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Sample records for malignant thyroid neoplasms

  1. NDRG1 protein overexpression in malignant thyroid neoplasms

    Renê Gerhard

    2010-06-01

    Full Text Available OBJECTIVES: The aim of this study was to examine the expression of the N-myc downstream-regulated gene 1 protein in benign and malignant lesions of the thyroid gland by immunohistochemistry. INTRODUCTION: N-myc downstream-regulated gene 1 encodes a protein whose expression is induced by various stimuli, including cell differentiation, exposure to heavy metals, hypoxia, and DNA damage. Increased N-myc downstream-regulated gene 1 expression has been detected in various types of tumors, but the role of N-myc downstream-regulated gene 1 expression in thyroid lesions remains to be determined. METHODS: A tissue microarray paraffin block containing 265 tissue fragments corresponding to normal thyroid, nodular goiter, follicular adenoma, papillary thyroid carcinoma (classical pattern and follicular variant, follicular carcinoma, and metastases of papillary and follicular thyroid carcinomas were analyzed by immunohistochemistry using a polyclonal anti- N-myc downstream-regulated gene 1 antibody. RESULTS: The immunohistochemical expression of N-myc downstream-regulated gene 1 was higher in carcinomas compared to normal thyroid glands and nodular goiters, with higher expression in classical papillary thyroid carcinomas and metastases of thyroid carcinomas (P < 0.001. A combined analysis showed higher immunohistochemical expression of NDRG1 in malignant lesions (classical pattern and follicular variant of papillary thyroid carcinomas, follicular carcinomas, and metastases of thyroid carcinomas compared to benign thyroid lesions (goiter and follicular adenomas (P = 0.043. In thyroid carcinomas, N-myc downstream-regulated gene 1 expression was significantly correlated with a more advanced TNM stage (P = 0.007 and age, metastasis, tumor extent, and size (AMES high-risk group (P = 0.012. CONCLUSIONS: Thyroid carcinomas showed increased immunohistochemical N-myc downstream-regulated gene 1 expression compared to normal and benign thyroid lesions and is correlated with more advanced tumor stages.

  2. FNA of misclassified primary malignant neoplasms of the thyroid: Impact on clinical management

    Shah Sejal; Faquin William; Izquierdo Roberto; Khurana Kamal

    2009-01-01

    Background: Fine needle aspiration (FNA) cytology is a popular, reliable and cost effective technique for the diagnosis of thyroid lesions. The aim of our study was to review cases of misclassified primary malignant neoplasms of the thyroid by FNA, and assess the causes of cytologic misdiagnosis and their impact on clinical management. Methods: Clinical data, FNA smears and follow-up surgical specimens of cases diagnosed with primary thyroid carcinoma were reviewed. Results: Of the 365 c...

  3. FNA of misclassified primary malignant neoplasms of the thyroid: Impact on clinical management

    Shah Sejal

    2009-01-01

    Full Text Available Background: Fine needle aspiration (FNA cytology is a popular, reliable and cost effective technique for the diagnosis of thyroid lesions. The aim of our study was to review cases of misclassified primary malignant neoplasms of the thyroid by FNA, and assess the causes of cytologic misdiagnosis and their impact on clinical management. Methods: Clinical data, FNA smears and follow-up surgical specimens of cases diagnosed with primary thyroid carcinoma were reviewed. Results: Of the 365 cases with a malignant diagnosis by FNA over a period of 11 years, nine (2.4 % were identified with discrepant histologic diagnosis with regard to the type of primary thyroid malignancy. In addition, four cases were added from the consultation files of the Massachusetts General Hospital. Areas of difficulty contributing to misclassification included overlapping cytologic features (n = 6, rarity of tumors (n = 3, and sampling limitations (n = 4. Of the 13 cases, 12 underwent total or near total thyroidectomy and one patient had concurrent surgical biopsy. Measurement of serum calcitonin levels in one case, with an initial cytologic diagnosis of medullary carcinoma, prevented unnecessary lymph node dissection. Misclassification of medullary carcinoma as papillary carcinoma precluded lymph node dissection in one case. Further management decisions were based on the final histologic diagnosis and did not require additional surgery. Two cases of undifferentiated (anaplastic thyroid carcinoma were misdiagnosed as papillary thyroid carcinoma. Both patients received total thyroidectomies, which may not otherwise have been performed. Conclusions: A small subset of primary malignant neoplasms of the thyroid may be misclassified with regard to the type of malignancy on FNA. The majority of primary malignant neoplasms diagnosed on FNA require thyroidectomy. However, initial cytologic misclassification of medullary carcinoma or undifferentiated carcinoma as other malignant neoplasms or vice versa may have an impact on clinical management.

  4. Older Age and Larger Tumor Size Predict Malignancy in Hürthle Cell Neoplasms of the Thyroid

    Zhang, Yi Wei; Greenblatt, David Yu; Repplinger, Daniel; Bargren, Anna; Adler, Joel T.; Sippel, Rebecca S.; Chen, Herbert

    2016-01-01

    Background Hürthle cell neoplasms (HCNs) are rare tumors of the thyroid gland. The definitive treatment for Hürthle cell carcinoma (HCC) is total thyroidectomy, while thyroid lobectomy is adequate for Hürthle cell adenoma (HCA). However, differentiating HCC from HCA either before or during surgery is a challenge. The purpose of this study was to identify factors that predict malignancy in patients with HCN. Methods Between May 1994 and January 2007, 1,199 patients underwent thyroid surgery at an academic medical center. Medical records of 55 consecutive patients who underwent thyroid resections for the preoperative diagnosis of HCN were reviewed. Results Of the 55 patients with HCN, 46 (84%) had adenomas and 9 (16%) had carcinomas. Patients with HCC were significantly older than those with HCA (66 ± 6 years versus 53 ± 2 years, P = 0.01). Patients with carcinoma also had significantly larger thyroid nodules (4.5 ± 0.7 cm versus 2.5 ± 0.2 cm, P < 0.001). All HCNs less than 2 cm in diameter were benign. The malignancy rate increased with nodule size: 18% of nodules measuring 2–4 cm, and 44% of those larger than 4 cm were HCC. One patient with HCC had recurrence of the disease, but there were no disease-related deaths. Conclusion Advanced patient age and larger nodule size are two important factors that predict malignancy in patients with HCN. In patients with these and other known risk factors for HCC, total thyroidectomy should be considered. PMID:18665423

  5. Malignant neoplasms in organ transplant recipients

    Radiologic and clinicopathologic features were analyzed in 29 recipients with 31 malignant neoplasms. Malignant neoplasms included ten non-Hodgkin lymphomas, one case of Hodgkin disease, and 19 carcinomas of the skin, colon, head and neck, thyroid, lung, uterus, and vulva. Lymphoma had the most widespread organ involvement, with spread to lymph nodes, central nervous system, liver, spleen, muscle, and native and transplanted kidney. Comparison of cyclosporine-treated and -untreated recipients indicated that the latter had a shorter interval from transplantation to tumor diagnosis (4 vs 54 months) and demonstrated more extensive tumor spread

  6. Horner's syndrome and thyroid neoplasms.

    Leuchter, Igor; Becker, Minerva; Mickel, Robert; Dulguerov, Pavel

    2002-01-01

    Although thyroid goiter is a common condition, it rarely results in Horner's syndrome. We report a case of a patient with an intrathoracic multinodular goiter complicated by Horner's syndrome. Benign thyroid disease was confirmed pathologically, and the patient's symptoms improved after surgery. In the literature, the major cause of Horner's syndrome is neoplasia, with malignant lesions being twice as frequent as benign tumors. An extensive review of the literature demonstrates a different repartition for thyroid neoplasia: including our case, 38 cases of Horner's syndrome secondary to a benign thyroid tumor are described, against only 8 cases caused by a thyroid carcinoma. We conclude that contrary to the commonly held opinion, Horner's syndrome is more often due to benign thyroid diseases than to thyroid malignancies. PMID:11891400

  7. Horner's syndrome and thyroid neoplasms

    Leuchter, Igor; Becker, Minerva; Mickel, Robert; Dulguerov, Pavel

    2002-01-01

    Although thyroid goiter is a common condition, it rarely results in Horner's syndrome. We report a case of a patient with an intrathoracic multinodular goiter complicated by Horner's syndrome. Benign thyroid disease was confirmed pathologically, and the patient's symptoms improved after surgery. In the literature, the major cause of Horner's syndrome is neoplasia, with malignant lesions being twice as frequent as benign tumors. An extensive review of the literature demonstrates a different re...

  8. The surgical management of benign and malignant thyroid neoplasms in Marshall Islanders exposed to hydrogen bomb fallout.

    Dobyns, B M; Hyrmer, B A

    1992-01-01

    On March 1, 1954, a serious fallout accident occurred during the United States atomic testing program at Bikini in the Trust Territory of the Pacific Islands. Following the detonation of a large thermonuclear device (known as Bravo) an unexpected shift in winds resulted in deposition of radioactive debris on several inhabited atolls in the Marshall Islands. During the early post-detonation period military, sea, and air surveys traced the hottest portion of the parabolic cloud as it drifted in an ever widening pattern of diminishing concentration eastward and southeast of Bikini. The center of the cloud passed North of the Rongelap Atoll, which was the nearest inhabited atoll. This report concerns the development of thyroid lesions, the special circumstances encountered during thyroid surgery, and the results of the surgical management of benign and malignant lesions that were subsequently encountered in this population. PMID:1290253

  9. Efficacy of Cytokeratin 19 expression on fine needle aspiration cell blocks in pre-operative diagnosis of malignant thyroid neoplasms

    Vimal Bhandari

    2012-01-01

    Full Text Available Context: Accurate diagnosis of malignant lesions of thyroid remains a challenge, especially when classical features are lacking on cytological examination. Aims: To evaluate the expression of Cytokeratin 19 (CK 19 on cell blocks made from thyroid swellings diagnosed as papillary carcinoma or follicular adenoma/carcinoma on fine needle aspiration cytology (FNAC smears. Materials and Methods: Aspirates from fifty patients diagnosed as papillary or follicular lesions on FNAC were enrolled in the study. Cell blocks were simultaneously made along with aspiration using standard cell block techniques. These cell blocks were subjected to Cytokeratin 19 immunoassay using immunoperoxidase ABC (avidin biotin complex. Statistical Analysis Used: Chi-square test for statistical significance and Goldman test for sensitivity and specificity. Results: Evaluation of the expression of Cytokeratin 19 on cell blocks revealed that almost all papillary thyroid carcinomas stained strongly positive while all follicular adenomas and follicular carcinomas were found to be negative for CK 19 immunostaining. The difference in frequency of Cytokeratin 19 positive papillary carcinoma and follicular adenomas was statistically significant. The predictive value of a positive CK 19 test was found to be 100% while that of a negative test was 93.9%. Conclusions: Cytokeratin 19 immunostaining in conjunction with fine needle aspiration cell blocks can be a valuable marker in pre-operative diagnosis of papillary thyroid carcinoma along with its variants (sclerosing and follicular. This can help the clinician in formulation of treatment as papillary thyroid carcinoma is treated by radical measures as against the more conservative approach for benign follicular lesions.

  10. Ultrasonography a useful adjunctive in management of thyroid neoplasms

    Latoo, Manzoor; Lateef, Mohammed; Kirmani, Omar

    2007-01-01

    Fine needle aspiration cytology has been the gold standard of diagnosis in case of thyroid neoplasm. However ultrasonography of thyroid neoplasm is a useful guide for an operating thyroid surgeon. We in our study evaluated patients of thyroid neoplasm with USG thyroid & studied its role in the therapeutic management of neoplasm. In our study of 10 patients of thyroid neoplasm we found USG of the thyroid neoplasm as a valuable guide in management.

  11. RENAL DAMAGE WITH MALIGNANT NEOPLASMS

    I. B. Kolina

    2015-01-01

    Full Text Available The relationship between renal damage and malignant neoplasms is one of the most actual problems of the medicine of internal diseases. Very often, exactly availability of renal damage determines the forecast of cancer patients. The range of renal pathologies associated with tumors is unusually wide: from the mechanical effect of the tumor or metastases on the kidneys and/or the urinary tract and paraneoplastic manifestations in the form of nephritis or amyloidosis to nephropathies induced with drugs or tumor lysis, etc. Thrombotic complications that develop as a result of exposure to tumor effects, side effects of certain drugs or irradiation also play an important role in the development of the kidney damage. The most frequent variants of renal damage observed in the practice of medical internists (therapists, urologists, surgeons, etc., as well as methods of diagnosis and treatment approaches are described in the article. Timely and successful prevention and treatment of tumor-associated nephropathies give hope for retaining renal functions, therefore, a higher life standard after completion of anti-tumor therapy. Even a shortterm episode of acute renal damage suffered by a cancer patient must be accompanied with relevant examination and treatment. In the caseof transformation of acute renal damage into the chronic kidney disease, such patients need systematic and weighted renoprotective therapy and correct dosing of nephrotoxic drugs.

  12. Malignant intraperitoneal neoplasms of childhood

    Objective. The purpose of this paper is to review and categorize the CT appearances of primary and secondary intraperitoneal neoplasms in children. Materials and methods. We retrospectively reviewed the CT images of 14 cases of intraperitoneal neoplasms. They were reviewed for bowel wall thickening, mesenteric nodules, ascites, calcification, peritoneal nodules, omental caking, and contrast enhancement. Results. Computed tomography images of 14 cases of intraperitoneal neoplasms were evaluated: rhabdomyosarcoma (5), lymphoma (3), neuroblastoma (2), germ cell tumor (1), mesothelioma (1), Wilms tumor (1), and hepatocellular carcinoma (1). Nodular enhancement was seen in all cases, ascites in most, significant bowel wall thickening only with lymphoma, and calcification only with germ cell tumors. Omental caking was present both with rhabdomyosarcoma and lymphoma. Conclusions. While rare in pediatrics, intraperitoneal neoplasms occur in children, and CT is useful in identifying these peritoneal neoplasms. (orig.)

  13. Malignant intraperitoneal neoplasms of childhood

    Chung, C.J.; Fordham, L.A. [Department of Radiology, UNC School of Medicine, Chapel Hill, NC (United States); Bui, V. [School of Medicine, University of North Carolina, Chapel Hill, NC (United States); Hill, J. [Department of Radiology, Medical University of South Carolina, Charleston, SC (United States); Bulas, D. [Department of Radiology, Children`s National Medical Center, Washington, DC (United States)

    1998-05-01

    Objective. The purpose of this paper is to review and categorize the CT appearances of primary and secondary intraperitoneal neoplasms in children. Materials and methods. We retrospectively reviewed the CT images of 14 cases of intraperitoneal neoplasms. They were reviewed for bowel wall thickening, mesenteric nodules, ascites, calcification, peritoneal nodules, omental caking, and contrast enhancement. Results. Computed tomography images of 14 cases of intraperitoneal neoplasms were evaluated: rhabdomyosarcoma (5), lymphoma (3), neuroblastoma (2), germ cell tumor (1), mesothelioma (1), Wilms tumor (1), and hepatocellular carcinoma (1). Nodular enhancement was seen in all cases, ascites in most, significant bowel wall thickening only with lymphoma, and calcification only with germ cell tumors. Omental caking was present both with rhabdomyosarcoma and lymphoma. Conclusions. While rare in pediatrics, intraperitoneal neoplasms occur in children, and CT is useful in identifying these peritoneal neoplasms. (orig.) With 5 figs., 1 tab., 34 refs.

  14. Malignant lymphoma of the thyroid gland

    Čaparević Zorica

    2002-01-01

    Full Text Available Introduction Malignant lymphoma of the thyroid gland can be defined as a lymphoma arising from the thyroid gland. Lymphomas of the thyroid gland represent less than 5% of primary thyroid neoplasms and are two to three times more common in women than in men, whereas the median age is usually close to 60 years. Majority of thyroid lymphomas are diffuse, large-cell lymphomas. The incidence of thyroid lymphomas in patients with Hashimoto thyroiditis has markedly increased and this phenomenon is probably related to their pathogenesis. Clinical presentation Unlike most other thyroid neoplasms, lymphomas are usually rapidly enlarging masses and local symptoms are common: pain, hoarseness, dysphagia, and dyspnea or stridor. Diagnosis To evaluate the extent of disease, a chest x-ray and CT scans of the head and neck, chest, abdomen, and pelvis are necessary. An excisional or large-needle biopsy may also be necessary to make the correct diagnosis. Occasionally, these tumors can be confused with anaplastic thyroid carcinomas, which can lead to serious mistakes in management. A gallium scan or a positron emission tomography (PET scan can help later to establish whether any residual abnormality, observed on x-ray studies after treatment, contains active lymphoma or scar tissue. After diagnosis, patients are clinically staged (without surgery using appropriate computed tomography scans or magnetic resonance imaging. Therapy Assessment of the extent of thyroid lymphomas is crucial for prognosis and treatment. Total thyroidectomy may improve the prognosis in patients with intrathyroidal disease only. It is very important to identify patients with favorable prognostic factors and to treat them with standard chemotherapy (CHOP and radiotherapy protocols. Patients with diffuse large-cell primary thyroid lymphomas should not be treated with radiation therapy alone. Conclusion The best treatment results for malignant lymphomas of the thyroid gland are achieved using a combined-modality therapy.

  15. Multiple primary malignant neoplasms in breast cancer patients in Israel

    The data of an epidemiologic study of multiple primary malignant neoplasms in breast cancer patients in Israel are presented. During the 18-year period of the study 12,302 cases of breast carcinoma were diagnosed, and, of these, 984 patients (8%) had multiple primary malignant tumors. Forty-seven of these patients developed two multiple primary cancers. A significantly higher than expected incidence of second primary cancers occurred at the following five sites: the opposite breast, salivary glands, uterine corpus, ovary, and thyroid. Cancers of the stomach and gallbladder were fewer than expected. Treatment of the breast cancer by irradiation was associated with an increased risk of subsequent cancers of lung and hematopoietic system. The prognosis was mainly influenced by the site and malignancy of the second primary cancer. The incidence of multiple primary malignancies justifies a high level of alertness to this possibility in the follow-up of breast cancer patients

  16. Osteosarcoma as a second malignant neoplasm

    Purpose: The aim of this study is to compare primary and secondary osteosarcomas using data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program. Methods: Osteosarcoma cases were identified in the SEER Cancer Incidence Public-Use Database, 1973-96 (1511 primary and 133 secondary osteosarcomas). Secondary osteosarcomas were further classified as occurring within or outside the previously irradiated field. Comparisons among groups were performed by nominal logistic regression. Survival analyses were performed using Kaplan-Meir and proportional hazards regression. Results: Secondary osteosarcomas were more likely to have a non-extremity primary site and an older age at diagnosis (>40 years) (<0.0001 for both). Secondary osteosarcoma cases continued to be more likely to have a non-extremity site when excluding those occurring within the radiation field. Five-year overall survival was 50% lower for secondary osteosarcomas for both extremity and non-extremity sites. Primary malignancies associated with secondary osteosarcomas included 14 lymphomas/leukemias, six sarcomas, 54 carcinomas, and seven other cancers. Secondary osteosarcomas occurring within a field of radiation were more likely to occur at a younger age, have a malignancy with a primary morphology other than carcinoma, a non-limb site, and a longer duration between their primary malignant neoplasms and the development of osteosarcoma. No difference in the overall survival was noted between secondary osteosarcomas occurring within an irradiated field and those that did not. Conclusions: Secondary osteosarcomas are associated with carcinomas especially in the elderly. Although a 50% decreased 5-year survival was observed for secondary osteosarcomas in this study, this might not reflect the current outcomes with more aggressive therapy

  17. The spectrum of histologically diagnosed malignant neoplasms in Sabah, 1983-1988.

    Ganesan, J; Pillai, S S; Gudum, H R

    1991-06-01

    Malignant neoplasms diagnosed histologically in the state of Sabah during the period November 1983 to October 1988 were analysed to determine the distribution of malignant neoplasms according to site, age, sex and major ethnic groups. The five commonest malignant neoplasms in males were carcinomas of the nasopharynx, stomach, skin, lung and liver. In females the five commonest malignant neoplasms were carcinomas of the cervix uteri, breast, ovary, thyroid and skin. There was variation in these frequencies among the major ethnic groups. The most striking of these was the high frequency of nasopharyngeal carcinoma among Kadazan and Chinese males but not in males of the other indigenous groups. A significant number of patients with nasopharyngeal carcinoma was found in the younger age groups and most of the patients in the younger age groups were Kadazans. A relatively high frequency of carcinoma of the stomach, skin and liver was seen among Kadazans and other indigenous groups while carcinoma of the lung was seen relatively frequently among Chinese males. Among females carcinomas of the breast and cervix uteri were the most frequent malignant neoplasms in all the main ethnic groups. Possible reasons for these findings are discussed. PMID:1839414

  18. Malignancy in Solitary Thyroid Nodule.

    Majumder, K R; Karmakar, R; Karim, S S; Al-Mamun, A

    2016-01-01

    This prospective study was done to find out the relative frequency of the malignancy in cold solitary thyroid nodules with other solitary thyroid nodules (hot and warm). This study was carried out in the Department of General Surgery and Otolaryngology - Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2011 to February 2012. One hundred (100) patients with clinically and ultrasonographically diagnosed as solitary thyroid nodules were included. Out of them, 52% of patients were in the third and fourth decades of life and 26% were in the second decade of life. In sex distribution, females were more affected than males and female: male ratio was 2.1:1. All patients presented with neck swelling, which moved with deglutition and 18% presented with palpitation. Solitary nodule was present in about 60% in the right lobe and 32% in the left lobe. In 72% patients, radioiodine uptake was low; in 25% patient's radioiodine uptake was normal. The thyroid scan revealed 72% cold nodule, in 25% patients radioiodine uptake was normal. On Ultrasonographic study, 60% were solid, 28% cystic and others mixed. Each and every patient of this series was treated surgically. Mostly (73%) lobectomy was done. Total thyroidectomy was done in 16% cases. On histopathology, 56% were colloid nodule, 28% were adenoma and 16% were carcinoma. Among the 16% malignant patients, majority of the patients had their age between 21-48 years. Histopathological types were mostly papillary (50%). Complications of surgery were mostly hoarseness of voice (5%), hematoma (4%), infection (2%) and hypoparathyroidism (3%). In this study, more malignant cases (20.83%) were found in cold solitary nodules. PMID:26931247

  19. Radiotherapy of malignant thyroid tumours

    Radiotherapy of malignant thyroid tumours is usually secondary to surgical treatment. Operation should be as radical as possible but also be connected with as little risk as possible and take account of the possibility of radiotherapy. Radiotherapy here means radioiodine therapy as well as external radiotherapy. Radioiodine therapy is employed for local treatment of the thyroid with the objective of radical tumour destruction, either to destroy tumour foci or residues in apparently normal thyroid tissue or for complete elimination of the thyroid as metastases can be detected and treated reliably only after elimination of the thyroid. Radioiodine therapy is also used for the treatment of accumulating metastases; especially in small-focus lung metastases, it has a remittent or even a curative effect. Practical aspects of 131I-therapy are discussed, including radiation protection regulations and side-effects. Generally, external megavolt therapy with an intended curative effect on the primary tumour and the regional excretory ways is used in all types of tumour with the exception of differential thyreocyte carcinomas of stage T0sub(-)2N0M0 or in case of metastases distant from the primary tumour (M1). Palliative radiotherapy should be applied as early as possible in order to prevent pathological fractures, to give relief of pain, and to reduce local symptoms. Aspects of information and guidance of the patient and after-care are discussed. Results of the treatment and the prognosis of the patient are determined by the following factors: Histology, tumour stage, sex, age. The best prognosis is given for women under 40 with differentiated carcinoma and stage T0sub(-)2N0M0 (five-years survival rate 80%). Early detection, advances in surgery, radiotherapy and hormone therapy, and adherence to the above guidelines have improved the prognosis significantly. (orig./MG)

  20. Morphological and immunohistochemical characterization of spontaneous thyroid gland neoplasms in guinea pigs (Cavia porcellus).

    Gibbons, P M; Garner, M M; Kiupel, M

    2013-03-01

    Reports of thyroid gland neoplasms in guinea pigs (Cavia porcellus) are rare, but thyroid tumors are among the most common neoplasms seen in cases submitted to Northwest ZooPath. This report describes the histological and immunohistochemical characteristics of thyroid neoplasms and lists the concurrent conditions found in guinea pig cases submitted to Northwest ZooPath during 1998 to 2008. Of 526 guinea pig case submissions, 19 had thyroid neoplasms. The most common clinical findings included a palpable mass on the ventral neck and progressive weight loss. Neoplasms were removed as an excisional biopsy from 7 guinea pigs, and 3 of these animals died within a few days after surgery. Radiographic mineral density was detected in 2 masses. Five of the neoplasms were reported as cystic; 5 were black or a dark color. Histologically, the neoplasms were classified as macrofollicular thyroid adenoma (8), thyroid cystadenoma (1), papillary thyroid adenoma (3), follicular thyroid carcinoma (5), follicular-compact thyroid carcinoma (1), and small-cell thyroid carcinoma (1). Osseous metaplasia was present in 8 neoplasms, and myeloid hyperplasia was present in 1 neoplasm. All 19 neoplasms were positive for thyroid transcription factor 1 and thyroglobulin but negative for parathyroid hormone and calcitonin. Numerous concurrent diseases, including hepatopathies, cardiomyopathies, and nephropathies, were present and considered to be the cause of death in many cases. Research is needed to determine the appropriate modalities for antemortem diagnosis and treatment and whether thyroid disease plays a role in the pathogenesis of chronic degenerative diseases in guinea pigs. PMID:22688583

  1. Galectin-3 immunostaining in thyroid neoplasms Imunomarcação por galectina-3 em neoplasias de tireóide

    Marcos Emanuel de Alcântara Segura; Albino Verçosa de Magalhães

    2005-01-01

    Although fine-needle aspiration biopsy (FNAB) of the thyroid gland is the most important presurgical proceeding in defining the malignancy of a nodular lesion, it has limitations such as shared cytological morphology between malignant and benign lesions. Galectin-3, a b-galactoside-binding lectin is expressed mainly by malignant thyroid neoplasms. Fifty-seven specimens, including 14 papillary carcinomas, 22 follicular carcinomas and 21 follicular adenomas were tested for immunohistochemical s...

  2. Aftercare of malignant thyroid growth

    The 'standard programme of aftercare for patients with malignant thyroid growths' practised in our department comprises the following measures: - Searching for residual tissues and recurrences in the neck/throat region and for metastases by means of physical examination, scintigraphy, x-ray diagnosis and laboratory tests (including determination of tumour markers); - monitoring and treatment of side effects by thyroidectomy (recurrent paresis, parathyroprival tetany); - prevention, detection and treatment of side effects of high-dosed radio-iodine therapy (on salivary glands and bone marrow) or those of cytostatic treatment (on heart muscle and bone marrow); - monitoring substitutive and suppressive treatment with thyroxines; - psychological guidance and genetic counselling. Corresponding to therapeutic approach, the overall aftercare programme is aimed primarily at papillary and follicular carcinoma and C-cell carcinoma. However, aftercare is hardly effective with anaplastic carcinoma owing to its persistently bad prognosis and its 50% survival time of some three months. (orig./MG)

  3. Surgery for Malignant Sublingual and Minor Salivary Gland Neoplasms.

    Bradley, Patrick J; Ferris, Robert L

    2016-01-01

    Malignant sublingual gland neoplasms are rare, early-stage neoplasms presenting as painless non-ulcerated masses in the antero-lateral floor of the mouth. The majority of patients present with advanced disease, with symptoms of pain or anaesthesia of the tongue. Malignant minor salivary gland neoplasms are more common, the majority (>80%) of which present in the oral cavity, most frequently in the palatal area, as painless masses or as obstructive symptoms in the head and neck region. The most frequent pathologies are adenoid cystic carcinoma and mucoepidermoid carcinoma (>85%), with the majority presenting at an advanced stage (III/IV). Wide tumour-free surgical margin excision is the treatment of choice, followed by radiotherapy, after discussion of the multidisciplinary head and neck cancer tumour board. Improvements in survival and quality of life have been achieved since the introduction of endoscopic and robotic surgeries for many minor salivary gland malignancies. PMID:27092950

  4. Thyroid cancer: a lethal endocrine neoplasm

    This conference focuses on the controversies about managing thyroid cancer, emphasizing the possibility that the treatment of patients with potentially fatal thyroid cancer may be improved. Although the mortality rate from thyroid cancer is low, it is the highest among cancers affecting the endocrine glands (excluding the ovary). Exposure to radiation during childhood in the 1930s and 1940s increased the incidence of but not the mortality from thyroid cancer, because these tumors are mainly papillary cancers developing in young adults. These rates may change as the exposed cohort ages. Risk factors that increase mortality include older patient age and the growth characteristics of the tumor at diagnosis, the presence of distant metastases, and cell type (for example, the tall-cell variants of papillary cancer, follicular cancer [to be distinguished from the more benign follicular variant of papillary cancer], medullary cancer, and anaplastic cancer). Local metastases in lymph nodes do not seem to increase the risk for death from papillary cancer, but they do increase the risk for death from follicular and medullary cancer. In the latter, mortality is decreased by the early detection and treatment of patients with the familial multiple endocrine neoplasia syndrome 2a. There are excellent tumor markers for differentiated cancer of the parafollicular and of the follicular cells. Measuring the calcitonin level allows early diagnosis of familial medullary cancer, whereas measuring the thyroglobulin level, although useful only after total thyroidectomy, allows early recognition of recurrence or metastases of papillary or follicular cancer. Initial surgery, protocols for follow-up, and the use of radioiodine for the ablation of any residual thyroid and the treatment of metastatic cancer are discussed.128 references

  5. Thyroid neoplasms after radiation therapy for adolescent acne vulgaris

    There is a potential hazard of thyroid cancer after exposure to external irradiation for the treatment of adolescent acne vulgaris. We noted a 60% incidence of thyroid carcinoma among 20 patients with such a history, who were operated on for thyroid nodules during a five-year period. Eighty-three percent of the patients with carcinoma had either a follicular or a mixed papillary-follicular carcinoma; 17% had a papillary carcinoma; 33% had regional node metastases; none had evidence of distant metastases. The interval between radiation exposure and thyroidectomy ranged from nine to 41 years. This association of thyroid neoplasms and a prior history of radiation for acne vulgaris may be coincidental and therefore remains to be proved by retrospective surveys of large numbers of treated patients with appropriate controls

  6. Malignant pulmonary neoplasms causing airspace consolidation : CT findings

    To determine the CT findings of consolidative malignant neoplasms of the lung. Seventeen patients in whom pulmonary consolidation was seen on chest radiography were involved in this study. In all cases malignancy was subsequently proven;the neoplasms involved were bronchioloalveolar carcinoma (n=9), malignant lymphoma (n=4), mucoepidermoid tumor (n=1), metastasis from colon cancer (n=2), and metastasis from pancreatic mucinous adenocarcinoma (n=1). CT images were retrospectively analyzed in terms of enhancement pattern of the consolidation, morphologic appearance of an air-bronchogram, CT angiogram sign, pseudocavitation, and lymphadenopathy. Visually assessed enhancement pattern of the consolidation showed lower attenuation than adjacent muscles in bronchioloalveolar carcinoma (8/9) and metastasis (1/3);isoattenuation in malignant lymphoma (3/4), mucoepidermoid carcinoma (1/1), and metastasis (1/3); and higher attenuation in bronchioloalveolar carcinoma (1/9), malignant lymphoma (1/4), and metastasis (1/3). Among the 15 of 17 patients for whom an airbronchogram was available, a stretching and squeezing pattern was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). CT angiogram sign was identified in bronchioloalveolar carcinoma (5/9), malignant lymphoma (2/4), and metastasis (3/3). Pseudocavitation was observed in two patients with bronchioloalveolar carcinoma, while lymphadenopathy was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). Conglomerate and extrathoracic lymphadenopathy are commonly associated with malignant lymphoma. Malignant neoplasms which apper as consolidative lung lesions appear not only as bronchioloalveolar carcinoma, which is well known, but also in other forms. Although these lesions cannot be differentiated on the basis of air-bronchography and CT angiography, poor enhancement of consolidative lesion and pseudocavitation are characteristic findings of bronchioloalveolar carcinoma, and conglomerate or extrathoracic lymphadenopathy are also characteristic of malignant lymphoma

  7. Malignant pulmonary neoplasms causing airspace consolidation : CT findings

    Kim, Bong Soo; Park, Choong Ki; Kim, Kwon Hyung; Bae, Jae Ik; Park, Dong Woo; Kim, Yong Soo; Choi, Yo Won; Jeon, Seok Chol; Hahm, Chang Kok [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of); Baek, Jung Hwan [Dae Rim St. Mary' s Hospital, Seoul (Korea, Republic of)

    1999-11-01

    To determine the CT findings of consolidative malignant neoplasms of the lung. Seventeen patients in whom pulmonary consolidation was seen on chest radiography were involved in this study. In all cases malignancy was subsequently proven;the neoplasms involved were bronchioloalveolar carcinoma (n=9), malignant lymphoma (n=4), mucoepidermoid tumor (n=1), metastasis from colon cancer (n=2), and metastasis from pancreatic mucinous adenocarcinoma (n=1). CT images were retrospectively analyzed in terms of enhancement pattern of the consolidation, morphologic appearance of an air-bronchogram, CT angiogram sign, pseudocavitation, and lymphadenopathy. Visually assessed enhancement pattern of the consolidation showed lower attenuation than adjacent muscles in bronchioloalveolar carcinoma (8/9) and metastasis (1/3);isoattenuation in malignant lymphoma (3/4), mucoepidermoid carcinoma (1/1), and metastasis (1/3); and higher attenuation in bronchioloalveolar carcinoma (1/9), malignant lymphoma (1/4), and metastasis (1/3). Among the 15 of 17 patients for whom an airbronchogram was available, a stretching and squeezing pattern was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). CT angiogram sign was identified in bronchioloalveolar carcinoma (5/9), malignant lymphoma (2/4), and metastasis (3/3). Pseudocavitation was observed in two patients with bronchioloalveolar carcinoma, while lymphadenopathy was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). Conglomerate and extrathoracic lymphadenopathy are commonly associated with malignant lymphoma. Malignant neoplasms which apper as consolidative lung lesions appear not only as bronchioloalveolar carcinoma, which is well known, but also in other forms. Although these lesions cannot be differentiated on the basis of air-bronchography and CT angiography, poor enhancement of consolidative lesion and pseudocavitation are characteristic findings of bronchioloalveolar carcinoma, and conglomerate or extrathoracic lymphadenopathy are also characteristic of malignant lymphoma.

