Indian Journal of Endocrine Surgery and Research

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Volume 17, Number 1, January-June 2022

LETTER FROM IAES PRESIDENT'S DESK

Kailash C Mohapatra

Letter from IAES President's Desk

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/ijesr-17-1-iv  |  Open Access |  How to cite  | 

MESSAGE FROM THE DESK OF EDITOR IN CHIEF

Pooja Ramkant

Message from the Desk of Editor in Chief

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/ijesr-17-1-v  |  Open Access |  How to cite  | 

Announcement

Announcement

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/ijesr-17-1-vii  |  Open Access |  How to cite  | 

EDITORIAL

Mallika Tewari

Cancer Care in India

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:3] [Pages No:1 - 3]

Keywords: Cancer Care India, National Cancer Control Programme

   DOI: 10.5005/jp-journals-10088-11192  |  Open Access |  How to cite  | 

Original Article

Pooja Ramakant, Meenakshi Yeola

Identification of Challenges Faced by Medical Faculties Trained in Curriculum Implementation Support Program in Implementation of New MBBS Curriculum

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:4] [Pages No:4 - 7]

Keywords: Competency-based medical education, Curriculum implementation support program workshop, Medical curriculum

   DOI: 10.5005/jp-journals-10088-11180  |  Open Access |  How to cite  | 

Abstract

We planned to do a study to document the various challenges faced by medical faculties while implementing the new competency-based curriculum for the medical graduates. The study was planned as a survey, and Google form-based questionnaire was sent to all faculties residing in Uttar Pradesh and who had completed curriculum implementation support program (CISP) workshop from King George's Medical College during years 2019–2020. The questions were designed keeping in mind the relevant issues such as time constraints, resources, team work, coordination, financial constraints, feasibility of practically implementing the new curriculum, and how mature are our students in adapting to the new methods of teaching. Many faculty members could not respond to the questionnaire as they were preoccupied with COVID pandemic crisis management. Majority of the faculties found mild to moderate level of difficulty in understanding the new curriculum. There was mixed response in regard to practical implementation of the new curriculum as 44% found moderate level of difficulty and resistance to adapt to the new system. Forty-three percent faced financial constraints in establishing the skills lab. Fifty-nine percent agreed that they had enough teaching learning methods. Majority found limited manpower, lack of enthusiasm, limited time especially in COVID pandemic, and online mode of teaching methods, lack of adequate resources, and difficulty in coordination as the challenging issues in implementation of the new curriculum. The solutions they suggested were to have regular meetings, listen to the problems and work on solutions, periodically motivate the faculties to adapt to the new system, train all faculties in CISP workshop, and to have short-term and long-term goals well defined to track the progress.

PERSONAL EXPERIENCE

Pooja Ramakant

When a Surgeon is a Patient Himself Undergoing Surgery: My Personal Experience

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:2] [Pages No:8 - 9]

   DOI: 10.5005/jp-journals-10088-11187  |  Open Access |  How to cite  | 

CASE REPORT

Mithun Raam, Kul Ranjan Singh, Pooja Ramakant, Anand Kumar Mishra

All that Glitters is not Gold — Lateral Cervical Dermoid Cyst — Thyroglossal Duct Variant

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:4] [Pages No:10 - 13]

Keywords: Dermoid cyst, Etiopathogenesis, Lateral neck swelling, Solitary thyroid nodule

   DOI: 10.5005/jp-journals-10088-11190  |  Open Access |  How to cite  | 

Abstract

Dermoid cysts are rare, embryonically derived swellings that arise along line of embryonic fusion, usually in the midline of the neck. We report a rare case that was diagnosed clinically as a solitary nodule of the thyroid gland but was reported to be a dermoid cyst of the lateral cervical (thyrohyoid) region and discuss its etiopathogenesis, clinical presentation, imaging, and management.

