Papers by Dr Abhijit Thakur
Adrenal Angiomyolipoma: A Surgical Rarity
International journal of scientific research, 2021
Adrenal Angiomyolipoma's are extremely rare forms of lipomatous tumours of adrenal gland. The... more Adrenal Angiomyolipoma's are extremely rare forms of lipomatous tumours of adrenal gland. They may go undetected for years without symptoms. The patient may become symptomatic, once the tumour has gained a signicant size, mainly back pain. We are reporting our case which is a one of a kind benign Adrenal tumour. Adrenal Angiomylipomas are found as incidentalomas in patients, generally presenting with mild to no symptoms, leading to a long delay before they are diagnosed. However, early diagnosis is key, not only to alleviate symptoms but to also prevent a future surgical disaster due to rupture causing cardiovascular shock if large enough. Our patient presented with dull aching ank pain without any systemic symptoms. The diagnosis requires a multifocal approach to be conrmed including hormonal assay and radiological testing whereas following a “clinical only” approach maybe insufcient and often mislead a clinician from establishing an accurate diagnosis. These patients could...
CO70 - Thyroïdectomie endoscopique par voie latérale : évolution naturelle de la parathyroïdectomie endoscopique
Indian Journal of Surgical Oncology, 2010
The concept of surgical invasiveness cannot be limited to the length or to the site of the skin i... more The concept of surgical invasiveness cannot be limited to the length or to the site of the skin incision. It must be extended to all structures dissected during the procedure. Therefore, MIT or MIP should properly be defined as operations through a short and discrete incision that permits direct access to the thyroid or parathyroid gland, resulting in a focused dissection. Parathyroid glands are particularly suitable for minimally invasive surgery as most parathyroid tumors are small and benign. MIP are performed through a limited or discrete incision when compared to classic open transverse cervical incision and are targeted on one specific parathyroid gland. The concept of these limited explorations is based on the fact that 85% of patients will have single-gland disease. MIP must be proposed only for patients with sporadic hyperparathyroidism in whom a single adenoma has been clearly localized by preoperative imaging studies. The minimal access approaches to the thyroid gland may be broadly classified into three groups: the mini-open lateral approach via a small incision, minimally invasive video-assisted thyroidectomy via the midline and various endoscopic techniques. Endoscopic extracervical approaches have the main advantage of leaving no scar in the neck but cannot reasonably be described as minimally invasive as they require more dissection than conventional open surgery. Initially the indications for MIT were a solitary thyroid nodule of less than 3 cm in diameter in an otherwise normal gland. Today, MIT are also proposed in patients with small nodular goiters, Graves's diseases and low risk papillary thyroid cancers. Some concern remains about the radicality of MIT in this latter group but preliminary results are comparable to those of conventional surgery both in terms of I-131 uptake and serum thyroglobuline levels. Demonstrating the advantages of MIT and MIP over conventional surgery is not easy. Main complications, such as nerve injury, hypoparathyroidism, or hemorrhage, are the same as in conventional surgery. Several studies comparing conventional surgery with minimally invasive techniques using a cervical access have shown a diminution of postoperative pain, and better cosmetic results with minimally invasive techniques. MIP and MIT seem overall to be an advance but only randomized studies will demonstrate the real benefit.
Muscle Fungal Granuloma Due to Cladosporium Species: A Novel Surprise
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2022
The spectrum of mycotic diseases continue to expand, making it challenging for treatment of infec... more The spectrum of mycotic diseases continue to expand, making it challenging for treatment of infections caused by a diverse array of opportunistic fungi especially in immuno-compromised individuals. The species of Cladosporium implicated in human infections is found as causative agents for infections of the central nervous system, lung, liver, keratitis, and dental granulomas. Involvement of a muscle by a fungal granuloma in an immunocompromised individual by Cladosporium species is very rare and has been never reported before to the best of our knowledge. Below we present a novel case of a 34 year old, Post-transplant Immunocompromised male to have developed a lump within the Triceps Brachii muscle which was found to be a Cladosporium Cladosporioides granuloma and was treated successfully with a multimodal approach of Surgery and Voriconazole anti-fungal therapy.