  8. Benign vs. Malignant Skin Adnexal Neoplasms: How Useful are Silhouettes?

    Rajalakshmi Tirumalae; M O Roopa

    2013-01-01

    Background: Skin adnexal tumors are daunting diagnostic problems. Cytologic atypia does not always imply malignancy and "typia" does not underscore a benign course. Bernard Ackerman first described criteria on silhouettes that enable distinction between the two. Aims: To evaluate the histologic features on silhouettes of benign and malignant skin adnexal tumors. To identify overlaps and confounding features. Materials and Methods: A blinded retrospective review of all skin adnexal neoplasms b...

  9. Primary mucosa-associated lymphoid tissue thyroid lymphoma: a rare thyroid neoplasm of extrathyroid origin

    Dimitrios Hadjidakis

    2012-01-01

    Full Text Available Primary thyroid lymphoma is a rare malignancy, representing 2-8% of all thyroid malignancies and 1-2% of all extranodal lymphomas. The majority of cases concern non-Hodgkin`s lymphoma of B cell origin, following by Hodgkins disease, T cell lymphomas and rarely marginal zone B-cell mucosa-associated lymphoid tissue (MALT lymphomas. MALT lymphomas have been associated with long-standing autoimmune Hashimoto`s thyroiditis. We present the case of a 44-years-old woman with thyroid MALT lymphoma in the background of multinodular goiter of autoimmune origin.

  10. Collecting and Storing Malignant, Borderline Malignant Neoplasms, and Related Samples From Young Patients With Cancer

    2015-11-12

    Acute Undifferentiated Leukemia; Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative; Childhood Acute Lymphoblastic Leukemia; Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies; Childhood Chronic Myelogenous Leukemia; Chronic Lymphocytic Leukemia; Hairy Cell Leukemia; Juvenile Myelomonocytic Leukemia; Mast Cell Leukemia; Neoplasm of Uncertain Malignant Potential; Prolymphocytic Leukemia; Secondary Acute Myeloid Leukemia; T-cell Large Granular Lymphocyte Leukemia; Unspecified Childhood Solid Tumor, Protocol Specific

  11. Magnetic resonance imaging of ovarian malignant neoplasms

    Thirty-four patients with ovarian malignant tumor were studied by magnetic resonance imaging (MRI). The findings were reviewed and compared with surgical findings concerning tumor invasion to the bladder, the uterus, and the rectum. The accuracy of MRI evaluation of the presence of ascites was also reviewed. The MRI analysis classifications were as follows: 1) fat, colon or small intestine between the tumor and the organs, 2-a) absence of fat layer and compression of organs by the cystic area of the tumor, 2-b) absence of fat layer and compression of organs by the solid part of the tumor, 3) the organs were deformed by the tumor or the interface of the organ and the tumor was obliterated. Groups 1) and 2-a) were considered to be free of invasion while 2-b) and 3) were considered to indicate invasion. Using these criteria, the accuracy of evaluation of invasion was 71% for the uterus, 73% for the bladder and 74% for the rectum. Accurate detection of ascites was made in only 68%. The MRI sagittal plane can directly show the relationship between the uterus, the bladder and the tumor, so that diagnosis of tumor invasion by MR imaging is easier than by CT. However, MRI could not differentiate between ascites and invasion nor demonstrate ascites as accurately as CT. (author)

  12. Thyroid Malignancies in Survivors of Hodgkin Lymphoma

    Michaelson, Evan M. [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States); Chen, Yu-Hui [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Silver, Barbara; Tishler, Roy B.; Marcus, Karen J. [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States); Stevenson, Mary Ann [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Ng, Andrea K., E-mail: ang@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States)

    2014-03-01

    Purpose: To quantify the incidence of thyroid cancer after Hodgkin lymphoma (HL) and determine disease characteristics, risk factors, and treatment outcomes. Methods and Materials: Thyroid cancer cases were retrospectively identified from a multi-institutional database of 1981 HL patients treated between 1969 and 2008. Thyroid cancer risk factors were evaluated by a Poisson regression model. Results: With a median follow-up duration of 14.3 years (range, 0-41.2 years), 28 patients (1.4%) developed a thyroid malignancy. The overall incidence rate (expressed as the number of cases per 10,000 person-years) and 10-year cumulative incidence of thyroid cancer were 9.6 and 0.26%, respectively. There were no observed cases of thyroid malignancy in patients who received neck irradiation for HL after age 35 years. Age <20 years at HL diagnosis and female sex were significantly associated with thyroid cancer. The incidence rates of females aged <20 at HL diagnosis in the first 10 years, ≥10 years, ≥15 years, and ≥20 years after treatment were 5, 31, 61, and 75 cases per 10,000 person-years of follow-up, respectively. At a median follow-up of 3.5 years after the thyroid cancer diagnosis, 26 patients (93%) were alive without disease, 1 (4%) was alive with metastatic disease, and 1 (4%) died of metastatic disease, at 6 and 3.6 years after the thyroid cancer diagnosis, respectively. Conclusions: Although HL survivors have an increased risk for thyroid cancer, the overall incidence is low. Routine thyroid cancer screening may benefit females treated at a young age and ≥10 years from HL treatment owing to their higher risk, which increases over time.

  13. Thyroid Malignancies in Survivors of Hodgkin Lymphoma

    Purpose: To quantify the incidence of thyroid cancer after Hodgkin lymphoma (HL) and determine disease characteristics, risk factors, and treatment outcomes. Methods and Materials: Thyroid cancer cases were retrospectively identified from a multi-institutional database of 1981 HL patients treated between 1969 and 2008. Thyroid cancer risk factors were evaluated by a Poisson regression model. Results: With a median follow-up duration of 14.3 years (range, 0-41.2 years), 28 patients (1.4%) developed a thyroid malignancy. The overall incidence rate (expressed as the number of cases per 10,000 person-years) and 10-year cumulative incidence of thyroid cancer were 9.6 and 0.26%, respectively. There were no observed cases of thyroid malignancy in patients who received neck irradiation for HL after age 35 years. Age <20 years at HL diagnosis and female sex were significantly associated with thyroid cancer. The incidence rates of females aged <20 at HL diagnosis in the first 10 years, ≥10 years, ≥15 years, and ≥20 years after treatment were 5, 31, 61, and 75 cases per 10,000 person-years of follow-up, respectively. At a median follow-up of 3.5 years after the thyroid cancer diagnosis, 26 patients (93%) were alive without disease, 1 (4%) was alive with metastatic disease, and 1 (4%) died of metastatic disease, at 6 and 3.6 years after the thyroid cancer diagnosis, respectively. Conclusions: Although HL survivors have an increased risk for thyroid cancer, the overall incidence is low. Routine thyroid cancer screening may benefit females treated at a young age and ≥10 years from HL treatment owing to their higher risk, which increases over time

  14. Combined treatment of parotid malignant neoplasms with postoperative neutron therapy

    Based on the study results of a group of 22 patients with parotid malignant neoplasms, being treated in combination with postoperative neutron radiotherapy, the authors have observed a considerable decrease of local recurrences. Sparing surgery with preparing and preserving the facial nerve branches as the first part of the combined treatment and neutron postoperative radiotherapy as the second part yield good cosmetic results and contribute to the social rehabilitation of the patients, also maintaining the radically of the operation. (authors)

  15. Extrapancreatic malignancies and intraductal papillary mucinous neoplasms of the pancreas

    Jaime Benarroch-Gampel

    2010-10-01

    Full Text Available Over the last two decades multiple studies have demonstrated an increased incidence of additional malignancies in patients with intraductal papillary mucinous neoplasms (IPMNs. Additional malignancies have been identified in 10%-52% of patients with IPMNs. The majority of these additional cancers occur before or concurrent with the diagnosis of IPMN. The gastrointestinal tract is most commonly involved in secondary malignancies, with benign colon polyps and colon cancer commonly seen in western countries and gastric cancer commonly seen in Asian countries. Other extrapancreatic malignancies associated with IPMNs include benign and malignant esophageal neoplasms, gastrointestinal stromal tumors, carcinoid tumors, hepatobiliary cancers, breast cancers, prostate cancers, and lung cancers. There is no clear etiology for the development of secondary malignancies in patients with IPMN. Although population-based studies have shown different results from single institution studies regarding the exact incidence of additional primary cancers in IPMN patients, both have reached the same conclusion: there is a higher incidence of extrapancreatic malignancies in patients with IPMNs than in the general population. This finding has significant clinical implications for both the initial evaluation and the subsequent long-term follow-up of patients with IPMNs. If a patient has not had recent colonoscopy, this should be performed during the evaluation of a newly diagnosed IPMN. Upper endoscopy should be performed in patients from Asian countries or for those who present with symptoms suggestive of upper gastrointestinal disease. Routine screening studies (breast and prostate should be carried out as currently recommended for patient’s age both before and after the diagnosis of IPMN.

  16. Second Malignant Neoplasms after Radio-Chemotherapy of Hodgkins Lymphoma

    The objective of this study is to identify the second malignant neoplasms (SMNs) after treatment of Hodgkins lymphoma (HL)in long-term survivors (LTS) of Hodgkins disease (HD) patients who were regularly attending the pediatric oncology clinic of National Cancer Institute (NCI). 42 LTS were studied. During 3 years period, all patients subjected to through clinical history/ examination. Files were revised for date of diagnoses, original site(s), stage, histopathological subtypes and dose/ duration of therapy. Clinical examination was done with laying stress on blood pressure, pulse, chest and cardiac examination, visceromegaly and the presence of lymphadenopathy. Lab investigations included CBC, ESR and bone marrow aspirate and/or biopsy. Radiodiagnostic studies were done whenever indicated. One LTS had acute myeloid leukemia [AML] as a second malignant neoplasm. Finally, the study documented the risk of secondary malignancy [AML] was one of the long-term sequelae of radio-chemotherapy in HD patients. Recommendations regarding the follow-up of therapy for HD and Screening for early detection of late effects were discussed. New strategies with reduction or elimination of radiation dose are needed for dealing with HD, especially in children.

  17. Second Malignant Neoplasms After Treatment of Childhood Acute Lymphoblastic Leukemia

    Schmiegelow, K.; Levinsen, Mette Frandsen; Attarbaschi, Andishe; Baruchel, Andre; Devidas, Meenakshi; Escherich, Gabriele; Gibson, Brenda; Heydrich, Christiane; Horibe, Keizo; Ishida, Yasushi; Liang, Der-Cherng; Locatelli, Franco; Michel, Gérard; Pieters, Rob; Piette, Caroline; Pui, Ching-Hon; Raimondi, Susana; Silverman, Lewis; Stanulla, Martin; Stark, Batia; Winick, Naomi; Valsecchi, Maria Grazia

    2013-01-01

    PURPOSE: Second malignant neoplasms (SMNs) after diagnosis of childhood acute lymphoblastic leukemia (ALL) are rare events. PATIENTS AND METHODS: We analyzed data on risk factors and outcomes of 642 children with SMNs occurring after treatment for ALL from 18 collaborative study groups between 1980...... and 2007. RESULTS: Acute myeloid leukemia (AML; n = 186), myelodysplastic syndrome (MDS; n = 69), and nonmeningioma brain tumor (n = 116) were the most common types of SMNs and had the poorest outcome (5-year survival rate, 18.1% ± 2.9%, 31.1% ± 6.2%, and 18.3% ± 3.8%, respectively). Five...

  18. Meningioma as second malignant neoplasm after oncological treatment during childhood

    A total of 38 patients (18 female/20 male) with childhood meningioma were recruited from the German registry HIT-Endo (1989-2009). In 5 cases meningioma occurred as second malignant neoplasm (SMN). Histologies were confirmed by reference assessment in all cases (SMN: 2 WHO I, 1 WHO II, 2 WHO III). The SMNs were diagnosed at a median age of 12.4 years with a median latency of 10.2 years after primary malignancy (PMN; 4 brain tumors, 1 lymphoblastic leukemia; median age at diagnosis 2.7 years). Meningioma occurred as SMN in the irradiated field of PMN (range 12-54 Gy). The outcome after treatment of SMN meningioma (surgery/irradiation) was favorable in terms of psychosocial status and functional capacity in 4 of 5 patients (1 death). We conclude that survivors of childhood cancer who were exposed to radiation therapy at young age harbor the risk of developing meningioma as a SMN at a particularly short latency period in case of high dose exposure. (orig.)

  19. Meningioma as second malignant neoplasm after oncological treatment during childhood

    Mueller, H.L.; Gebhardt, U. [Klinikum Oldenburg (Germany). Dept. of Pediatric Hematology and Oncology; Warmuth-Metz, M. [University Hospital Wuerzburg (Germany). Dept. of Neuroradiology; Pietsch, T. [Bonn Univ. (Germany). Dept. of Neuropathology; Soerensen, N. [Evangelisches Krankenhaus, Oldenburg (Germany). Dept. of Neurosurgery; Kortmann, R.D. [University Hospital Leipzig (Germany). Dept. of Radiooncology

    2012-05-15

    A total of 38 patients (18 female/20 male) with childhood meningioma were recruited from the German registry HIT-Endo (1989-2009). In 5 cases meningioma occurred as second malignant neoplasm (SMN). Histologies were confirmed by reference assessment in all cases (SMN: 2 WHO I, 1 WHO II, 2 WHO III). The SMNs were diagnosed at a median age of 12.4 years with a median latency of 10.2 years after primary malignancy (PMN; 4 brain tumors, 1 lymphoblastic leukemia; median age at diagnosis 2.7 years). Meningioma occurred as SMN in the irradiated field of PMN (range 12-54 Gy). The outcome after treatment of SMN meningioma (surgery/irradiation) was favorable in terms of psychosocial status and functional capacity in 4 of 5 patients (1 death). We conclude that survivors of childhood cancer who were exposed to radiation therapy at young age harbor the risk of developing meningioma as a SMN at a particularly short latency period in case of high dose exposure. (orig.)

  20. Thyroidal malignancy and scintigraphy; Schilddrsenmalignitaet und Szintigrafie

    Brandt-Mainz, K.; Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin Radionuk, Essen (Germany)

    2008-09-15

    Thyroid hypofunctional ('scintigraphic cool or cold') nodules are detected frequently. Dependent on the clinical situation, on morbidity and on economic aspects it is necessary to select patients for surgery and to avoid unnecessary surgical treatment. Therefore it is necessary to develop appropriate diagnostic algorithm to manage hypofunctional thyroid nodules. The ultrasound guided fine-needle aspiration cytology (FNA) is on the one hand side a useful diagnostic tool, but on the other hand side there exist certain limitations. It is questionable if the nodule is correctly reached. In case of heterogeneous larger mixed nodules or multiple hypofunctional nodules, it is difficult to choose the correct location of punctation. Furthermore a certain number of FNA's is not diagnostic without any result or due to 'follicular neoplasia'. {sup 99m}Tc-MIBI-sctintigraphy (MIBI) and {sup 18}F-FDG-positron-emission-tomography (FDG-PET) are established methods in the follow-up of differentiated thyroid cancer after thyroidectomy with elevated thyroglobulin-levels without adequate 131-Iodine-uptake. Moreover in case of parafollicular medullary thyroid carcinomas after thyroidectomy with elevated calcitonin-concentrations the FDG-PET is a valuable diagnostic method in localizing tumor. However these tracers gain in importance in differentiating malignant from benign preoperative hypofunctional nodules. In conclusion MIBI-scintigraphy should be used routinely to plan the correct guide of FNA. The application of both methods (MIBI and FNA) improves the differentiation of dignity, whereas a negative MIBI-examination and a negative FNA is able to exclude malignancy nearly. In this way the number of unnecessary numbers of surgical treatments can be reduced. FDG-PET is not definitely superior compared to MIBI-scintigraphy. From the cost perspective MIBI is more attractive than FDG-PET. (orig.)

  1. Primary osteosarcoma of the thyroid gland: report of a rare neoplasm Osteossarcoma primário da glândula tireoide: relato de uma neoplasia rara

    Eduardo Cambruzzi; João Grigoleti Scholl; Alberto Salgueiro Molinari; Karla Lais Pêgas

    2013-01-01

    Primary mesenchymal tumors of the thyroid gland are extremely rare. The authors report a case of primary thyroid osteosarcoma in a male patient presenting a tumoral mass in the neck. CT scan demonstrated a large tumor in the right thyroid lobe with areas of calcification. The surgical specimen consisted of a hard brown-gray tumor, measuring 13 × 11 × 7.5 cm. Microscopy revealed a high-grade malignant neoplasm composed of polygonal cells of intermediate size, chondroid pattern in some areas an...

  2. Sensitivity and Specificity of Galectin-3 and Glypican-3 in Follicular-Patterned and Other Thyroid Neoplasms

    Younes, Sheren Fouad

    2016-01-01

    Introduction Diagnosing follicular-patterned thyroid neoplasm can be quiet challenging in some cases, where an immunohistochemical profiling becomes mandatory. Galectin-3 may be a helpful tool for classical PTC diagnosis, but it cannot be considered as a diagnostic marker of malignancy. Glypican-3, in contrast, is not thoroughly studied in thyroid neoplasms. Aim Determine the sensitivity and specificity of galectin-3 and glypican-3 in diagnosing thyroid carcinoma and follicular-patterned thyroid carcinoma. Materials and Methods A retrospective study was conducted on archival blocks diagnosed from pathology department between 2010 and 2012 including 17 cases of follicular adenoma, 16 cases of Classic Papillary Thyroid Carcinoma (PTC), 6 cases of Follicular Variant of Papillary Thyroid Carcinoma (FVPTC), 3 cases of follicular carcinoma, 5 cases of medullary carcinoma and 1 case of Hürthle cell carcinoma. The nearby non neoplastic (normal) thyroid follicles present in both adenoma and carcinoma cases were also evaluated. Study Design Evaluation of both galectin-3 and glypican-3 expression using standard immunohistochemical techniques. Statistical Analysis Used Descriptive analysis of the variables and statistical significances were calculated by non-parametric chi-square test using the Statistical Package for the Social Sciences version 12.0 (SPSS). Results Five (30%) and 4 (24%) out of the 17 studied follicular adenoma cases, were positively stained by galectin-3 and glypican-3 respectively, while 30 (97%) and 25 (81%) cases out of the studied 31 carcinoma cases were positively stained by galectin-3 and glypican-3 respectively. The sensitivity, specificity and diagnostic accuracy of galectin-3 vs. glypican-3 in discrimination between thyroid carcinoma and adenoma was 96.8%, 70.6%, and 87.5%vs. 81% 76.5% and 79% respectively. As for the discrimination between follicular-patterned thyroid carcinoma and follicular adenoma it was 90%, 71% and 78% vs. 90% 76.5% and 82%. Conclusion Glypican-3 is more specific while galectin-3 is more sensitive in diagnosing thyroid carcinoma while glypican-3 is more specific than galectin-3 in discriminating follicular-patterned neoplasm.

  3. Malignant solitary fibrous tumor of the thyroid: a case-report and review of the literature

    Wellington Alves Filho

    2014-06-01

    Full Text Available Solitary fibrous tumor (SFT is an uncommon spindle-cell neoplasm that most often involves the pleura, rarely occurring in extra-thoracic locations. Twenty-six cases of SFT arising in the thyroid gland have been described. We report a case of a 60-year-old woman presenting an 8-month history of enlargement of the neck associated with dysphagia. The patient underwent a right hemithyroidectomy and SFT of the thyroid was diagnosed. Immunohistochemistry showed positivity for CD34 marker, and the high number of mitoses and the presence of cellular atypia suggested that the tumor was malignant. To our knowledge, this is the second case of malignant SFT of the thyroid gland ever reported. Due to the rarity of these tumors, the indication of adjuvant therapy and prognosis are uncertain. Long-term follow-up after surgical resection seems to be advisable.

  4. Galectin-3: A promising marker of thyroid malignancy

    Cveji? Dubravka S.

    2003-01-01

    Full Text Available Background: Galectin-3 is an endogenous beta-galactoside binding lectin implicated in neoplastic transformation and tumor progression. High levels of this lectin have recently been found in malignant thyroid tumors, but not in normal or benign thyroid tissue, suggesting galectin-3 as a promising presurgical marker of thyroid malignancy. Methods: We analyzed immunohistochemically galectin-3 expression in thyroid tissue using a monoclonal antibody. The total of 108 tissue specimens included 55 cases of thyroid carcinoma (30 papillary, 15 follicular, and 10 anaplastic type, 15 samples of follicular adenoma, 15 samples of normal thyroid tissue, and 23 thyroid tissue specimens from human fetuses (16 to 37 weeks of intrauterine life. Results: The results showed galectin-3 expression in 20/30 papillary carcinomas, 11/15 follicular carcinomas, 10/10 anaplastic carcinomas, and 4/15 follicular adenomas. Thyroid follicular cells in normal adult and fetal tissue were negative. Conclusions: These results further confirm that galectin-3 expression is a feature of malignant thyroid cells, and that immunohistochemical detection of galectin-3 could be useful in thyroid carcinoma diagnostics. The absence of galectin-3 in thyroid cells during fetal development suggests that galectin-3 is expressed de novo during malignant transformation of thyroid epithelium, thus it should not be considered an oncofetal antigen.

  5. Pleural mass forming extramedullary hematopoiesis masquerading as a malignant neoplasm.

    Meykler, Simon; Obstfeld, Amrom; Jhala, Nirag; Vergara, Norge; Gupta, Prabodh K

    2015-12-01

    Extramedullary hematopoiesis (EMH) represents the presence of immature hematopoietic elements and their differentiation into mature blood components outside of the medullary bone and may be seen in a variety of circumstances in the postnatal period, but is most strongly associated with disorders of the hematopoietic system. Postnatally, EMH is typically identified at sites of fetal hematopoiesis, the spleen, and liver, but occasional reports have identified it in nearly every tissue of the body. We report a case of EMH presenting as pleural mass, initially suspected to represent a neoplastic process in a patient with multiple comorbidities, including history of carcinoma, but without co-existing hematologic disorder. On-site evaluation of the fine-needle aspiration specimen was initially suspicious for a malignant neoplasm, but further evaluation revealed the lesion to be a mass forming focus of non-hepatosplenic EMH. In the era of increasing utilization of imaging, mass forming EMH is increasingly detected. When unsuspected, EMH may present a diagnostic challenge for the pathologist and may be confused for a neoplastic process. Diagn. Cytopathol. 2015;43:996-999. © 2015 Wiley Periodicals, Inc. PMID:26303071

  6. Corticosteroid correction of leukopenia in radiotherapy for malignant neoplasms

    In radiation therapy, depression of hematopoiesis, particularly leukopoiesis, is a common attendant phenomenon presenting a complex therapeutic problem that is not readily solved. On account of this and in connection with some reports in te literature, the Roentgenology and Radiology Chair at the Sofia Medical Faculty has undertaken a study of corticosteroid leukostimulating effects in 25 female patients with extinct ovarian function. These patients with carcinomas were distributed as follows. By site of carcinoma: 11, uterus; 8, breast; 5, ovarium; 1, larynx. By clinical stage: 3, first stage; 13, second stage; 8, third stage; 1, forth stage. By degree of leukopenia: 4, light (3000-4000); 20, intermediate (2000-3000); 1, severe (1000-2000). Five of the patients were given corticosteroids alone; the remaining 20, corticosteroids plus conventional leukostimulators (leukogen, leuko-4, folic acid, vitamin B6). The following results were obtained: averaged over the group, leukopenia correction time was of 5.96 days per patient; rise in leukocyte counts relative to initial levels, by 79%. For comparison, observations were made on a control group of 25 patients with the same pathologic entities, who were given no corticosteroids but only the above mentioned conventional leukostimulators. Findings in this group were as follows: average correction time, 9.16 days; rise in leukocyte counts, by 22%. These results give us reason to assume that corticosteroids may be a good means for obtaining a more rapid and effective correction of leukopenias in radiotherapy of malignant neoplasms. (author)

  7. Unusual malignant solid neoplasms of the kidney: Cross-sectional imaging findings

    Karaosmanoglu, Ali Devrim; Hahn, Peter F. [Dept. of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston (United States); Shirkhoda, Ali [Dept. of Radiology, University of California School of Medicine, Irvine (United States); Onur, Mehmet Ruhi; Ozmen, Mustafa [Dept. of Radiology, University of Hacettepe School of Medicine, Ankara (Turkmenistan)

    2015-08-15

    Malignant kidney neoplasms are the most frequently encountered solid kidney masses. Although renal cell carcinoma is the major renal malignancy, other solid malignant renal masses should be considered in the differential diagnosis of solid renal masses that do not contain a macroscopic fatty component. In this pictorial essay, we present the imaging findings of a primitive neuroectodermal tumor, primary liposarcoma of the kidney, primary neuroendocrine tumor, leiomyosarcoma, synovial sarcoma, malignant fibrous histiocytoma, sclerosing fibrosarcoma and renal metastasis of osteosarcoma.

  8. Unusual malignant solid neoplasms of the kidney: Cross-sectional imaging findings

    Malignant kidney neoplasms are the most frequently encountered solid kidney masses. Although renal cell carcinoma is the major renal malignancy, other solid malignant renal masses should be considered in the differential diagnosis of solid renal masses that do not contain a macroscopic fatty component. In this pictorial essay, we present the imaging findings of a primitive neuroectodermal tumor, primary liposarcoma of the kidney, primary neuroendocrine tumor, leiomyosarcoma, synovial sarcoma, malignant fibrous histiocytoma, sclerosing fibrosarcoma and renal metastasis of osteosarcoma

  9. Unusual Malignant Solid Neoplasms of the Kidney: Cross-Sectional Imaging Findings

    Karaosmano?lu, Ali Devrim; Shirkhoda, Ali; Ozmen, Mustafa; Hahn, Peter F.

    2015-01-01

    Malignant kidney neoplasms are the most frequently encountered solid kidney masses. Although renal cell carcinoma is the major renal malignancy, other solid malignant renal masses should be considered in the differential diagnosis of solid renal masses that do not contain a macroscopic fatty component. In this pictorial essay, we present the imaging findings of a primitive neuroectodermal tumor, primary liposarcoma of the kidney, primary neuroendocrine tumor, leiomyosarcoma, synovial sarcoma, malignant fibrous histiocytoma, sclerosing fibrosarcoma and renal metastasis of osteosarcoma. PMID:26175585

  10. Familial Adenomatous Polyposis—Rendering a Diagnosis Based on Recognition of an Unusual Primary Thyroid Neoplasm

    Berean, Kenneth W; Owen, David A.; Eric M. Yoshida; Schaeffer, David F.

    2011-01-01

    It has been well established in the literature that the cribriform-morular variant of papillary thyroid carcinoma (CMVPTC) has been observed with higher frequency in familial adenomatous polyposis (FAP) patients. In the usual setting, patients with FAP are identified based on their germline mutations and the diagnosis of thyroid neoplasm is made after the FAP diagnosis. We herein report a case in which the recognition of a CMVPTC led to the initial diagnosis of FAP. The histological and clini...

  11. Benign and Malignant Nodular Thyroid Disease in Acromegaly. Is a Routine Thyroid Ultrasound Evaluation Advisable?

    Reverter, Jordi L.; Fajardo, Carmen; Resmini, Eugenia; Salinas, Isabel; Mora, Mireia; Llatjós, Mariona; Sesmilo, Gemma; Rius, Ferran; Halperin, Irene; Webb, Susan M; Ricart, Veronica; Riesgo, Pedro; Mauricio Puente, Dídac; Puig-Domingo, Manel

    2014-01-01

    Data on the prevalence of benign and malignant nodular thyroid disease in patients with acromegaly is a matter of debate. In the last decade an increasing incidence of thyroid cancer has been reported. The aim of this study was to evaluate the prevalence of goiter, thyroid nodules and thyroid cancer in a large series of patients with acromegaly with a cross-sectional study with a control group. Six Spanish university hospitals participated. One hundred and twenty three patients (50% ...

