HighlightsEctopic Thyroid Tissue in the mediastinum is very rare.ETT can be associated with normal thyroid function and normal thyroid anatomical location.ETT should be differentiated from substernal goiter.

HighlightsOsseous metaplasia is an unusual presentation a breast lump.In unusual breast lumps, a tissue biopsy should be obtained.Osseus metaplasia of the breast can be presented as a breast lump.

Background: Primary thyroid lymphoma (PTL) is a rare disease, accounting for 5% of all thyroid malignancies. Diffuse B-cell lymphoma (DBCL) is the most common type of PTL. The diagnosis of PTL depends on biopsy results, and its management depends on the histological type. Case Presentation: A 66-year-old female complained of a huge neck mass on the right side that had started growing 3 months previously and was associated with compressive and B symptoms. She had undergone left hemithyroidectomy 20 years previously. On examination, a huge neck mass measuring 10 × 6 cm was detected on the right side that had shifted the trachea to the contralateral side. CT scanning revealed a huge soft tissue mass in the neck with compressive signs. Fine-needle aspiration (FNA) showed variably sized lymphocytes and large epithelial cells with occasional atypical cells. Tissue biopsy revealed DBCL, which is suggestive of PTL. Discussion: PTL affects only the thyroid gland and the regional lymph nodes. Most PTL originate from B cells, especially DBCL, which accounts for 50–80% of all PTL. FNA may have limited capability to differentiate between anaplastic carcinoma of the thyroid and thyroid lymphoma. If FNA fails to determine PTL tissue, it should be determined using biopsy. A multidisciplinary approach is the best management technique for PTL. Radiotherapy, surgery, or both can be used for local control, while chemotherapy can be used for disseminated or hidden disease. Conclusion: Tissue biopsy is needed to exclude other differential diagnoses, whereas a multidisciplinary approach is needed to manage PTL.

HighlightsHypoglossal nerve palsy is rare complication of oropharyngeal manipulation.Most of cases of neuro-paxic type which resolve spontaneously within 6 months.Corticosteroid use have not yet shown an advantage.Neck extension and strap muscles retraction during thyroidectomy may be considered predisposing factors.

Purpose Li-Fraumeni syndrome (LFS) is a rare autosomal cancer syndrome caused by a germline mutation in the TP53 gene. Breast cancer in LFS patients is of various subtypes; however, limited data are available on the clinicopathological features of these subtypes and their appropriate treatments. This study aimed to review the clinical features and treatments for breast cancer in South Korean patients with germline TP53 mutations. Methods Data on the clinicopathological features and treatment of all breast cancer patients with LFS were collected retrospectively from the available database of 4 tertiary hospitals in the Republic of Korea. Results Twenty-one breast cancer cases in 12 unrelated women with confirmed germline TP53 mutations were included in the study. The median age at diagnosis was 33.5 years. The histopathological diagnosis included invasive ductal carcinoma (n = 16), ductal carcinoma in situ (n = 3), and malignant phyllodes tumor (n = 2). While 42% and 31% of the cases were positive for estrogen and progesterone receptors, respectively, 52.6% were human epidermal growth factor receptor 2 (HER2) positive, and 21% were triple-negative. The treatments included mastectomy (52%) and breast-conserving surgery (38%). Five patients underwent radiotherapy (RT). The median follow-up period was 87.5 (8–222) months. There were 3 ipsilateral and 4 contralateral breast recurrences during the follow-up, and 8 patients developed new primary cancers. In the post-RT subgroup, there were 2 ipsilateral and 2 contralateral breast recurrences in 1 patient, and 4 patients had a new primary cancer. Conclusion As reported in other countries, breast cancer in LFS patients in South Korea had an early onset and were predominantly but not exclusively positive for HER2. A multidisciplinary approach with adherence to the treatment guidelines, considering mastectomy, and avoiding RT is encouraged to prevent RT-associated sequelae in LFS patients.