World Journal of Surgery, 2008
Background Laparoscopic adrenalectomy is the procedure of choice for small adrenal tumors, but so... more Background Laparoscopic adrenalectomy is the procedure of choice for small adrenal tumors, but some concerns have been voiced when this approach is adopted for larger tumors and pheochromocytomas. The aim of this study was to examine the results of the laparoscopic resection of large pheochromocytomas.
Significance of Biochemical Parameters in Differentiating Uniglandular from Multiglandular Disease and Limiting Use of Intraoperative Parathormone Assay
World Journal of Surgery, 2009
We studied whether serum calcium and parathormone (PTH) levels are significantly different for un... more We studied whether serum calcium and parathormone (PTH) levels are significantly different for uniglandular disease (UGD) and multiglandular disease (MGD) and whether intraoperative rapid intact parathormone (IOPTH) monitoring can be avoided in some cases of minimally invasive parathyroidectomy (MIP) without affecting cure rates, substantiating various previous published studies. This is a single-referral-center retrospective review of prospectively collected data for 281 patients with sporadic primary hyperparathyroidism (sPHPT) from January 1999 to February 2005. The calcium and PTH values were categorized using the following parameters: calcium > or = 3 mmol/l = 1, < 3 mmol/l = 0, PTH > or = 100 pg/ml = 1, PTH < 100 = 1. P values for serum calcium and PTH by ANOVA were 0.0547 and 0.3936, respectively, and by the Mann-Whitney test were 0.1606 and 0.6208, respectively. We had 118 patients with concordant technetium 99 m sestamibi scintigraphy (MIBI) and neck ultrasonography (US) and UGD was confirmed in 118 (100%) cases. No significant difference between serum calcium and PTH for UGD and MGD was found. IOPTH monitoring could be avoided when there is concordant positive MIBI and neck US for single, unilateral, hyperfunctioning gland without affecting cure rates.
Ectopic cervical thymoma mimicking as papillary thyroid carcinoma: A diagnostic dilemma
Indian Journal of Pathology and Microbiology, 2010
Ectopic cervical thymomas are often confused with thyroid or parathyroid swellings due to their a... more Ectopic cervical thymomas are often confused with thyroid or parathyroid swellings due to their anatomical positioning. Predominant epithelial thymoma can be misdiagnosed as papillary thyroid carcinoma on fine needle aspiration and lymph node metastasis of epithelial tumor on frozen section. Predominantly lymphocytic thymomas have often been misinterpreted as Hashimoto's thyroiditis or malignant lymphoma, either by fine needle aspiration or on frozen section analysis. If cytology is doubtful and is not correlating with clinical, anatomical and surgical findings; immunohistochemistry is a very important tool in such cases to give final answer. Thyroid cell specific proteins such as thyroglobulin, thyroid transcription factor-1, thyroperoxidase and dipeptidyl aminopeptidase-4, neuroendocrine markers chromogranin, calcitonin and parathyroid hormone could be used to rule out thyroid or parathyroid origin. We present such rare case of ectopic cervical thymoma mimicking as papillary thyroid carcinoma.
Revival of parathyroid adenoma: a rare cause of recurrent hyperparathyroidism
ANZ Journal of Surgery, 2008
... Revival of parathyroid adenoma: a rare cause of recurrent hyperparathyroidism. Abhijit Thakur... more ... Revival of parathyroid adenoma: a rare cause of recurrent hyperparathyroidism. Abhijit Thakur MS,; Frederic Sebag MD,; Catherine De Micco MD,; David Taïeb MD,; Jean FranÇois Henry MD. Article first published online: 29 MAY 2008. DOI: 10.1111/j.1445-2197.2008.04549.x. ...