  12. Risk of neoplasia and malignancy in "dominant" thyroid swellings.

    Cusick, E L; Krukowski, Z H; MacIntosh, C A; Matheson, N A

    1991-01-01

    OBJECTIVE--To determine the risk of neoplasia and malignancy in "dominant" thyroid swellings. DESIGN--Prospective analysis during six years. SETTING--Thyroid clinic serving the Grampian region. PATIENTS--574 consecutive patients presenting with a discrete thyroid swelling, of whom 179 (31%) were classified clinically as having a dominant area of enlargement within a multinodular gland. RESULTS--After clinical and cytological assessment 77 dominant swellings were excised. Of the excised swelli...

  13. Histologically benign but clinically malignant neoplasms in the thorax: CT–pathological overview

    The purpose of this article is to review the computed tomography (CT) and histopathological features of uncommon primary neoplasms of the thorax that can manifest clinically malignant features (multiplicity of pulmonary nodules, an invasive nature, and metastases or recurrence after surgery) with little evidence of histological malignancy.

  14. Spatio-temporal models for incidence of malignant neoplasms in the area subjected to radioactive contamination after the Chernobyl accident

    Data from oncology studies performed in the Ukraine, Belarus, and Russia on the number of new patients with cancer (including leukemia) from 1980 through 1990 in 12 regions adjacent to the Chernobyl nuclear power plant are summarized in this paper. Spatio-temporal models for determining the incidence of malignant diseases in the population were developed. The analysis of possible correlations between dose equivalents and incidence of cancer in populations living in the contaminated areas were performed. The incidence of malignant neoplasms, including hemoblastoses, was found to be trending upward during both the pre- and post-accident periods, and the increases were not related to radiation dose. There have been no statistically significant increases in incidences of any tumors (with the possible exception of thyroid tumors), attributable to radiation doses, even in the most contaminated open-quotes controlled areaclose quotes (CA). Three cases of thyroid cancer in 1990 in children living in areas where considerable amounts of radioactive iodine were deposited suggests that the absorbed doses from the intake of radioiodine may have resulted in an increased incidence of thyroid cancers. However, this and other conclusions of the study are necessarily limited by the fact that this is an ecological study with no data on individual cancer cases, and the limited follow-up period of the results of the study signify the need for thorough epidemiological studies based on the study of individuals. 3 refs., 17 figs., 6 tabs

  15. Solid malignant neoplasms after childhood irradiation: decrease of the relative risk with time after irradiation

    The pattern of the temporal distribution of solid cancer incidence after irradiation in childhood is not well known, although, its importance in radioprotection is well known. We studied a cohort of 1 055 children from 8 European cancer centres, who received radiotherapy between 1942 and 1985 for a first cancer in childhood. After a mean follow-up of 19 years, 26 children developed a solid second malignant neoplasm (SMN), as compared to 5.6 expected from general population rates. Both the excess relative risk and the excess of absolute risk of solid SMN were higher among children who were younger at time of the irradiation. After reaching a maximum 15 to 20 years after irradiation, the excess relative risk of SMN decreased with time after irradiation, when controlling for age at irradiation and sex. The analysis of the risk of thyroid, brain and breast cancer together, as a function of the dose averaged on these 3 organs lead to similar results. (authors). 16 refs., 8 tabs., 2 figs

  16. Reconsideration of the use of 99Tcm-MIBI thyroid imaging for detection of thyroid malignancy in thyroid nodules

    Objective: To reconsider the use of 99Tcm-methoxyisobutylisonitrile (MIBI) thyroid imaging for detection of thyroid malignancy in thyroid nodules. Methods: One hundred and one of 106 thyroid nodules patients underwent routine 99TcmO4- scan first, then after injection of 370 MBq 99Tcm-MIBI dual-phase (15 min and 2 h) thyroid imaging was performed in all 106 patients within 1 week. After operation the result of thyroid imaging was compared with pathologic findings. Results: Among 5/13 cases of thyroid malignancy and 23/93 of benign nodules, 99Tcm-MIBI imaging showed positive result. The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI scintigraphy were 38.5%, 75.3%, 17.9% and 89.7%, respectively. No statistics difference was found between benign and malignant thyroid nodules χ2=0.49, P > 0.05). Conclusions: 99Tcm-MIBI thyroid imaging is not specific for thyroid malignancy. Thereby its clinical value is limited. (authors)

  17. Scintigraphic and clinical evaluation of nontoxic thyroid neoplasms

    256 patients were referred to the endocrinic clinic because of enlarged thyroid gland. All of them except one were subjected to thyroid scintigraphy (TS). The scintiscans were cold in 123 patients. The cold scintiscans were distributed evenly on the various referral diagnoses with half the patients of each group having cold TS. A total of 216 of the referred patients underwent surgery, among them the 123 with cold TS. Five patients were found to have thyroid cancer (TC), none of whom had been referred with this diagnosis. For the entire material the incidence of TC was 2,3% (95% confidence limits: 0.8-5.7%). Calculated on the basis of those patients who had cold TS, the incidence was 2,4% (95% confidence limits: 0.8-7.1%). It is concluded that the diagnosis of TC is difficult to extablish preoperatively, and that TS is of no greater diagnostic value in this connection

  18. Predictive Factors of Malignancy in Residual Thyroid Tissue after Partial Thyroidectomy in Patients with Differentiated Thyroid Cancer

    Gokay, Ferhat; Berker, Dilek; Arduc, Ayse; Ozuguz, Ufuk; Isik, Serhat; Dagdelen, Iffet; Tuna, Mazhar Muslum; Guler, Serdar

    2015-01-01

    AbstractAlthough partial thyroidectomy has lower operative risk, it potentially caries the risk of leaving residual malignancy. The aim of this study was to establish malignancy rate in residual thyroid tissue in patients with differentiated thyroid cancer (DTC) who underwent partial thyroid surgery and subsequently had completion thyroidectomy. We also investigated a number of clinical and biochemical factors that may anticipate the presence of malignancy in the thyroid remnant. Data of 58...

  19. Thyroid neoplasms after radiation therapy for adolescent acne vulgaris. [X radiation

    Paloyan, E.; Lawrence, A.M.

    1978-01-01

    There is a potential hazard of thyroid cancer after exposure to external irradiation for the treatment of adolescent acne vulgaris. We noted a 60% incidence of thyroid carcinoma among 20 patients with such a history, who were operated on for thyroid nodules during a five-year period. Eighty-three percent of the patients with carcinoma had either a follicular or a mixed papillary-follicular carcinoma; 17% had a papillary carcinoma; 33% had regional node metastases; none had evidence of distant metastases. The interval between radiation exposure and thyroidectomy ranged from nine to 41 years. This association of thyroid neoplasms and a prior history of radiation for acne vulgaris may be coincidental and therefore remains to be proved by retrospective surveys of large numbers of treated patients with appropriate controls.

  20. Radioiodine treatment for malignant thyroid disease

    Berg, Gertrud [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology

    2006-12-15

    Radioiodine treatment for thyroid disease has been given for half a decade in Sweden. The most common indication for treatment is hyperthyroidism, when iodine uptake is high. The situation in which radioiodine treatment is used in thyroid cancer is less favourable and measures therefore have to be taken to optimize the treatment. Treatment should be performed early in the course of the disease to achieve the highest possible differentiation. Before treatment the iodine and goitrogen intake should be kept low. Stimulation of the thyrocytes by thyroid-stimulating hormone (TSH) should be high. It is conventionally achieved by thyroid hormone withdrawal rendering the patient hypothyroid, or by the recently available recombinant human TSH (rhTSH) which can be recommended for ablation of the thyroid remnant after thyroidectomy and for treatment of metastases in fragile patients unable to undergo hypothyroidism. Finally, stunning - the negative effect of a prior test dose from radioactive iodine - should be avoided.

  1. Value of 18F-FDG PET/CT in the diagnosis of multiple primary malignant neoplasms

    Objective: To explore the value of 18F-FDG PET/CT in diagnosis of multiple primary malignant neoplasms. Methods: Five thousand eight hundred and twenty-two patients with suspected tumors were retrospectively reviewed. All cases underwent 18F-FDG PET/CT and 32 patients were confirmed with multiple primary malignancies by biopsy or resection. Mean standardized uptake value (SUVmean) was calculated and SUVmean ≥ 2.5 and abnormal morphological changes on CT were used as a standard to diagnose a malignant tumor. The sensitivity and accuracy of PET/CT in diagnosis of multiple primary malignant neoplasms were calculated. Results: The incidence rate of multiple primary malignant neoplasms was 0.55%.Double primary malignant neoplasms were in 30 cases and triplicate primary malignant tumors were in 2 cases. There were 66 malignant tumor lesions. The average of SUVmean in 66 malignant tumor lesions was 6.68±3.61. The results of PET/CT were 58 true positive lesions and 8 false negative lesions. The sensitivity and accuracy of 18F-FDG PET/CT in diagnosis of multiple primary malignant neoplasms were 87.9% and 87.9% respectively. Conclusion: 18F-FDG PET/CT whole body scan has an important value in the diagnosis of multiple primary malignant neoplasms. (authors)

  2. Malignant transformation of nodular hyperplasia in the thyroid: a case report

    In, Hyun Sin; Kim, Dong Wook; Yoon, Hye Kyoung [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2007-12-15

    Thyroid carcinogenesis is traditionally thought to originate 'de novo'. However, it is debatable whether a malignant transformation can possibly arise from a benign thyroid nodule, as suggested for the malignant transformation of a thyroid adenoma. To the best of our knowledge, no studies have been performed addressing the malignant transformation of nodular hyperplasia in the thyroid gland. Here, we report a case of nodular hyperplasia with focally malignant degeneration.

  3. Imaging of the thyroid in benign and malignant disease.

    Intenzo, Charles M; Dam, Hung Q; Manzone, Timothy A; Kim, Sung M

    2012-01-01

    The thyroid gland was one of the first organs imaged in nuclear medicine, beginning in the 1940s. Thyroid scintigraphy is based on a specific phase or prelude to thyroid hormone synthesis, namely trapping of iodide or iodide analogues (ie, Tc99m pertechnetate), and in the case of radioactive iodine, eventual incorporation into thyroid hormone synthesis within the thyroid follicle. Moreover, thyroid scintigraphy is a reflection of the functional state of the gland, as well as the physiological state of any structure (ie, nodule) within the gland. Scintigraphy, therefore, provides information that anatomical imaging (ie, ultrasound, computed tomography [CT], magnetic resonance imaging) lacks. Thyroid scintigraphy plays an essential role in the management of patients with benign or malignant thyroid disease. In the former, the structure or architecture of the gland is best demonstrated by anatomical or cross-sectional imaging, such as ultrasound, CT, or even magnetic resonance imaging. The role of scintigraphy, however, is to display the functional state of the thyroid gland or that of a clinically palpable nodule within the gland. Such information is most useful in (1) patients with thyrotoxicosis, and (2) those patients whose thyroid nodules would not require tissue sampling if their nodules are hyperfunctioning. In neoplastic thyroid disease, thyroid scintigraphy is often standard of care for postthyroidectomy remnant evaluation and in subsequent thyroid cancer surveillance. Planar radioiodine imaging, in the form of the whole-body scan (WBS) and posttherapy scan (PTS), is a fundamental tool in differentiated thyroid cancer management. Continued controversy remains over the utility of WBS in a variety of patient risk groups and clinical scenarios. Proponents on both sides of the arguments compare WBS with PTS, thyroglobulin, and other imaging modalities with differing results. The paucity of large, randomized, prospective studies results in dependence on consensus expert opinion and retrospective analysis with inherent bias. With a growing trend not to ablate low-risk patients, so that a PTS cannot be performed, some thyroid carcinoma patients may never have radioiodine imaging. In routine clinical practice, however, imaging plays a critical role in patient management both before and after treatment. Moreover, as evidenced by the robust flow of publications concerning WBS and PTS, planar imaging of thyroid carcinoma remains a topic of great interest in this modern age of rapidly advancing cross sectional and hybrid imaging with single-photon emission computed tomography, single-photon emission computed tomography/CT, and positron emission tomography/CT. PMID:22117813

  4. Role of Histological Criteria and Immunohistochemical Markers in Predicting Risk of Malignancy in Parathyroid Neoplasms.

    Kumari, Niraj; Chaudhary, Nandita; Pradhan, Roma; Agarwal, Amit; Krishnani, Narendra

    2016-06-01

    Parathyroid carcinoma (PC) is a rare neoplasm accounting for 0.5-6 % of primary hyperparathyroidism. Histological criteria are currently considered as established means to diagnose malignancy in parathyroid neoplasms; however, it does not accurately predict the risk of aggressive behaviour of PC. Immunohistochemical (IHC) markers have been used in the literature with variable results. This work was planned to study whether IHC markers would have any added advantage over histology in predicting outcome in parathyroid neoplasms. Two hundred twenty-seven parathyroid neoplasms were reviewed according to older and revised histological criteria. IHC was performed for parafibromin, APC, galectin-3, PGP9.5 and Ki67. Diagnostic categories were correlated with clinical, biochemical, histological features and IHC markers. Chi-square test was used to analyse categorical variables. Review of histology by earlier and revised criteria showed a change in diagnosis of five cases of atypical adenoma (15.1 %), all of which were diagnosed as carcinoma according to earlier criteria. Change in diagnosis did not affect behaviour of disease as none of the cases showed recurrence or metastasis on follow-up. Combination of PF, Gal-3 and PGP9.5 showed 50 % sensitivity, 97.9 % specificity and 95.4 % predictive accuracy for PC. Histological criteria still remains the most established method for predicting risk of malignancy in parathyroid neoplasms irrespective of whether old or revised criteria are used. Combination of positive (Gal-3, PGP9.5) and negative (PF) IHC markers may be used as an adjunct to histology in histological, atypical and malignant parathyroid neoplasms to obviate the need for repeated follow-up. PMID:26984237

  5. The utility of PAX5 immunohistochemistry in the diagnosis of undifferentiated malignant neoplasms.

    Jensen, Kristin C; Higgins, John P T; Montgomery, Kelli; Kaygusuz, Gulsah; van de Rijn, Matt; Natkunam, Yasodha

    2007-08-01

    PAX5 is a B-cell transcription factor whose expression at the protein level is reliably detected by immunohistochemistry in routine biopsies. The purpose of this study was to investigate whether PAX5 immunohistochemistry has diagnostic benefit as a B-cell marker in the work-up of undifferentiated malignant neoplasms. Twenty-five cases previously diagnosed as undifferentiated malignant neoplasms were selected. In addition, 59 hematolymphoid and 884 non-hematolymphoid malignancies were studied such that the specificity of PAX5 immunohistochemistry could be addressed. Two of the 25 (8%) undifferentiated neoplasms showed diffuse staining for PAX5, which indicated a B-cell derivation for these neoplasms that was not appreciated at the time of initial diagnosis. PAX5 staining was detected in the vast majority of hematolymphoid tumors of B-cell derivation but only in 5 of 884 (less than 1%) non-hematolymphoid tumors. Our results further show that PAX5 may be the only detectable marker of B lineage in lymphomas that lack or show equivocal CD45RB and CD20 expression. We conclude that the addition of PAX5 to a panel of immunohistologic markers used in the interrogation of undifferentiated neoplasms is of diagnostic benefit. Its expression can also facilitate the diagnosis of classical and nodular lymphocyte-predominant Hodgkin lymphoma with atypical morphologic and immunohistologic features. Lastly, we have shown that the lack of its expression at the protein level in many epithelial and mesenchymal neoplasms renders PAX5 expression an extremely specific marker of the B lineage. PMID:17529924

  6. The thyroid malignancies at the Esslingen Radiation Institute

    This work concerns itself with the results of the therapy of thyroid malignancies in the years 1968-1979. The frequency of differentiated/undifferentiated tumors was 90.9/9.1%, follicular/papillary carcinomas 71.4/19.5%. Three times as many women suffer from thyroid cancer as men. Differentiated carcinomas appear preferably in middle age (50 a), undifferentiated around 60 to 70 years. Papillary carcinomas metastasise in 26.7% of the cases in the neck region and 6.7% in the lungs, follicular in 34.5%, the most frequent, in the lungs. The therapy method used was I 131 and/or telecobalt. The 3-year survival rate with undifferentiated tumors was 27%, the 5-year survival rate of papillary carcinoma was 40%, of follicular carcinoma 33%. Clearly papillary carcinomas have the best prognosis of all thyroid malignancies, especially when they appear in younger patients. (orig./TRV)

  7. Radiation markers in lymphocytes of peripheral blood of the decontamination workers with malignant neoplasms

    The character of the dose dependence of radiation markers (dicentric chromosomes) in lymphocytes of peripheral blood of the decontamination workers both with malignant neoplasms and other diseases is studied. In spite of remote terms of the studies resulted in elimination of a significant part of radiation markers from peripheral blood, the 'dose-effect' dependence remains only in the group with neoplasms. In the group with diseases of the nervous system, blood circulation, digestive system, etc., this dependence is expressed weaker or unavailable at all. We offer to consider the availability of dicentric chromosomes to be a reason to include these persons into the group of especially high oncologic risk

  8. Prevalence of benign and malignant thyroid nodules in patients with previous history of radiotherapy for Tinea capitis in childhood (in khorosan province)

    Increased prevalence of thyroid cancer was noted in patients with previous history of radiotherapy of the head and neck region in childhood. According to previous research, radiotherapy for Ti nia capitis was using up to 30 years ago in Khorasan Province. This study tries to evaluate prevalence of benign and malignant thyroid nodules and detect and treat these patients earlier to prevent more complications and increased cost. Methods and patients: Using mass media, we recalled all patients with history of radiotherapy for Tinea capitis in childhood. A questionnaire was filled for each patient and thyroid examination, thyroid scan and thyroid sonography were performed. Fine needle aspiration biopsy (FNAB) was done if a thyroid nodule larger than 1 cm was palpable. Serum TSH was measured in all patients. Also thyroid surgery was recommended for all patients with thyroid nodules more than 1 cm. A control group was defined from a group of patients who referred for non thyroidal sonography to radiology department of Ghaem hospital. These patients also were evaluated by clinical examination and thyroid sonography. Results: We studied 180 patients with mean age of 47.7 years and 127 age and sex m etched controls. Thyroid nodules was palpated in 45.5% of patients and 7% of controls (P0.01). The mean largest diameter of nodules were 24.8 mm in patients and 10.8 mm in control group (P<0.001). 75% of patients were agreed with FNAB and 5% of them had suspicious cytology results. No suspicious or malignant results was noted in control group. Twenty seven patients (33.7%) were operated. Pathological results were benign in 89.9% and malignant in 1% of patients. His study showed that thyroid nodules and thyroid neo plasma were significantly more larger in the patients group. Thyroid neoplasm were more frequent in younger patients with latent thyroid (from radiotherapy) of less than 40 years, so aggressive evaluation is recommended in these group

  9. A rare case of metastatic thyroid carcinoma presenting as primary renal neoplasm

    Full text: Thyroid cancer is one of the common neoplasms accounting for 2% of all diagnosed neoplasms. Papillary carcinoma, If diagnosed and treated with radio iodine after thyroidectomy well in time, offers excellent survival benefit. Role of Radio iodine Whole body scan is crucial in these cases in detecting focal lesions and metastases. Common sites of metastases include cervical LN, trachea, esophagus, lungs, bones and brain. Metastases to kidneys are very rare and reported in very few cases. Our case is a 72 yrs old mother of serving soldier, a known case of CAD, DM, and HTN admitted with insidious onset right flank abdominal pain. Clinical examination revealed BP of 170/100mmHg, no pallor, edema or puffiness. Abdomen examination revealed mild tenderness in the right renal angle. There was no free fluid or organomegaly. Subsequent evaluation with USG was inclusive. MRI abdomen revealed a mass lesion involving lower pole and distorting intra renal structures. The lesion was seen extending in to right renal artery. A diagnosis of Renal Cell Carcinoma (RCC) was made. She underwent right radical nephrectomy. Biopsy of post operative specimen revealed surprising histo pathological features of metastatic Papillary carcinoma of thyroid. She underwent a total thyroidectomy and thyroid specimen confirmed follicular variant of Papillary Carcinoma Thyroid in the setting of multiple hypoechoic nodules. She had a markedly elevated Serum Thyroglobulin of 2118.0 ng/ml. Post operative 131I Whole Body Scan revealed residual functional thyroid with skeletal metastases. She was given high dose radio iodine ablation with 218 mCi. She was reviewed twice subsequently in Feb 2009 and Aug 2009. She was given 221 mCi of 131I ablation given for solitary residual bone mets with raised Tg (345 ng/ml) while Aug 2009 WB Scan was normal along with normal serum Tg (2.1 ng/ml).This case describes an unusual case of elderly lady with FVPTC presenting as renal mass suspected to be a case of RCC with extension in to renal vein which would have carried worst prognosis as compared to thyroid carcinoma which was successfully made disease free over last two years. Treatment of kidney mass led to the discovery of primary thyroid neoplasm and its specific treatment. This also highlights importance of structural imaging such as USG,CT and MRI and subsequent histopathological confirmation

  10. Role of indium-111 labelled platelet scintigraphy in the management of thrombocytopenic patients with malignant neoplasms

    Oriuchi, N.; Korkmaz, M.; Kim, E.E.; Delpassand, E.S.; Wong, F.; Podoloff, D.A. [Texas Univ., Houston, TX (United States). Dept. of Nuclear Medicine; Wallace, S. [Texas Univ., Houston, TX (United States). Dept. of Diagnostic Radiology

    1998-03-01

    This study was done to investigate the role of indium-111 labelled platelet scintigraphy in the treatment of thrombocytopenia in patients with malignant neoplasms. The study involved 20 consecutive patients with thrombocytopenia associated with malignant neoplasms or hematological disorders and without evidence of underproduction of megakaryocytes due to chemotherapy or bone marrow infiltration by the malignancy. Splenic sequestration of platelets was evaluated by measuring spenic uptake of {sup 111}In-labelled platelets, and findings were correlated with the outcome of splenectomy and medication. Of the 20 patients, 13 had splenic sequestration of platelets. Seven of the 13 patients underwent splenectomy; six of these seven patients experienced a complete response. The other six patients received medication only and showed no response. Of the seven patients without splenic sequestration of platelets, five received medication, and four of them responded to it. {sup 111}In-labelled platelet scintigraphy has a role in selecting appropriate therapy and predicting its efficacy in patients with thrombocytopenia associated with malignant neoplasms. (orig.)

  11. Second malignancies following the treatment of differentiated thyroid carcinoma with radioiodine

    Full text: To see the incidence of second cancers in patients with well differentiated thyroid carcinoma after being treated with radioiodine. Medical records of 814 (417 males, 397 females) patients with differentiated thyroid cancer treated at Institute of Nuclear Medicine and Ultrasound, Dhaka were reviewed. The purpose was to investigate the incidence of second cancer in these patients after radioiodine therapy. The age range of the patient population treated with radioiodine was 9 to 69 years. Doses of radioiodine given were in the range of 30 to 100mCi for ablation and 150 to 250mCi for treatment of metastasis. The median follow-up period was 93.7± 15 months. Eleven (1.35 %) of the 814 patients developed a second malignancy. Two patients (0.25%) developed chronic myelogenous leukemia within a latency period of 5 years and after receiving a cumulative dose of 600- 670mCi. The over all incidence of second malignancy in the form of solid tumors was 1.10%. Of the nine patients with solid tumors, there were two patients with renal cell carcinoma, three patients with parotid gland tumor, one patient with pancreatic cancer, one with adenocarcinoma of the stomach, one with carcinoid tumor and one with small cell carcinoma of the lungs. The mean latency period for development of these tumors was 6.92 ± 3.934 years and the mean cumulative dose received by all these patients was 537.25±120.55 mCi. Follow-up of a fairly large cohort of patients treated with radioiodine showed a low incidence of second neoplasm. No relation was observed between the cumulative dose received and the development of a second malignancy. Thyroid carcinoma is a polygenic disease, which may be associated with other malignancies. Common environmental or genetic factors as well as long-term carcinogenic effects of radioiodine therapy should be considered. (author)

  12. Malignant neoplasms on the territories of Russia damaged owing to the Chernobyl accident

    The work presents the results of descriptive analysis of development of onco epidemiological situation in six of the most polluted regions owing to the Chernobyl accident in 1981-1994. The growth of malignancies incidence is marked in all territories as well as in the Russian Federation as a whole. The most adverse tendencies have been revealed in the Bryansk, Orel, Ryazan regions. It is marked that the formation of a structure, levels and trends of the malignancies incidence has been occurring under influence of a complex of factors usual up to the accident. The analysis of the data from the specialized cancer-register evidences that the incidence of thyroid malignancies is actively growing in the population of the Bryansk region. The probability of connection of growth of the thyroid cancer incidence in children of the Bryansk region with the Chernobyl accident is reasonably high, but should be confirmed through the application of methods of analytical epidemiology

  13. Fluorescence lifetime of normal, benign, and malignant thyroid tissues

    Brandao, Mariana; Iwakura, Ricardo; Basilio, Fagne; Haleplian, Kaique; Ito, Amando; de Freitas, Luiz Carlos Conti; Bachmann, Luciano

    2015-06-01

    Fine-needle aspiration cytology is the standard technique to diagnose thyroid pathologies. However, this method results in a high percentage of inconclusive and false negatives. The use of time-resolved fluorescence techniques to detect biochemical composition and tissue structure alterations could help to develop a portable, minimally invasive, and nondestructive method to assist during surgical procedures. This study aimed to use fluorescence lifetimes to differentiate healthy and benign tissues from malignant thyroid tissue. The thyroid tissue was excited at 298-300 nm and the fluorescence decay registered at 340 and 450 nm. We observed fluorescence lifetimes at 340 nm emission of 0.80±0.26 and 3.94±0.47 ns for healthy tissue; 0.90±0.24 and 4.05±0.46 ns for benign lesions; and 1.21±0.14 and 4.63±0.25 ns for malignant lesions. For 450 nm emissions, we obtain lifetimes of 0.25±0.18 and 3.99±0.39 ns for healthy tissue, 0.24±0.17 and 4.20±0.48 ns for benign lesions, 0.33±0.32 and 4.55±0.55 ns for malignant lesions. Employing analysis of variance, we differentiate malignant lesions from benign and healthy tissues. In addition, we use quadratic discriminant analysis to distinguish malignant from benign and healthy tissues with an accuracy of 76.1%, sensitivity of 74.7%, and specificity of 83.3%. These results indicate that time-resolved fluorescence can assist medical evaluation of thyroid pathologies during surgeries.

  14. Glioneuronal Neoplasms with Malignant Histological Features: A Study of 36 Cases

    Tar?k T?HAN

    2010-01-01

    Full Text Available Objective: Malignant glioneuronal tumors show considerable morphological diversity. Their biological behavior and clinicopathological characteristics are incompletely understood. With the exception of anaplastic ganglioglioma, they are not assigned to a specific entity in the current WHO classification. It is also not clear whether histological features of these neoplasms influence prognosis.Material and Method: We identified 36 glioneuronal tumors with malignant histological features among the departmental archives and neuropathology consultation files of the authors. We reviewed the pathological and radiological features of these tumors to construct a preliminary histological categorization.Results: Based on their pathological features, we divided the study group into three histologically distinct categories: 1 glioneuronal tumors with a malignant glial component (anaplastic gangliogliomas; 2 glioneuronal tumors with a malignant neuronal/neuroblastic component; 3 glioneuronal tumors with both malignant neuronal and glial components. All tumors occurred in a younger age group compared to glioblastomas and appeared radiologically well-defined, cystic and solid with variable contrast enhancement. There was a high rate of local recurrence (29 of 36 patients and 12 patients died during follow-up period. Median progression-free survival was less than 12 months, and did not differ among categories. Cerebrospinal tumor spread was seen in only one patient. Concurrent WHO grade I ganglioglioma and the presence of a malignant neuronal component did not appear to influence prognosisConclusion: MGNTs were considered in three simple categories based on their malignant component(s. Tumors in all categories exhibited a high rate of local recurrence and aggressive behavior akin to malignant gliomas as opposed to classical PNET. Nevertheless, MGNT demonstrated clinicopathological features that distinguish them from typical glioblastoma. The exact nosology of MGNTs is unresolved and our study underscores the need for a more comprehensive classification of these neoplasms within the WHO scheme.

