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Benzylthiouracil has been recently observed to be associated with antineutrophil cytoplasmic antibody-positive vasculitis, resulting in crescentic glomerulonephritis. We report an 8-year-old girl treated with benzylthiouracil for Graves's disease who developed an ANCA-positive vasculitis with pulmonary hemorrhage. She responded to corticosteroids and discontinuation of benzylthiouracil. This represents the first pediatric case of benzylthiouracil-induced diffuse alveolar hemorrhage.

Background Tumor deposits are irregular clusters of tumor cells in adipose tissue, discontinuous from the primary tumor. While their prognostic relevance has been well established in colorectal and gastric cancers, their significance in breast cancer remains poorly understood. This case highlights the presence of tumor deposits in breast cancer, with focus on their potential prognostic implications as well as the need for clearer diagnostic criteria. Case presentation We report the case of a 58-year-old Tunisian woman who presented with a 2-cm breast nodule. Clinically, the lesion was staged as T4bN0Mx, and imaging classified it as American College of Radiology category 5. Fine needle biopsy revealed an invasive grade III breast carcinoma according to the Scarff–Bloom–Richardson grading scale. The patient received hormone therapy, radiotherapy, and neoadjuvant chemotherapy followed by mastectomy with axillary dissection. Histopathological examination of axillary adipose revealed 14 tumor deposits and five metastatic lymph nodes with extracapsular extension. The pathological response to chemotherapy was poor, with more than 50% residual tumor. The patient is currently in good condition and is receiving hormone therapy. Conclusion Although tumor deposits are correlated with poor prognosis in other cancers, particularly in colorectal and gastric cancer, limited data are available for breast cancer. Owing to the unclear diagnostic criteria, they are often considered as lymph node metastases. To address this issue, we recommend reporting tumor deposits, and we encourage further studies on larger cohorts to better define their prognostic value and eventually, discuss their inclusion in the tumor, node, metastasis staging system.

Background Collision tumors are rare but well-documented phenomena, where two distinct tumors of different origins are found together. We present a unique case of a parathyroid adenoma revealing a subclinical widespread breast carcinoma. Case presentation A 67-year-old Tunisian woman with a history of triple-negative breast carcinoma was diagnosed with hypercalcemia and elevated parathyroid hormone levels. Imaging studies revealed an ectopic mediastinal parathyroid adenoma and a jugulo-carotid mass. Microscopic exam showed a well-circumscribed parathyroid adenoma, surrounded by a thin fibrous capsule, containing multifocal deposits of large, atypical cells negative for parathyroid markers (synaptophysin and chromogranin) and positive for cytokeratin 7. The jugulo-carotid mass was an ectopic thyroid adenoma that was also infiltrated, confirming a subclinical spread of breast carcinoma. Conclusion Parathyroid metastases from breast carcinoma are rare, although more frequent than primary malignancies of the parathyroid gland. This case highlights the need to consider metastatic involvement in cases of parathyroid adenoma, particularly in patients with a history of malignancy. Further research is warranted to elucidate the mechanisms underlying tumor-to-tumor metastases and to assess its impact on clinical management and prognosis.