Ectopic cervical thymomas are often confused with thyroid or parathyroid
swellings due to their a... more Ectopic cervical thymomas are often confused with thyroid or parathyroid
swellings due to their anatomical positioning. Predominant epithelial thymoma
can be misdiagnosed as papillary thyroid carcinoma on fi ne needle aspiration
and lymph node metastasis of epithelial tumor on frozen section. Predominantly
lymphocytic thymomas have often been misinterpreted as Hashimoto’s thyroiditis
or malignant lymphoma, either by fi ne needle aspiration or on frozen section
analysis. If cytology is doubtful and is not correlating with clinical, anatomical
and surgical fi ndings; immunohistochemistry is a very important tool in such
cases to give fi nal answer. Thyroid cell specifi c proteins such as thyroglobulin,
thyroid transcription factor-1, thyroperoxidase and dipeptidyl aminopeptidase-4,
neuroendocrine markers chromogranin, calcitonin and parathyroid hormone
could be used to rule out thyroid or parathyroid origin. We present such rare
case of ectopic cervical thymoma mimicking as papillary thyroid carcinoma.
The concept of surgical invasiveness cannot be limited to the length or to the site of the skin i... more The concept of surgical invasiveness cannot be limited to the length or to the site of the skin incision. It must be extended to all structures dissected during the procedure. Therefore, MIT or MIP should properly be defined as operations through a short and discrete incision that permits direct access to the thyroid or parathyroid gland, resulting in a focused dissection. Parathyroid glands are particularly suitable for minimally invasive surgery as most parathyroid tumors are small and benign. MIP are performed through a limited or discrete incision when compared to classic open transverse cervical incision and are targeted on one specific parathyroid gland. The concept of these limited explorations is based on the fact that 85% of patients will have single-gland disease. MIP must be proposed only for patients with sporadic hyperparathyroidism in whom a single adenoma has been clearly localized by preoperative imaging studies. The minimal access approaches to the thyroid gland may be broadly classified into three groups: the mini-open lateral approach via a small incision, minimally invasive video-assisted thyroidectomy via the midline and various endoscopic techniques. Endoscopic extracervical approaches have the main advantage of leaving no scar in the neck but cannot reasonably be described as minimally invasive as they require more dissection than conventional open surgery. Initially the indications for MIT were a solitary thyroid nodule of less than 3 cm in diameter in an otherwise normal gland. Today, MIT are also proposed in patients with small nodular goiters, Graves's diseases and low risk papillary thyroid cancers. Some concern remains about the radicality of MIT in this latter group but preliminary results are comparable to those of conventional surgery both in terms of I–131 uptake and serum thyroglobuline levels. Demonstrating the advantages of MIT and MIP over conventional surgery is not easy. Main complications, such as nerve injury, hypoparathyroidism, or hemorrhage, are the same as in conventional surgery. Several studies comparing conventional surgery with minimally invasive techniques using a cervical access have shown a diminution of postoperative pain, and better cosmetic results with minimally invasive techniques. MIP and MIT seem overall to be an advance but only randomized studies will demonstrate the real benefit.
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Papers by Dr Abhijit Thakur
swellings due to their anatomical positioning. Predominant epithelial thymoma
can be misdiagnosed as papillary thyroid carcinoma on fi ne needle aspiration
and lymph node metastasis of epithelial tumor on frozen section. Predominantly
lymphocytic thymomas have often been misinterpreted as Hashimoto’s thyroiditis
or malignant lymphoma, either by fi ne needle aspiration or on frozen section
analysis. If cytology is doubtful and is not correlating with clinical, anatomical
and surgical fi ndings; immunohistochemistry is a very important tool in such
cases to give fi nal answer. Thyroid cell specifi c proteins such as thyroglobulin,
thyroid transcription factor-1, thyroperoxidase and dipeptidyl aminopeptidase-4,
neuroendocrine markers chromogranin, calcitonin and parathyroid hormone
could be used to rule out thyroid or parathyroid origin. We present such rare
case of ectopic cervical thymoma mimicking as papillary thyroid carcinoma.