  15. Benign and malignant nodular thyroid disease in acromegaly. Is a routine thyroid ultrasound evaluation advisable?

    Reverter, Jordi L; Fajardo, Carmen; Resmini, Eugenia; Salinas, Isabel; Mora, Mireia; Llatjós, Mariona; Sesmilo, Gemma; Rius, Ferran; Halperin, Irene; Webb, Susan M; Ricart, Veronica; Riesgo, Pedro; Mauricio, Dídac; Puig-Domingo, Manel

    2014-01-01

    Data on the prevalence of benign and malignant nodular thyroid disease in patients with acromegaly is a matter of debate. In the last decade an increasing incidence of thyroid cancer has been reported. The aim of this study was to evaluate the prevalence of goiter, thyroid nodules and thyroid cancer in a large series of patients with acromegaly with a cross-sectional study with a control group. Six Spanish university hospitals participated. One hundred and twenty three patients (50% men; mean age 59±13 years; disease duration 6.7±7.2 years) and 50 controls (51% males, mean age 58±15 years) were studied. All participants underwent thyroid ultrasound and fine needle aspiration. Cytological analysis was performed in suspicious nodules between 0.5 and 1.0 cm and in all nodules greater than 1.0 cm. Goiter was more frequently found in patients than in controls (24.9 vs. 8.3%, respectively; pthyroid disease as well as nodules greater than 1 cm were also more prevalent in acromegalic patients (64.6%, vs. 28.6%, pthyroid carcinoma was confirmed in two cases (3.3% of patients with thyroid nodules), representing 1.6% of the entire group of patients with acromegaly (2.4% including a case with previously diagnosed papillary thyroid carcinoma). These data indicated that thyroid nodular disease and cancer are increased in acromegaly, thus justifying its routine ultrasound screening. PMID:25127456

  16. Incidentally detected thyroid papillary carcinoma on positron emission tomography in a patient with malignant melanoma

    Zeki Dostbil

    2012-09-01

    Full Text Available Focal or diffusely increased 18F-fluorodeoxyglucose (18FDG uptake in thyroid gland are occasionally seen during 18FDG positron emission tomography (PET scanning. Increased 18FDG uptake in thyroid nodules may be associated with benign or malignant tumours. In our case who was diagnosed as malignant melanoma, focally increased 18FDG uptake in a thyroid nodule was noticed. Thus, fine needle aspiration biopsy of the thyroid nodule was performed. On suspicious findings for the thyroid papillary cancer were reported, total thyroidectomy was performed. Histopathological evaluation revealed the thyroid papillary carcinoma. So, therapy for the incidental thyroid papillary carcinoma was commenced in this case who was under the follow-up for the malignant melanoma.J Clin Exp Invest 2012; 3 (3: 430-432Key words: Thyroid, papillary carcinoma, FDG-PET, thyroid incidentaloma

  17. Analysis of various malignant neoplasms detected by FDG-PET cancer screening program. Based on a Japanese nationwide survey

    The most distinctive feature of Fluorodeoxyglucose (FDG)-PET cancer screening program is the ability to find various kinds of malignant neoplasms in a single test. The aim of this survey is to clarify the range and frequency of various malignant neoplasms detected by FDG-PET cancer screening performed in Japan. 'FDG-PET cancer screening' was defined as FDG-PET or positron emission tomography and computed tomography (PET/CT) scan with or without other tests performed for cancer screening of healthy subjects. This survey was based on a questionnaire regarding FDG-PET cancer screening. We analyzed the situation of 9 less frequently found malignant neoplasms including malignant lymphoma, malignancy of head and neck, esophagus, hepatobiliary and gallbladder, pancreas, kidney, cervical and uterine, ovary, and bladder. The detailed information of subjects with the suspected 9 kinds of malignant neoplasms mentioned above in the FDG-PET cancer screening program was studied in a total of 1,219 cases from 212 facilities. A statistical significance between PET/CT and PET was found in relative sensitivity and positive predictive value (PPV) for renal cell cancer. Malignant lymphoma was frequently of indolent type, suspected head and neck cancers had many false-positive results, and pancreatic cancer detected in this program was often in the advanced stage even in asymptomatic subjects. The recommendation of combined screening modality to PET or PET/CT was as follows: gastric endoscopy for assessing early esophageal cancer; abdominal ultrasound for screening hepatobiliary and gallbladder cancer; pelvic magnetic resonance imaging for assessing gynecological and pelvic cancers; and the CA125 blood test for screening ovarian cancer. Delayed image was helpful depending on the type of suspected malignant neoplasm. We analyzed various types of malignant neoplasms detected by the FDG-PET cancer screening program and presented recommended combination of examinations to cover FDG-PET and PET/CT. (author)

  18. Second primary malignant neoplasm following radiation therapy for head and neck cancer

    This retrospective analysis reports the results of radiotherapy in 8272 patients with cancer who were treated at Tokyo Women's Medical College between 1966 and 1984. One thousand one hundred and four cases were irradiated for head and neck tumor during this period. Twenty-nine of the total number of patients (0.35 %) were found to have second primary malignant neoplasms following radiotherapy according to the criteria of radiation-induced or related cancers. Twenty of these were head and neck tumors with an incidence of 1.81 % among all head and neck cancer patients. If recurrence of highly suspected cases was excluded, the incidence of radiation-induced or -related cancer was 0.18 % among all malignancies and 0.63 % among all head and neck tumors. Cases of multiple primary malignant neoplasm have been increasing in number and second cancer following radiotherapy has gradually become a big problem. However, the mechanisms of cancer etiology on which radiation and many other factors have an influence are not clear at this time, as there are many risks to human life. It is important not to underestimate the value of radiotherapy in cancer treatment today. (author)

  19. Hematological follow-up studies on patients with thyroid neoplasms after 131I therapy

    Based on 391 thyroid neoplasms diagnostic hematological follow-up studies were registered in 34 patients with an overall J-131-dose of more than 500 mCi including the following parameters: 1. Peripheral blood control. 2. Bone marrow aspiration. 3. Cell volume distribution size of leukocytes after preparative enrichment. If in doubt a bone marrow scintigraphy was added. The adjunctive diagnostic procedure was correlated with histological criteria of thyroid carcinoma and J-131 retention after therapeutic application of radioiodine. In particular, a case report is given regarding a patient of 66 years with follicular thyroid carcinoma receiving 990 mCi J-131 during a period of 11 years after having had total thyroidectomy twice. The development of acute leucemia followed by death happened 16 years later. The moment of bone marrow transformation was determined exactly. The value of blood parameters can be calculated as follows: 1. Peripheral blood controls are limited by lack of efficiency. 2. Biopsy of bone marrow can detect hypoplastic alteration being latent in circulating blood for some years, even of J-131 cumulation dose below 500 mCi. 3. The analysis of distribution size of leukocytes represents a functional aspect after radiation induced in injury of bone marrow. (author)

  20. Preoperative diagnosis of multiple primary malignant neoplasm in gastrointestinal and breast cancers. Impact of FDG-PET/CT

    The reports of multiple primary malignant neoplasm (MPMN) have increased due to the development of imaging technologies that have influenced the extension of the 5-year relative survival rate for all cancers. Integrated positron emission and computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) has shown its advantages for detecting, staging, evaluating the prognosis, and offering better insights for survivors, their families and physicians. The aim of this study was to retrospectively investigate the impact of whole-body FDG-PET/CT in detecting MPMN during the initial staging work-up of gastrointestinal and breast malignancy, and to describe their characteristics. The cases were identified by reviewing the Dokkyo Medical University Hospital PET Center's database, searching for patients referred from the Department of Surgical Oncology and the Department of Gastroenterological Surgery, who underwent preoperative staging with whole-body FDG PET/CT at our center between January 2007 and December 2009. A total of 778 patients matched these criteria. Of them, 40 PET/CT reports mentioned suspicious cases of MPMN. The medical records of these 40 cases were retrieved and examined. The follow-up data of these patients was reviewed until February 2010. Of 778, 32 patients were diagnosed with additional unexpected cancers, which 27 (3.5%) were incidental double cancers and 5 (0.64%) had triple primary lesions. Overall 37 MPMN, twelve corresponded to stage 0, nineteen to stages I-II, three to stages III-IV, and three remained uncertain. Sensitivity and positive predictive value of FDG PET/CT in detecting a controversial lesion were 76.5% and 70.3%, respectively. The colorectum was the most common site for synchronous MPMN (17 of 37 cancers 45.9%), followed by stomach (9; 24.3%), prostate (3; 8.1%), thyroid (3; 8.1%), breast (2; 5.4%), biliary duct (1; 2.7%), kidney (1; 2.7%), and lung (1; 2.7%). FDG PET/CT was useful for finding multiple primary malignant neoplasm with a relatively high sensitivity. Physicians should pay special attention to rule out the presence of unexpected additional primary lesions in initial staging work-up for colorectal cancer. (author)

  1. Hyperfractionation in radiotherapy of malignant neoplasms. Polish studies in relation to the world experience

    Theoretical assumptions for hyperfractionation and accelerated hyperfractionation in radiotherapy of malignant neoplasms are presented. Polish clinical studies in this field are presented basing on the responses to questionnaires which were sent to oncological centres. Most of the studies included patients with advanced head and neck cancer and also patients with brain tumours and cervical cancer. Different hyperfractionation schedules were used reflecting various approaches proposed in famous world centres. Polish phase studies included so far small groups of patients. It seems justified to undertake multicentre randomized trial according to common protocol. (author)

  2. Intensity modulated radiotherapy (IMRT) for pediatric cancer patients: The advantage and fear of second malignant neoplasm

    Intensity-modulated radiotherapy is used for delivering more efficient homogenous dose to the target and lowering of dose to the surrounding normal tissues. However, a second malignant neoplasm may develop after prolonged latent period. The use of modern precise radiotherapy techniques in the pediatric age group has many controversial issues in spite of its proven dosimetric distribution advantages and the considerable decrease of normal tissue complication probability (NTCP). This concern is due to many factors; mainly the exposure of a larger volume of normal tissues to low dose radiotherapy. Children have more proliferating tissues compared to the adults. However, the epidemiological data did not detect an increase in the incidence of radiation-induced second malignancy. This issue is still controversial as IMRT and other precise radiotherapy techniques were not widely used except recently. This may entail a thorough careful follow up for children treated with these techniques to detect any incidence increase

  3. Methylation of the thyroid stimulating hormone receptor: diagnostic marker of malignity in thyroid cancer

    The methylation state of the gene promoter for the receptor of the thyroid stimulating hormone (TSH) in the diagnosis of thyroid tumors of epithelial origin was analyzed. The study was conducted in thyroid tissue obtained from paraffin blocks of different thyroid pathologies (papillary, follicular and undifferentiated carcinoma and follicular adenomas). The work was done by using the DNA modification technique with sodium bisulfite, and polymerase chain reaction was applied to analyze the gene methylation state. Methylation of the promoter for the gene of the TSH receptor was found in the papillary carcinomas (33 of 40; 82.5 %), in 10 undifferentiated carcinomas (100 %), and in 10 of the 15 follicular carcinomas analyzed (66.6 %). No methylation was observed in the 8 follicular adenomas under study. The methylation of the gene for the TSH receptor was proposed as a new diagnostic marker of malignity and as a basis for using demethylating agents together with radioiodine therapy in patients with thyroid cancer of epithelial origin that do not respond to therapy. (Author)

  4. Laser spectroscopy as a method for diagnosing cancer and assessing the efficacy of treatment of malignant neoplasms

    Akleyev, Alexander; Romanskaya, Yulia; Kisselyov, Mikhail; Vazhenin, Andrei

    2005-08-01

    The issues of early diagnosis and effective treatment of malignant neoplasms are of vital importance for the Urals region which in 1950-1960 became the site of several radiation incidents with the resultant overexposures of dozens of thousands of residents who have manifested increased risks of leukemia and solid cancer incidence. The present study has demonstrated the efficacy of the method of laser-correlation spectrometry (LCS) of blood plasma and serum for early diagnosis of malignant neoplasms and prediction of relapses of tumor following radical treatment. The LCS method is characterized by a sufficiently high diagnostic sensitivity in relation to malignant tumors. It has been established that LC spectra obtained for patients with malignant neoplasms differ significantly from those for patients with non-cancer pathology of the same sites. The LCS methodology has manifested a sufficiently high prognostic sensitivity (76.6%) in relation to complete regression after radical treatment and progression (78.0%) of the tumor process. A positive prognostic criterion of the course of a malignant neoplasm after radical treatment in patients without relapse and metastases is a statistically significant (p

  5. Primary osteosarcoma of the thyroid gland: report of a rare neoplasm / Osteossarcoma primrio da glndula tireoide: relato de uma neoplasia rara

    Eduardo, Cambruzzi; Joo Grigoleti, Scholl; Alberto Salgueiro, Molinari; Karla Lais, Pgas.

    2013-02-01

    Full Text Available Tumores mesenquimais da glndula tireoide so extremamente raros. Os autores relatam um caso de osteossarcoma primrio de tireoide em um paciente masculino que apresentou massa tumoral na regio cervical. A tomografia computadorizada demonstrou um grande tumor no lobo tireoideano direito, com zonas [...] de calcificao. A pea cirrgica consistia de um tumor marrom-acinzentado e firme, medindo 13 11 7,5 cm. microscopia, foi encontrada neoplasia maligna de alto grau composta por clulas poligonais de tamanho intermdio, com um padro condroide em algumas reas e formao de osteoide. O processo revelou imunoexpresso negativa para AE1/AE3, protena glial fibrilar cida (GFAP), antgeno da membrana epitelial (EMA), p53 e fator de transcrio da tireoide (TTF-1) e imunopositividade para CD99 e S100. O diagnstico de osteossarcoma primrio da glndula tireoide foi, ento, estabelecido. Abstract in english Primary mesenchymal tumors of the thyroid gland are extremely rare. The authors report a case of primary thyroid osteosarcoma in a male patient presenting a tumoral mass in the neck. CT scan demonstrated a large tumor in the right thyroid lobe with areas of calcification. The surgical specimen consi [...] sted of a hard brown-gray tumor, measuring 13 11 7.5 cm. Microscopy revealed a high-grade malignant neoplasm composed of polygonal cells of intermediate size, chondroid pattern in some areas and osteoid formation. The process was immunonegative for AE1/AE3, glial fibrillary acidic protein (GFAP), epithelial membrane antigen (EMA), p53 and thyroid transcription factor-1 (TTF-1), and immunopositive for CD99 and S100. Thus the diagnosis of primary osteosarcoma of the thyroid gland was established.

  6. Presence of lung metastases in bitches affected by malignant mammary neoplasms in Medellin (Colombia

    Brigitte Gmez J.

    2012-08-01

    Full Text Available Objective. To define the presence of lung metastasis in bitches with malignant mammary neoplasms. Materials and methods. Thirty female dogs that were attended at Veterinary Hospital (University of Antioquia, Medellin, Colombia were selected for the study. At consultation clinical variables and grade of mammary and inguinal lymph node compromise were registered. Latero-lateral and ventral-dorsal radiographic images of thorax were done for identification of radiographic lesions suggestive of lung metastasis. At surgery biopsies of affected mammary glands were taken for histopathological study and classification of tumors. Data were analyzed by descriptive statistics. Results. The average ( standard error age at clinical diagnosis was 10.872.65 year old. French poodle (46.6% cross-breed (13.3% and Schnauzer (10% were the breeds most frequently affected by mammary tumors. The most frequent tumor found was carcinoma (81%, followed by adenoma (8.1%, and other types (10.8%. The most frequently affected mammary glands by tumors were the right and the left inguinal glands (70% and 66.6%, respectively. Five out of 30 bitches (16.6% had lung metastasis according to radiographic examination. From this group of dogs, 4 out of 5 neoplasms (80% were diagnosed as complex carcinoma by histopathology diagnosis. Conclusions. We provide evidence suggesting that complex carcinoma is the most frequent mammary tumor in bitches in our city and it is highly related to lung metastasis.

  7. Inflammatory pseudotumor of the occipital condyle imitating a malignant neoplasm - a case report

    Inflammatory pseudotumor is a non-neoplastic process of unknown etiology characterized by proliferation of connective tissue with an inflammatory infiltrate. IPT most frequently arises in the orbit, but can also be found in the larynx, the paranasal sinus and rarely in the skull base. We present the case of a 20-year-old patient with a 4-month history of headache and insomnia. Neurological examination showed limited head mobility and hypoglossal nerve dysfunction. The patient was afebrile and no abnormalities in blood tests were found. CT revealed the presence of a tumor mass destructing the right occipital condyle. MRI was performed and the mass was surgically removed. The histological diagnosis was non-specific chronic inflammatory granulation tissue. Inflammatory pseudotumors can often mimic malignant neoplasms, especially in cases where bone destruction is observed. IPT of the occipital condyle is a rare but aggressive lesion that should be treated by surgical excision. (author)

  8. Canine malignant mammary gland neoplasms with advanced clinical staging treated with carboplatin and cyclooxygenase inhibitors.

    Lavalle, Gleidice Eunice; De Campos, Ceclia Bonolo; Bertagnolli, Anglica Cavalheiro; Cassali, Geovanni Dantas

    2012-01-01

    Surgery remains the treatment of choice for female dogs with mammary gland tumors. Chemotherapy is not commonly used as an adjuvant therapy. Cyclooxygenase 2 (COX-2) has been related to angiogenesis development in tumors, disease progression and worse prognosis. The aim of this prospective study was to compare overall survival periods of female dogs diagnosed with advanced mammary tumors submitted to different treatment protocols, including surgery, chemotherapy and cyclooxygenase inhibitors. Twenty-nine female dogs were evaluated and treated with four different protocols. The overall survival of patients with low COX-2 scores was longer when compared to patients with high COX-2 scores. Different proposed adjuvant treatments associated with surgery led to a statistically significant longer overall survival when compared to surgical treatment alone. Canine patients presenting malignant mammary gland neoplasms with advanced clinical staging should be submitted to complementary therapeutic medication based on clinical staging and immunophenotypical characteristics of the disease. PMID:22523289

  9. Renal cell carcinoma as a second malignant neoplasm in a patient with non-syndromic hemihypertrophy and previous Wilms tumor

    Survivors of childhood Wilms tumors are at an increased risk of second malignant neoplasms. Recently, it has been postulated that renal cell carcinoma is among the malignancies for which this population is at risk. We present the unique case of an adult Wilms tumor survivor with non-syndromic hemihypertrophy (NSHH) who developed renal cell carcinoma. This case highlights the need for close follow-up in two populations: adults who have survived Wilms tumor and those with NSHH. (orig.)

  10. GATA3 Expression in Normal Skin and in Benign and Malignant Epidermal and Cutaneous Adnexal Neoplasms.

    Mertens, Richard B; de Peralta-Venturina, Mariza N; Balzer, Bonnie L; Frishberg, David P

    2015-12-01

    Initial investigations reported GATA3 to be a sensitive and relatively specific marker for mammary and urothelial carcinomas. Recently, GATA3 expression has been described in several other epithelial tumors. However, there has been only limited investigation of GATA3 expression in cutaneous epithelial tumors. The objective of this study was to examine the immunohistochemical expression of GATA3 in a wide variety of cutaneous epithelial neoplasms. GATA3 expression was evaluated in 99 benign and 63 malignant cutaneous epithelial tumors. GATA3 was consistently and usually strongly expressed in clear cell acanthoma, trichofolliculoma, trichoepithelioma, trichilemmoma, sebaceous adenoma, sebaceoma, apocrine hidrocystoma, apocrine tubular papillary adenoma, hidradenoma papilliferum, and syringocystadenoma papilliferum. Hidradenomas exhibited variable positive staining. Most poromas, syringomas, chondroid syringomas, cylindromas, and spiradenomas were negative or only focally and weakly positive. Focal staining was present in all pilomatrixomas. Thirteen of 14 basal cell carcinomas, 21 of 24 squamous carcinomas, and all 6 sebaceous carcinomas exhibited positive staining. The 1 apocrine carcinoma, both mucinous carcinomas, and 2 of 3 microcystic adnexal carcinomas also exhibited positive staining, whereas the 1 eccrine porocarcinoma and the 1 adenoid cystic carcinoma were negative. One of 11 Merkel cell carcinomas exhibited focal weak staining. Our findings demonstrate that GATA3 is expressed in a wide variety of benign and malignant cutaneous epithelial neoplasms. In addition to carcinomas of breast and urothelial origin and other more recently described GATA3-positive tumors, the differential diagnosis of a metastatic tumor of unknown primary origin that expresses GATA3 should also include a carcinoma of cutaneous epithelial origin. PMID:26595821

  11. `Cold` thyroid nodules: What does it mean? Association of `hot thyroid nodules with {sup 99m} Tc-tetrosfosmin` in previous `cold technetium thyroid nodules` and thyroid malignancies

    Lima, Tadeu de Almeida; Pellini, Marcos P.; Almeida, Jose Carlos C.; Novaes, Luciene Targat; Pinto, Everton G.; Amarante Junior, Jose Luiz; Manhaes, Ricardo A. [MEDILABS Medicina Nuclear, Rio de Janeiro, RJ (Brazil)

    1997-12-31

    Full text. Tetrofosmin, a new lipophilic technetium-phosphine agent, proposed initially for myocardial perfusion imaging in which the precise mechanism of uptake into myocardial cells is likely to be similar to that of sestamibi, demonstrates in experimental data an accumulation in the mitochondria, a phenomenon dependent on the amount of proteins and energetic substrate (J Nucl Med, 35:48 P-47 P, 1994). Studies of biodistribution of Technetium-99 m-Tetrofosmin show early thyroid uptake which rapidly clears from normal thyroid tissue (tracer washout 4 h after injection), but it may be retained longer in malignant tumor lesion. Some reports have been describing localization of metastatic lesions of mixed thyroid cancer ( J Nucl Med, 36:2248-2251, 1995), follicular thyroid carcinoma (Eur J Nucl Med 22:1218-1220, 1995) and medullary thyroid carcinoma (J Nucl Med 38:227-230, 1997), utilizing Tc 99 m-Tetrofosmin and/or Sestamibi. We decided to use Tetrofosmin in our patients, since we hypothesized that its biological features and intracellular uptake mechanisms could justify its clinical applications in the differential of neoplastic diseases before surgery. We describe 2 patients, in a series of 6 who had no significant tracer uptake (cold nodules) with Technetium, that became `hot nodules` with Tc 99-Tetrofosmin, in which histologic findings after fine needle biopsy and thyroidectomy confirmed Hurthle cell Adenoma with Papillary Carcinoma nd the other a Papillary Multicentric Carcinoma. The other four patients are waiting for surgery. In conclusion, besides detecting metastatic lesions enabling us to better evaluation of the extended malignant disease, thyroid scintigraphic studies with Tc 99 m-Tetrofosmin seems to contribute for understanding and predicting of thyroid malignancies pre-surgically

  12. 'Cold' thyroid nodules: What does it mean? Association of 'hot thyroid nodules with 99m Tc-tetrosfosmin' in previous 'cold technetium thyroid nodules' and thyroid malignancies

    Full text. Tetrofosmin, a new lipophilic technetium-phosphine agent, proposed initially for myocardial perfusion imaging in which the precise mechanism of uptake into myocardial cells is likely to be similar to that of sestamibi, demonstrates in experimental data an accumulation in the mitochondria, a phenomenon dependent on the amount of proteins and energetic substrate (J Nucl Med, 35:48 P-47 P, 1994). Studies of biodistribution of Technetium-99 m-Tetrofosmin show early thyroid uptake which rapidly clears from normal thyroid tissue (tracer washout 4 h after injection), but it may be retained longer in malignant tumor lesion. Some reports have been describing localization of metastatic lesions of mixed thyroid cancer ( J Nucl Med, 36:2248-2251, 1995), follicular thyroid carcinoma (Eur J Nucl Med 22:1218-1220, 1995) and medullary thyroid carcinoma (J Nucl Med 38:227-230, 1997), utilizing Tc 99 m-Tetrofosmin and/or Sestamibi. We decided to use Tetrofosmin in our patients, since we hypothesized that its biological features and intracellular uptake mechanisms could justify its clinical applications in the differential of neoplastic diseases before surgery. We describe 2 patients, in a series of 6 who had no significant tracer uptake (cold nodules) with Technetium, that became 'hot nodules' with Tc 99-Tetrofosmin, in which histologic findings after fine needle biopsy and thyroidectomy confirmed Hurthle cell Adenoma with Papillary Carcinoma nd the other a Papillary Multicentric Carcinoma. The other four patients are waiting for surgery. In conclusion, besides detecting metastatic lesions enabling us to better evaluation of the extended malignant disease, thyroid scintigraphic studies with Tc 99 m-Tetrofosmin seems to contribute for understanding and predicting of thyroid malignancies pre-surgically

  13. Intrathyroidal thymic tissue mimicking a malignant thyroid nodule in a 4-year-old child

    So Hyun Park

    2014-01-01

    Full Text Available

    Intrathyroidal thymic tissue is rare and may be confused with a malignant thyroid nodule because of hyperechoic dots mimicking calcifications. We report the case of a thyroid nodule with malignant ultrasonographic findings in a 4-year-old child, which was confirmed cytologically as ectopic thymic tissue. The sonographic findings of ectopic thymus were similar to those of the thymus; therefore, clinicians should be familiar with ultrasonography findings of normal thymic tissue.

  14. Intrathyroidal thymic tissue mimicking a malignant thyroid nodule in a 4-year-old child

    Park, So Hyun [Dept. of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Ryu, Chang Woo; Kim, Gou Young; Shim, Kye Shik [Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    2014-03-15

    Intrathyroidal thymic tissue is rare and may be confused with a malignant thyroid nodule because of hyperechoic dots mimicking calcifications. We report the case of a thyroid nodule with malignant ultrasonographic findings in a 4-year-old child, which was confirmed cytologically as ectopic thymic tissue. The sonographic findings of ectopic thymus were similar to those of the thymus; therefore, clinicians should be familiar with ultrasonography findings of normal thymic tissue.

  15. Diagnostic value of Thallium 201 scintigraphy in determining malignancy of the cold thyroid nodule

    In this paper we discuss and quantify the respective values of Thallium 201 scintigraphy and cytologic punction in determining malignancy of the cold thyroid nodule. These two diagnostic tests are evaluated on the basis of their sensitivity and specificity while taking into consideration various therapeutic attitudes in the presence of a cold thyroid nodule

  16. Shear wave elastography of thyroid nodules for the prediction of malignancy in a large scale study

    Highlights: •Elasticity indices of malignant thyroid nodules were higher than those of benign. •High elasticity indices were the independent predictors of thyroid malignancy. •SWE evaluation could be useful as adjunctive tool for thyroid cancer diagnosis. -- Abstract: Objectives: The purpose of this study is to validate the usefulness of shear wave elastography (SWE) in predicting thyroid malignancy with a large-scale quantitative SWE data. Methods: This restrospective study included 476 thyroid nodules in 453 patients who underwent gray-scale US and SWE before US-guided fine-needle aspiration biopsy (US-FNA) or surgical excision were included. Gray-scale findings and SWE elasticity indices (EIs) were retrospectively reviewed and compared between benign and malignant thyroid nodules. The optimal cut-off values of EIs for predicting malignancy were determined. The diagnostic performances of gray-scale US and SWE for predicting malignancy were analyzed. The diagnostic performance was compared between the gray-scale US findings only and the combined use of gray-scale US findings with SWEs. Results: All EIs of malignant thyroid nodules were significantly higher than those of benign nodules (p ≤ .001). The optimal cut-off value of each EI for predicting malignancy was 85.2 kPa of Emean, 94.0 kPa of Emax, 54.0 kPa of Emin. Emean (OR 3.071, p = .005) and Emax (OR 3.015, p = .003) were the independent predictors of thyroid malignancy. Combined use of gray-scale US findings and each EI showed elevated sensitivity (95.0–95.5% vs 92.9%, p ≤ .005) and AUC (0.820–0.834 vs 0.769, p ≤ .005) for predicting malignancy, compared with the use of only gray-scale US findings. Conclusions: Quantitative parameters of SWE were the independent predictors of thyroid malignancy and SWE evaluation combined with gray-scale US was adjunctive to the diagnostic performance of gray-scale US for predicting thyroid malignancy

  17. Minimally Invasive Adenocarcinoma of the Lung as Second Malignant Neoplasm Following Pediatric Rhabdomyosarcoma.

    Bradee, Allison R; Lehman, Alice; Reed, Robyn C; Watson, Andrea; Acton, Robert

    2016-02-01

    Primary pulmonary tumors are extremely rare in the pediatric population; however, sporadic cases of invasive pulmonary adenocarcinoma as a second malignant neoplasm (SMN) have been described in survivors of pediatric cancers. Pediatric patients with rhabdomyosarcoma (RMS) have a particularly increased risk of developing a SMN when compared to the general population, though pulmonary adenocarcinoma has not been previously described in a RMS patient. A 12-year-old female previously treated for stage IV pelvic RMS was found to have a left pulmonary nodule on surveillance computed tomography. The nodule was detected 4.25 years after the completion of treatment, which included resection, chemotherapy, and radiation to the abdomen and pelvis. Wedge resection of the pulmonary lesion was performed with negative margins. Histopathological examination revealed minimally invasive adenocarcinoma. Pulmonary adenocarcinoma may rarely present as a SMN in pediatric cancer survivors. The pathogenesis of this association is not yet entirely clear, but may include chemotherapy-induced mutagenesis and/or genetic predisposition. As pulmonary adenocarcinoma may present as a lung lesion radiographically indistinguishable from metastatic RMS, it should be considered in the differential diagnosis of any pediatric RMS survivor presenting with a new pulmonary nodule, especially in cases with late recurrence. Pediatr Blood Cancer 2015 Wiley Periodicals, Inc. PMID:26174135

  18. Leukemia in patients following radiotherapy for malignant neoplasms in the pelvic region

    A prospective study of 1572 women treated with radiotherapy for cervical (1478 women) and ovarian cancer (95 women) was done. Patients had been followed clinically and especially by blood tests between 1961 and 1981, comprising 8990 women-years (WY). Following radiotherapy, 5 patients developed non-lymphocytic leukemia [2 acute myeloblastic leukemia (AML), 1 acute monocytic leukemia (AMoL), and 2 chronic myeloid leukemia (CML)]. Based on rates for the general population, 0.45 case would be expected, and, therefore, the relative risk was 11.2. The average mean marrow dose for all our subjects was calculated to be 11.77 rad, the risk of radiation-induced leukemia was 0.43 excess case per year per one million women exposed to 1 rad of radiation to the bone marrow. Four patients with cervical cancer who developed leukemia were in a high-dose-rate group treated with both a linear accelerator (Linac) and remote afterloading system (RALS), and 1 patient with ovarian cancer who developed leukemia was treated with a Linac alone. This is the first report of a statistically significant increased risk of leukemia for patients treated with large doses of radiation for malignant neoplasms in the pelvic region. (author)

  19. More Complete Removal of Malignant Brain Tumors by Fluorescence-Guided Surgery

    2015-10-30

    Benign Neoplasms, Brain; Brain Cancer; Brain Neoplasms, Benign; Brain Neoplasms, Malignant; Brain Tumor, Primary; Brain Tumor, Recurrent; Brain Tumors; Intracranial Neoplasms; Neoplasms, Brain; Neoplasms, Intracranial; Primary Brain Neoplasms; Primary Malignant Brain Neoplasms; Primary Malignant Brain Tumors; Gliomas; Glioblastoma

  20. Risk of Malignancy in Thyroid Incidentalomas Identified by Fluorodeoxyglucose-Positron Emission Tomography

    Chun, A Reum; Jo, Hye Min; Lee, Seoung Ho; Chun, Hong Woo; Park, Jung Mi; Kim, Kyu Jin; Jung, Chan Hee; Mok, Ji Oh; Kang, Sung Koo; Kim, Chul Hee; Kim, Bo Yeon

    2015-01-01

    Background Thyroid incidentalomas detected by 2-deoxy-2-18F-fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) have been reported in 1% to 4% of the population, with a risk of malignancy of 27.8% to 74%. We performed a retrospective review of FDG-avid thyroid incidentalomas in cancer screening subjects and patients with nonthyroid cancer. The risk of malignancy in thyroid incidentaloma and its association with the maximal standardized uptake value (SUVmax) in 1...

  1. Second malignant neoplasms after a first cancer in childhood: temporal pattern of risk according to type of treatment

    de Vathaire, F; Hawkins, M; Campbell, S.; Oberlin, O.; Raquin, M-A; Schlienger, J-Y; Shamsaldin, A; Diallo, I.; Bell, J; E. Grimaud; Hardiman, C.; Lagrange, J-L; Daly-Schveitzer, N; Panis, X; Zucker, J-M

    1999-01-01

    The variation in the risk of solid second malignant neoplasms (SMN) with time since first cancer during childhood has been previously reported. However, no study has been performed that controls for the distribution of radiation dose and the aggressiveness of past chemotherapy, which could be responsible for the observed temporal variation of the risk. The purpose of this study was to investigate the influence of the treatment on the long-term pattern of the incidence of solid SMN after a fir...

