No abstract

Mondor's disease of the breast is a rare, benign sclerosing superficial thrombophlebitis of the subcutaneous veins of the anterior or lateral chest wall, which is treated conservatively. We aim in this study to evaluate the outcome and effectiveness of our treatment protocol using oral diclofenac sodium and topical diclofenac sodium patch in 172 patients. A retrospective database analysis of 172 female patients between January 2001 and December 2010 was done. The treatment protocol consisted of group 1: treatment by oral diclofenac sodium 100 mg once daily for 3 weeks. Group 2: treatment by diclofenac sodium patches for 8 hours twice daily (morning and evening) for 1 week. The patients were instructed to document the time as soon as pain relief is achieved following the patch application and the intake of the oral dose. The incidence rate was 2.49%. Diclofenac sodium patch was statistically found to be significantly better in subsiding the inflammatory process of the veins, relieving the pain, and enhancing faster healing rate. We conclude that diclofenac sodium patch showed a promising role in the treatment of Mondor's disease of the breast by significantly decreasing the inflammatory process due to its transdermal migration action within a short period and the ability to reach a high local concentration. It achieved the best results for rapid relief of pain and disease regression compared to the oral capsules. Therefore, our protocol was changed to implement diclofenac sodium patch as the first choice in treating Mondor's disease of the breast.

We conclude that gynecomastia is a benign breast disease but recent reports had described malignant variants, mostly DCIS, including 5 young males in our series. Therefore, regardless of the age group, histopathological examination of the resected gynecomastia tissue should be carefully done in all patients. Further evidence-based studies are needed to investigate the optimum management of incidental DCIS in gynecomastia specimens.

<p class="abstract"><strong>Background:</strong> Graves' disease is an autoimmune disease that affects the thyroid gland and frequently results in hyperthyroidism and an enlarged thyroid. Treatment of Graves' disease includes antithyroid drugs, radioiodine (radioactive iodine I-131), and thyroidectomy, either total, or subtotal excision. In this paper, we aim to analyse the outcome of thyroidectomy performed on patients affected by Graves' disease in Medina – Saudi Arabia, and evaluate if thyroidectomy should be considered the first treatment option for all patients with Graves' disease.</p><p class="abstract"><strong>Methods:</strong> A retrospective database analysis of the surgical treatment outcome of 574 Saudi Arabian patients who were affected with Graves' disease between January 2003 and December 2012 was done. The computerized database medical records were reviewed and analysed for preoperative, intraoperative, and postoperative factors.  </p><p class="abstract"><strong>Results:</strong> 194 (33.8%) patients were males, and 380 (66.2%) were females. The average age of patients was 44 ± 2 years. 154 (26.8%) had subtotal thyroidectomy, and 420 (73.2%) had total thyroidectomy performed. There was (0%) recurrent laryngeal nerve injury, and (0%) intraoperative complication were recorded. With a follow up time of 2 years, 7 (1.22%) patients developed recurrent disease (all in subtotal thyroidectomy group). There were no recurrences in the total thyroidectomy patients, and 11 (1.9%) patients were found in histopathology to have papillary thyroid cancer (all in total thyroidectomy group).</p><p><strong>Conclusions:</strong> We conclude that total thyroidectomy is a safe and effective treatment modality for Graves' disease that offers rapid and long-lasting results, in addition to eliminating the risk of recurrence and malignancy. It should be offered to all confirmed Graves' disease patients during counselling.</p>

No abstract