A paradoxical role for an acute phase reactant in decompensated cirrhosis.

Background: This study aims to determine the predictive power of baseline C-reactive protein (CRP) value in cirrhotic patients with ascites, without overt infection, that might lead to spontaneous bacterial peritonitis (SBP)/ cellullitis.

Methods: 152 consecutive cirrhotic patients with ascites, without overt infection were included in the study, after measuring the baseline CRP value. All patients were followed up for a duration of one year, or till development of SBP/cellulitis.

Clinical images. Thyroid follicular carcinoma presenting as intraorbital, intracranial, and subcutaneous metastasis.

Follicular carcinoma of the thyroid usually metastasizes through a hematogenous route to the bone, lung, and central nervous system. Metastasis to subcutaneous tissues and retro-orbital region is unusual. We report an unusual case of follicular thyroid carcinoma with metastasis to subcutaneous tissues in the right temporal region with invasion of bone and intraorbital and intracranial tissues that was diagnosed by a computed tomography scan and biopsy.