Follicular variant of papillary carcinoma thyroid is an aggressive variant of papillary carcinoma thyroid. It is more commonly associated with extrathyroidal extension and regional lymphadenopathy. It can rarely be associated with microscopic vascular invasion but tumor thrombus into great veins is a rare phenomenon. We present a case of 60-year-old male with follicular variant of papillary carcinoma thyroid with tumor thrombosis in superior thyroid vein and internal jugular vein (IJV). We report a case of a 60-year-old male who presented with a large swelling in the lower part of left side of neck for 4 months. Clinical examination revealed a hard swelling of 12x8 cm in left side of neck. Ultrasonography showed a solitary thyroid mass of the left lobe and a dilated left superior thyroid vein and ipsilateral IJV. Fine-needle aspiration cytology revealed follicular variant of PTC cells. Total thyroidectomy was done. A tumor thrombus was discovered in the superior thyroid vein and left IJV was found to be dilated. The left IJV with superior thyroid vein was ligated and excised. The patient recovered well after the operation with no local or distant metastasis detected. Follicular variant of PTC commonly spreads to the lymph nodes. Vascular spread via direct intravascular extension through superior thyroid vein is extremely rare. On palpation cord like IJV is felt on the involved side. Neck ultrasound play important role in the diagnosis. Aggressive surgical treatment with IJV ligation above and below the tumor thrombus is recommended to minimize the risk of potentially fatal complications of the intraluminal masses. Intravascular tumor extension into IJV of neck in follicular variant of PTC is rare and can be associated with serious consequences. Total thyroidectomy with thrombectomy with ligation of IJV must be done.

Background and Objectives: This study investigates the role of manuka honey in the healing of postoperative mastoid cavity.Subjects and Method This was a single centre prospective study on 40 consecutive patients of chronic otitis media undergoing canal wall down mastoidectomy. Manuka honey soaked in gel foam was kept in the mastoid cavity for the study group and antibiotic soaked gel foam was kept for the control group. Culture swabs from mastoid granulations were sent at various times from both groups. The healing of the mastoid cavity was assessed in the follow up period. Results: Preoperatively 15 out of 20 patients (75%) had a positive aural swab culture in the study group while 11 out of 20 (55%) in the control group had a positive aural swab culture. The most common organism isolated was Pseudomonas aeruginosa and Proteus mirabilis. One month after mastoidectomy only 4 patients (20%) had sterile culture and 16 patients (80%) had grown organisms; in the control group, 7 patients (35%) had sterile culture and 13 patients (65%) had growth on culture. The mean merchant scores for the study group and the control were 2.61 (2-5) and 2.05 (1-4), respectively. At 3 months 13 patients (65%) with sterile culture and 7 patients (35%) had growth on culture; in the control group, 16 patients (80%) had sterile culture and 4 had shown persistent growth on culture (p=0.28). All positive cultures were aerobic in both groups. The mean merchant scores for the study group and the control were 1.03 (0-4) and 0.7 (0-3), respectively (p=0.09). Conclusion Healing of mastoid cavity was almost similar in both groups (p>0.05). Manuka honey exhibited antibacterial activity against Pseudomonas, Proteus, Klebsiella, Escherichia coli, Staphylococcus.