CASE REPORT

Shreya Surendra, Priyanka Rohit Singh, Supriya Sen, Varghese Thomas, Shawn Sam Thomas, Deepak Thomas Abraham, MJ Paul

Case Report of Rare Hereditary Endocrine Cancer Syndrome: Multiple Endocrine Neoplasia Type 2B

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:3] [Pages No:14 - 16]

Keywords: Medullary thyroid carcinoma, Mucosal neuromas, Multiple endocrine neoplasia type 2B

   DOI: 10.5005/jp-journals-10088-11188  |  Open Access |  How to cite  | 

Abstract

Multiple endocrine neoplasia type 2B (MEN2B) is an extremely rare hereditary thyroid cancer syndrome. The individuals are presented with an aggressive form of medullary thyroid carcinoma (MTC). They have classic morphology features that aid in the diagnosis of the syndrome.

CASE REPORT

Jnaneshwari Jayaram, Anita Dhar, Suneha Kumari, Kanika Sharma, Hemant Sachani, Shamim Ahmed Shamim, Mehar Chand Sharma, Anurag Srivastava

Multiple Paragangliomas with Novel Mutation: A Rare Entity

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:4] [Pages No:17 - 20]

Keywords: Carotid body tumor, Novel mutation, Paraganglioma, Succinate dehydrogenase

   DOI: 10.5005/jp-journals-10088-11182  |  Open Access |  How to cite  | 

Abstract

Head and neck paragangliomas (HNPGLs) are rare, rarely functional tumors known to have a genetic predisposition. Carotid body tumors (CBT) are the most common HNPGLs followed by jugular bulb tumors, vagus nerve, and tympanic plexus. The prevertebral region is not the known area for these tumors as seen in our case making it a rare case. Mutations in SDH-D linked genes are commonly associated with multiple HNPGLs. SDH-D mutations with single-gene deletion are rare as seen in the present case. Bilateral carotid body tumors need to be managed in a staged manner. Patients with HNPGLs need annual clinical, hormonal, and radiological, surveillance for early diagnosis and management. First-degree relatives, especially males, need surveillance as SDH-D mutations exhibit maternal imprinting. We describe here the management of a middle-aged male who came with neck swelling on evaluation and was found to have nonfunctional bilateral carotid body tumors, mediastinal, and a rare prevertebral tiny lesion.

CASE REPORT

Chanchal Rana, Kulranjan Singh, Pooja Ramakant, Anand Mishra

PD-L1-positive Anaplastic Transformation in a BRAF V600E Expressing Papillary Thyroid Carcinoma with Cutaneous Metastasis: An Unusual Case Report

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:3] [Pages No:21 - 23]

Keywords: Anaplastic transformation, Cutaneous metastasis, Papillary, Thyroid

   DOI: 10.5005/jp-journals-10088-11178  |  Open Access |  How to cite  | 

Abstract

Cutaneous metastasis in thyroid carcinoma is extremely rare (<1%) and usually accompanies follicular and papillary thyroid carcinoma (PTC). Less than 20 cases of anaplastic thyroid carcinoma with cutaneous metastasis have been described so far. We present a case of a 53-year-old male who presented with a longstanding thyroid swelling with a history of rapid increase for 2 months associated with bilateral cervical lymphadenopathy. Fine needle aspiration cytology revealed a variable picture from both lobes of the thyroid with PTC in the left lobe and anaplastic carcinoma in the right lobe. Total thyroidectomy with bilateral modified radical neck dissection was performed which supported the cytology findings. BRAF V600E and PD-L1 expression were analyzed using immunohistochemistry. Postoperatively, the patient received radioactive iodine ablation therapy, but developed cutaneous metastasis in the neck and thoracic region, which on fine needle aspiration cytology revealed metastatic anaplastic thyroid carcinoma. The patient did not respond to the therapy and succumbed to the disease within a month after surgery. Cutaneous metastasis may develop in thyroid carcinoma, which must be differentiated from skin adnexal malignancies due to different management strategies. BRAF V600E and PD-L1 expression in primary thyroid tumors can identify the possible cases who may benefit from immunotherapy, which can lead to an improved overall survival.

