Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ectopic lingual thyroid along with a normally located thyroid gland is an uncommon condition caused by an aberrant descent of thyroid during embryogenesis. It is more common among females and expresses during puberty, pregnancy and menopause. It is mostly associated with hypothyroidism. Patient usually presents with complaints of dysphagia, dysphonia and suffocation. Treatment of choice depends upon the primary complaint of the patient. We present the case of a young female who underwent tracheostomy to relieve respiratory tract obstruction during puberty and was later diagnosed as a case of ectopic lingual thyroid by radioactive iodine uptake and CT scan imaging. She had an associated hypothyroidism; patient was then put on thyroxine and after making her euthyroid she was operated by transoral route and her ectopic lingual thyroid was removed. She was discharged on a maintenance dose of thyroxin.
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PMID:A case report of coexistence of ectopic lingual thyroid with hypoplastic normal thyroid gland. 3206 34

This review aimed to provide an overview of the level of maturity of normal tissue complication probability (NTCP) models for head and neck cancer (HNC) patients. A systematic literature review was performed to retrieve NTCP models for HNC toxicities. Patient population characteristics, NTCP model and the predictors, treatment technique and endpoint definition were extracted per article. Models were then scored based on the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) consensus guidelines to evaluate their generalizability. 335 articles on photon and proton therapy of HNC were identified and 52 relevant articles were further analyzed. Eighteen articles on xerostomia and sticky saliva (TRIPOD types 1a-2b: 15; TRIPOD type 3: 1; TRIPOD types 4a: 1 & 4b:1), thirteen articles on dysphagia and tube feeding dependence (TRIPOD types 1a-2b: 7; TRIPOD type 3: 2; TRIPOD types 4a:2 & 4b:2), five articles on oral mucositis (TRIPOD types 1a-2b: 4; TRIPOD type 4b: 1), seven articles on hypothyroidism (TRIPOD types 1a-2b: 4; TRIPOD type 3: 1; TRIPOD types 4a: 1 & 4b:1), four articles on hearing loss and tinnitus (TRIPOD type 1a: 4) and ten articles on esophagitis (TRIPOD types 1a-2b: 9; TRIPOD type 4a: 1) were included. External validation studies of HNC NTCP models are scarce. Moreover, the majority of them were validating a model developed by the same researchers. Only 2 independent external validation studies were found. There is a strong need to publish external validation studies to get more mature NTCP models applicable in clinical practice.
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PMID:Generalizability assessment of head and neck cancer NTCP models based on the TRIPOD criteria. 3215 5

BACKGROUND Riedel's thyroiditis is a rare form of immunoglobulin G (IgG) 4-related invasive fibrosis of the thyroid gland; given its scarce incidence, standardized therapeutic guidelines are unavailable. Although complications are unusual, obstructive symptoms produced by the stony-hard goiter may put patients' lives at risk. The diagnosis must be biopsy-proven, and treatment consists of thyroid hormone replacement and anti-inflammatory drugs, although sometimes thyroidectomy may be required. CASE REPORT A 69-year-old woman presented with a 7-month history of progressive hypothyroidism and obstructive dysphagia. On physical examination, she had a large, stony-hard goiter. A Doppler ultrasound study revealed a massive, avascular enlargement of the thyroid gland. A computed tomography scan failed to demonstrate any extrathyroidal extension of the abnormal tissue. A Tru-Cut biopsy of the thyroid was performed. Extensive replacement of thyroid follicles by prominent bands of fibrous tissue was observed, with follicular obliteration and mild focal occlusive phlebitis. A lymphoplasmacytic infiltrate was clearly identified; no oxyphilic nor giant cells were found. On immunohistochemistry, the immunoglobulin G (IgG) 4/IgG ratio in the plasma cell infiltrate was 40%; increased serum IgG4 levels were also found, supporting the diagnosis of Riedel's thyroiditis. The patient was successfully treated with levothyroxine replacement and tamoxifen with prompt resolution of obstructive symptoms. CONCLUSIONS Fibrous thyroiditis should be considered in the differential diagnosis of primary hypothyroidism in a patient with a stony-hard goiter. Although steroids are often used as a therapeutic strategy for this disease, our patient had an excellent therapeutic response to tamoxifen, avoiding adverse effects associated with steroid therapy, the higher cost of monoclonal antibody therapy, and surgery-associated risks.
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PMID:IgG4-Related Fibrous Thyroiditis (Riedel's Thyroiditis): A Case Report. 3317 82


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