after transoral endoscopic thyroidectomy vestibular approach. A comprehensive literature search on implantation of thyroid tissue secondary to thyroid procedures was performed.
Accidental tearing of the capsule during previous surgery may lead to the subcutaneous implantation. Through literature review, a total 29 articles with 47 patients were identified. 33.3% were benign lesions, and implantation was mostly secondary to fine needle aspiration biopsy (46.5%).
Subcutaneous or port site implantation after endoscopic thyroid surgery may occur in benign thyroid pathologies and therefore, oncologic principles must be strictly followed during surgery regardless of its histopathological nature.

BACKGROUND: We have performed an updated meta-analysis of randomized controlled trials (RCT) comparing total thyroidectomy (TT) with less than total thyroidectomy (LTT) for benign multinodular non-toxic goiter (BMNG).
OBJECTIVE: The objective was to evaluate the effects and outcomes of TT as compared to LTT.
METHODS: Eligibility criteria: RCTs comparing TT vs LTT.
METHODS: PubMed, Embase, Cochrane Library and online registers were searched for articles comparing TT with LTT. Risk of bias: Articles were assessed for risk of bias using the Cochrane\'s revised tool to assess risk of bias in randomized trials (RoB 2 tool).
RESULTS: The main summary measures were risk difference using a random effects model.
RESULTS: Five randomized controlled trials were included in the meta-analysis. Recurrence rate was lower for TT compared to LTT. Adverse events like temporary or permanent recurrent laryngeal nerve (RLN) palsy and permanent hypoparathyroidism were similar in both groups except for the rate of temporary hypoparathyroidism which was lower in the LTT group.
CONCLUSIONS: All studies had unclear risk of bias for blinding of the participants and personnel and high risk of bias for certain selective reporting. This meta-analysis did not show any clear benefit or harm of either procedure (TT vs LTT) for goiter recurrence and re-operation rates (for both recurrence and incidental thyroid cancer). However, re-operation for goiter recurrence was significantly higher in the LTT group based on a single RCT. Evidence suggests increased rates of temporary hypoparathyroidism with TT but there was no difference in the rate of RLN palsy and permanent hypoparathyroidism between the two methods. The overall quality of evidence was low to moderate.