CASE REPORT

Sagnik Roy, Nitin Agarwal, Apoorva Mardi

A Case of Multiple Pulsatile Scalp Metastases Secondary to Occult Follicular Thyroid Carcinoma

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:3] [Pages No:24 - 26]

Keywords: Euthyroid, Follicular thyroid carcinoma, Occult

   DOI: 10.5005/jp-journals-10088-11183  |  Open Access |  How to cite  | 

Abstract

Background: Follicular thyroid carcinoma (FTC) is the second most common thyroid malignancy after papillary thyroid Ca, but compared to papillary Ca, it has a greater tendency to metastasize to the lung (mc) and then the bones. The incidence of skull metastasis in FTC ranges from 2.5 to 5.8%, and in most reported cases, metastasis occurred after the diagnosis and treatment of primary tumor; but in few cases, skull metastasis becomes the presenting feature of an occult FTC. Herein, we report a patient with an occult FTC presenting with multiple pulsatile scalp metastases. Case: A 50-year-aged lady presented to surgical OPD with multiple scalp swellings for 1 year post trivial trauma. There were no other swellings in neck or other parts of the body or any complaints s/o of hypo- or hyperthyroidism. On examination, there were three pulsatile, nonmobile, irregular, firm-to-hard swellings on scalp; thyroid and neck examination were normal, and no lymph nodes were palpable. Contrast-enhanced computed tomography head and X-ray skull showed multiple focal lytic lesions involving outer and inner tables of the skull. Ultrasonography neck showed no thyroid nodules and no lymph nodes. Fine-needle aspiration cytology of scalp showed repetitive microfollicles and clusters of follicular cells s/o follicular thyroid Ca with scalp metastasis. Patient operated by palliative total thyroidectomy and referred for radioiodine ablation. Conclusion: Skull metastasis is a rare site for metastasis of FTC. In most reported cases, skull metastases of FTC were located in the skull base or occipital area. In our case, it was seen in occipital, parietal, and frontal bone. So thyroid examination and early detection and evaluation of thyroid nodules may help to diagnose thyroid carcinoma before distant metastasis occurs.

SHORT COMMUNICATION

D VNSSVAMS Mahalakshmi, Sabaretnam Mayilvaganan, Sarrah Idrees, Nidhi Tripathy, PRK Bhargav, Sapana B Jain, Aromal Chekavar

Pemberton's Sign Revisited after 75 Years

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:2] [Pages No:27 - 28]

Keywords: Hugh Spear, Pemberton's maneuver, Respiratory distress

   DOI: 10.5005/jp-journals-10088-11185  |  Open Access |  How to cite  | 

SHORT COMMUNICATION

Sabaretnam Mayilvaganan, Prathyusha Godi, Sarrah Idrees, PRK Bhargav

“Thyroid Surgery Using Hypnosis—An Old Wine in a New Bottle”

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:1] [Pages No:29 - 29]

Keywords: Hypnosis, Thyroid cancer, Thyroid surgery

   DOI: 10.5005/jp-journals-10088-11181  |  Open Access |  How to cite  | 

LETTER TO THE EDITOR

PRK Bhargav, Sabaretnam Mayilvaganan, D VNSSVAMS Mahalakshmi, Sarrah Idrees, Rijuta Aphale, Sapana B Jain, Aromal Chekavar, Rinelle Mascarenhas

A to Z of Endocrine Surgical Practice

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:1] [Pages No:30 - 30]

Keywords: Hail history taking, Laparoscopic options, Refresh radiology

   DOI: 10.5005/jp-journals-10088-11179  |  Open Access |  How to cite  | 

View Point

Sabaretnam Mayilvaganan, Sarrah Idrees, PRK Bhargav, Sapana B Jain, D VNSSVAMS Mahalakshmi, Aromal Chekavar

Interesting but Unusual Two Poster Presentations in Endocrine Surgery

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:4] [Pages No:31 - 34]

Keywords: Endocrine surgery, Poster, Presentation

   DOI: 10.5005/jp-journals-10088-11186  |  Open Access |  How to cite  | 

Abstract

A poster presentation is an effective way to communicate the research in a short, concise, and informative format. These poster presentations are considered by many endocrine surgeons as an easy task, but actually require a lot of thought and preparation to achieve success. We present two different types of poster presentation: First one with 3D picture technique, and the second one, a video poster and how it impacted presentation.

