Articles: nodular-goiter.
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The coexistence of thyroid autonomy (Plummer's disease) and Graves' disease has been termed "Marine-Lenhart syndrome". During the last years, several papers have been published on the development of Graves' disease shortly after radioiodine therapy of Plummer's disease (autonomy). Especially in patients with elevated thyroid antibodies, the incidence of this event is significantly higher after radioiodine therapy of autonomy. ⋯ The original paper published by Marine and Lenhart comes to the conclusion that the two diseases are different expressions of one disease. Looking at the literature, we have to state now that the Marine-Lenhart syndrome has never existed: With Plummer we know now that Plummer's and Graves' disease are different diseases. They may develop in the same patient but independent from each other.
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Nontoxic multinodular goiter (MNG) is frequently observed in the general population, but little is known about the underlying genetic susceptibility to this disease. Familial cases of MNG have been reported, and published reports describe 5 families that also contain at least 1 individual with a Sertoli-Leydig cell tumor of the ovary (SLCT). Germline mutations in DICER1, a gene that codes for an RNase III endoribonuclease, have been identified in families affected by pleuropulmonary blastoma (PPB), some of whom include cases of MNG and gonadal tumors such as SLCTs. ⋯ DICER1 mutations are associated with both familial MNG and MNG with SLCT, independent of PPB. These germline DICER1 mutations are associated with dysregulation of miRNA expression patterns.
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Case Reports
[Urgent thyroidectomy for a mechanical syndrome caused by a toxic nodular goiter--a case report].
We present a case of emergency surgery of an 86-year-old patient with an extensive cevicomediastinal toxic nodular goiter. Acutely onset mechanical syndrome during hospitalization of the patient in another department for a different diagnosis (vertebrogenic algic syndrome of Th-L spine) warranted acute intubation and mechanical ventilation. ⋯ All published cases of acute compression syndrome with respiratory insufficiency involve anaplastic carcinoma transformation, fast growing lymphoma, injuries with an intraglandular haemorrhage or infected cysts. In this case the reason was the benign disease of the thyroid gland.