SummaryAn 11‐month‐old Arabian filly was presented for chronic diarrhoea, ill‐thrift and intermittent colic. Abdominal ultrasonography revealed multifocal regions of marked colonic wall thickening. Exploratory laparotomy confirmed multifocal, multi‐sized nodular and segmental intramural mass‐like lesions affecting the right ventral and transverse colon, respectively. Locally extensive regions of mural thickening in the aborad transverse colon resulted in severe luminal restriction (<2.5 cm) and subsequent obstruction of the orad transverse and right dorsal colons with impacted feed material. The lesions were unresectable and full‐thickness biopsy samples were submitted for histopathological evaluation. The filly was subsequently diagnosed with transmural intestinal ganglioneuromatosis of the right ventral and transverse colons. The filly was successfully conservatively managed over a 24‐month follow‐up duration. Management consisted of long‐term dietary modifications in the form of a low‐bulk diet, as well as enteral laxatives and a tapering course of corticosteroids postoperatively. This is the first case of intestinal ganglioneuromatosis in veterinary literature that was (1) diagnosed in a juvenile horse, (2) successfully medically managed and (3) followed up for more than 12 months.
Aim: The aim of the study is to evaluate the value of thyroid-stimulating hormone (TSH)-stimulated thyroglobulin (sTg) measurements by the end of the 1 st -year postablation in differentiated thyroid cancer (DTC) patients with biochemical non complete response (indeterminate and incomplete response). Patients and Methods: One hundred patients with DTC underwent near-total thyroidectomy and radioactive remnant ablation by iodine-131 (I 131 ) with regular follow-up every 6 months during the first 2 years and at 6–12-month intervals thereafter by I 131 whole-body scan (WBS), neck ultrasound, and sTg measurement in the hypothyroid state (TSH >30 mU/L). Patients were divided according to the imaging findings and sTg level into three groups: excellent response (ER) – no evidence of disease by imaging and sTg <1 ng/mL, indeterminate or acceptable response (AR) – nonspecific findings on imaging studies and sTg < 10 ng/mL, and incomplete response (IR) – patients with incomplete structural and/or incomplete biochemical response (sTg > 10 ng/mL). Results: The follow-up at 6-month postablation showed ER in 3 (3%) patients, AR in 29 (29%) patients, and IR in 68 (68%) patients. The second follow-up at 9–12-month postablation showed dramatic biochemical response with ER, indeterminate, and IR in 50 (50%), 34 (34%), and 16 (16%) patients, respectively, and 14 (14%) patient had structural recurrence. This change is highly statistically significant ( P = 0.00). In the last follow-up (ranges from 3 to 10 years), 53 (55.8%) patients achieved ER, 42 (44.2%) AR and no patient with non complete response. The change in patients with IR between the second and the last follow-up is also statistically significant ( P = 0.001). Conclusion: sTg measurement by the end of the 1 st year is more reliable in the follow-up of patients with DTC and biochemical non complete response and considered significant predictor of disease-free status. Patients with biochemical IR still have the chance to achieve ER or AR by the passage of time without additional therapies.
Aim The aim of this study was to evaluate the long-term overall therapy outcomes and clinicopathological risk factors in patients with differentiated thyroid cancer (DTC) and iodine avid bone metastases. Methods Our study included 93 patients [female to male ratio (2:1)]. All patients were subjected to clinical examination, laboratory assessment, I-131 whole body scan, and neck ultrasound. Iodine avid metastases were treated with successive radioactive iodine-131 (RAI-131) doses. The overall response was defined as complete response (CR), incomplete response (IR) [partial response (PR) and stable disease (SD)], and progressive disease (PD). Results Fifty-four patients had follicular carcinoma and 39 with papillary type. Isolated bone metastases, bone and lung metastases, and multi-organ metastases were found in 45, 34, and 14 patients, respectively. The overall CR, PR, SD, and PD were found in 8.6%, 28%, 46.2%, and 17.2% patients, respectively. Adjunctive radiotherapy resulted in more CR, IR, and low PD rates compared to RAI-131 therapy (9.0%, 78.3%, 12.7% vs. 7.9%, 56.8%, and 23.7%, respectively) (P = 0.03). The overall survival rate was 88.2% and median follow-up period was 123 months. Female patients, papillary carcinoma, and single focal lesion had better overall response rate. Males, extrathyroidal extension, vascular invasion, and lymph nodes metastases had increased PD and decreased global response rates. Conclusion Despite of low CR rate (8.6%), most patients with DTC and iodine avid bone metastases had SD (46.2%) and long lived (88.2%). Adjunctive radiotherapy reduced PD and improved outcome. Males, extra thyroid extension and vascular invasion were bad prognostic factors.
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