Gland surgery最新文献

{"title":"Development and validation of a novel pancreaticojejunostomy strategy based on the anatomical location of the main pancreatic duct that can reduce the risk of postoperative pancreatic fistula after pancreatoduodenectomy.","authors":"Kang Xue, Li Wang, Lang Chen, Xiaofeng Liu, Angzhi Li, Zihe Wang, Shengzhong Hou, Junjie Xiong, Bole Tian","doi":"10.21037/gs-24-235","DOIUrl":"10.21037/gs-24-235","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pancreatic fistula (POPF) is a common complication after pancreaticoduodenectomy (PD). The effect of the location of the main pancreatic duct on POPF development is not completely elucidated. This study aimed to investigate the association between the location of the main pancreatic duct and POPF, and the effect of pancreaticojejunostomy based on the location of the main pancreatic duct on the risk of POPF.</p><p><strong>Methods: </strong>This retrospective study enrolled 871 patients who underwent PD between January 2018 and December 2021. Logistic regression analysis was performed to identify the independent risk factors associated with POPF. Predictive performance was evaluated using the receiver operating characteristic curves. In addition, a novel pancreaticojejunostomy strategy that could reduce the risk of POPF was adopted.</p><p><strong>Results: </strong>Based on the multivariate analysis, the pancreatic texture and the location of the main pancreatic duct were the independent risk factors of POPF. A threshold ratio of 0.397 was used to distinguish the central from the eccentric pancreatic ducts. Notably, patients with the central pancreatic duct had a significantly lower incidence rate of POPF than those with the eccentric pancreatic ducts (10.6% <i>vs.</i> 44.8%, P<0.001). The novel group exhibited a significantly lower incidence rate of POPF than the conventional group (13.7% <i>vs.</i> 23.0%, P=0.02), and the incidence rate of other complications was not high.</p><p><strong>Conclusions: </strong>The location of the main pancreatic duct is associated with POPF development. However, implementing the novel pancreaticojejunostomy approach can effectively reduce the risk of POPF while ensuring safety.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1693-1707"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoparathyroidism after thyroidectomy: a matter of definition, experience and new adjuncts.","authors":"Paulina Kuczma, Frédéric Triponez","doi":"10.21037/gs-24-256","DOIUrl":"10.21037/gs-24-256","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1873-1877"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumboabdominal migration of injected polyacrylamide hydrogel following breast augmentation: a case report and literature review.","authors":"Tingting Li, Yu Gui, Xiang Cui, Li Chen","doi":"10.21037/gs-24-311","DOIUrl":"10.21037/gs-24-311","url":null,"abstract":"<p><strong>Background: </strong>Polyacrylamide hydrogel (PAAG) injection has been used for breast augmentation, enjoying popularity for nearly 20 years in the late 20^th century. However, numerous complications were gradually observed in the years following the injection, including breast lumps, inflammation, firmness, and migration. Distant migration of breast fillers is relatively rare.</p><p><strong>Case description: </strong>This case report describes the treatment of a patient who experienced complications due to distant migration of fillers after PAAG injection for breast augmentation. The patient had a right-sided lumboabdominal mass measured approximately 35 cm × 20 cm, with asymmetrical breasts and a significantly smaller right-side breast compared to the left-side. The patient underwent surgery to extract the breast augmentation material from the lumboabdominal wall and breasts, followed by a robot-assisted excision of the lumboabdominal wall capsule and removal of residual breast augmentation agent in breasts, and immediate prosthetic breast reconstruction. Postoperative abdominal scarring was strategically concealed in an area that can be covered by pants, and the breast incisions were hidden under the axillary regions. The patient was satisfied with the abdominal scarring and reconstructed breasts.</p><p><strong>Conclusions: </strong>Robot-assisted excision of the lumboabdominal wall capsule is a feasible technique for extensive migration of breast fillers in the future. Further follow-up is needed to determine the long-term effects.