  2. Assessment of enzymatic activity of salinary glands in comprehensive radiotherapy of malignant neoplasms of head and neck

    It is shown that in the course of combined radiotherapy of patients with malignant tumour localization in the head and neck increase in the activity of alpha-amylase of saliva and decrease in enzymatic activity, depending on the absorbed isoeffective dose, take place. Suppression of enzymatic activity of saliva was more clearly pronounced in the patients subjected to neutron radiation, than those subjected to the standard conditions of gamma-therapy. Indices of saliva enzymatic activity in the process of combined radiotherapy were used as criterion of tolerance of salinary glands in the patients with malignant neoplasms in the head and neck. 6 refs.; 3 tabs

  3. Metastatic malignant struma ovarii with coexistence of Hashimoto’s thyroiditis

    Russo, Marco; Marturano, Ilenia; Masucci, Romilda; Caruso, Melania; Fornito, Maria Concetta; Tumino, Dario; Tavarelli, Martina; Squatrito, Sebastiano

    2016-01-01

    Summary Struma ovarii is a rare ovarian teratoma characterized by the presence of thyroid tissue as the major component. Malignant transformation of the thyroidal component (malignant struma ovarii) has been reported in approximately 5% of struma ovarii. The management and follow-up of this unusual disease remain controversial. We report the case of a woman with a history of autoimmune thyroiditis and a previous resection of a benign struma ovarii that underwent hystero-annexiectomy for malignant struma ovarii with multiple papillary thyroid cancer foci and peritoneal involvement. Total thyroidectomy and subsequent radioiodine treatment lead to complete disease remission after 104 months of follow-up. The diagnosis and natural progression of malignant struma ovarii are difficult to discern, and relapses can occur several years after diagnosis. A multidisciplinary approach is mandatory; after surgical excision of malignant struma, thyroidectomy in combination with 131I therapy should be considered after risk stratification in accordance with a standard approach in differentiated thyroid cancer patients. Learning points Malignant struma ovarii is a rare disease; diagnosis is difficult and management is not well defined. Predominant sites of metastasis are adjacent pelvic structures. Thyroidectomy and 131I therapy should be considered after risk stratification in accordance with standard approaches in DTC patients. PMID:27224256

  4. Adoptive immunotherapy with interleukin-2 and lymphokine-activated killers in patients with malignant neoplasms of the female reproductive system (a review of literature

    A. N. Gritsai

    2015-01-01

    Full Text Available The review highlights current approaches to adoptive immunotherapy in patients with malignant neoplasms of the female reproductive system.In spite of the obvious advances made by scientists of the world in treating malignant neoplasms, the existing treatment options remain insufficientlyeffective. To search for novel highly effective and safe treatments is an urgent problem of oncology. Adoptive immunotherapy is oneof the priorities in this regard.

  5. Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule

    Basu S

    2005-01-01

    Full Text Available Secondary neoplasm of the thyroid mimicking a primary thyroid lesion is a rare finding, especially in an individual without a past history of malignancy. A case of squamous cell carcinoma metastatic to the thyroid (presenting as a solitary thyroid nodule, who had an unsuspected primary in the esophagus is described. Usually, multiple areas of the gland are involved in the secondary involvement of the thyroid. The clinical presentation of an apparently asymptomatic mass with neck lymphadenopathy, normal thyroid functions, and a cold nodule on 99mTcO4- thyroid scan can often lead to a misdiagnosis as primary thyroid neoplasm. The present case underscores the fact that due importance to the subtle signs and symptoms and a high degree of suspicion, whenever the histology is unusual for a thyroid primary, is needed and the workup should include ruling out other primary malignancies.

  6. Primary osteosarcoma of the thyroid gland: report of a rare neoplasm Osteossarcoma primário da glândula tireoide: relato de uma neoplasia rara

    Eduardo Cambruzzi

    2013-02-01

    Full Text Available Primary mesenchymal tumors of the thyroid gland are extremely rare. The authors report a case of primary thyroid osteosarcoma in a male patient presenting a tumoral mass in the neck. CT scan demonstrated a large tumor in the right thyroid lobe with areas of calcification. The surgical specimen consisted of a hard brown-gray tumor, measuring 13 × 11 × 7.5 cm. Microscopy revealed a high-grade malignant neoplasm composed of polygonal cells of intermediate size, chondroid pattern in some areas and osteoid formation. The process was immunonegative for AE1/AE3, glial fibrillary acidic protein (GFAP, epithelial membrane antigen (EMA, p53 and thyroid transcription factor-1 (TTF-1, and immunopositive for CD99 and S100. Thus the diagnosis of primary osteosarcoma of the thyroid gland was established.Tumores mesenquimais da glândula tireoide são extremamente raros. Os autores relatam um caso de osteossarcoma primário de tireoide em um paciente masculino que apresentou massa tumoral na região cervical. A tomografia computadorizada demonstrou um grande tumor no lobo tireoideano direito, com zonas de calcificação. A peça cirúrgica consistia de um tumor marrom-acinzentado e firme, medindo 13 × 11 × 7,5 cm. À microscopia, foi encontrada neoplasia maligna de alto grau composta por células poligonais de tamanho intermédio, com um padrão condroide em algumas áreas e formação de osteoide. O processo revelou imunoexpressão negativa para AE1/AE3, proteína glial fibrilar ácida (GFAP, antígeno da membrana epitelial (EMA, p53 e fator de transcrição da tireoide (TTF-1 e imunopositividade para CD99 e S100. O diagnóstico de osteossarcoma primário da glândula tireoide foi, então, estabelecido.

  7. Dose to the site of second malignant neoplasms development after radiotherapy among patients treated in childhood

    Diallo, I.; Alziar, I.; Shamsaldin, A.; Guerin, S.; Vathaire, F. de [Institut National de la Sante et de la Recherche Medicale (INSERM), 94 - Villejuif (France). Inst. Gustave Roussy; Grimaud, E.; Chavaudra, J.; Lefkopoulos, D. [Institut National de la Sante et de la Recherche Medicale (INSERM), Medical Physics Dept., 94 - Villejuif (France). Inst. Gustave Roussy; Quiniou, E. [Institut National de la Sante et de la Recherche Medicale (INSERM), Unit 350, Curie In stitute, 75 - Paris (France); Dondon, M.G. [Institut National de la Sante et de la Recherche Medicale (INSERM), IC 10213 and Biostatistics Unit, Curie In stitute, 75 - Paris (France)

    2006-07-01

    Full text of publication follows: In spite of the improvements in treatment techniques, radiotherapy always involves unwanted irradiation of healthy organs and tissues. Our aim was to quantify the dose to the site of the second malignant neoplasm (S.M.N.) development. The study focused on 155 patients with S.M.N. among a cohort of 4,581 individuals, at least 2-year survivors, treated between 1942 and 1986, for a solid cancer during childhood in 8 centres in France and Great Britain. The software package Dos-EG was used to estimate the radiation doses. Concepts introduced by the International Commission on Radiation Units and Measurements about the volumes were used to specify relative doses. Thus, we were able to determine the relative position of S.M.N. development with respect to the target volume. About 25% of S.M.N. occurred in sites where the estimated radiation dose was lower than 0.9 Gy and 35 % in sites where doses were lower than 5 Gy. The median dose to the site of origin of S.M.N. was about 12.9 Gy (range: 0 -73 Gy). Among all cases, 19.13 % occurred within the treated volume enclosed in the 95 % isodose surface, 25.22 % within the irradiated volume between the 95% and 50 % isodose surfaces, 35.65 % in the penumbra region between the 50 % and 20 % isodose surfaces, and 20.00 % were beyond the penumbra region. With the introduction of sophisticated treatment techniques such as intensity modulated radiotherapy, both treated volume and irradiated volume are reduced but the volume receiving low doses is substantially enlarged. This study showed that a notable fraction of S.M.N. occurred in regions where the dose received is lower than 5 Gy. These results should be considered when assessing whether the benefit of the treatment is higher than the risk. (authors)

  8. The value of contrast-enhanced 64-row CT in differentiating benign from malignant serous ovarian neoplasms

    Objective: To assess the diagnostic value of contrast-enhanced 64-row CT scanning in deciding benign or malignant serous ovarian tumors. Methods: Fifty-eight cases of serous ovarian tumors proved pathologically were reviewed, including 25 malignant tumors, 25 benign, 8 borderline tumors. All patients underwent 64-row CT scanning, including plain scanning and contrast-enhance scanning. The tumors' shape, density, blood supply and enhancement features were evaluated. Results: Twenty-five cases of benign serous cystic adenoma were mostly unicameral, and showed a moderate mural enhancement only in 4 cases (16%) due to chronic pelvic infection and the others (21/25, 84%) had no of slight enhancement. Malignant tumors were cystic-solid mass with unclear margin, irregular shape and septa. Twenty-two cases of serous cystadenocarcinoma out of 25 cases (88%) appeared obvious enhancement and other 3 cases no enhancement. And 7 cases out of 8 (87.5%) borderlined serous cystadenomas showed different enhancement patterns. Conclusion: Benign ovarian serous neoplasms were mostly unicameral and no strong mural enhancement, suggesting a lack of blood supply. While, there were obvious enhancement in the ovarian serous cystadenocarcinoma and borderline serous cystadenoma with malignant potential. The 64-row CT is helpful for differentiating the nature of the serous ovarian neoplasm. (authors)

  9. Diagnostic criteria of well differentiated thyroid tumor of uncertain malignant potential; a histomorphological and immunohistochemical appraisal

    Background: Well differentiated thyroid tumor of uncertain malignant potential (WDTUMP) represents a true ‘‘gray zone’’ of ‘‘follicular patterned’’ thyroid lesions, that needs to be characterized in order to outright the diagnosis of carcinoma and avoid unnecessary aggressive treatment. Aim: To emphasize on the histomorphological criteria for more accurate diagnosis of WDT-UMP. Also to compare the immunohistochemical expression of CK19 of WDT-UMP versus adenoma and papillary thyroid carcinoma (PTC). Materials and methods: The study included 60 thyroid specimens; 18 WDT-UMPs, 24 PTC (18 classic variant and 6 follicular variants) and 18 benign thyroid lesions (8 adenoma, 6 Hashimoto’s thyroiditis and 4 hyperplastic nodules). H and E stained sections were assessed according to the published major and minor criteria of malignancy in the thyroid. CK 19 immunostaining was examined and evaluated according to the proportion and intensity scores. Results: We could detect the absence of nuclear inclusions, presence of characteristic nuclear groove, nuclear clearing, ovoid nuclei, nuclear crowdness, nuclear enlargement and pleomorphism as important reliable features for diagnosis of WDT-UMP with Ρ value (<0.0001 for each). WDT-UMP showed moderate to strong CK 19 immunostaining with proportion scores 3 and 4; an intermediate expression profile; higher than adenoma and less than papillary carcinoma ( Ρ < 0.0001). Conclusion: The constellations of both major and minor criteria of malignancy are important clues for WDT-UMP diagnosis which could be ascertained by CK 19 immunostaining.

  10. Proteomics of thyroid tumours provides new insights into their molecular composition and changes associated with malignancy.

    Martínez-Aguilar, Juan; Clifton-Bligh, Roderick; Molloy, Mark P

    2016-01-01

    Around 5% of the general population have palpable thyroid nodules. Although most thyroid tumours are benign, thyroid cancer represents the most common malignancy of the endocrine system, comprising mainly follicular and papillary thyroid carcinomas. Previous studies have shed some light on the molecular pathogenesis of thyroid cancer but there have not been any comprehensive mass spectrometry-based proteomic studies of large scale to reveal protein expression differences between thyroid tumours and the molecular alterations associated with tumour malignancy. We applied data-independent acquisition mass spectrometry which enabled quantitative expression analysis of over 1,600 proteins from 32 specimens to compare normal thyroid tissue with the three most common tumours of the thyroid gland: follicular adenoma, follicular carcinoma and papillary carcinoma. In follicular tumours, we found marked reduction of the tumour suppressor and therapeutic target extracellular protein decorin. We made the novel observation that TGFβ-induced protein ig-h3 (TGFBI) was found frequently overexpressed in follicular carcinoma compared with follicular adenoma. Proteomic pathway analysis showed changes in papillary carcinoma were associated with disruption of cell contacts (loss of E-cadherin), actin cytoskeleton dynamics and loss of differentiation markers, all hallmarks of an invasive phenotype. PMID:27025787

  11. Thyroid and associated polyglandular neoplasms in patients who received head and neck irradiation during childhood

    One hundred fifty-one patients with a history of childhood irradiation to the head, neck, and thorax had neck explorations (142 for cold thyroid nodules and 9 for hypercalcemia). Fifty-nine of the patients had thyroid carcinoma, and associated glandular tumors were found in 20 others. In addition, 6 female patients developed breast carcinoma; 4 of these women also had thyroid carcinoma. In this series, 48.6% of the patients irradiated for acne and 36.4% with tonsil and adenoid irradiation developed thyroid carcinoma, but only 10.5% with thymic irradiation did so. It is suggested that the workup on these patients include not only complete thyroid and parathyroid testing, but also a careful examination of all salivary glands, both major and minor. Women should have thorough breast examinations and should perhaps be followed as if they were in the potentially high-risk breast group. When thyroid surgery is performed, a total thyroidectomy is recommended

  12. Volume changes of thyroid nodules after thyroxine suppression therapy: the usefulness in predicting malignancy

    To evaluate the usefulness of volume change after thyroxine suppression therapy in predicting the malignancy of thyroid nodules. We analyzed 28 cases of thyroid nodules diagnosed as benign by aspiration cytology or biopsy before thyroxine suppression therapy and which did not decrease more than 50 % in volume after therapy. Using Ultrasonography we measured the volume of nodules before and after thyroxine suppression therapy and then determined volume change by calculating nodule volume suppression rate (NVSR) and comparing this between benign and malignant nodules. All cases were surgically confirmed. NVSR(%) = nodule volume after treatment / nodule volume before treatment X100. Seventeen (60.7 %) of 28 thyroid nodules which showed less than 50% NVSR after thyroxine therapy were shown by surgical resection to be malignant, while 11(39.3%) were benign. The malignant cases were papillary carcinoma (n=9) and follicular carcinoma (n=8), while benign cases were either follicular adenoma (n=7) or adenomatous hyperplasia (n=4). The mean volume of malignant thyroid nodules was 5.2±4.5cm3 before thyroxine suppression therapy and 5.9±4.5cm3 after therapy, and that of benign nodules, 12.1±10.3cm3 before therapy and 10.1±9.9cm3 after. NVSR was 127.2±46.2 % in malignant nodules and 79.4±21.0 % in benign nodules, with no significant difference between the two groups (P < 0.05). Although further studies may be required, fine needle aspiration cytology or biopsy showed that among bening thyroid nodules which did not decrease more than 50 % in volume after thyroid therapy, the incidence of malignancy revealed by surgical resection was more than 60 %. Surgical exporation of these nodules is therefore highly recommended

  13. Implications of imaging criteria for the management and treatment of intraductal papillary mucinous neoplasms - benign versus malignant findings

    Evaluation of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiation of pancreatic intraductal papillary mucinous neoplasm (IPMN) subtypes based on objective imaging criteria. Fifty-eight patients with 60 histologically confirmed IPMNs were included in this retrospective study. Eighty-three imaging studies (CT,n = 42; MRI,n = 41) were analysed by three independent blinded observers (O1-O3), using established imaging criteria to assess likelihood of malignancy (-5, very likely benign; 5, very likely malignant) and histological subtype (i.e., low-grade (LGD), moderate-grade (MGD), high-grade dysplasia (HGD), early invasive carcinoma (IPMC), solid carcinoma (CA) arising from IPMN). Forty-one benign (LGD IPMN,n = 20; MGD IPMN,n = 21) and 19 malignant (HGD IPMN,n = 3; IPMC,n = 6; solid CA,n = 10) IPMNs located in the main duct (n = 6), branch duct (n = 37), or both (n = 17) were evaluated. Overall accuracy of differentiation between benign and malignant IPMNs was 86/92 % (CT/MRI). Exclusion of overtly malignant cases (solid CA) resulted in overall accuracy of 83/90 % (CT/MRI). The presence of mural nodules and ductal lesion size ≥30 mm were significant indicators of malignancy (p = 0.02 and p < 0.001, respectively). Invasive IPMN can be identified with high confidence and sensitivity using CT and MRI. The diagnostic problem that remains is the accurate radiological differentiation of premalignant and non-invasive subtypes. (orig.)

  14. Implications of imaging criteria for the management and treatment of intraductal papillary mucinous neoplasms - benign versus malignant findings

    Walter, Thula Cannon; Steffen, Ingo G.; Stelter, Lars H.; Hamm, Bernd; Denecke, Timm; Grieser, Christian [Charite - Universitaetsmedizin Berlin, Klinik fuer Radiologie, Campus Virchow-Klinikum, Berlin (Germany); Maurer, Martin H. [Universitaetsklinik Bern, Universitaetsinstitut fuer Radiologe, Inselspital, Bern (Switzerland); Bahra, Marcus; Faber, Wladimir; Klein, Fritz [Charite - Universitaetsmedizin Berlin, Klinik fuer Allgemein-, Viszeral- und Transplantationschirurgie Campus Virchow-Klinikum, Berlin (Germany); Blaeker, Hendrik [Charite - Universitaetsmedizin Berlin, Institut fuer Pathologie, Campus Charite Mitte, Berlin (Germany)

    2015-05-01

    Evaluation of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiation of pancreatic intraductal papillary mucinous neoplasm (IPMN) subtypes based on objective imaging criteria. Fifty-eight patients with 60 histologically confirmed IPMNs were included in this retrospective study. Eighty-three imaging studies (CT,n = 42; MRI,n = 41) were analysed by three independent blinded observers (O1-O3), using established imaging criteria to assess likelihood of malignancy (-5, very likely benign; 5, very likely malignant) and histological subtype (i.e., low-grade (LGD), moderate-grade (MGD), high-grade dysplasia (HGD), early invasive carcinoma (IPMC), solid carcinoma (CA) arising from IPMN). Forty-one benign (LGD IPMN,n = 20; MGD IPMN,n = 21) and 19 malignant (HGD IPMN,n = 3; IPMC,n = 6; solid CA,n = 10) IPMNs located in the main duct (n = 6), branch duct (n = 37), or both (n = 17) were evaluated. Overall accuracy of differentiation between benign and malignant IPMNs was 86/92 % (CT/MRI). Exclusion of overtly malignant cases (solid CA) resulted in overall accuracy of 83/90 % (CT/MRI). The presence of mural nodules and ductal lesion size ≥30 mm were significant indicators of malignancy (p = 0.02 and p < 0.001, respectively). Invasive IPMN can be identified with high confidence and sensitivity using CT and MRI. The diagnostic problem that remains is the accurate radiological differentiation of premalignant and non-invasive subtypes. (orig.)

  15. Multiple primary malignant neoplasms in patients with esophageal cancer treated with radiation therapy

    Thirty-two of 178 patients with esophageal cancer treated with radiation therapy had multiple primary neoplasms (MPN). The outcomes of patients with MPN and those without did not differ significantly. Radiation therapy for second neoplasms was limited in some patients because they had received radiation for an earlier cancer. In a patient who underwent surgical resection for hypopharyngeal cancer, intraluminal radiation therapy for a esophageal cancer could not be performed owing to the narrow interposition of the jejunum. On the other hand, a patient treated with radiation for a first neoplasm died of pulmonary complications after surgical resection of a subsequent lung cancer. Because the outcome of treatment of early-stage second cancers was good, careful examination for additional cancers should be performed after treatment of a first neoplasm. (author)

  16. Significance of ultrasound features in predicting malignant solid thyroid nodules: Need for fine-needle aspiration

    The purpose of this study was to provide sonographic and colour flow criteria helpful for differentiation between benign and malignant solid thyroid nodules. Methods: This prospective study was carried out at Sindh Institute of Urology and Transplantation (SIUT), Karachi Pakistan from 01.05.07 to 31.12.08. Sonographic scans of 78 thyroid nodules in 66 patients were performed and characteristics of thyroid nodules that were studied included microcalcifications, an irregular or microlobulated margins, marked hypoechogenicity, a shape that was taller than it was wide and color flow pattern in Color Doppler ultrasound. The presence and absence of characteristics of nodules were classified as having positive or negative findings. If even one of these sonographic features was present, the nodule was classified as positive (malignant). If a nodule had none of the features described, it was classified as negative (benign). The final diagnosis of a lesion as benign (n = 53) or malignant (n = 25) was confirmed by fine needle aspiration biopsy, and patients who were proved to have benign lesions were followed-up for 6 months and malignant lesions which were proved on histopathology after FNA were subjected to surgery. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were then calculated on the basis of our proposed classification method. Results: Among 78 solid thyroid nodules 35 lesions were classified as positive considering the sonographic characteristics and 23 of them were proved to be malignant on histopathology. Out of 43 lesions which were classified as negative, 2 were proved to be malignant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy based on our sonographic classification method were 93.8%, 66%, 56.1%, 95.9%, and 74.8%, respectively. Conclusion: Ultrasound is valuable for identifying many malignant or potentially malignant thyroid nodules. No single ultrasound criterion is reliable in differentiating all benign from malignant thyroid nodules, but many US features aid in predicting the benign or malignant nature of a given nodule. Fine-needle aspiration biopsy should be performed on thyroid nodules classified as positive, regardless of palpability. (author)

  17. Frequent expression of the variant CD30 in human malignant myeloid and lymphoid neoplasms.

    Horie, R; Gattei, V; Ito, K; Imajo-Ohmi, S; Tange, T; Miyauchi, J; Pinto, A; Degan, M; De Iuliis, A; Tassan Mazzocco, F; Rossi, F M; Higashihara, M; Watanabe, T

    1999-12-01

    We earlier identified a variant of CD30 (CD30v) that retains only the cytoplasmic region of the authentic CD30. This variant is expressed in alveolar macrophages. CD30v can activate the nuclear factor-kappaB (NF-kappaB) as CD30, and its overexpression in HL-60 induced a differentiated phenotype. To better understand the physiological and pathological functions of CD30v, expression of this variant was examined using a multiple approach to examine 238 samples of human malignant myeloid and lymphoid neoplasms. Screening by reverse transcriptase-polymerase chain reaction (RT-PCR) revealed expression of CD30v transcripts in 52 of 72, 7 of 11, 63 of 90, and 7 of 30 samples of acute myeloid leukemia (AML), myeloid blast crisis of myeloproliferative disorders (MBC), and lymphoproliferative disorders (LPDs) of B- and T-cell origin, respectively. CD30v expression was high in monocyte-oriented AMLs (FAB M4 and M5), B-cell chronic lymphocytic leukemia (B-CLL), and multiple myeloma (MM). Using the specific antibody HCD30C2, prepared using a peptide corresponding to the nine amino acids of the amino-terminal CD30v, expression of CD30v protein was detected in 10 of 25 and 2 of 10 AML and ALL samples, respectively. In AMLs, immunocytochemical detection of CD30v revealed the presence of loose clusters of CD30v-expressing cells dispersed amid a population of CD30v-negative blasts. Finally, the parallel expression of CD30v mRNA and protein, as evidenced by Northern and Western blotting, was confirmed in selected cases of AMLs and LPDs. A significant correlation was found between expressions of CD30v and CD30 ligand transcripts in AML and LPD (P = 0.02, odds ratio = 3.2). The association of CD30v with signal-transducing proteins, tumor necrosis factor receptor-associated factor (TRAF) 2, and TRAF5 was demonstrated by coimmunoprecipitation analysis, as was demonstrated for authentic CD30 protein. Expression of transcripts for TRAF1, TRAF2, TRAF3, and TRAF5, as demonstrated by RT-PCR, was noted in leukemic blasts that express CD30v. Collectively, frequent expression of CD30v along with TRAF proteins in human neoplastic cells of myeloid and lymphoid origin provide supportive evidence for biological and possible pathological functions of this protein in the growth and differentiation of a variety of myeloid and lymphoid cells. PMID:10595933

  18. Surface-enhanced Raman spectroscopy for differentiation between benign and malignant thyroid tissues

    Li, Zuanfang; Li, Chao; Lin, Duo; Huang, Zufang; Pan, Jianji; Chen, Guannan; Lin, Juqiang; Liu, Nenrong; Yu, Yun; Feng, Shangyuan; Chen, Rong

    2014-04-01

    The aim of this study was to evaluate the potential of applying silver nano-particle based surface-enhanced Raman scattering (SERS) to discriminate different types of human thyroid tissues. SERS measurements were performed on three groups of tissue samples including thyroid cancers (n = 32), nodular goiters (n = 20) and normal thyroid tissues (n = 25). Tentative assignments of the measured tissue SERS spectra suggest interesting cancer specific biomolecular differences. The principal component analysis (PCA) and linear discriminate analysis (LDA) together with the leave-one-out, cross-validated technique yielded diagnostic sensitivities of 92%, 75% and 87.5%; and specificities of 82.6%, 89.4% and 84.4%, respectively, for differentiation among normal, nodular and malignant thyroid tissue samples. This work demonstrates that tissue SERS spectroscopy associated with multivariate analysis diagnostic algorithms has great potential for detection of thyroid cancer at the molecular level.

  19. Surface-enhanced Raman spectroscopy for differentiation between benign and malignant thyroid tissues

    The aim of this study was to evaluate the potential of applying silver nano-particle based surface-enhanced Raman scattering (SERS) to discriminate different types of human thyroid tissues. SERS measurements were performed on three groups of tissue samples including thyroid cancers (n = 32), nodular goiters (n = 20) and normal thyroid tissues (n = 25). Tentative assignments of the measured tissue SERS spectra suggest interesting cancer specific biomolecular differences. The principal component analysis (PCA) and linear discriminate analysis (LDA) together with the leave-one-out, cross-validated technique yielded diagnostic sensitivities of 92%, 75% and 87.5%; and specificities of 82.6%, 89.4% and 84.4%, respectively, for differentiation among normal, nodular and malignant thyroid tissue samples. This work demonstrates that tissue SERS spectroscopy associated with multivariate analysis diagnostic algorithms has great potential for detection of thyroid cancer at the molecular level. (letter)

  20. Percutaneous port-catheter system implantation via left subclavian artery in the treatment of advanced malignant neoplasms

    Objective: To evaluate the value of percutaneous port-catheter system (PCS) implantation via left subclavian artery in the treatment of advanced malignant neoplasms. Methods: The technique was used to treat 200 patients with advanced malignant neoplasms, 178 cases of primary liver carcinoma, 10 cases of metastatic liver cancer, 5 cases of pelvic neoplasm, 4 cases of gallbladder carcinoma, 3 cases of lung cancer. The authors performed implantation of PCS under guidance of DSA and fluoroscopy according to the arterial blood supply of tumors. Body of PCS was subcutaneously implanted below puncture point. The implanted catheter tip was positioned in the target artery. Intra-arterial chemotherapy or chemo-embolization with emulsion of anti-cancerous agents and lipiodol were regularly carried out via PCS. Results: 200 patients were traced for 3 months to 3 years, 202 PCS were implanted in 200 patients. Because of left and right hepatic artery supplied tumor simultaneously in 2 patients with liver cancer, another PCS was implanted for the right femoral artery (double PCS). The successful rate was 99%. Complications occurred in 7 cases (3.5%), including indwelling catheter tip dislocation (2 cases, 1%), disconnection between port and catheter after the procedure (1 cases, 0.5%), pneumothorax (2 cases, 1%), skin fester (1 cases, 0.5%), massive blood effusion in subcutaneous tissue (1 cases, 0.5%), target vessel closed off (2 cases, 1%). There was no serious complication. Conclusion: Percutaneous PCS implantation via left subclavian artery is safe, feasible and less traumatic. It provides a safe intra-arterial chemotherapy or chemo-embolization with emulsion of anti-cancerous agents and lipiodol for patient with malignant tumor

  1. Expression of aminopeptidase-n (CD 13) in normal tissues and malignant neoplasms of epithelial and lymphoid origin.

    Dixon, J.; Kaklamanis, L.; Turley, H; Hickson, I D; Leek, R. D.; Harris, A. L.; Gatter, K C

    1994-01-01

    AIMS--To provide a detailed knowledge of the distribution of the CD13 molecule, also known as the protease aminopeptidase-N, on both normal tissues and malignant neoplasms of epithelial and lymphoid origin. METHODS--CD13 antigen was examined by immunocytochemistry, using a recently produced antibody (VS5E) alongside a commercially available anti-CD13 monoclonal antibody. The VS5E recognising CD13 was produced by immunising a doxorubicin resistant breast cancer cell line (MCF-7-ADr). A strikin...

  2. Malignancy Risk Stratification of Thyroid Nodules: Comparison between the Thyroid Imaging Reporting and Data System and the 2014 American Thyroid Association Management Guidelines.