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BACKGROUND: The clinical and pathologic spectrums of goitres are wide. Even though Nigeria\'s Federal Capital Territory is within the geographic goitre bed, there is a paucity of thyroidrelated data from this region. The objective of this study was to determine the clinical presentation, management and outcomes of patients with goitre operated-on at the Department of Surgery, Asokoro District Hospital, in Abuja, Nigeria.
METHODS: This is a retrospective study involving patients managed between January 2001 and December 2015. Data were extracted from patients\' medical records, operation registers, and histopathology records. Variables were; age, sex, diagnosis, types of operation performed, post-operative complications and histological findings. All patients had general anaesthesia via cuffed endotracheal intubation and the surgical technique used was skin crease transverse collar stud incision.
RESULTS: One hundred and thirty four (134) patients were involved in the study: 124(92.5%) were females and 10(7.5%) males. Mean age was 38years±11.0SD. Seventy-seven (57.5%) patients had simple multi-nodular goitre, followed by simple left nodular goitre 20(14.9%) and simple right nodular goitre 17(12.7%). One hundred and twenty-one (90.5%) patients did not have any complications. On histologic examination, most of the lesions were multinodular goitres 60(44.8%), followed by simple nodular goitres, 23(17.2%). Follicular adenoma was the commonest neoplastic variant accounting for 12(9.1%) cases.
CONCLUSIONS: The pattern of goitres in Abuja simulates that from other parts of Nigeria and many other African countries though with fewer malignancies in the present study. The management and outcome of goitres in Asokoro District Hospital Abuja is comparable to those obtained from other centres in Nigeria. Pre-and postoperative complications were also minimal.
UNASSIGNED: Le spectre clinique et pathologique des goitres sont larges. Bien que le territoire de la capitale fédérale du Nigeria se trouve dans le lit géographique du goitre, il y a peu de données sur la thyroïde dans cette région. L’objectif de cette étude était de déterminer la présentation clinique, la gestion et les résultats des patients atteints de goitre opérés au département de chirurgie de l’hôpital du district d’Asokoro, à Abuja, au Nigeria.
UNASSIGNED: Il s’agit d’une étude rétrospective portant sur des patients pris en charge entre janvier 2001 et décembre 2015. Les données ont été extraites des dossiers médicaux des patients, des registres d’opérations et des dossiers d’histopathologie. Les variables étaient : l’âge, le sexe, le diagnostic, les types d’opérations pratiquées, les complications postopératoires et les résultats histologiques. Tous les patients ont bénéficié d’une anesthésie générale par une intubation endotrachéale à ballonnet, et la technique chirurgicale utilisée était l’incision transversale du pli cutané incision du collet.
UNASSIGNED: Cent trente-quatre (134) patients ont participé à l’étude: 124 (92,5%) étaient des femmes et 10 (7,5%) des hommes. L’âge moyen était de 38 ans±11,0SD. Soixante-dix-sept (57,5 %) patients présentaient un goitre simple et multi-nodulaire, suivi d’un goitre nodulaire simple gauche 20(14,9%, et le goitre nodulaire simple droit 17 (12,7 %). Cent vingt et un (90,5 %) patients n’ont présenté aucune complication. A l’examen histologique, la plupart des lésions étaient des goitres multinodulaires 60(44,8%), suivis par des goitres nodulaires simples, 23(17,2%). L’adénome folliculaire était la variante néoplasique la plus courante avec 12 cas (9,1 %).
CONCLUSIONS: Le modèle de goitres à Abuja simule celui d’autres régions du Nigeria et de nombreux autres pays africains, bien qu’avec moins de tumeurs malignes dans la présente étude. La gestion et le résultatmde goitres à l’hôpital du district d’Asokoro à Abuja sont comparables à celles obtenus dans d’autres centres au Nigeria. Les complications pré et postopératoires étaient également minimes.
UNASSIGNED: Goitres, modèle, résultat de la gestion, Abuja.

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To search for effective and safe methods aimed at reducing the frequency of surgical treatment for nodular thyroid pathology. 1999-2019 literature review conducted using NLM databases. There is more and more evidence in the literature on the efficacy and safety of minimally invasive treatments for thyroid nodular disease. Based on the literature data, it was revealed that the most effective technique for minimally invasive treatment is laser thermal ablation of thyroid nodules under visual control. This technique can be considered an alternative to surgical intervention in the treatment of benign thyroid nodules and, in most cases, leads to a decrease or complete disappearance of the nodule, clinical manifestations, or cosmetic defects. Unlike surgical treatment, it is practically devoid of the likelihood of formidable complications and, as a rule, passes without any threatening consequences for the patient. While the use of laser thermal ablation is expanding, the international medical community has begun to incorporate this technique into treatment guidelines and is making efforts to disseminate it in general clinical practice. Since the method of laser thermal ablation can be considered an effective alternative to surgical intervention for the treatment of benign thyroid nodules, it is necessary to widely introduce it into the general clinical practice in Russia and algorithms for providing medical care to patients with nodular goiter. The introduction of imaging-guided laser thermal ablation into clinical practice and its inclusion in the algorithms for the provision of medical care to patients with thyroid nodular pathology will significantly improve the quality and availability of medical care for patients with thyroid nodular pathology.