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1863-1872"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of best evidence on prevention of intracranial infection after endoscopic endonasal transsphenoidal pituitary neoplasm resection.","authors":"Jing Wang, Ping Yu, Qi Chen, Zhijun Han, Qing Wang, Xiaojie Lu, Xuechao Wu, Chun Bian, Mingzhu Gao","doi":"10.21037/gs-24-415","DOIUrl":"10.21037/gs-24-415","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intracranial infection is one of the most serious complications after pituitary neoplasm resection. However, the quality of the evidence for existing preventive measures varies significantly, and the related content is scattered, and the scope is broad. Nurses lack the specificity and targeted guidance for preventing intracranial infections after endoscopic endonasal transsphenoidal surgery (EETS), and nurses find that evidence necessitates screening and identification during its application, and it is challenging to utilize current tool for guiding clinical practice. Thus, the protocols for preventing intracranial infection after EETS required further refinement. The aim of this study is to summarize the relevant evidence for preventing postoperative intracranial infections after endoscopic endonasal transsphenoidal pituitary neoplasm resection, in order to reduce the incidence of postoperative intracranial infection and provide a reference for clinical medical staff.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We systematically searched a variety of platforms, including British Medical Journal Best Practice, UpToDate, DynaMed, Guidelines International Network, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, Australian Joanna Briggs Institute Evidence based Healthcare Center Database, National Institute for Health and Clinical Excellence, Medlive, Wanfang Data, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Cochrane Library, Embase, PubMed, Web of Science, and Chinese biomedical literature service system (Sinomed) to collect clinical decisions, relevant guidelines, evidence summaries, systematic reviews, and expert consensus documents on the prevention of intracranial infection in this context according to the 6S evidence model. The search included literature published up to December, 2023. Then conduct literature screening and evaluation, extract and summarize relevant evidence on perioperative prevention of intracranial infection after EETS from the selected literature. Two researchers applied the JBI levels of evidence preappraisal system (2014 version) to categorize the included evidence into five levels (level 1a being the highest and level 5c being the lowest).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 16 pieces of literature were reviewed, including 6 clinical decision-makings, 2 guidelines, 2 systematic reviews, and 6 expert consensus documents. Ultimately, 24 pieces of best evidence for preventing intracranial infections after EETS for pituitary adenomas were formed, and they will be divided into four categories: multidisciplinary collaboration, preoperative evaluation and informed consent, intraoperative prevention and control, and postoperative observation and prevention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This summarized the best evidence for preventing intracranial infection after endoscopic endonasal transsphenoidal p","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1759-1769"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early death prediction model for breast cancer with synchronous lung metastases: an analysis of the SEER database.","authors":"Qiang Li, Tuo Sun, Zhengdong Zhang","doi":"10.21037/gs-24-240","DOIUrl":"10.21037/gs-24-240","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer with lung metastases (BCLM) is a serious condition that often leads to early death. This study aims to screen the risk factors of early death in BCLM patients and establish a simple and accurate nomogram prediction model. Identifying prognostic markers and developing accurate prediction models can help guide clinical decision-making.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results (SEER) database was used to analyze a sizable sample of data, encompassing 4,238 BCLM patients diagnosed between 2010 and 2015. Stepwise regression was used to manage the collinearity of variables and to construct a prediction model based on the histogram. The results were subjected to internal validation and contrasted with those of related investigations.