    Yoon, Jung Hyun; Lee, Hye Sun; Kim, Eun-Kyung; Moon, Hee Jung; Kwak, Jin Young

    2016-03-01

    Purpose To compare malignancy risk stratification of thyroid nodules with the 2014 American Thyroid Association (ATA) management guidelines and the Thyroid Imaging Reporting and Data System (TIRADS). Materials and Methods This retrospective study was approved by the institutional review board. The requirement to obtain informed consent was waived. From November 2013 to July 2014, 1293 thyroid nodules in 1241 patients (mean age, 50.8 years ± 13.5) were included in this study. All nodules measured at least 10 mm. Solidity, hypoechogenicity or marked hypoechogenicity, microlobulated to irregular margin, microcalcifications or mixed calcifications, and nonparallel shape were considered suspicious features at ultrasonography (US). A TIRADS category and the US pattern as determined with ATA guidelines were assigned to each nodule. The correlation between the TIRADS category or ATA pattern and the malignancy rate was evaluated with the Spearman rank test. Results Of the 1293 thyroid nodules, 1059 (81.9%) were benign and 234 (18.1%) were malignant. Forty-four of the 1293 nodules (3.4%) did not meet the criteria for the ATA patterns and were classified as "not specified." The malignancy rates of TIRADS category 3, 4a, 4b, 4c, and 5 nodules were 1.9% (six of 316 nodules), 4.2% (17 of 408 nodules), 12.9% (33 of 256 nodules), 49.8% (130 of 261 nodules), and 92.3% (48 of 52 nodules), respectively, with significant differences between categories (P < .001). Malignancy rates of nodules with very low, low, intermediate, and high suspicion for malignancy with the ATA guidelines and not specified patterns were 2.7% (11 of 407 nodules), 3.1% (10 of 323 nodules), 16.7% (39 of 233 nodules), 58.0% (166 of 286 nodules), and 18.2% (eight of 44 nodules), respectively, with significant differences between patterns (P < .001). There was high correlation between classification with TIRADS (r = 1.000, P < .001) and ATA guidelines (r = 0.900, P = 0.037), without statistically significant differences (P = .873). Conclusion Both TIRADS and the ATA guidelines provide effective malignancy risk stratification for thyroid nodules. Nodules that do not meet the criteria for a specific pattern with the ATA guidelines have a relatively high risk of malignancy (18.2%). (©) RSNA, 2015 Online supplemental material is available for this article. PMID:26348102

  3. Inter-Institutional Comparison of Personalized Risk Assessments for Second Malignant Neoplasms for a 13-Year-Old Girl Receiving Proton versus Photon Craniospinal Irradiation

    Children receiving radiotherapy face the probability of a subsequent malignant neoplasm (SMN). In some cases, the predicted SMN risk can be reduced by proton therapy. The purpose of this study was to apply the most comprehensive dose assessment methods to estimate the reduction in SMN risk after proton therapy vs. photon therapy for a 13-year-old girl requiring craniospinal irradiation (CSI). We reconstructed the equivalent dose throughout the patients body from therapeutic and stray radiation and applied SMN incidence and mortality risk models for each modality. Excluding skin cancer, the risk of incidence after proton CSI was a third of that of photon CSI. The predicted absolute SMN risks were high. For photon CSI, the SMN incidence rates greater than 10% were for thyroid, non-melanoma skin, lung, colon, stomach, and other solid cancers, and for proton CSI they were non-melanoma skin, lung, and other solid cancers. In each setting, lung cancer accounted for half the risk of mortality. In conclusion, the predicted SMN risk for a 13-year-old girl undergoing proton CSI was reduced vs. photon CSI. This study demonstrates the feasibility of inter-institutional whole-body dose and risk assessments and also serves as a model for including risk estimation in personalized cancer care

  4. Inter-Institutional Comparison of Personalized Risk Assessments for Second Malignant Neoplasms for a 13-Year-Old Girl Receiving Proton versus Photon Craniospinal Irradiation

    Taddei, Phillip J., E-mail: pt06@aub.edu.lb [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Unit 1202, 1515 Holcombe Blvd, Houston, TX 77030 (United States); The University of Texas Graduate School of Biomedical Sciences at Houston, P.O. Box 20334, Houston, TX 77225 (United States); Department of Radiation Oncology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020 (Lebanon); Khater, Nabil [Department of Radiation Oncology, Hôtel-Dieu de France Hospital, University of St. Joseph, P.O. Box 166830, Alfred Naccache Blvd, Beirut (Lebanon); Zhang, Rui [Medical Physics Program, Department of Physics and Astronomy, Louisiana State University, 202 Nicholson Hall, Tower Dr., Baton Rouge, LA 70803 (United States); Department of Physics, Mary Bird Perkins Cancer Center, 4950 Essen Lane, Baton Rouge, LA 70809 (United States); Geara, Fady B. [Department of Radiation Oncology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020 (Lebanon); Mahajan, Anita [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Unit 1202, 1515 Holcombe Blvd, Houston, TX 77030 (United States); The University of Texas Graduate School of Biomedical Sciences at Houston, P.O. Box 20334, Houston, TX 77225 (United States); Jalbout, Wassim [Department of Radiation Oncology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020 (Lebanon); Pérez-Andújar, Angélica [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Unit 1202, 1515 Holcombe Blvd, Houston, TX 77030 (United States); Youssef, Bassem [Department of Radiation Oncology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020 (Lebanon); Newhauser, Wayne D. [Medical Physics Program, Department of Physics and Astronomy, Louisiana State University, 202 Nicholson Hall, Tower Dr., Baton Rouge, LA 70803 (United States); Department of Physics, Mary Bird Perkins Cancer Center, 4950 Essen Lane, Baton Rouge, LA 70809 (United States)

    2015-03-10

    Children receiving radiotherapy face the probability of a subsequent malignant neoplasm (SMN). In some cases, the predicted SMN risk can be reduced by proton therapy. The purpose of this study was to apply the most comprehensive dose assessment methods to estimate the reduction in SMN risk after proton therapy vs. photon therapy for a 13-year-old girl requiring craniospinal irradiation (CSI). We reconstructed the equivalent dose throughout the patient’s body from therapeutic and stray radiation and applied SMN incidence and mortality risk models for each modality. Excluding skin cancer, the risk of incidence after proton CSI was a third of that of photon CSI. The predicted absolute SMN risks were high. For photon CSI, the SMN incidence rates greater than 10% were for thyroid, non-melanoma skin, lung, colon, stomach, and other solid cancers, and for proton CSI they were non-melanoma skin, lung, and other solid cancers. In each setting, lung cancer accounted for half the risk of mortality. In conclusion, the predicted SMN risk for a 13-year-old girl undergoing proton CSI was reduced vs. photon CSI. This study demonstrates the feasibility of inter-institutional whole-body dose and risk assessments and also serves as a model for including risk estimation in personalized cancer care.

  5. Diffusion-weighted MR imaging and ADC mapping in differentiating benign from malignant thyroid nodules

    To determine the diagnostic accuracy of Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) mapping in differentiating benign from malignant thyroid nodules by taking histopathology as the gold standard. Study Design:Across-sectional analytical study. Place and Duration of Study: Department of Radiology at Combined Military Hospital (CMH), Lahore, from August 2012 to July 2013. Methodology: Thirty-five patients, who were referred to radiology department of CMH, Lahore, for ultrasound or Fine Needle Aspiration Cytology (FNAC) of thyroid gland, fulfilling the inclusion and exclusion criteria, were included in the study. They were evaluated on 1.5 Tesla MRI machine with T1- and T2-weighted imaging as well as fat-suppressed technique. DWI was done using b-values of 0 and 1000 s/mm2 and ADC values were calculated for the thyroid nodules. All of these patients were subjected to ultrasound guided core biopsy and histopathology results were correlated with ADC values. Results: The benign nodules showed facilitated diffusion while malignant nodules showed restricted diffusion. T-test was used to assess the difference in mean ADC values between benign and malignant nodules. The mean ADC value of the malignant thyroid nodules (0.94 ± 0.16 x 10/sup -3/mm2/s) was significantly lower than that of the benign thyroid nodules (1.93 ±0.13 x 10/sup -3/mm2/s) (p-value < 0.05). ADC value of 1.6 x 10/sup -3/mm2/s was used as a cut-off, for differentiating benign from malignant thyroid nodules. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of DWI and ADC values in differentiating benign from malignant thyroid nodules were 93%, 95%, 93%, 95% and 92.3%, respectively. Conclusion: DWI is a non-invasive diagnostic tool for characterization and differentiation between benign and malignant thyroid nodules. It not only decreases the burden of unnecessary surgeries when pre-operative FNAC and biopsy are inconclusive, but is also helpful in reaching a definite diagnosis when a nodule is not amendable to biopsy due to any reason. (author)

  6. Frequency and significance of pulmonary nodules on thin-section CT in patients with extrapulmonary malignant neoplasms

    Purpose: To determine the frequency and significance of pulmonary nodules detected on thin-section CT in patients with extrapulmonary malignant neoplasms. Materials and methods: The institutional review board approved this study. This study retrospectively evaluated 308 patients with extrapulmonary carcinomas or sarcomas and had undergone thin-section chest CT (2 mm slice thickness) for staging. Three radiologists identified non-calcified nodules and evaluated the size, the growth and the distance from the nearest pleural surface. The characteristics of the nodules were defined based on the results of either a diagnostic biopsy or nodule growth. Results: One or more non-calcified pulmonary nodules were detected in 75% of the patients (233/308). One hundred and thirty-seven of these patients had nodules that met the criteria of either benign or malignant nodules. Nodules smaller than 10 mm were more likely to be benign, whereas those 10 mm or greater were more likely to be malignant (22/26, 85%; P < .0001). Most nodules less than 10 mm from the pleura were benign (91%), whereas approximately half of the nodules 10 mm or more away from the pleura were malignant (20/43, 47%; P < .0001). Patients with melanoma, sarcoma, or testicular carcinoma were more likely to have malignant nodules. A multivariable analysis demonstrated the nodule size (P < .0001) and distance from the pleura were predictive of malignancy. Conclusion: The nodule detection rate on thin-section CT in patients with extrapulmonary malignancy is high. Most of the nodules smaller than 10 mm or less than 10 mm from the pleura are benign.

  7. [Solid and papillary epithelial neoplasm of the pancreas--a rare malignant tumor of pancreas].

    Solecki, Rafał; Kedra, Bogdan; Czupryna, Antoni; Nowak, Krystyna

    2005-01-01

    The paper presents two cases of solid and papillary epithelial neoplasm of the pancreas (SPENP)--a rare pancreatic neoplasm in a 45-year-old woman admitted to the hospital with the diagnosis of pancreatic tail tumor and 22-year-old woman with the diagnosis of pancreatic head tumor. First patient was subjected to peripheral pancreatic resection; the second patient was subjected to Whipple pancreatoduodenectomy. Histopathological examination confirmed SPENP. The authors present cases and review of the literature on SPENP. PMID:16786800

  8. Retarded cutaneous hypersensitivity reactions in patients treated with cytostatic drugs and Co60 because of genital malignant neoplasms

    The effect of application of cytostatic drugs and telegammatherapy (Co60) was tested by means of cutaneous hyperactivity reactions in 89 women treated because of malignant neoplasms of the genital organs. The skin tests with 2,4-dinitrochlorobenzene (DNCB) and purified protein derivate (PPD) were used. The group 1 constituted of 36 women treated with cytostatic drugs through a period of 7 months to 4 years. The appearance of retarded cutaneous hypersensitivity to DNCB and PPD correlated with the clinical state of the subjects. In cases of improvement of the clinical state the skin reactions were more intensive, when the disease progreded the reactions became weak or disappeared. When the clinical state remained unchanged - the same was true with the skin reactions. In the group 253 women were treated by means of irradiation (Co60) because of similar diagnosis of malignant genital neoplasm. In all cases a regression of the retarded cutaneous hypersensitivity to DNCB and PPD was observed, together with a decrease of the number of white blood cells in the peripheric blood. Correlation of the individual skin reactions to DNCB and PPD demonstrated that the latter gave a smaller percent of positive reactions in comparison with the former agent, these reactions were also less sensitive. (author)

  9. Thyroid Malignancy Association with Cortical and Subcortical Brain SPECT Changes In Patients Presenting with a Myalgic Encephalomyelitis / Chronic Fatigue Syndrome

    Thyroid malignancy in ME/CFS patients greatly exceeds the normal incidence of thyroid malignancy in any known subgroup. The thyroid malignancy incidence in the ME/CFS group may exceed 6,000 / 100,000. As part of their investigation, Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) patients should be examined by thyroid ultrasound for evidence of thyroid pathology and malignancy. Thyroid pathology may be missed in this group of patients if investigation relies only upon serum testing for TSH, FT3, FT4, microsomal and thyroglobulin antibodies, which are usually normal. Thyroid uptake scans tend also to be normal and may also miss malignant lesions. A newly recognized syndrome may exist in ME/CFS patients characterized by: (a) thyroid malignancy, (b) persistent abnormal cortical and subcortical SPECT brain scans (NeuroSPECT), (c) failure of thyroidectomy surgery and hormone replacement to correct the fatigue syndrome, and (d) an unusual high incidence of cervical vertebrae osteoarthritic changes. ME/CFS patients with treated non-malignant thyroid disease and abnormal NeuroSPECT scans may also fail to improve despite adequate thyroid hormone replacement. A brief summary of the differences between ME and CFS is discussed. Lee, Hur and Ahn [1] stated that thyroid malignancy is said to be an infrequent occurrence found in 0.5 to 3 patients per 100,000 in the general population. They noted that in a subgroup of patients booked for mammography, a thyroid ultrasound was also performed. In this group, they found thyroid malignancy frequency was as high as 3 per 100,000. It is not known if their subgroup was at a higher risk for malignancy. Mittelstaedt [2] in the Globe and Mail states that thyroid malignancy was 15 per 100,000. In the past 100 patients whom I have investigated for (ME/CFS)[3], with or without associated Fibromyalgia Syndrome (FS), I have found that 6% of these patients had thyroid malignancy. In each of these patients the diagnosis was made by ultrasonography and needle biopsy under ultrasonography. This was followed by surgical removal of the thyroid, and each case the malignancy was confirmed. These findings would suggest that 6% of the ME/CFS patients seen, or 6,000 cases per 100,000, had a confirmed thyroid malignancy. Unfortunately, these figures may be conservative since we are in the process of obtaining needle biopsies on six further cases of these first 100 patients. In addition, we have not yet performed thyroid ultrasound on all 100 cases. We are in the process of further investigation of those patients who had not yet been investigated by thyroid ultrasound. Previously, it has been noted that the increased incidence of thyroid malignancy in the general population is only associated with increased radiation exposure. Patients presenting with symptoms of ME/CFS or Fibromyalgia may have significant higher thyroid malignancy incidence. NeuroSPECT was performed with the radiopharmaceutical NeuroliteTM and processed with the software Neurogam by Segami Corp.( Maryland USA.) (au)

  10. Bilateral malignant mixed serous adenocarcinoma and malignant transitional cell carcinoma of the ovaries: An extremely rare neoplasm

    Ozdemir, Ozhan; Sari, Mustafa Erkan; Atalay, Cemal Resat; Sen, Ertugrul; Ozhamam, Esra

    2015-01-01

    Mixed epithelial ovarian carcinomas are extremely rare and comprise less than 4% of all malignant ovarian tumors. We report a 61-year-old postmenopausal woman with bilateral adnexal masses. In the postoperative histopathological evaluation, mixed epithelial carcinoma with areas of disseminated serous adenocarcinoma and less prevalent areas of malignant transitional cell carcinoma was observed. Up-to-date, there have been only two cases with mixed serous adenocarcinoma and ma...

  11. Relation between cardiovascular pathologic conditions and malignant tumours as seen by pathologist. I. Frequency of malignant neoplasms in the population with myocardial hypertrophy as seen by pathologist.

    Kruś, S; Biela, B; Cieciura, M

    1992-01-01

    Relatively low co-existence of malignant neoplasms and chronic cardiovascular disease was documented in this work the emphasis being put on the conditions running with myocardial hypertrophy. The percentage of malignancy in the total autopsy material of 5821 men and 6849 women was 27.8 and 23.0 resp., and in the subgroup with heart weight 300-400 g, 36.8 and 31.0 resp. This percentage was significantly lower in separated subgroups of: a. arterial hypertension, 6.6 and 10.2, b. cardio-pulmonary syndrome, 23.0 and 18.5, c. healed myocardial infarct accompanied by myocardial hypertrophy, 13.3 and 11.7, d. acquired valvar deformity, 15.3 and 10.1. The subgroup of heart weight 150-250 g showed 57.2% and 46.6% of cases with malignancy while that of cardiac weight over 600 g-7.4% and 5.7%. In the subgroup of normal right-(2-3 mm) and left-ventricular (10-12 mm) wall thickness corresponding percentage equalled 29.4 and 30.1, in the subgroup of right-ventricular wall thickness over 6 mm--14.4 and 8.8, and in that of left-ventricular wall thickness over 18 mm--12.5 and 9.4. Scanty available information suggests some antimitotic activity of catecholamines believed to condition that of chalones. Catecholamines are also attributed with the stimulation of myocardial hypertrophy. The correlation of our findings with assumptions mentioned above seem to justify a hypothesis, or only a possibility, that compensatory mechanisms active in the cardiovascular diseases create an unfavourable background for the development of neoplasm. PMID:1287547

  12. Malignant and benign ovarian neoplasms among atomic bomb survivors, Hiroshima and Nagasaki, 1950 - 80

    For 1950 - 80, 194 ovarian cancer cases were ascertained among the 70,030 females of the RERF Life Span Study (LSS-E85) sample, and 106 autopsied cases with benign ovarian neoplasms were ascertained among all 3,046 autopsies performed in the same sample. On the basis of microscopic review, 66 % of the cancer and 84 % of the benign tumor cases were classified by histological type. The age-adjusted ovarian cancer incidence rates showed a statistically significant increase with increased exposure dose, both in the entire exposed group (P 0.10). The distribution of histological types of both cancer and benign tumor of the ovary did not vary significantly with radiation dose. The data are consistent with the hypothesis that radiation injury of ovaries with secondary excess of gonadotrophic hormones are important causative factors in the development of ovarian neoplasms. (author)

  13. Assessment of microsatellite instability in bladder and thyroid malignancies.

    Vaish, Minal; Mishra, S K; Mandhani, Anil; Mittal, R D; Mittal, Balraj

    2003-01-01

    Microsatellite instability (MSI) is an indicator of a defective DNA mismatch repair system (MMR) that results from somatic mutations. The present work has been planned to investigate MSI and its clinical significance in human urinary bladder and thyroid cancers in Indian patients. Tumor tissues of histologically confirmed cases of urinary bladder and thyroid cancers, respectively, were obtained. Clinical data on tumor stage and histopathological grades were recorded. Corresponding matched peripheral blood was taken as a control. Genomic DNA was isolated from the tumor tissues and blood using a standard phenol-chloroform extraction method. Polymerase chain reaction was done to amplify mononucleotide microsatellite markers, BAT-26, BAT-40, TGFbetaRII, IGFIIR, hMSH3, and Bax by using specific primer sequences. For analysis of allelic patterns, the PCR products were run on 8% denaturing Polyacrylamide gel and sizing was done using a pUC18 sequencing ladder. The instability with BAT-26 and BAT-40 was found to be 20% and 45% in urinary bladder and 33% and 19% in thyroid cancers, respectively. However, no instability was observed with the other four-mononucleotide markers in either of the cancers studied. Eighty-three percent of the unstable urinary bladder cancers were found to have a high grade in a superficial group, whereas only 27% MSI+ve were muscle invasive cancers. Forty percent of unstable thyroid lesions were found to be at high risk of developing metastasis. Association of BAT-26 and BAT-40 instabilities with high grade tumors as well as risk tumors may help in choosing a more definite therapy at the outset. PMID:12616616

  14. Thyroid abnormalities associated with treatment of malignant lymphoma

    The effects on the thyroid of radiation therapy to the neck and/or chemotherapy were investigated in 54 Hodgkin's and 72 non-Hodgkin's lymphoma patients. These patients had received radiation therapy with doses ranging from 2000 to 4000 rad (median 3600 rad) to the cervical or mantle fields and/or multiple-agent chemotherapy following usual staging procedures. Palpable abnormalities of the thyroid were found in 15 patients. The patients with irradiation to the neck had a higher incidence of hypothyroidism than those patients treated with chemotherapy alone (31/74 vs. 8/52, P less than 0.001 for TSH and 10/74 vs. 1/52, P less than 0.025 for T4). A higher frequency of elevated serum TSH levels and antithyroid antibodies were also observed in patients receiving radiation therapy alone to the neck than in those receiving both radiation therapy and chemotherapy (19/33 vs. 12/41, P less than 0.025 for TSH and 16/33 vs. 7/41, p less than 0.01 for antibodies), suggesting that chemotherapy agents may reduce the thyroid dysfunction induced by irradiation. There was no difference in prevalence of elevated TSH levels following irradiation to the neck between patients in whom lymphangiogram was or was not performed

  15. [Basedow's disease associated with benign and malignant nodular disease of the thyroid: diagnosis and treatment].

    Erdas, Enrico; Licheri, Sergio; Pisano, Giuseppe; Pomata, Mariano; Daniele, Giovanni Maria

    2004-01-01

    Nowadays the prevalence of thyroid nodules in Graves' disease (GD) is estimated as ranging from 15 to 33% and several studies support a high risk of thyroid cancer in this condition. The present study presents a retrospective analysis of 41 cases of GD submitted to total thyroidectomy from 1995 to 2003, aimed at discovering the most useful elements for an optimal diagnostic and therapeutic strategy. We identified 23 patients with coexisting nodular goitre (nodular variants of GD) and among these we carried out a comparative study of 12 cases with only benign nodules and 7 with thyroid carcinoma detected prior to the operation. Four cases were not considered because of incidental microcarcinomas. We found no significant differences in the number, average size and radionuclide imaging of nodules in the two groups. In contrast, analysis of ultrasonographic findings showed that hypoechogenicity correlated closely with malignancy, particularly if associated with ill-defined margins, microcalcifications and intranodular vascular patterns, whereas hyperechogenicity was a typical appearance of benign lesions. Our study suggests that routine thyroid US scans should be considered for complete evaluation of GD, since this pathology frequently implies the development of thyroid nodules which are not always detectable at clinical or radionuclide examination. Surgery is mandatory when nodules with suspicious ultrasonographic features are found and if malignancy cannot be excluded at fine needle aspiration cytology. PMID:15152509

  16. Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

    Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto's thyroiditis and 30 hyperthyroid patients with Graves' disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto's thyroiditis showed slightly decreased Tg levels. In Graves' disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (<30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves' disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases. (orig.)

  17. An 8-year evaluation of nasal and paranasal sinuses malignant neoplasms in Tehran University of Medical Sciences hospitals

    Mohsen Naraghi

    2009-07-01

    Full Text Available Introduction: Nasal and paranasal sinuses malignant neoplasms are usually diagnosed in advanced stages because of non-specific and benign symptoms. In this study we evaluated the symptoms, pathology and treatment of paranasal sinuses malignancies in patients admitted to Tehran University of Medical Sciences affiliated hospitals. Material and Methods: In this descriptive study, medical files of patients diagnosed with paranasal sinus malignancies and admitted to Imam Khomeini and Amir Aalam hospitals between 2000-2007 were evaluated. Results: Of 75 patients, 47 were male and 28 were female. The mean age was 55±14.1 years. The most common sinus involvement was seen in Maxillary sinuses (86.7% and 18 patients had concurrent involvement of other sinuses. The most common pathology was squamous cell carcinoma (40% and the most common clinical symptom was nasal obstruction (%28. Distant metastasis was found in 46 patients and 42 patients presented with eye involvement Eleven patients underwent endoscopic resection. Conclusion: The presence of eye involvement and distant metastasis in a large number of the patients showed that diagnosis of paranasal cancers is delayed because of their nonspecific symptoms. Therefore further education of clinical manifestations of paranasal sinus cancers is emphasized. 

  18. The Evolution of a Malignancy Risk Prediction Model for Thyroid Nodules Using the Artificial Neural Network

    Shahram Paydar

    2016-01-01

    Full Text Available Background: Clinically frank thyroid nodules are common and believed to be present in 4% to 10% of the adult population in the United States. In the current literature, fine needle aspiration biopsies are considered to be the milestone of a model which helps the physician decide whether a certain thyroid nodule needs a surgical approach or not. A considerable fact is that sensitivity and specificity of the fine needle aspiration varies significantly as it remains highly dependent on the operator as well as the cytologist’s skills. Practically, in the above group of patients, thyroid lobectomy/isthmusectomy becomes mandatory for attaining a definitive diagnosis where the majority (70%-80% have a benign surgical pathology. The scattered nature of clinically gathered data and analysis of their relevant variables need a compliant statistical method. The artificial neural network is a branch of artificial intelligence. We have hypothesized that conduction of an artificial neural network applied to certain clinical attributes could develop a malignancy risk assessment tool to help physicians interpret the fine needle aspiration biopsy results of thyroid nodules in a context composed of patient’s clinical variables, known as malignancy related risk factors. Methods: We designed and trained an artificial neural network on a prospectively formed cohort gathered over a four year period (2007-2011. The study population comprised 345 subjects who underwent thyroid resection at Nemazee and Rajaee hospitals, tertiary care centers of Shiraz University of Medical Sciences, and Rajaee Hospital as a level I trauma center in Shiraz, Iran after having undergone thyroid fine needle aspiration. Histopathological results of the fine needle aspirations and surgical specimens were analyzed and compared by experienced, board-certified pathologists who lacked knowledge of the fine needle aspiration results for thyroid malignancy. Results: We compared the preoperative fine needle aspiration and surgical histopathology results. The results matched in 63.5% of subjects. On the other hand, fine needle aspiration biopsy results falsely predicted malignant thyroid nodules in 16% of cases (false-negative. In 20.5% of subjects, fine needle aspiration was falsely positive for thyroid malignancy. The Resilient back Propagation (RP training algorithm lead to acceptable accuracy in prediction for the designed artificial neural network (64.66% by the cross- validation method. Under the cross-validation method, a back propagation algorithm that used the resilient back propagation protocol - the accuracy in prediction for the trained artificial neural network was 64.66%. Conclusion: An extensive bio-statistically validated artificial neural network of certain clinical, paraclinical and individual given inputs (predictors has the capability to stratify the malignancy risk of a thyroid nodule in order to individualize patient care. This risk assessment model (tool can virtually minimize unnecessary diagnostic thyroid surgeries as well as FNA misleading.

  19. Risk analyses of mortality due to malignant neoplasms among atomic bomb survivors in Hiroshima Prefecture based on ABS93D

    Risk of mortality due to malignant neoplasm was analyzed among atomic bomb survivors with ABS93D (Atomic Bomb Survivors 1993 Dose). The period subjected to analysis was that from Jan. 1, 1968 to Dec. 31, 1992. The number of the subjects was 47,204 in total who were registered as atomic bomb survivors in authors' facility data base essentially living in Hiroshima prefecture and giving the estimated dose of ABS93D or having been exposed at farther distance than 3 km from the explosion site without experience of existing in the city. They were divided in 2 groups of exposed (≥5 mGy of bone marrow dose) and non-exposed (<5 mGy) ones. The organ dose was the sum of doses of neutron and gamma ray based on ABS93D. The neoplasms analyzed were leukemia and cancers of esophagus, stomach, liver, pancreas, colon, lung, mammary gland and uterus. Risk ratio of the exposed group relative to non-exposed group per 1 Gy, the ratio according to the dose and the time change of the ratio were calculated and some of cancers gave statistically significant high risk in exposed group. (K.H.)

  20. Investigation on the value of spectral CT imaging in diagnosis of benign and malignant thyroid nodules

    Objective: To explore the value of gemstone spectral imaging (GSI) in the detection and differential diagnosis of benign and malignant thyroid nodules. Methods: The spectral CT images in 88 patients with thyroid nodules were analyzed retrospectively. All the patients underwent spectral CT scanning, including 33 patients undergoing biphase enhanced CT imaging. Nodules were divided into benign and malignant ones according to histopathologic results. The iodine concentration, slope of spectral curve, effective atomic number in non-enhanced and enhanced scanning were compared between benign and malignant group by the Wilcoxon rank sum test, respectively. The optimal iodine concentration threshold to predict malignancy was obtained by receiver operating characteristic curve (ROC), sensitivity and specificity were achieved. Results: A total of 106 nodules were detected, including 76 benign and 30 malignant nodules. In non-contrast CT imaging, the average iodine concentration, slope of spectral curve, effective atomic number of were 2.35 × 100 μg/ml, 0.29 and 7.71 for benign group: -0.51 × 100 μg/ml, -0.06 and 7.52 for malignant group (Z value were -3.072, -3.107 and -3.055, respectively; P<0.05). In the arterial phase, the average iodine concentration, slope of spectral curve, effective atomic number of the two group were 27.22 × 100 μg/ml, 3.23 and 9.10 for benign group; 18.81 × 100 μg/ml, 2.24 and 8.69 for malignant group (Z value were -2.582, -2.582 and -2.564, respectively; P<0.05). In venous phase,no significant difference was found for each parameter between the two groups (P>0.05). The optimal iodine concentration to predict malignancy was -0.35 × 100 μg/ml in non-enhanced phase with 56.7% sensitivity and 73.7% specificity. The optimal iodine concentration was 22.91 × 100 μg/ml in arterial phase, with 76.2% sensitivity and 75.0% specificity. Using iodine concentration to predict malignancy in both non-contrast phase and arterial phase, the sensitivity and specificity were 81.2% and 73.3%, while the accuracy was 81.6%. Conclusion: Gemstone spectral CT imaging can quantitatively evaluate the iodine content of thyroid nodules, having a potential value in differential diagnosis of thyroid nodules. (authors)

  1. Hodgkin’s lymphoma emerging radiation treatment techniques: trade-offs between late radio-induced toxicities and secondary malignant neoplasms

    2013-01-01

    Background Purpose of this study is to explore the trade-offs between radio-induced toxicities and second malignant neoplasm (SMN) induction risk of different emerging radiotherapy techniques for Hodgkin’s lymphoma (HL) through a comprehensive dosimetric analysis on a representative clinical model. Methods Three different planning target volume (PTVi) scenarios of a female patient with supradiaphragmatic HL were used as models for the purpose of this study. Five treatment radiation techniques were simulated: an anterior-posterior parallel-opposed (AP-PA), a forward intensity modulated (FIMRT), an inverse intensity modulated (IMRT), a Tomotherapy (TOMO), a proton (PRO) technique. A radiation dose of 30 Gy or CGE was prescribed. Dose-volume histograms of PTVs and organs-at-risk (OARs) were calculated and related to available dose-volume constraints. SMN risk for breasts, thyroid, and lungs was estimated through the Organ Equivalent Dose model considering cell repopulation and inhomogeneous organ doses. Results With similar level of PTVi coverage, IMRT, TOMO and PRO plans generally reduced the OARs’ dose and accordingly the related radio-induced toxicities. However, only TOMO and PRO plans were compliant with all constraints in all scenarios. For the IMRT and TOMO plans an increased risk of development of breast, and lung SMN compared with AP-PA and FIMRT techniques was estimated. Only PRO plans seemed to reduce the risk of predicted SMN compared with AP-PA technique. Conclusions Our model–based study supports the use of advanced RT techniques to successfully spare OARs and to reduce the risk of radio-induced toxicities in HL patients. However, the estimated increase of SMNs’ risk inherent to TOMO and IMRT techniques should be carefully considered in the evaluation of a risk-adapted therapeutic strategy. PMID:23360559

  2. Neck ultrasonography as preoperative localization of primary hyperparathyroidism with an additional role of detecting thyroid malignancy

    Kwon, Joon Ho; Kim, Eun-Kyung [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Lee, Hye Sun [Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Moon, Hee Jung [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Kwak, Jin Young, E-mail: docjin@yuhs.ac [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of)

    2013-01-15

    Objective: To evaluate and compare the diagnostic performances of high-resolution ultrasonography and {sup 99m}Tc-sestamibi scintigraphy for the preoperative localization of abnormal parathyroid glands and to evaluate the ability of US for additional diagnostic roles in detecting thyroid malignancy in patients with pHPT. Materials and methods: Preoperative localization images of 115 parathyroid adenomas from high-resolution ultrasonography (US) and {sup 99m}Tc-sestamibi scintigraphy (SS) were studied from 105 patients, who had undergone parathyroidectomy. Sensitivity, accuracy, and positive predictive value were calculated for the identification of adenomas in lesions and patients for both US and SS, respectively, and US and SS diagnostic performances were compared using generalized estimating equation. Results: Preoperative imaging by both modalities localized 105 (93.8%) of the 112 parathyroid lesions confirmed at surgery and histology. Sensitivity, accuracy, and positive predictive value were 93.1% and 92.2%, 90.4% and 89.5%, and 96.9% and 96.9% by US and SS, respectively, without any statistically significant differences (P = 0.796, 0.796, 0.879). US found incidental thyroid nodules in 47 patients (47/107, 43.9%), and 7 patients (7/107, 6.5%) were confirmed to have malignancy based on pathology results (all had papillary thyroid carcinoma). Conclusion: Neck ultrasonography and {sup 99m}Tc-sestamibi scintigraphy are complementary methods of the preoperative localization of parathyroid adenomas. Neck ultrasounds add an additional thyroid gland evaluation, and can be useful in the detection of incidental thyroid gland lesions, especially malignant nodules.

  3. Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management

    Jun D Tai

    2012-01-01

    Full Text Available Background: Presently it is difficult to differentiate malignancy for thyroid nodules by palpation, ultrasonography and fine-needle aspiration cytology (FNAC at the outpatient department, especially for solitary thyroid nodule (STN. So a great emphasis should be placed on the STN. AIms: The objective of this study was to investigate the predictive clinicopathological risk factors for malignancy in patients with STN and further to provide an appropriate clinical management. Materials and Methods: The records were reviewed from 265 patients with STN who had undergone thyroidectomy in our hospital. All cases were classified as two independent groups in terms of the final pathological results to assess the independent risk factors using a multinomial logistic regression analysis. Results: A multinomial logistic analysis revealed that the male gender, microcalcification and cervical lymphadenopathy were independent risk factors related to malignancy in patients with STN. The incidence of malignancy in patients with 0,1,2,3 risks was 10.71%, 26.6%, 61.43%, and 100%, respectively. Conclusions: Male gender, microcalcification and lymphadenopathy were independent risk factors for predicting the malignancy in patients with STN. Patients with more than two of those risk factors should be subjected to further examination or thyroidectomy. The findings may provide a simple and reasonable management for the STN.