Establish outcomes following cochlear implantation (CI) in patients with Pendred syndrome. Systematic review and narrative synthesis. Databases searched: Medline, Pubmed, Embase, Web of Science, Cochrane Collection and ClinicalTrials.gov. No limits placed on language or year of publication. Review conducted in accordance with the PRISMA statement. Searches identified 251 abstracts and 242 full texts. Of these, 22 studies met inclusion criteria reporting outcomes in 231 patients with at least 234 implants. Hearing outcomes were generally good with patients experiencing useful functional improvement. A total of 46 minor complications were reported in 78 cases. The methodological quality of included studies was modest, predominantly consisting of case reports and non-controlled case series with small numbers of patients. All studies were OCEBM grade III-IV. Hearing outcomes following CI in Pendred syndrome are generally good with useful functional improvement. However, outcomes reported in published studies lack long term follow up.

Investigating novel biomarkers discriminating thyroid nodules is a matter of great importance for differential diagnosis. The current study was planned to investigate the diagnostic value of fibulin-1 in plasma specimens of patients with thyroid nodules. A literature review was also performed to gain an understanding of the existing research relevant to the main role of fibulin-1 in carcinogenesis. In this case-control study, the levels of plasma fibulin-1 were compared in 82 subjects including papillary thyroid cancer (PTC; n = 30), multinodular goiter (MNG; n = 30), and healthy subjects (n = 22) using enzyme-linked immunosorbent assay (ELISA). Fibulin-1 levels of patients with PTC and MNG were documented to be significantly lower than those of healthy subjects (PTC vs. Healthy; P = 0.000, MNG vs. Healthy; P = 0.000). No statistically significant differences were found between PTC and MNG groups when fibulin-1 levels were compared (P > 0.05). Low level of plasma fibulin-1 was associated with an increased risk of PTC tumorigenesis (odds ratio = 0.810; 95% CI: 0.704-0.933; P = 0.003). Further, fibulin-1 had an appropriate diagnostic value for detecting PTC patients with a sensitivity of 73.33%, and specificity of 100% at the cutoff value > 4.9 (ng/ml). According to the results of the present research which are tied well with previous studies, the abnormal downregulation of fibulin-1 may play a role in the PTC and MNG tumorigenesis. In addition, fibulin-1 probably promotes the development and progression of other human cancer; however, further studies are needed to improve current understandings.

Pituitary blastoma is a malignant neoplasm of the pituitary gland that was recognized by the World Health Organization in 2017. It is commonly diagnosed in children before 24 months of age. Here, we report the first case of a young adult patient who was diagnosed with pituitary blastoma with increased levels of growth hormone instead of adrenocorticotropic hormone and provide a review of the literature.
A 19-year-old woman presented to our hospital with visual disturbance. She had a medical history of Wilms\' tumor and multinodular goiter. The brain imaging showed a 3.2 × 2.5 × 1.8-cm solid sellar and suprasellar cystic mass that upwardly displaced the optic chiasm. She had an elevated level of growth hormone but a normal level of adrenocorticotropic hormone, cortisol, and prolactin. The mass was subtotally removed through the left pterional craniotomy. The pathologic examination suggested a pituitary blastoma. Thereafter, the patient was treated with chemotherapy and radiotherapy. At 4-year follow-up postsurgery, her overall well-being is good.
Although in this case the patient was a young adult, pituitary blastoma should be taken into consideration when children have an enhanced sellar and suprasellar mass with peripherally located cysts.

There is an increased incidence of thyroid nodules and cancer. In this article, the reasons for this increase are evaluated and discussed. The factors causing increases in the incidence of nodules are the same as those causing increases in thyroid cancer. There are publications from all over the world regarding the rising incidence of thyroid cancer; it is especially associated with papillary cancer. The literature was reviewed and evaluated with regard to this significant phenomenon. Thyroid-stimulating hormone (TSH) is the main mitotic factor. Any agent that elevates TSH will stimulate nodule formation. Therefore, the incidence of thyroid nodules is high in endemic goiter regions due to iodine deficiency. This paper has described many of the factors causing this higher incidence. Of note, metabolic syndrome and insulin resistance are important factors associated with the increased incidence of nodular goiter and papillary thyroid cancer today. However, these data must be confirmed by other studies in the future.