This study has demonstrated the importance of factors such as tumor size, nuclear grade, and stage in the assessment of prognosis of RCC patients. More studies in India with more patients are needed to demonstrate the importance of these prognostic factors.

A 14-year-old boy was referred to a rheumatology clinic with left elbow pain, swelling, and stiffness for the past 6 months. His pain aggravated at night and was relieved with ibuprofen. He gave no history of polyarthralgia or morning stiffness. On examination, he had a diffuse swelling around the posterolateral aspect of the elbow. He had an effusion and a fixed flexion deformity of 40 degrees with further flexion to 120 degrees.Radiographs of the distal humerus showed a well-defined radiolucent lesion with central calcification and adjacent diffuse sclerosis in the lateral aspect of the wall of the olecranon fossa (Fig. 1a). Multidetector computed tomography (MDCT) showed a cortical-based lesion with an intraarticular component and dense central mineralization (Fig. 1b). Post-contrast T1 fat-suppressed (FS) magnetic resonance images (MRI) demonstrated enhancement along the margins of the lesion, intense reactive synovitis, and joint effusion (Fig. 1c). The imaging findings were suggestive of an osteoid osteoma (OO). His hand radiographs did not show any evidence of periarticular osteopenia commonly seen in inflammatory arthritides. Radiographs of his lumbar spine did not show evidence of syndesmophyte/sacroiliitis.Spontaneous onset symptoms with the absence of morning stiffness, normal blood counts, ESR, CRP, RA factor, ANA, ACCP, uric acid, and imaging ruled out inflammatory,

INTRODUCTION There is a lot of controversy around the study of the familial papillary thyroid carcinoma (CPFT), which has a different behaviour than sporadic. The aim of this investigation is to establish the differences and similarities between sporadic papillary thyroid carcinoma and the familial one in order to determine if the familial type is a more aggressive clinical entity than sporadic. MATERIAL AND METHODS A retrospective cohort study in 231 patients with papillary thyroid carcinoma (CPT) from 2006 to 2018. One group was established according to the presence of two or more relatives as CPFT (n = 46) and the other group were the sporadic cases (n = 185). Throughout this study the clinical-pathological characteristics of both groups were compared based on the analysis of twenty-one variables. RESULTS After having carried out this investigation, statistically significant differences have only been found in the vascular invasion (p < 0.001), presenting 3.8% in the sporadic group compared to the 21.7% found in the CPFT with an Odds Ratio of 7.6. CONCLUSIONS Based on our experience, patients with CPFT present a higher frequency of multifocal neoplasia, capsular invasion, vascular invasion, lymph node invasion and recurrence than sporadic CPT. However, these differences were only significant while analyzing the vascular invasion variable. Although the results of our study have been unable to prove that the CPFT is more aggressive than sporadic CPT, we recommend performing periodic ultrasounds such as the screening of the members of the families with CPFT. Finally, we conclude that more studies are needed.

Papillary thyroid carcinoma (PTC) is the most common form of differentiated thyroid carcinoma (DTC). It is generally confined to the neck with or without spread to regional lymph nodes. Distant metastases is rare, if occurs, it usually involves lung and bone. Additional locations have only been sporadically reported and were identified during the course of follow-up, subsequently to a thyroid surgery. Distant metastases as the initial presentation of PTC is a rare event. We, herein, report two cases of PTC presenting initially as metastases at unusual sites and discuss the importance of meticulous histopathological and immunohistochemical examination in such situations. Our aim is to increase awareness of the unique possibility of PTC presenting as metastatic deposits at unexpected sites.