  4. A Rare Presentation of Autonomously Functioning Papillary Thyroid Cancer: Malignancy in Marine-Lenhart Syndrome Nodule

    Uludag, Mehmet; Aygun, Nurcihan; Ozel, Alper; Yener Ozturk, Feyza; Karasu, Rabia; Ozguven, Banu Yilmaz; Citgez, Bulent; Mihmanli, Mehmet; Isgor, Adnan

    2016-01-01

    Objective. Marine-Lenhart Syndrome (MLS) is defined as concomitant occurrence of autonomously functioning thyroid nodule (AFTN) with Graves' disease (GD). Malignancy in a functional nodule is rare. We aimed to present an extremely rare case of papillary thyroid cancer in a MLS nodule with lateral lymph node metastases. Case. A 43-year-old male presented with hyperthyroidism and Graves' ophthalmopathy. On Tc99m pertechnetate scintigraphy, a hyperactive nodule in the left upper thyroid pole was detected and the remaining tissue showed a mildly increased uptake. The ultrasonography demonstrated 15.5 × 13.5 × 12 mm sized hypoechoic nodule in the left upper pole of the thyroid and round lymph nodes on the left side of the neck. Fine needle aspiration biopsy (FNAB) of the nodule and lymph node revealed cytological findings consistent with papillary cancer. Total thyroidectomy with central and left modified radical neck dissection was performed. On pathologic examination, two foci of micropapillary cancer were detected. The skip metastases were present in three lymph nodes on the neck. Conclusion. AFTN can be seen rarely in association with GD. It is not possible to exclude malignancy due to the clinical and imaging findings. In the presence of suspicious clinical and sonographic features, FNAB should be performed.

  5. Quantitative estimation and clinical significance of accumulation and washout of thallium-201 chloride in follicular thyroid neoplasm

    Uptake and washout ratios of thallium-201 chloride (201TlCl) were studied to confirm their clinical applicability in the differential diagnosis of benign and malignant follicular lesions of the thyroid. Sixty-six patients with follicular tumor of the thyroid underwent preoperative thallium scintigram after an intravenous injection of 2 mCi (74 MBq) of 201TlCl. The early accumulation and washout ratios of 201TlCl were obtained by an online data-processing system. All tumors were surgically resected and histopathologically diagnosed as either follicular adenoma (49 patients) or follicular carcinoma (17 patients). Scintigraphic values in terms of the early accumulation and washout ratios were compared between follicular adenoma and follicular carcinoma. Both the early accumulation and washout ratios were significantly higher in follicular carcinoma than in follicular adenoma. It was concluded that dynamic studies on accumulation and washout rates of 201TlCl might be clinically reliable to differentiate between follicular adenoma and follicular carcinoma. (author)

  6. Second Malignant Neoplasms in Digestive Organs After Childhood Cancer: A Cohort-Nested Case-Control Study

    Tukenova, Markhaba; Diallo, Ibrahima [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Anderson, Harald [Department of Cancer Epidemiology, Lund University, Lund (Sweden); Hawkins, Mike [Center for Childhood Cancer Survivor Studies, Department of Public Health and Epidemiology, University of Birmingham, Birmingham (United Kingdom); Garwicz, Stanislaw [Childhood Cancer Research Center, University Children' s Hospital, Lund (Sweden); Sankila, Risto [Finnish Cancer Registry, Helsinki (Finland); El Fayech, Chiraz [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Winter, Dave [Center for Childhood Cancer Survivor Studies, Department of Public Health and Epidemiology, University of Birmingham, Birmingham (United Kingdom); Rubino, Carole [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Adjadj, Elisabeth [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Curie Institute, Paris (France); Haddy, Nadia; Oberlin, Odile [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Moller, Torgil [Department of Cancer Epidemiology, Lund University, Lund (Sweden); Langmark, Froydis [Finnish Cancer Registry, Helsinki (Finland); and others

    2012-03-01

    Purpose: Cancers of the digestive system constitute a major risk for childhood cancer survivors treated with radiotherapy once they reach adulthood. The aim of this study was to determine therapy-related risk factors for the development of a second malignancy in the digestive organs (SMDO) after a childhood cancer. Methods and Materials: Among 4,568 2-year survivors of a childhood solid cancer diagnosed before 17 years of age at eight French and British centers, and among 25,120 patients diagnosed as having a malignant neoplasm before the age of 20 years, whose data were extracted from the Nordic Cancer Registries, we matched 58 case patients (41 men and 17 women) of SMDO and 167 controls, in their respective cohort, for sex, age at first cancer, calendar year of occurrence of the first cancer, and duration of follow-up. The radiation dose received at the site of each second malignancy and at the corresponding site of its matched control was estimated. Results: The risk of developing a SMDO was 9.7-fold higher in relation to the general populations in France and the United Kingdom. In the case-control study, a strong dose-response relationship was estimated, compared with that in survivors who had not received radiotherapy; the odds ratio was 5.2 (95% CI, 1.7-16.0) for local radiation doses between 10 and 29 Gy and 9.6 (95% CI, 2.6-35.2) for doses equal to or greater than 30 Gy. Chemotherapy was also found to increase the risk of developing SMDO. Conclusions: This study confirms that childhood cancer treatments strongly increase the risk of SMDO, which occur only after a very long latency period.

  7. Second Malignant Neoplasms in Digestive Organs After Childhood Cancer: A Cohort-Nested Case-Control Study

    Purpose: Cancers of the digestive system constitute a major risk for childhood cancer survivors treated with radiotherapy once they reach adulthood. The aim of this study was to determine therapy-related risk factors for the development of a second malignancy in the digestive organs (SMDO) after a childhood cancer. Methods and Materials: Among 4,568 2-year survivors of a childhood solid cancer diagnosed before 17 years of age at eight French and British centers, and among 25,120 patients diagnosed as having a malignant neoplasm before the age of 20 years, whose data were extracted from the Nordic Cancer Registries, we matched 58 case patients (41 men and 17 women) of SMDO and 167 controls, in their respective cohort, for sex, age at first cancer, calendar year of occurrence of the first cancer, and duration of follow-up. The radiation dose received at the site of each second malignancy and at the corresponding site of its matched control was estimated. Results: The risk of developing a SMDO was 9.7-fold higher in relation to the general populations in France and the United Kingdom. In the case-control study, a strong dose–response relationship was estimated, compared with that in survivors who had not received radiotherapy; the odds ratio was 5.2 (95% CI, 1.7–16.0) for local radiation doses between 10 and 29 Gy and 9.6 (95% CI, 2.6–35.2) for doses equal to or greater than 30 Gy. Chemotherapy was also found to increase the risk of developing SMDO. Conclusions: This study confirms that childhood cancer treatments strongly increase the risk of SMDO, which occur only after a very long latency period.

  8. Secondary Neoplasms in Children with Hodgkin’s Lymphoma Receiving C-MOPP and Radiotherapy: Presentation of Four Cases

    Gözdaşoğlu, Sevgi; Pamir, Ali; Ünal, Emel; Gökçora, İsmail Haluk; Uluoğlu, Ömer; Ceyhan, Koray; Deda, Haluk; Işıkman, Erdoğan; Yavuz, Gülsan; Taçyıldız, Nurdan; Çavdar, Ayhan

    2016-01-01

    Patients who survive Hodgkin lymphoma (HL) are at increased risk of secondary neoplasms (SNs). A wide variety of SNs have been reported, including leukemias, non-Hodgkin’s lymphomas, and solid tumors, specifically breast and thyroid cancers. Herein we report subsequent neoplasms in four patients with HL receiving chemoradiotherapy. It is interesting that three SNs, fibrosarcoma, thyroid carcinoma, and retrobulbar meningioma, were observed in the radiation area in one of our patients. A hypopharyngeal epithelioid malignant peripheral nerve sheath tumor as an unusual secondary malignant neoplasm developed in another patient, while a benign thyroid nodule and invasive ductal breast carcinoma were observed at different times in the female patient. Follicular adenoma of the thyroid gland developed in one of our patients. PMID:26377258

  9. The results of combined therapy malignant neoplasms of maxillary sinus at Oncology Center in Poznan

    Between 1985-1989 22 patients with malignant neoplasma maxillary sinus have been treated. At the first stage the surgical resection of maxilla was performed. Most of the patients (77%) had histopathological diagnosis of carcinoma planoepitheliale, 13% carcinoma solidum and 4% carcinoma adenoides cysticum. All patients had adjuvant therapy by Co-60 irradiation. Single fraction dose of 2 Gy/T 5 times a week up to total dose of 60-70 Gy/T has been applied. In the follow-up period of minimum 36 months the free-symptoms survival rate of 18%. (author)

  10. A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: A reality?

    Veyrieres, J.-B., E-mail: jbveyrieres@hotmail.fr [Département d’imagerie médicale, Hôpital d’Instruction des Armées St Anne, Bd Saint Anne, BP 20545 Toulon cedex (France); Albarel, F., E-mail: frederique.albarel@ap-hm.fr [Département médical d’endocrinologie et des pathologies métaboliques, Hôpital Universitaire la Timone, Assistance publique des Hôpitaux de Marseille, 264 rue Saint Pierre, 13385 Marseille cedex 5 (France); Lombard, J. Vaillant, E-mail: Josiane.vaillant@ap-hm.fr [Département d’imagerie médicale, Hôpital Universitaire la Timone, Assistance publique des Hôpitaux de Marseille, 264 rue Saint Pierre, 13385 Marseille cedex 5 (France); Berbis, J., E-mail: Julie.berbis@ap-hm.fr [Département de santé publique, Université de Médecine, 27, Bd Jean Moulin, 13385 Marseille cedex 5 (France); Sebag, F., E-mail: frederic.sebag@ap-hm.fr [Département de chirurgie des pathologies endocriniennes et métaboliques, Hôpital Universitaire la Timone, Assistance publique des Hôpitaux de Marseille, 264 rue Saint Pierre, 13385 Marseille cedex 5 (France); and others

    2012-12-15

    Objectives: To evaluate hability of a threshold value in ShearWave™ elastography to rule out malignant thyroid nodules while studying its pertinence in association with morphological signs. Equipment and methods: 148 patients (110 women and 38 men; 52.5 y.o. 15.8) referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography. Characteristics of the morphological signs and maximum elastographic index were calculated in relation to histology. Association of morphological signs alone and then of elastography was also evaluated. One hundred and fifty one nodules were studied on a double-blind basis. Results: 297 nodules were studied. Thirty-five cancers were detected (11.6%). Elastographic index was higher in malignant nodules (115 kPa 60.4) than in benign nodules (41 kPa 25.8) (p < 0.001, Student's t-test). Cut off value of 66 kPa was the best to discriminate malignant nodules with a sensitivity of 80% (CI 95%, 62.5; 90.9) and a specificity of 90.5% (CI 95%, 86.1; 93.6) (p = 0.0001). Association of elastography and morphological ultrasound signs presented a sensitivity of 97% (CI 95%, 83.3; 99.8) and a negative predictive value of 99.5% (CI 95%, 95.6; 99.9). Interobserver reproducibility proved to be excellent with an interclass correlation of 0.97 (CI 95%, 0.96; 0.98) (p < 0.001). Conclusion: The 66 kPa threshold in Shear Wave elastography is the best ultrasound sign to rule out malignant thyroid nodules. The method is simple, quantitative, reproducible and usable in the study of nodules larger than 3 cm. Progress must still be made in the study of calcified nodules and follicular tumors.

  11. Automated benign & malignant thyroid lesion characterization and classification in 3D contrast-enhanced ultrasound.

    Acharya, U Rajendra; S, Vinitha Sree; Molinari, Filippo; Garberoglio, Roberto; Witkowska, Agnieszka; Suri, Jasjit S

    2012-01-01

    In this work, we present a Computer Aided Diagnosis (CAD) based technique for automatic classification of benign and malignant thyroid lesions in 3D contrast-enhanced ultrasound images. The images were obtained from 20 patients. Fine needle aspiration biopsy and histology confirmed malignancy. Discrete Wavelet Transform (DWT) and texture based features were extracted from the thyroid images. The resulting feature vectors were used to train and test three different classifiers: K-Nearest Neighbor (K-NN), Probabilistic Neural Network (PNN), and Decision Tree (DeTr) using ten-fold cross validation technique. Our results show that combination of DWT and texture features in the K-NN classifier resulted in a classification accuracy of 98.9%, a sensitivity of 98%, and a specificity of 99.8%. Thus, the preliminary results of the proposed technique show that it could be adapted as an adjunct tool that can give valuable second opinions to the doctors regarding the nature of the thyroid nodule. The technique is cost-effective, non-invasive, fast, completely automated and gives more objective and reproducible results compared to manual analysis of the ultrasound images. We however intend to establish the clinical applicability of this technique by evaluating it with more data in the future. PMID:23365926

  12. Undifferentiated thyroid carcinomas (including lymphomas and metastases of extrathyroidal malignancies): Radio- and chemotherapy

    The unsatisfactory results obtained with percutaneous irradiation of undifferentiated thyroid carcinomas led to the search for improved methods of local radiotherapy. Among these are hyperfractionated irradiation, also in combination with chemotherapy, and combined pre- and postoperatively applied hyperfractionated radio- and chemotherapy. The incidence of local recurrences is markedly reduced under this therapy. Only few empirical reports on cytostatic therapy of undifferentiated thyroid carcinomas exist. Remissions can be expected in one third of the cases and, with combined adriblastin/cis-platinum therapy, complete remissions are occasionally also achieved. There are good chances of the survival time being prolonged in responders. Cytostatics are not indicated for patients in a poor general condition. Malignant lymphomas of the thyroid are rare. Therapy is stage-related and consists in radiotherapy and/or cytostatic treatment. Metastases of extrathyroidal malignancies are surgically removed only if no further metastases are detectable in the rest of the body. Otherwise, any therapy applied depend on the metastasis-related symptoms. (orig./ECB)

  13. The reliability of fine-needle aspiration biopsy in terms of malignancy in patients with hashimoto thyroiditis.

    Kapan, Murat; Onder, Akin; Girgin, Sadullah; Ulger, Burak Veli; Firat, Ugur; Uslukaya, Omer; Oguz, Abdullah

    2015-02-01

    The aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives. PMID:25692426

  14. Clinical study of 89Sr therapy with radiosensitization by nicotinamide and carbogen in multiple bone metastasis of malignant neoplasms

    Objective: To evaluate the curative effect and side effects of 89Sr therapy with radiosensitization by nicotinamide and carbogen in multiple bone metastasis of malignant neoplasms. Methods: Ninety-seven patients were divided into 4 groups respectively: group A, 89Sr + nicotinamide + carbogen (24 patients); group B, 89Sr + nicotinamide(22 patients); group C, 89Sr + carbogen (25 patients); group D, 89Sr, (26 patients). 89SrCl was intravenously injected at a dose of 1.48-2.22 MBq/kg. Nicotinamide was taken orally 1 hour before 89SrCl injection, 6 g/day, tid, d1-d5. Aspiration of carbogen(95%O2 + 5%CO2 ) gases, 6 L/min, 10 minutes, qd, d1-d5. Results: The effective rate of pain control and QOL improvement in A group were higher than in groups B, C and D (91.7% VS 77.3%, 76.0% and 69.2%, P=0.048). The lesions assessed by SPECT imaging in every group was not significantly different at three months after treatment. I to II degree toxic effect on bone marrow appeared in every group and there were no significantly inter-group differences. Conclusions: Combinative therapy using 89Sr + nicotinamide + carbogen is more effective to treat multiple metastatic bone pain and for improvement of QOL. The side effects are not increased. (authors)

  15. Application of Texture Analysis Method for Classification of Benign and Malignant Thyroid Nodules in Ultrasound Images

    Ali Abbasian Ardakani

    2015-03-01

    Full Text Available Background: The aim of this study was to evaluate computer aided diagnosis (CAD system with texture analysis (TA to improve radiologists' accuracy in identification of thyroid nodules as malignant or benign. Methods: A total of 70 cases (26 benign and 44 malignant were analyzed in this study. We extracted up to 270 statistical texture features as a descriptor for each selected region of interests (ROIs in three normalization schemes (default, 3 and 1%-99%. Then features by the lowest probability of classification error and average correlation coefficients (POE+ACC, and Fisher coefficient (Fisher eliminated to 10 best and most effective features. These features were analyzed under standard and nonstandard states. For TA of the thyroid nodules, Principle Component Analysis (PCA, Linear Discriminant Analysis (LDA and Non-Linear Discriminant Analysis (NDA were applied. First Nearest-Neighbour (1-NN classifier was performed for the features resulting from PCA and LDA. NDA features were classified by artificial neural network (A-NN. Receiver operating characteristic (ROC curve analysis was used for examining the performance of TA methods. Results: The best results were driven in 1-99% normalization with features extracted by POE+ACC algorithm and analyzed by NDA with the area under the ROC curve (Az of 0.9722 which correspond to sensitivity of 94.45%, specificity of 100%, and accuracy of 97.14%. Conclusion: Our results indicate that TA is a reliable method, can provide useful information help radiologist in detection and classification of benign and malignant thyroid nodules.

  16. Total sacrectomy and Galveston L-rod reconstruction for malignant neoplasms. Technical note.

    Gokaslan, Z L; Romsdahl, M M; Kroll, S S; Walsh, G L; Gillis, T A; Wildrick, D M; Leavens, M E

    1997-11-01

    Although radical resection is the best treatment for malignant sacral tumors, total sacrectomy for such tumors has been performed in only a few instances. Total sacral resection requires reconstruction of the pelvic ring plus establishment of a bilateral union between the lumbar spine and iliac bone. This technique is illustrated in two patients harboring large, painful, sacral giant-cell tumors that were unresponsive to prior treatment. These patients were treated with complete en bloc resection of the sacrum and complex iliolumbar reconstruction/stabilization and fusion. Surgery was performed in two stages, the first consisting of a midline celiotomy, dissection of visceral/neural structures, and ligation of internal iliac vessels, followed by an anterior L5-S1 discectomy. The second stage consisted of mobilization of an inferiorly based myocutaneous rectus abdominis pedicle flap for wound closure, followed by an L-5 laminectomy, bilateral L-5 foraminotomy, ligation of the thecal sac, division of sacral nerve roots, and transection of the ilia lateral to the tumor and sacroiliac joints. Placement of the instrumentation required segmental fixation of the lumbar spine from L-3 down by means of pedicle screws and the establishment of a bilateral liaison between the lumbar spine and the ilia by using the Galveston L-rod technique. The pelvic ring was then reestablished by means of a threaded rod connecting left and right ilia. Both autologous (posterior iliac crest) and allograft bone were used for fusion, and a tibial allograft strut was placed between the remaining ilia. The patients were immobilized for 8 weeks postoperatively and underwent progressive rehabilitation. At the 1-year follow-up review, one patient could walk unassisted, and the other ambulated independently using a cane. Both patients controlled bowel function satisfactorily with laxatives and diet and could maintain continence but required self-catheterization for bladder emptying. The authors conclude that in selected patients, total sacrectomy represents an acceptable surgical procedure that can offer not only effective local pain control, but also a potential cure, while preserving satisfactory ambulatory capacity and neurological function. PMID:9347991

  17. Real-time quantitative analysis of E-cadherin expression in ret/PTC-1-activated thyroid neoplasms.

    Smyth, P; Sheils, O; Finn, S; Martin, C; O'Leary, J; Sweeney, E C

    2001-10-01

    Papillary thyroid carcinoma (PTC), the most common variety of thyroid cancer, is found in a variety of morphologic variants, usually grows slowly, and is clinically indolent, although rare, aggressive forms, with local invasion or distant metastases, occur. Our group has previously demonstrated an association between Hashimoto thyroiditis and ret/PTC-1 activation, and have hypothesised that c-ret activation might be implicated in immune reaction to thyroid epithelium. The objective of this study was to examine expression of the cellular adhesion molecule, E-cadherin, in various thyroid tumor types and Hashimoto thyroiditis in the context of ret/PTC-1 positivity by using laser capture microdissection and TaqMan reverse transcription-polymerase chain reaction (RT-PCR). Variable down-regulation of E-cadherin among carcinomas was demonstrated, with anaplastic carcinomas showing little or no expression. Follicular thyroid carcinomas consistently had significantly decreased E-cadherin expression compared with papillary thyroid carcinomas. The ret/PTC-1-positive papillary thyroid carcinoma (PTCret+) and Hashimoto thyroiditis cases had consistently lower E-cadherin expression levels than the corresponding ret/PTC-1-negative papillary carcinomas (PTCret-), suggesting not only an association between ret activation and the loss of cellular adhesion but also, more significantly, an association between papillary thyroid carcinoma and Hashimoto thyroiditis. PMID:12574841

  18. Thyroiditis

    ... inflammation but presenting in different ways. For example, Hashimoto’s thyroiditis is the most common cause of hypothyroidism ... This would be the case in patients with Hashimoto’s thyroiditis. If the thyroiditis causes rapid thyroid cell ...

  19. Synchronous Hurthle Cell Carcinoma and Papillary Carcinoma in a Patient with Hashimoto’s Thyroiditis: A Rare Case Report

    Narayanan O. Navya

    2014-10-01

    Full Text Available Hashimoto’s thyroiditis, the most common autoimmune thyroid disease, is due to destruction of the thyroid gland by autoantibodies. Various types of thyroid malignancies may arise in Hashimoto’s thyroiditis. Follicular carcinomas, papillary carcinomas, lymphomas, medullary carcinomas and hurthle cell neoplasms may develop in Hashimoto’s thyroiditis. We present a rare case report of a 35-year-old female who presented with hypothyroidism of a two-year duration. A diagnosis of Hashimoto’s thyroiditis was made for which she was under treatment. Due to the recent increase in size of the thyroid, a fine needle aspiration cytology was done. A preoperative diagnosis of Hurthle cell neoplasm was made based on fine needle aspiration cytology findings. The total thyroidectomy specimen revealed Hashimoto’s thyroiditis with synchronous papillary carcinoma and Hurthle cell carcinoma, which is a very rare occurrence.

  20. Subsequent malignancies in patients treated with 131-iodine for thyroid cancer

    I-131 was administered to 298 patients with thyroid cancer, and there has been a follow-up of at least two years. Follow-up periods were: 2.5 to 30 years (median 14.5) in living patients, 2.5 to 15 years (median 5.5) in patients dead of tumour ≥ 2 years after first treatment and 2.5 to 23 years (median nine) in patients dead without tumour. Person-years at risk were (total applied activity of I-131): 1119 (3 to 21 GBq), 1477 (22 to 65 GBq), 521 (61 to 170 Gbq). 33 subsequent malignancies in 31 patients were observed, compared to an expected number of 17. The relative risk of subsequent malignancies is therefore 1.94 with a 95% confidence intervall of 1.15 to 3.05. This increase in the incidence of subsequent malignancies after I-131 treatments is largely due to the significantly increased incidence of leukemia and bladder cancer. Estimated radiation doses to the bone marrow in the patients with leukemia were 301 cGy to 792 cGy and the doses to the bladder in patients with bladder cancer were 2250 cGy to 10, 350 cGy. After a total activity of less than 37 GBq I-131, no cases of bladder cancer or leukemia were observed. The observed number of subsequent malignancies are compared with the expected number according to several dose-effect estimations. (orig.)

  1. Glioblastoma multiforme and papillary thyroid carcinoma - A rare combination of multiple primary malignancies

    Swaroopa Pulivarthi

    2015-01-01

    Full Text Available We are describing a 19-year-old white woman who presented with two synchronous primary cancers, namely glioblastoma multiforme and papillary thyroid cancer. The patient was admitted with dizziness, headache, and vomiting. CT head revealed acute intraparenchymal hematoma in the right cingulate gyrus and the splenium of the corpus callosum. Carotid and cerebral angiogram were unremarkable. MRI of the brain demonstrated a non-enhancing and non-hemorrhagic component of the lesion along the lateral margin of the hemorrhage just medial to the atrium of the right lateral ventricle that was suspicious for a tumor or metastasis. Brain biopsy confirmed it as glioblastoma mutiforme. CT chest was done to rule out primary cancer that revealed a 11 mm hypodense lesion in the left lobe of the thyroid and ultrasound-guided fine-needle aspiration biopsy confirmed it as papillary thyroid carcinoma. We should evaluate for multiple primary malignancies in young patients who are found to have primary index cancer.

  2. Malignant lymphoma of the thyroid gland: a clinical and pathologic study of twenty cases.

    Rasbach, D A; Mondschein, M S; Harris, N L; Kaufman, D S; Wang, C A

    1985-12-01

    Among 20 patients with malignant lymphoma of the thyroid gland, the mean age at diagnosis was 63 years and the male to female ratio was 1:6. All patients had a firm, rapidly enlarging neck mass. In 90% of the patients the mass had been present for less than 1 year; in 40%, for less than 1 month. Approximately half of the patients tested had hypothyroidism; three fourths had elevated antithyroid antibodies. There was one nodular lymphoma. The remaining 17 cases available for review were diffuse. Thyroid lobectomy was performed in seven patients, limited excision in eight, and needle biopsy alone in five. External irradiation was administered in 11 cases (55%). Chemotherapy was used alone in one patient (5%) and in combination with radiotherapy in eight (40%). Six patients (30%) were alive without evidence of recurrent disease at follow-up ranging from 1 to 12 years. Eleven patients had died of lymphoma, all but one dying within 1 year. One patient died of other causes and two were lost to follow-up study. There was no appreciable effect of patient age or sex, lymphoma histology, or extent of surgical resection on survival. Treatment of choice for primary lymphoma of the thyroid gland appears to be external irradiation or chemotherapy, alone or in combination. The role of surgery is limited to making a tissue diagnosis of lymphoma, unless the tumor is completely intrathyroidal. PMID:3906977

  3. Adrenocortical oncocytic neoplasm presenting with Cushing's syndrome: a case report

    Kabayegit Ozlem

    2008-07-01

    Full Text Available Abstract Introduction Oncocytic neoplasms occur in several organs and are most commonly found in the thyroid, kidneys and salivary glands. Oncocytic neoplasms of the adrenal cortex are extremely rare and are usually non-functioning. Case presentation We report the case of an adrenocortical oncocytic neoplasm with uncertain malignant potential in a 31-year-old man with Cushing's syndrome. The patient had been operated on following diagnosis of a 7 cm adrenal mass. Following surgery, the Cushing's syndrome resolved. The patient is still alive with no metastases one year after the surgery. Conclusion Adrenocortical oncocytic neoplasms must be considered in the differential diagnosis of both functioning and non-functioning adrenal masses.

  4. Horner syndrome as a manifestation of thyroid carcinoma: a rare association

    Bernardo Pereira

    2013-08-01

    Full Text Available An 82-year-old patient presented a progressively growing hard thyroid nodule, and left ptosis. Additionally, ophthalmologic evaluation revealed ipsilateral miosis, diagnostic findings of Horner syndrome. Computerized tomography revealed a 7.5-cm thyroid mass infiltrating the main neck vessels. Although clinical and imaging data were suggestive of poorly differentiated thyroid carcinoma, fine-needle aspiration led to the diagnosis of papillary carcinoma. Paliative care was proposed to the patient due to the advanced stage of the neoplasm and to significant comorbidities. Horner syndrome is an infrequent manifestation of thyroid disorders and benign etiologies are more often implied. Malignant thyroid neoplasms represent a rare cause of Horner syndrome. However, an appropriate and prompt diagnosis is paramount for timely treatment of rare thyroid malignancies.

  5. Ultrasound diagnosis for retrojugular lymphadenopathy in the patient having a history of total thyroidectomy due to thyroid malignancy

    Nam, Seung Min; Kim, Dong Wook [Busan Paik Hospital/Inje Univ. College of Medicine, Busan (Korea, Republic of)

    2012-07-15

    This study aimed to assess the accuracy of ultrasound (US) diagnosis for retrojugular lymphadenopathy in patients who had undergone total thyroidectomy, due to thyroid malignancy. During a follow up period after total thyroidectomy, due to known thyroid malignancy, 41 patients underwent US diagnosis and US guided fine needle aspiration for retrojugular lymphadenopathy. Each lymphadenopathy was prospectively classified by a single radiologist into 1 of 3 diagnostic categories: 'benign', 'indeterminate for malignancy', and 'malignant'. Based on the cytohistopathology result, thyroglobulin tittering, and sonographic follow up, the adequacy of US diagnosis for retrojugular lymphadenopathy was assessed. Of the 41 retrojugular lymphadenopathies, malignant (n = 25) and benign (n = 16) lymphadenopathy were finally confirmed. Excluding 15 lymph nodes with indeterminate US diagnosis, the sensitivity, specificity, positive and negative predictive values, accuracy, and false positive and negative rates of US diagnosis were 100%, 66.7%, 95.8%, 100%, 96.2%, 0%, and 10%, respectively. There was no significant difference in the incidence of retrojugular lymphadenopathy, according to age, sex, and location (p > 0.05). In the patient with a history of total thyroidectomy, due to thyroid malignancy, US diagnosis for retrojugular lymphadenopathy showed a high accuracy.