</p><p><strong>Results: </strong>Of the 4,238 BCLM patients in this study, 3,232 did not die early. Of the 1,006 premature deaths, 891 were cancer specific. Lymph node involvement, tumor size, age, and race were all recognized as prognostic markers for premature mortality. A nomogram was constructed based on these factors to reliably predict cancer-specific death and early all-cause death.</p><p><strong>Conclusions: </strong>This study gives new insights into the prognosis of individuals with BCLM and finds critical prognostic variables for early mortality. The created nomogram might assist physicians in identifying individuals at high risk of early mortality and making treatment options.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1708-1728"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence and postoperative quality of life after surgical resection of unilateral cT1-T3N1bM0 papillary thyroid carcinoma.","authors":"Zhilin Qiu, Liang Zhang, Xi Guo, Zhaoming Ding, Jihua Han, Wen Bi, Bing Sun, Jiewu Zhang, Chunlei Nie","doi":"10.21037/gs-24-178","DOIUrl":"10.21037/gs-24-178","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Determining the optimal extent of surgery and improving postoperative quality of life for patients with papillary thyroid cancer has been an important challenge. Here, we evaluated postoperative quality of life after cT1-T3N1bM0 papillary thyroid carcinoma (PTC) to explore the optimal scope of surgical resection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this study, we investigated surgical outcomes in patients diagnosed with unilateral cT1-T3N1bM0 PTC, who were treated at Harbin Medical University Cancer Hospital from January 2008 to December 2018. To achieve this, we divided the patients into two distinct groups based on the extent of surgery they received: the non-total thyroidectomy group (group A) and the total thyroidectomy group (group B). To comprehensively evaluate the patients' well-being, we assessed their psychological status, disease recurrence rate, postoperative complications, and quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 362 patients diagnosed with thyroid cancer were included in this study, with group A (n=88) and group B (n=274) classified based on the extent of surgery received. Significant differences were observed between the two groups in terms of clinical and pathological characteristics, including age (χ&lt;sup&gt;2&lt;/sup&gt;=10.962, P=0.001), sex (χ&lt;sup&gt;2&lt;/sup&gt;=5.906, P=0.02), multifocal (χ&lt;sup&gt;2&lt;/sup&gt;=5.515, P=0.02), contralateral glandular nodule (χ&lt;sup&gt;2&lt;/sup&gt;=34.616, P&lt;0.001), clinical Tumor, Node, Metastasis (TNM) stage (χ&lt;sup&gt;2&lt;/sup&gt;=11.340, P=0.001), and complication rate (χ&lt;sup&gt;2&lt;/sup&gt;=4.265, P=0.04). Notably, group B exhibited higher rates of postoperative complications, including temporary recurrent laryngeal nerve injury (χ&lt;sup&gt;2&lt;/sup&gt;=4.630, P=0.03), and temporary hypocalcemia (χ&lt;sup&gt;2&lt;/sup&gt;=3.954, P=0.047) compared to group A. However, after adjustment for propensity score matching (PSM), the recurrence rate was independent of the surgical extent in both groups. In contrast, tumour size (&gt;1 cm) (χ&lt;sup&gt;2&lt;/sup&gt;=4.497, P=0.03), extrathyroidal invasion (χ&lt;sup&gt;2&lt;/sup&gt;=5.133, P=0.02) and pathological T stage (χ&lt;sup&gt;2&lt;/sup&gt;=7.663, P=0.02) increased the risk of recurrence. Moreover, there was no significant difference in the Hospital Anxiety and Depression Scale (HADS) scores between two groups (χ&lt;sup&gt;2&lt;/sup&gt;=1.266, P=0.53). Nevertheless, the postoperative quality of life, as well as the incidence of hoarseness (&lt;i&gt;t&lt;/i&gt;=11.77, P&lt;0.001), symptoms of calcium deficiency (&lt;i&gt;t&lt;/i&gt;=8.13, P&lt;0.001), and willingness to reduce medication (&lt;i&gt;t&lt;/i&gt;=3.60, P&lt;0.001) were significantly lower in group A than in group B.