View Point

Pallavi Prasad, Shikha Khati, Mayilvaganan Sabaretnam, Rinelle Mascarenhas, Sarrah Idrees, D VNSSVAMS Mahalakshmi, PRK Bhargav

Papillary Microcarcinoma Post-hemithyroidectomy –Completion or Follow-up?

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:3] [Pages No:35 - 37]

Keywords: Completion, Hemithyroidectomy, Multifocal, Papillary microcarcinoma, Thyroid

   DOI: 10.5005/jp-journals-10088-11189  |  Open Access |  How to cite  | 

Abstract

Papillary microcarcinoma (PMC) is on the rise, and so is multifocal PMC. We present an image collage of a case of multifocal PMC and briefly review the literature.

Photo Assay

Pooja Ramakant, Ganesh Bhat, Kul Ranjan Singh, Anand Mishra

Interesting Image of Very Large Level 1 to 4 Lymph Nodal Recurrences in a Patient with Papillary Thyroid Cancer

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:2] [Pages No:38 - 39]

Keywords: Endocrine cancer, Papillary thyroid carcinoma, Presentation, Thyroid surgery

   DOI: 10.5005/jp-journals-10088-11191  |  Open Access |  How to cite  | 

REVIEW ARTICLE

Gopal Puri, Komal Gupta, Chitresh Kumar

The Panorama of Hyperparathyroidism

[Year:2022] [Month:January-June] [Volume:17] [Number:1] [Pages:12] [Pages No:40 - 51]

Keywords: Hypercalcemia, Hyperparathyroidism, Primary hyperparathyroidism

   DOI: 10.5005/jp-journals-10088-11184  |  Open Access |  How to cite  | 

Abstract

Hyperparathyroidism occurs due to increased production of the parathyroid hormone (PTH) from the parathyroid glands. This can stem from abnormal secretion of the hormone as seen in primary and tertiary hyperparathyroidism. It can also be caused by defective homeostasis of the calcium metabolism, which can stimulate the production of PTH as in secondary hyperparathyroidism. The third most common endocrine disorder is primary hyperparathyroidism (PHPT), with its incidence being the highest among postmenopausal women. Seventy to eighty percent are asymptomatic, and the symptoms are related to chronic hypercalcemia rather than the elevated hormone levels. In the symptomatic group, nephrolithiasis is the most common followed by osteoporosis and increased fracture risk. With the advent of new diagnostic modalities, the severe presentation of the disease has decreased. Surgical excision of the gland(s) is a modality of choice for PHPT. Medical management is done using bisphosphonates, hormone replacement therapy, and calcimimetics and is usually required for mild disease. Secondary hyperparathyroidism occurs when the body tries to compensate for the low levels of ionized calcium by overproduction of the hormone. In the older population, vitamin D deficiency is a common cause of secondary hyperparathyroidism. Another cause is chronic kidney disease (CKD); these patients present with bone disease termed as osteodystrophy. It is also associated with cardiovascular disease and increased mortality. Treatment of secondary hyperparathyroidism is primarily medical using vitamin D supplements and calcium-based phosphate binders and calcimimetics. Dialysis is used for the management of acute nature. Tertiary hyperparathyroidism is usually a result of long-standing secondary hyperparathyroidism with autonomous parathyroid production. It can also occur with a few genetic diseases. Total parathyroid gland removal with autotransplantation in the forearm is the preferred management.

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