Anaplastic thyroid carcinoma in a retrosternal goiter presenting as fever of unknown origin
Article Abstract:
Tumors often cause prolonged fevers with unknown origin, although cancer of the thyroid gland is not usually associated with the occurrence of fever. A case is described of a 66-year-old woman with complaints of a fever and dry cough lasting three weeks. She had a retrosternal goiter, an enlarged thyroid gland displaced behind the sternum (the narrow flat bone lying in the center of the front of the chest). Her physical examination, thyroid function tests, laboratory findings and X-rays were normal, although there were some abnormalities in the blood. Antibiotics and steroids did not affect the course of the disease, and after three months she developed hoarseness, although imaging techniques did not show any physical changes other than enlargement of the goiter. Surgery revealed the presence of a rapidly growing cancer within the enlarged thyroid gland. The patient died 10 days after the operation, probably due to a pulmonary embolism, a mobile blood clot in the lungs. This case is unusual in that: (1) there are no reports of fevers associated with thyroid cancer; (2) this rapidly-growing cancer in the enlarged and displaced thyroid gland delayed the detection and diagnosis of the tumor; and (3) common imaging techniques failed to detect the thyroid cancer. This report suggests that the occurrence of fever with no known cause in retrosternal goiter may result from the presence of cancer.
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Neurologic manifestations of giant cell arteritis
Article Abstract:
Giant cell arteritis (GCA), also called temporal arteritis, is the chronic inflammation of the large arteries, such as the temporal and occipital arteries located in the head region, and the ophthalmic artery located in the eye. This condition is also accompanied by the presence of giant cells. GCA leads to thickening of the intima, the interior lining of the blood vessel, with subsequent narrowing and blockage of the lumen, the blood vessel cavity. Elderly persons are commonly affected, and GCA is associated with several disorders of the nervous system, including blindness and stroke, the sudden loss of consciousness followed by paralysis due to hemorrhage the brain. GCA is too often thought of as a disease of the temporal arteries, the blood vessels located in the temples, and many rare nerve-related symptoms of GCA are not recognized. A better understanding of the disease process (pathophysiology) of GCA will help in identifying less common symptoms, and in allowing rapid diagnosis and treatment to avoid further progression of the disease. The pathophysiology and neurologic symptoms of GCA, particularly disorders of the eye, are reviewed. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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