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In patients with PTC diagnosed as unilateral cT1-T3N1bM0 and a contralateral glandular nodule ≤2 cm, the preservation of the contralateral gland does not appear to have a significant impact on the rate of tumour recurrence in patients with tumour size (&lt;1 cm), no extrathyroidal invasion, and pathological T stage (&lt; T3). Instead, preserving gland p","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1740-1751"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of gasless insufflation transaxillary endoscopic thyroidectomy on the parathyroid gland injury in patients with thyroid cancer: a retrospective analysis.","authors":"Yiyan Hong, Hongliang Zhan, Longying Zhang, Kunzhai Huang, Miaomiao Zheng, Fuxing Zhang","doi":"10.21037/gs-24-234","DOIUrl":"10.21037/gs-24-234","url":null,"abstract":"<p><strong>Background: </strong>Recently, endoscope has been widely used in thyroid surgery and gasless insufflation transaxillary endoscopic thyroidectomy (GTET) has been the mainstay of thyroid surgery. Parathyroid gland (PG) damage is a common complication of thyroid surgery. Therefore, the aim of this study was to investigate the effect of GTET on hypoparathyroidism (HPT) in patients with thyroid cancer.</p><p><strong>Methods: </strong>According to the surgical approach, the patients were divided into a GTET group and a conventional open thyroidectomy (COT) group. Univariate analysis and logistic regression were used to identify factors associated with PG injury. The odds ratio (OR) and 95% confidence interval (CI) for each independent variable were calculated.</p><p><strong>Results: </strong>A retrospective analysis was conducted on 405 patients diagnosed with papillary thyroid cancer (PTC). A total of 51 patients experienced PG injury, including 7 cases (5%) of GTET group and 44 cases (16.5%) of COT group (P<0.001). Among them, the incidence of GTET group injury with one PG was 50.4%, two were 2.9%, and COT group were 59.8% and 7.9%, respectively (P=0.006). Univariate and multivariate analysis revealed that GTET was a protective factor for PG injury (OR, 0.251; 95% CI, 0.110-0.576; P=0.001), while Hashimoto's thyroiditis (HT) was identified as a risk factor for PG injury (OR, 2.722; 95% CI, 1.114-6.654; P=0.02).</p><p><strong>Conclusions: </strong>GTET reduces the incidence of PG injury and nerve injury, when PTC is combined with HT, it increases the risk of PG injury.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1729-1739"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic thyroid follicular carcinoma in the right mandible: a case report.","authors":"Rong He, Yongzhi Wu, Xue Xiao, Yafei Chen, Xiufa Tang, Yi Men, Bo Han","doi":"10.21037/gs-24-288","DOIUrl":"10.21037/gs-24-288","url":null,"abstract":"<p><strong>Background: </strong>Ectopic thyroid carcinoma in the mandible is extraordinarily rare; few histologically proven cases have been reported in the literature. Embryologically, cases of ectopic thyroid occur with a developmental abnormality during the migration of the thyroid gland from the floor of the primitive foregut to its final position in the neck. Ectopic thyroid tissue can be found around the course of the thyroglossal duct or laterally in the neck, and even in the mediastinum or below the diaphragm. Since 90% of ectopic thyroid tissues are located at tongue bases, the mandible ectopic thyroid gland is extremely rare. Theoretically, ectopic thyroid glands in the mandible are unlikely to become cancerous. Clinically, follicular carcinoma is less common than papillary carcinoma in both the ectopic thyroid regions and the eutopic anterior neck position. This case is the first to report a cancerous ectopic thyroid in the mandibular bone with eutopic thyroid follicular adenoma and adenomatous goiter.</p><p><strong>Case description: </strong>Here, we report a case of mandible follicular thyroid cancer (MFTC). A 72-year-old male was presented with a chief complaint of pain and discomfort in the lower right back tooth that had persisted for over 3 months, with cone-beam computed tomography (CBCT) revealing a mass in the right mandible. The patient's mandible mass was removed via right hemimandibulectomy, and reconstruction was simultaneously performed using free autogenous rib grafts. The postoperative pathology diagnosis revealed follicular thyroid carcinoma. In addition, this patient underwent a total thyroidectomy at another hospital 3 years ago for benign thyroid lesions.</p><p><strong>Conclusions: </strong>In conclusion, we present a rare case of ectopic follicular thyroid carcinoma located in the right mandible, accompanied by benign eutopic thyroid lesions. Effective management of such cases necessitates a multidisciplinary approach, and surgical resection is recommended for ectopic follicular thyroid carcinoma.