Background Anaplastic thyroid carcinoma is a rare and lethal disease that accounts for 1–2% of thyroid malignancies. It is an aggressive locoregional disease with a high rate of distant metastasis, a poor prognosis, and a mean survival rate of 3–6 months after diagnosis. This retrospective study aimed to analyse the clinical and pathological features of ATC to assess treatment procedures and its outcome. Methods We analysed data from 22 patients diagnosed with ATC from 2018 to 2021, using the Kaplan-Meier method and log-rank test to determine overall survival. Results Patients’ median age was 64.3 ± 17.1 years. Females were more affected (male/female ratio: 1:1.7); 14 cases occurred in females (63.6.4%), and eight in males (36.4%). The most common manifestations were neck enlargement (81.8%) and dyspnoea (72.27%), and the tumour size was > 4 cm in 17 (77.3%) patients. The percentage of cases that presented in clinical-stage IVA was 36.4%, with 31.8% presenting in clinical-stage IVB and 31.8% presenting in clinical-stage VIB. Among 22 cases, 14 (63.6%) were operable, and 8 (36.4) were inoperable (p = 0.015). Multimodal therapies were associated with better survival (surgery plus radiotherapy without systemic treatment, P = 0.063). The median overall survival was three months (IC 95%, 0.078–5.922). One-year and two-year survival rates were 9% and 4.5%, respectively. Conclusion ATC is a rapidly growing cancer that, fortunately, is rare. Early diagnosis and multimodality treatment may provide a better quality of life and survival time for this group of patients.
Background: Choledocholithiasis occurs in 10–15% of patients with symptomatic gallstones. Stones in the common bile duct ought to be removed to avoid complications like acute pancreatitis and cholangitis.Objective: To estimate the timing of Laparoscopic cholecystectomy after endoscopic sphincterotomy (post endoscopic retrograde cholangiopancreatography) and its outcomes.Patients and Methods: A clinical prospective comparative study was done in the Surgical Department of Rizgary Teaching Hospital in Erbil during the period from 1st of January 2019 to 1st of December 2021 on a sample of 50 patients with Common Bile duct stones categorized into two groups; group I (25) patients who underwent laparoscopic cholecystectomy within 72 hours of ERCP (early), while (25) patients with laparoscopic cholecystectomy beyond 3 days (1-6 weeks) of ERCP were included in group II (delayed). Results: Mean surgical duration for group I patients was significantly shorter than the mean surgical duration for group II patients (p=0.02). The mean hospital stay duration for group I patients was markedly shorter than the mean hospital stay duration for group II patients (p<0.001). There was an obvious association between the two groups regarding wider cystic duct, and intraoperative adhesions.Both findings were found more in group II. Conclusion: Earlier laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography has better intraoperative and postoperative outcomes than delayed laparoscopic cholecystectomy. Keywords: Gall stones, Obstructive jaundice, endoscopic retrograde cholangiopancreatography
Background: About 500–600 million people across the globe suffer from multinodular goitre (MNG), making it the most prevalent endocrine illness. The disease is considered endemic when more than 10% of a community has MNG. Women and the elderly are disproportionately affected by non-endemic goitre. In both endemic and nonendemic areas, the female-to-male ratio is roughly 3:1. Although the patient may not notice the goitre until their 40s or 50s, nodules form early on in endemic goitre and later in sporadic goitre. Aim of the study: The purpose of this study was to use histological analysis of complete thyroidectomy specimens to identify the prevalence and subtypes of thyroid cancers in non-toxic multi-nodular goitre (NTMNG). Patients and methods: This study was conducted from January 2018 to December 2022 in the Surgical Department at the Rizgary Teaching Hospital in Erbil, Iraq. Both a physical and sonographic examination was performed on each patient diagnosed with goitre. To reduce the possibility of malignancy in NTMNG, preoperative ultrasound-guided fine needle aspiration biopsy (UG-FNAB) was done on the dominant or chosen tumour in all patients. Patients were offered surgery as a treatment when diagnostic tests revealed abnormalities. Histopathological analysis of every surgically removed thyroid tissue was performed. Pre-op, intra-op, and post-op data were meticulously documented in a standardized fashion, and the outcomes were assessed. Results The goitre cases in this prospective analysis included 128 people. Seventy-six of them had a benign form of multinodular goitre. Sixty-three (82.9%) of the sample were female and thirteen (17.1%) were male. Patients' ages ranged from 23 to 74 years, with a mean age of 36 and a median age of 34±3.35 years. Colloid goitre was found in 28(36.84) %, follicular neoplasm in 3(3.94%), suggestive for malignancy in 3(3.94%), papillary in 4(5.34%), malignant in 3(3.94%), and inconclusive in the remaining 35(46.1%) of cases. Histopathological analysis was performed on all specimens obtained during complete thyroidectomy. Our study found a 15(19.7%) incidence of CA in NTMNG based on histopathology findings that 15 individuals had a malignant focus. Thyroid malignancy was detected in 15 of 76 samples (19.7%), with 8 papillary carcinomas (53.3%), 4 follicular carcinomas (26.6%), 2 Hurthle cell carcinomas (13.3%), and 1 anaplastic carcinoma (6.6%) found in NTMNG. Conclusion: It is important to remember that multinodular goitre is not benign and calls for additional screening for incidental or undiagnosed thyroid cancer.
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