Introduction: Thyroidectomy technique and extent are related to parathyroid injury and hypoparathyroidism. Total thyroidectomy is one of the most commonly performed endocrine surgeries, and the majority of patients recover completely without any complications. However, persistent hypoparathyroidism is the most prevalent long-term consequence following total thyroidectomy. While it is seldom deadly, it can cause severe morbidity for the patient and raise healthcare expenses. Methods: This retrospective cohort study was conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia. We included all confirmed thyroid cancer cases that underwent thyroidectomy with or without neck dissection between July 2016 and August 2022. The data was collected from a chart review of the electronic medical record system (BEST-care), and a data collection sheet was utilized. SPSS version 26 was used to analyze the data. Results: A total of 192 patients undergoing thyroid surgery were enrolled. One hundred forty-three (74.5%) were females and the mean age of participants was 45.29 ± 16.88 years. Most patients, 170 (88.5%), had a papillary histological type, and total thyroidectomy was performed in 150 (78.1%). A significant association was found between the type of surgery and postoperative hypoparathyroidism (p=<0.05*). In addition, hypocalcemia was seen in 147 (76.6%) of the patients. Postoperative hypoparathyroidism was significantly higher among patients who had asymptomatic postoperative hypocalcemia and those who received IV calcium gluconate (p=<0.05*). Moreover, postoperative hypocalcemia, hypomagnesemia, and hyperphosphatemia were significantly associated with postoperative hypoparathyroidism (p=<0.05*). Conclusion: The incidence of postoperative hypoparathyroidism is significantly higher among patients who underwent total thyroidectomy and had a normal level of preoperative parathyroid hormone (PTH) and magnesium (Mg) levels. Identifying these factors is a crucial step to minimize the occurrence of such complications.

The diagnosis of craniofacial osteosarcoma can be quite challenging, and the condition often goes unrecognized for a considerable period of time. In this report, we discuss the case of a 21-year old woman who presented with a one-year history of a small swelling over the left maxillary alveolar ridge. Upon further investigation, the histopathological examination showed high-grade chondroblastic osteosarcoma. The option of four cycles of neoadjuvant chemotherapy regimen preoperatively was chosen, and left inferior maxillectomy was performed along with reconstruction with obturator prosthesis. This case highlights the difficulties encountered in such rare cases of craniofacial osteosarcomas both in terms of the delay in the establishment of the diagnosis as well as management protocol. A high index of suspicion is required in cases of craniofacial osteosarcoma and early surgical resection with adequate safety margins is warranted.

Tongue rhabdomyosarcomas (RMSs) are extremely rare soft tissue tumors in the pediatric age group. The most common reported histopathology type is embryonal. To our knowledge, epithelioid type has not yet been reported in tongue RMSs. We report a case of an eight-year-old boy who presented with a painless tongue mass, and the biopsy demonstrated RMS epithelioid type. Head magnetic resonance imaging (MRI) was performed and showed peripherally enhancing mass with central cystic/necrotic component. Computed tomography (CT) scan of the neck showed involvement of the cervical lymph nodes, while metastatic workup was negative for malignancy. As the biopsy showed a positive margin, the patient underwent secondary resection. Moreover, he received adjuvant chemotherapy and radiotherapy. There was no evidence of the disease, and no metastasis was detected in a follow-up of three years. We also performed a literature review of pediatric tongue RMSs to assess the clinical presentation, histopathology, diagnosis, and management.

Synchronous cancers are multiple cancers that develop within six months of the initial diagnosis while metachronous cancers are those that develop more than six months after the initial diagnosis. A combination of three cancers is seen with several patients, which leads to a bad prognosis, and that of synchronous cancers is worse than that of metachronous cancers. Herein, we describe the case of a 62-year-old woman with multiple metachronous head and neck cancers.