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1840-1845"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of cervical bronchogenic cyst via minimally invasive video-assisted thyroidectomy: a report of two cases.","authors":"Chenyu He, Kewei Jiang, Jianye He, Shan Wang","doi":"10.21037/gs-24-301","DOIUrl":"10.21037/gs-24-301","url":null,"abstract":"<p><strong>Background: </strong>Bronchogenic cysts are rare congenital diseases, which are believed to occur through the separation of small diverticula buds from an abnormal budding process in the primitive foregut during the formation of the tracheobronchial tree. Ectopic types located in the thyroid region are extremely rare.</p><p><strong>Case description: </strong>In this study, we present two cases of cervical bronchogenic cysts identified during minimally invasive video-assisted thyroidectomy (MIVAT). The first case involved a 24-year-old male who presented with a persistent neck mass measuring 41 mm in the right cervical region for a duration of 2 weeks. The second case involved a 36-year-old male diagnosed with right papillary thyroid cancer for 2 months. The presence of any additional lesions was not identified prior to surgery. During surgery, the cysts were identified, resembling metastatic lymph nodes or lymphatic tuberculosis. Both cases were diagnosed with bronchogenic cysts with typical pathological features. The patients achieved successful recovery with no recurrence observed during the follow-up period. The morphological characteristics showed both variations and commonalities intraoperatively.</p><p><strong>Conclusions: </strong>This report aims to enhance the awareness of cervical bronchogenic cysts by providing comprehensive insights into the imaging, pathology, and clinical features. Since the lack of trustworthy preoperative diagnosis, we recommend suitable patients to have all suspected bronchogenic cysts removed via surgery, especially complete excision.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1823-1829"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast tuberculosis with bone destruction mimicking breast cancer with bone metastasis: a case report and literature review.","authors":"Li-Xin Li, Ya-Wen Wang, Yuan Lin, Yan-Duo Chen, Xu Chen, Xin Li, Xiao-Lin Zhou, Liang Su, Mei-Ying Lin, Kai Zhang","doi":"10.21037/gs-24-185","DOIUrl":"10.21037/gs-24-185","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) poses a significant global health challenge. While the incidence of breast TB (BTB) is relatively low, it can easily be mistaken for breast cancer or breast granulomatous lobulitis, potentially delaying timely intervention. The gold standard for diagnosis consists of <i>Mycobacterium TB</i> culture and Ziehl-Neelsen staining. Treatment typically consists of a combination of anti-TB therapy and surgical intervention.</p><p><strong>Case description: </strong>Our research group recently reported a case of BTB accompanied by rib bone destruction. Initially, imaging examinations suggested breast cancer with bone metastasis. However, subsequent real-time ultrasound-guided biopsy revealed chronic inflammation with granulomatous inflammation and extensive necrosis, which led to the diagnosis of BTB. Further T cells spot test (T-SPOT) testing predicted the likelihood of the presence of TB infection, and magnetic resonance imaging (MRI) indicated a high likelihood of TB. A biopsy of the breast lesions was performed and subsequent polymerase chain reaction (PCR) analysis of the aspirated specimens confirmed the presence of DNA from the <i>Mycobacterium TB</i> complex, as well as genes associated with rifampicin resistance. These findings led to the definitive diagnosis of BTB complicated by bone destruction. The patient underwent a 4-month course of anti-TB medication, followed by surgical intervention and an additional regimen of anti-TB drugs. Nine months post-surgery, the patient exhibited no indications of recurrence.</p><p><strong>Conclusions: </strong>The diagnosis of BTB with bone destruction is challenging, and clinicians need to be vigilant not to misdiagnose it as breast cancer or granulomatous lobulitis.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1853-1862"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}