  6. Is radioactive iodine-131 treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?

    Objective: Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-up. Materials and methods: Retrospective analysis of 413 DTC cases was performed; 252 received RAI-131 and 161 were treated with thyroidectomy alone. Exclusion criteria were: prior or synchronous non-thyroidal malignancies (within the first year), familial syndromes associated to multiple neoplasms, ionizing radiation exposure or second tumors with unknown histopathology. Results: During a mean follow-up of 11.0 ± 7.5 years, 17 (4.1%) patients developed solid NSSPM. Patients with NSSPM were older than those without (p = 0.02). RAI-131 and I-131 cumulative activity were similar in patients with and without NSSPM (p = 0.18 and p = 0.78, respectively). Incidence of NSSPM was 5.2% in patients with RAI-131 treatment and 2.5% in those without RAI-131 (p = 0.18). Using multivariate analysis, RAI-131 was not significantly associated with NSSPM occurrence (p = 0.35); age was the only independent predictor (p = 0.04). Under log rank statistical analysis, after 10 years of follow-up, it was observed a tendency of lower NSSPM-free survival among patients that received RAI-131 treatment (0.96 vs. 0.87; p = 0.06), what was not affected by age at DTC diagnosis. Conclusion: In our cohort of DTC survivors, with a long-term follow-up period, RAI-131 treatment and I-131 cumulative dose were not significantly associated with NSSPM occurrence. A tendency of premature NSSPM occurrence among patients treated with RAI-131 was observed, suggesting an anticipating oncogenic effect by interaction with other risk factors. (author)

  7. Radioactive iodine whole body scan (RIWB) strategy in malignant thyroid diseases: an approach to iodine 123 utilisation

    Nevertheless, the scan may be avoided if the expansive malignant intra-thyroidal lesion, treated by total thyroidectomy, has favorable prognosis criteria and there are not anti-thyroglobulin antibodies circulating. Indeed RIWB scan must be used periodically in follow-up of the other cases, scanning, if possible, with iodine-123 in order to avoid the stunning effect The RIWB post-therapeutic scan (after administration of a high activity of 1311) gives, of course, the best information concerning the eventual remaining post-surgery thyroid tissue and the eventual localisation of metastases. Therefore two different propositions has be done in the follow-up of patients with malignant thyroid lesions depending on the prognosis criteria. (author)

  8. Power Doppler US patterns of vascularity and spectral Doppler US parameters in predicting malignancy in thyroid nodules

    Aim: The purpose of this study was to determine whether spectral Doppler ultrasound (US) parameters, including resistive index (RI) and maximal systolic velocity (MSV), or vascular pattern can be used to distinguish malignant from benign thyroid nodules. Materials and methods: We prospectively examined 169 thyroid nodules in 134 patients undergoing sonographically guided fine-needle aspiration biopsy (FNAB). Vascularity as determined by power Doppler US imaging was defined as absent, perinodular alone, or intranodular. For each nodule, the RI and MSV values were recorded as the average of the recordings obtained. Results of the FNAB and surgical pathological examination, if available, were used as a proof of final diagnosis to categorize all nodules as benign or malignant. Results: Seven nodules were excluded from study because of non-diagnostic FNAB results due to hypocellular or insufficient cytological material. Of the remaining nodules, nine were malignant (all confirmed at surgery) and 153 were benign. Of the 145 nodules with intranodular vascularity, nine (6.2%) were malignant and the remaining 136 (93.8%) were benign. The malignant nodules had a mean RI of 0.60 on intranodular and 0.58 on perinodular arteries. These values were not significantly higher than those associated with benign nodules (RI = 0.57 and RI = 0.56, respectively). Malignant nodules had a mean MSV of 20.4 cm/s on intranodular and 35.3 cm/s on perinodular arteries that were also not significantly different from those associated with benign nodules (p > 0.05). Conclusion: The results of this study indicate that Doppler US characteristics including vascular pattern, RI and MSV are not useful parameters for distinguishing malignant from benign thyroid nodules. Therefore, Doppler US characteristics including vascular pattern, RI and MSV values of thyroid nodules can not be used as a diagnostic method to determine which nodules should undergo FNAB

  9. Role of AgNORs in thyroid lesions on fine needle aspiration cytology smears

    Asotra Sarita

    2008-01-01

    Full Text Available Background: Fine needle aspiration has an important role in diagnosis of thyroid neoplasm. However, it is difficult to differentiate between follicular adenoma and follicular carcinoma by cytology alone. Recently, silver staining has been performed for nucleolar organizer regions (AgNORs to differentiate various tumors. Aims: The present study was undertaken to see if the AgNOR technique could distinguish between benign and malignant lesions, particularly, follicular neoplasm. Materials and Methods: One hundred forty cases of thyroid lesions were examined, which included colloid goiter (n = 36, multinodular goiter (n = 38, subacute thyroiditis (n = 6, Hashimoto′s thyroiditis (n = 17, lymphocytic thyroiditis (n = 3, follicular neoplasm (n = 18, Hurthle cell neoplasm (n = 3, papillary carcinoma (n = 16, and medullary carcinoma (n = 3. Diagnosis was confirmed by histopathology in 80 cases. The usual one-step silver colloidal reaction was performed at room temperature for 35 minutes and intranuclear dots of silver deposits were counted in 100 cells. Results: AgNOR counts of benign and malignant lesions were compared and were found to be statistically significant (P < 0.001. The mean AgNOR counts were higher in neoplastic lesions. Conclusions: AgNOR counting in fine needle aspiration smears is a simple, sensitive, and cost-effective method for differentiating benign from malignant thyroid follicular neoplasms.

  10. Doxorubicin-induced myocardial failure in rats with malignant neoplasm: Protective role of fullerenol C60(OH24

    Injac Rade

    2008-01-01

    Full Text Available The therapeutic utility of the anthracycline antibiotic doxorubicin is limited due to its cardiotoxicity. Our aim was to investigate the efficacy of fullerenol C60(OH24 in preventing single, high-dose doxorubicin-induced cardiotoxicity in rats with malignant neoplasm. In vitro and in vivo studies have shown that fullerenol C60(OH24, has strong antioxidative potential. Experiment was performed on adult female Sprague Dawley rats with chemically induced mammary carcinomas. All 32 rats (2-5 groups received i.p. applications of 1-methyl-l-nitrosourea (MNU; 50 mg/kg body weight on the 50th and 113th day of age. Animals were randomly divided into five groups as follows: (1 Untreated control group - rats received saline only; (2 Cancer control group - rats received MNU and saline; (3 Dox group - rats received MNU and Dox 8 mg/kg; (4 Full/Dox group -rats received MNU and Full 100 mg/kg 30 min before Dox 8 mg/kg; (5 Full group - rats received MNU and Full 100 mg/kg. Tumor incidence was 4.94 +- 0.576 per rat. The animals were sacrificed 2 days after the application of doxorubicin and/or fullerenol, and the serum activities of CK, LDH and α-HBDH, as well as the levels of MDA, GSH, GSSG, GSH-Px, SOD, CAT, GR and TAS in the heart, were determined. The results obtained from the enzymatic activity in the serum show that the administration of a single dose of 8 mg/kg in all treated groups induces statistically significant damage. There are significant changes in the enzymes of LDH and CK (p < 0.05, after an i.p. administration of doxorubicin/fullerenol and fullerenol. Comparing all groups with untreated control group, point to the conclusion that in the case of a lower oc-HBDH/LDH ratio, results in more serious the liver parenchymal damage. The results revealed that doxorubicin induced oxidative damage and that the fullerenol antioxidative influence caused significant changes in MDA, GSH, GSSG, GSH-Px, SOD, CAT, GR and TAS level in the heart (p < 0.05. Ultra structural analysis of heart tissues from rats treated with doxorubicin and indicated that the hearts of the rats were protected from doxorubicin-induced subcellular damage. Doxorubicin/fullerenol rats did not appear to show significant cardiac damage although occasional focal loss of cristae in the mitochondria was observed. Therefore, it is suggested that fullerenol might be a potential cardioprotector in doxorubicin-treated individuals.

  11. Differentiation between cavernous hemangiomas and untreated malignant neoplasms of the liver with free-breathing diffusion-weighted MR imaging: Comparison with T2-weighted fast spin-echo MR imaging

    Objective: To test interobserver variability of ADC measurements and compare the diagnostic performances of free-breathing diffusion-weighted (FBDW) with that of T2-weighted FSE (T2WFSE) MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms. Materials and methods: Thirty-five patients with cavernous hemangiomas and 35 with untreated hepatic malignant neoplasms had FBDW and T2WFSE MR imaging. Hepatic lesions were characterized with ADC measurement and visual evaluation. Interobserver agreement for ADC measurement was calculated. Association between ADC value and lesion type was assessed using univariate analysis. Sensitivity, specificity and accuracy of ADC values and visual evaluation of MR images for the diagnosis of untreated malignant hepatic neoplasm were compared. Results: ADC measurements showed excellent interobserver correlation (intraclass correlation coefficient = 0.980). Malignant neoplasms had lower ADC values than hemangiomas for the two observers (1.11 x 10-3 mm2/s ± .21 x 10-3vs. 1.77 x 10-3 mm2/s ± .29 x 10-3 for observer 1 and 1.11 x 10-3 mm2/s ± .19 x 10-3vs. 1.79 x 10-3 mm2/s ± .32 x 10-3 for observer 2) and univariate analysis found significant correlations between lesion type and ADC values. Depending on ADC threshold value, accuracy for the diagnosis of malignant neoplasm varied from 82.9% to 94.3%. Using visual evaluation, FBDW showed better specificity and accuracy than T2WFSE MR images for the diagnosis of malignant neoplasm (97.1% vs. 77.1% and 94.3% vs. 62.9%, respectively). Conclusion: FBDW imaging provides reproducible quantitative information and surpasses the value of T2WFSE MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms.

  12. Trends in the incidence and mortality rates of malignant neoplasms in regions with radio ecological problems (Seslavtsi, Eleshnitsa, Yana) during the period 1995-1999

    A retrospective study is carried out to examine incidence and mortality trends of some malignant neoplasms in regions at high radioecological risk (Seslavtsi, Eleshnitsa, Yana) during the period 1995-1999. The analysis is made according to sex and age groups. Information sources are official medical statistics data, original records and database of the Oncological Dispensary in Sofia. The analysis of incidence and mortality dynamics doesn't show an increase in the incidence/mortality rate of the selected radiation-related oncological diseases compared with the same indices for the country within that period. (author)

  13. Identificacin molecular de helicobacter pylori en tejidos gstricos con neoplasias malignas embebidos en parafina / Molecular identification of helicobacter pylori in paraffin embedded gastric tissues with malignant neoplasm

    Edmundo Dants, Escobar Habeica; Yaxsier, de Armas Rodrguez; Nereyda, Cantelar de Francisco; Virginia, Cap de Paz; Fidel, Cathcart Roca; Marco Antonio, Jimnez Lpez.

    2013-06-01

    Full Text Available Introduccin: Helicobacter pylori es considerado uno de los principales agentes causales de gastritis crnica, lcera pptica y neoplasias gstricas malignas en humanos. Objetivo: evaluar el uso de la reaccin en cadena de la polimerasa para la identificacin de H. pylori y sus genotipos en tejidos [...] gstricos con neoplasias malignas embebidos en parafina. Material y Mtodos: se estudiaron secciones de 5 bloques de parafina procedentes de 5 pacientes mexicanos con neoplasias gstricas malignas. Se realizaron coloraciones de rutina y especiales de anatoma patolgica, as como la tcnica de la reaccin en cadena de la polimerasa para la deteccin del microorganismo y sus genotipos. Resultados: la tcnica de la reaccin en cadena de la polimerasa identific a este agente infeccioso en todos los bloques analizados en correspondencia con su deteccin a travs de las tcnicas histolgicas. Esta metodologa permiti demostrar una variabilidad gentica del patgeno en las muestras analizadas segn los genotipos vacA y cagA. Conclusiones: la reaccin en cadena de la polimerasa podra ser un mtodo eficaz en la identificacin del H. pylori en tejidos gstricos con neoplasias malignas embebidos en parafina. Esta se perfila como una estrategia atractiva para realizar estudios de epidemiologa molecular y permitir establecer posibles asociaciones de genotipos/subtipos del microorganismo con variables clnicas, epidemiolgicas y de manejo del paciente. Abstract in english Introduction: Helicobacter pylori is considered one of the main causal agents of chronic gastritis, peptic ulcer and gastric malignant neoplasms in humans. Objective: to evaluate polymerase chain reaction for identification of Helicobacter pylori and its genotypes in paraffin embedded gastric tissue [...] s with malignant neoplasms. Material and Methods: sections of five paraffin blocks from five patients with gastric malignant neoplasms were studied. They were analyzed through routine and special stains of pathological anatomy, as well as the polymerase chain reaction technic for microorganism and genotypes detection. Results: the infectious agent was identified in all of the analyzed blocks through the polymerase chain reaction technic in correspondence with its detection through histologic techniques. This methodology showed a genetic variability of the pathogen in the analyzed samples in respect to vacA and cagA genotypes. Conclusions: the polymerase chain reaction could be an efficacious method for the identification of H. pylori in paraffin embedded gastric tissues with malignant neoplasms. It is projected as an attractive strategy for performing studies of molecular epidemiology and the establishment of possible associations between genotypes/subtypes of the microorganism and clinic or epidemiologic variables, and patient handling.

  14. Delayed results of combined treatment of malignant neoplasms of nasal cavity and accessory basal sinuses with the use of remote neutron therapy

    Analysis of results of combined treatment of 24 patients with locally spread forms of malignant neoplasms in nasal cavity and accessory nasal sinuses, subjected to preoperational remote neutron therapy, was carried out. Mean neutron energy was 6.5 MeV, total focus dose - 38-40 Gy. It is shown that combined method of treatment features high efficiency, ensuring 5-year survival rate of 67.8% of the patients. However, the treatment is accompanied by grave complications, formation of face tissue-defects and radiation-induced cataract. The necessity of improving the methods of eye protection in the course of radiotherapy is emphasized. 1 ref

  15. Methotrexate/6-mercaptopurine maintenance therapy influences the risk of a second malignant neoplasm after childhood acute lymphoblastic leukemia: results from the NOPHO ALL-92 study

    Schmiegelow, Kjeld; Al-Modhwahi, Ibrahim; Andersen, Mette Klarskov; Behrendtz, Mikael; Forestier, Erik; Hasle, Henrik; Heyman, Mats; Kristinsson, Jon; Nersting, Jacob; Nygaard, Randi; Svendsen, Anne Louise; Vettenranta, Kim; Weinshilboum, Richard

    2009-01-01

    Among 1614 children with acute lymphoblastic leukemia (ALL) treated with the Nordic Society for Paediatric Haematology and Oncology (NOPHO) ALL-92 protocol, 20 patients developed a second malignant neoplasm (SMN) with a cumulative risk of 1.6% at 12 years from the diagnosis of ALL. Nine of the 16...... acute myeloid leukemias or myelodysplastic syndromes had monosomy 7 (n = 7) or 7q deletions (n = 2). In Cox multivariate analysis, longer duration of oral 6-mercaptopurine (6MP)/methotrexate (MTX) maintenance therapy (P = .02; longest for standard-risk patients) and presence of high hyperdiploidy (P...

  16. Diagnostic performance of combined elastosonography scoring and high-resolution ultrasonography for the differentiation of benign and malignant thyroid nodules

    Aim: To evaluate the diagnostic performance of the combined use of elstosonography (USE) scoring and high-resolution ultrasonography (HRUS) for the differentiation of benign and malignant thyroid nodule. Patients and methods: Forty-seven consecutive patients with 66 thyroid nodules were enrolled in the present study. Thyroid surgery had been already planned for all the patients. All of them were submitted to high-resolution ultrasonography and elastography scoring at the same sitting. The latter was determined with 5-point scoring method. The examination results were compared against pathological findings as the gold standard of reference. Results: The sensitivity, specificity, accuracy, positive predictive, and negative predictive values of HRUS in the differential diagnosis of thyroid nodules were 92.0%, 72.9%, 60.1%, 95.0%, and 63.1%, respectively, while that of ultrasound elastography scoring were 75.4%, 85.5%, 86.7%, 71.4%, and 90.5%, respectively. Combined use of both US techniques resulted in a higher diagnostic performance as it showed 95.4%, 94.8%, 95.2%, 82.3% and 98.8% sensitivity, specificity, accuracy, positive predictive, and negative predictive values, respectively. Conclusions: The use of combined USE and HRS for the differentiation of benign and malignant thyroid nodules resulted in a high diagnostic performance and a significant statistical difference as compared to HRUS or USE alone (P = 0.003)

  17. Malignant glomus tumor of the thyroid gland where is heretofore an unreported organ: a case report and literature review.

    Chung, Dong Hae; Kim, Na Rae; Kim, Taeeun; Ahn, Jungsuk; Lee, Sangho; Lee, Young Don; Cho, Hyun Yee

    2015-03-01

    Glomus tumors are relatively uncommon clinically benign tumors. Malignant glomus tumors are rare, and only a small number develop metastatic foci. The usual location is deep dermis or subcutis, but it has been reported in various locations. A 55-year-old man presented with an incidentally found thyroid mass. Neck ultrasound showed a mass with a heterogeneous hypoechoic calcific mass in the right lobe. Right lobectomy specimen showed the 3.6-cm-sized calcified mass composed of sheets of uniform round to polygonal cells and intervening staghorn-shaped vessels. Occasional cellular atypism and necrosis with increased mitotic activity (up to 7 per 10 high-power fields) were found. Infiltration to the residual thyroid parenchyma, vessel, thyroidal capsule, and strap muscle was found. These tumor cells were strongly positive for smooth muscle actin, collagen type IV, and vimentin with pericellular reticulin-cuffing. Ultrastructurally, closely packed oval-shaped tumor cells having cytoplasmic mitochondria, rough endoplasmic reticulums with pinocytotic vesicles along the plasmalemmal surface and thin filaments of 6 nm in diameter were surrounded by thick basal lamina. That mass was diagnosed as a malignant glomus tumor. Incidentally, a 0.5-cm-sized papillary carcinoma was found through entire embedding. Complete thyroidectomy with chemotherapy was done. Thirty months later, multiple metastases developed in the brain and lung, and he expired. To our knowledge, neither benign nor malignant thyroid glomus tumor has been previously described. Here, we describe the first case of a malignant glomus tumor in the thyroid gland. PMID:25544269

  18. Risk of Thyroid Nodular Disease and Thyroid Cancer in Patients with Acromegaly – Meta-Analysis and Systematic Review

    Wolinski, Kosma; Czarnywojtek, Agata; Ruchala, Marek

    2014-01-01

    Introduction Acromegaly is a quite rare chronic disease caused by the increased secretion of growth hormone (GH) and subsequently insulin - like growth factor 1. Although cardiovascular diseases remains the most common cause of mortality among acromegalic patients, increased prevalence of malignant and benign neoplasms remains a matter of debate. The aim of this study is to evaluate the risk of thyroid nodular disease (TND) and thyroid cancer in patients with acromegaly. Materials and Methods...

  19. Diagnostic value of early and delayed 201Tl thyroid scintigraphy in the evaluation of cold nodules for malignancy

    We performed 201Tl thyroid scintigraphy using an early and delayed scanning technique in 34 patients exhibiting cold nodules on sup(99m)Tc scans. Of the 29 benign nodules, 27 were correctly diagnosed as being negative, i.e. 93% specificity. However, two of five malignant nodules failed to concentrate activity on both the early and delayed scans. The low sensitivity (60%) of this method for detecting carcinomas limits its clinical value in the routine diagnostic work-up of patients with suspected thyroid cancer. Our findings are in contrast to previous more optimistic reports. (orig.)

  20. Pediatric Thyroid Cancer

    ... Meeting Calendar Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media interested ... thyroid malignancies. Medullary thyroid carcinoma (MTC) in the pediatric population is usually associated with specific inherited genetic ...

  1. Comparison of Diagnostic Accuracy of Real-Time Elastography and Shear Wave Elastography in Differentiation Malignant From Benign Thyroid Nodules.

    Tian, Wuguo; Hao, Shuai; Gao, Bo; Jiang, Yan; Zhang, Shu; Gu, Lingji; Luo, Donglin

    2015-12-01

    Thyroid nodules are relatively more prevalent in iodine-deficiency area, and the incidence increased sharply in the past decade in these areas. Workup of malignant from benign nodules in clinic was the main problem for managing thyroid nodules.An overall search for the articles about the diagnostic performance of real-time elastography (RTE) and shear wave elastography (SWE) before April 2015 in the databases of PubMed, Embase, and Google scholar. The pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curve were obtained from individual studies with a random-effects model. Subgroup and meta-regression analysis were also performed.Fifty-six studies involved in 2621 malignant nodules and 7380 benign nodules were contained in our meta-analysis. The pooled sensitivity and specificity of RTE was 83.0% and 81.2%, which is higher than SWE (sensitivity: 78.7%, specificity: 80.5%). The areas under the SROC curve of RTE and SWE were 0.885 and 0.842 respectively. RTE had higher diagnostic value for Caucasians than Asians. Stran ratio (SR) assessment had higher diagnostic performance than elasticity score (ES) system. Similarly, it had higher diagnostic value when malignant nodules were more than 50.In summary, the results revealed that RTE had higher diagnostic performance than SWE in differentiating malignant from benign nodules. However, future international multicenter studies in the region of thyroid risk need to further assess the diagnostic performance of RTE. PMID:26717367

  2. The role of projectional radiography in the detection of primary malignant and indeterminate bone neoplasms; Detektion von primaer malignen und intermediaeren Knochentumoren: Wertigkeit der Projektionsradiographie

    Mueller, C.; Imhof, H.; Kainberger, F. [Abt. fuer Osteoradiologie, Univ. fuer Radiodiagnostik, Medizinische Univ. Wien (Austria); Huber, W. [Univ. fuer Orthopaedie, Medizinische Univ. Wien (Austria)

    2005-02-01

    Purpose: to evaluate the role of projectional radiography in the detection of primary and potentially malignant bone neoplasms. Materials and methods: we retrospectively reviewed the images and medical records of 80 patients (42 male, 38 female; range: 6 to 73 years; mean: 33 years) with pathologically proven primary or indeterminate bone tumors. Results: the most common symptom was local pain (84%). In 69 of 80 patients (86%), projectional radiography was the first imaging modality, which correctly identified the malignant character of the bone lesion in 60 of these 69 patients (87%). In 2 patients, bone neoplasms were overlooked due to diagnostically inadequate image quality. The false-diagnosis rate was not significantly different between board-certified radiologists working in hospitals and radiologists in outpatient facilities (p>0.05). Bone tumors predominantly affecting adults, such as chondrosarcomas, needed a longer time for the diagnosis than bone tumors mainly found in childhood, such as osteosarcomas. The median age of patients with delayed imaging work-up because of attempted conservative therapy (45 years{+-}20 years) was significant higher than the median age of patients with immediate radiographic work-up (27 years{+-}16 years). (orig.)

  3. Von Reckling-hausen disease associated to thyroid carcinoma and malignant schwannoma of the chest wall. A case

    The multiple neurofibromatosis is an autosomal dominant hereditary disease associated to malignant schwannoma in about 3% of the cases and very rarely to others cancers. The study provides information on the case of a 32 year-old woman who suffers from this disease and presented two synchronous cancers: a papillary carcinoma of thyroid and a malignant schwannoma of the chest wall. The thyroid tumour was managed with hemithyroidectomy, hormonotherapy and radiotherapy, and the lesion of the thoracic wall was treated with local radical resection application of Marlex mesh and rotation of a musculocutaneous flap of the dorsal muscle. A review of the literature on the clinical aspects of this association and the surgical techniques employed to cover the defect of the chest wall is presented. (authors)

  4. Intrathyroid epithelial thymoma (ITET) and carcinoma showing thymus-like differentiation (CASTLE): CD5-positive neoplasms mimicking squamous cell carcinoma of the thyroid.

    Kakudo, Kennichi; Bai, Yanhua; Ozaki, Takashi; Homma, Kei-ichi; Ito, Yasuhiro; Miyauchi, Akira

    2013-05-01

    Carcinoma of possible thymic epithelial origin may occur within the thyroid gland, which was first reported by Miyauchi et al. as intrathyroid epithelial thymoma (ITET). ITET is a rare tumor comprising about 0.08% of all primary thyroid malignancies. It is a low-grade thyroid carcinoma with squamous cell differentiation whose overall survival rate was found to be 71%. Lymph node metastasis at surgery was found in 40% and hematogenous metastases developed in bones, liver and lungs. This tumor grows within the thyroid gland and invades into the thyroid parenchyma as well as into the extrathyroid structures. It is a well-circumscribed solid tumor with a sharp tumor border, but is not capsulated. After fixation, the cut surface of the tumor is gray-white in color and is a solid tumor with lobulation. Tumor calcification was not detected in our 15 cases. The tumor cells show solid sheets of growth with occasional keratinization without follicular or papillary structures. Lymphocytic infiltration in the stroma is one of the most characteristic features of this tumor. The tumor cells are polygonal epithelial cells with distinct nucleoli and ill-defined cell border. Positive immunoreactivity for CD5 is a key feature to differentiate it from undifferentiated carcinoma, poorly differentiated carcinoma, medullary (C cell) carcinoma and high-grade squamous cell carcinoma (so-called primary squamous cell carcinoma) of the thyroid. Negative immunoreactivity for calcitonin, TTF1 and thyroglobulin, and positive immunoreactivity for p63 and KIT are also helpful for differential diagnosis. Nuclear atypia is mild and mitoses are less frequent, with an intermediate proliferation index (MIB-1 labeling index is usually less than 20%), which are also helpful to differentiate it from high-grade primary squamous cell carcinoma of the thyroid. The tumors in our 15 cases demonstrate 3 histological subtypes: keratinizing squamous cell carcinoma type, non-keratinizing basaloid cell carcinoma (lymphoepithelioma-like) type and neuroendocrine carcinoma type, which correspond to subtypes of the mediastinal thymic carcinomas. PMID:23233417

  5. Neonatal neoplasms

    Purpose: To describe neoplasms diagnosed in children ≤ 28 days of age along with their treatment, associated congenital anomalies, and the long-term consequences of the diagnoses and treatments. Methods and Materials: Utilizing autopsy records, a computerized tumor registry, and medical records, we identified patients and stillborns at Duke University Medical Center (DUMC) diagnosed with neoplasms at ≤ 28 days of age between 1930 and 1998. Results: Twenty-three neonates with neoplasms were identified. There were 7 males (30%) and 16 females (70%). Follow-up of survivors ranged from 4 months to 27 years (mean 9 years). The 20 patients identified via the computerized registry system for 1980-1998 constitute 2% (20/925) of all neoplasms seen in patients ≤ 16 years of age over this same time period at DUMC. The histologic diagnoses were teratoma/germ cell tumor (n = 8, 35%), neuroblastoma (n = 5, 22%), retinoblastoma (n = 4, 17%), primary central nervous system (CNS) tumor (n = 3, 13%), and one case each of rhabdomyosarcoma, glossal glial choristoma, and hemangioma in the setting of Kasabach-Merritt Syndrome. Of the eight teratoma/germ cell tumor patients, 6 were female (75%) and 2 male (25%). There was one malignant germ cell tumor, 2 immature teratomas, and 5 teratomas. Two of the seven patients with immature teratomas or teratoma were long-term survivors following surgery. The one patient with malignant germ cell tumor, treated with surgery and chemotherapy, died. Associated anomalies were imperforate anus, congenital absence of a limb, left ventricular hypertrophy, fusion or absence of toes, coarctation of the aorta, and pulmonary valve dysplasia. Of the five children with neuroblastoma, 4 were female. INSS Stages were 1 (n = 1), 2A (n = 1), 3 (n = 1), and 4S (n = 2). Two were treated with surgery + chemotherapy + radiotherapy; two with surgery + chemotherapy; and one with surgery alone. Four children are long-term survivors. Associated congenital anomalies and medical problems were ventricular septal defect, seizure disorder, and Fanconi's anemia. A child with a dumbbell neuroblastoma, treated with surgery and chemotherapy, is paraplegic. Of the four children with retinoblastoma, two were female. Two had trilateral disease and two bilateral. Three of the four had a family history of retinoblastoma. The two children with trilateral retinoblastoma died after therapy with surgery, craniospinal and orbital irradiation, and chemotherapy. Two children with bilateral disease are long-term survivors: one treated with radiotherapy + chemotherapy and one with radiotherapy alone. They have marked orbital bone growth abnormalities. The three patients with CNS tumors were female. The histologies were glioblastoma multiforme, anaplastic astrocytoma, and malignant mixed oligodendroglioma. Two of the patients are long-term survivors after surgery + chemotherapy. Six children received eight courses of radiation therapy: 2 for Stage 4S neuroblastoma with respiratory compromise from an enlarging liver and 4 for retinoblastoma. The two infants with trilateral retinoblastoma received two courses of irradiation each: one of the treatment of intraocular tumor and a second, at an older age, for the pineal tumor. The most serious complication of anesthesia was a case of enterobacter cloacae sepsis in the central venous access line used for repetitively administering the anesthetic. Conclusion: The most common neonatal neoplasm histologic diagnoses are teratoma/germ cell tumor, neuroblastoma, and retinoblastoma. Neonatal neoplasms may be associated with congenital anomalies. Radiation therapy is administered infrequently in a population highly susceptible to late ill effects. When radiotherapy is required, anesthesia may be repetitively administered to aid in reproducible treatment

  6. Computer-aided diagnosis system for classifying benign and malignant thyroid nodules in multi-stained FNAB cytological images.

    Gopinath, Balasubramanian; Shanthi, Natesan

    2013-06-01

    An automated computer-aided diagnosis system is developed to classify benign and malignant thyroid nodules using multi-stained fine needle aspiration biopsy (FNAB) cytological images. In the first phase, the image segmentation is performed to remove the background staining information and retain the appropriate foreground cell objects in cytological images using mathematical morphology and watershed transform segmentation methods. Subsequently, statistical features are extracted using two-level discrete wavelet transform (DWT) decomposition, gray level co-occurrence matrix (GLCM) and Gabor filter based methods. The classifiers k-nearest neighbor (k-NN), Elman neural network (ENN) and support vector machine (SVM) are tested for classifying benign and malignant thyroid nodules. The combination of watershed segmentation, GLCM features and k-NN classifier results a lowest diagnostic accuracy of 60%. The highest diagnostic accuracy of 93.33% is achieved by ENN classifier trained with the statistical features extracted by Gabor filter bank from the images segmented by morphology and watershed transform segmentation methods. It is also observed that SVM classifier results its highest diagnostic accuracy of 90% for DWT and Gabor filter based features along with morphology and watershed transform segmentation methods. The experimental results suggest that the developed system with multi-stained thyroid FNAB images would be useful for identifying thyroid cancer irrespective of staining protocol used. PMID:23690210

  7. Computer-aided diagnosis system for classifying benign and malignant thyroid nodules in multi-stained FNAB cytological images

    An automated computer-aided diagnosis system is developed to classify benign and malignant thyroid nodules using multi-stained fine needle aspiration biopsy (FNAB) cytological images. In the first phase, the image segmentation is performed to remove the background staining information and retain the appropriate foreground cell objects in cytological images using mathematical morphology and watershed transform segmentation methods. Subsequently, statistical features are extracted using two-level discrete wavelet transform (DWT) decomposition, gray level co-occurrence matrix (GLCM) and Gabor filter based methods. The classifiers k-nearest neighbor (k-NN), Elman neural network (ENN) and support vector machine (SVM) are tested for classifying benign and malignant thyroid nodules. The combination of watershed segmentation, GLCM features and k-NN classifier results a lowest diagnostic accuracy of 60 %. The highest diagnostic accuracy of 93.33 % is achieved by ENN classifier trained with the statistical features extracted by Gabor filter bank from the images segmented by morphology and watershed transform segmentation methods. It is also observed that SVM classifier results its highest diagnostic accuracy of 90 % for DWT and Gabor filter based features along with morphology and watershed transform segmentation methods. The experimental results suggest that the developed system with multi-stained thyroid FNAB images would be useful for identifying thyroid cancer irrespective of staining protocol used.

  8. X-ray fluorescence analysis (XRF) and secondary ion mass spectrometry (SIMS) for analysis of iodine concentration in vitro in benign and malignant thyroid tissue

    Full text: The thyroid ability to store and concentrate iodine is of importance for radioiodine therapy in thyroid cancer. It is known that a normal thyroid contains 2-20 mg iodine while the information regarding malignant thyroid tissue is scarce. The purpose of this study was to investigate the iodine concentration in benign compared to malignant tissue. Methods: Thyroid tissue samples from healthy patients and from patients with papillary cancer were collected and frozen in connection with surgery. For the thyroid cancer patients, tissue was taken from both benign and malignant tissue. The iodine concentration was analysed with an XRF system consisting of a 241-Am source and an HPGe detector. When irradiating iodine containing tissue, characteristic X-rays are emitted. That radiation is detected with the strength of the detected signal being proportional to the amount of iodine in the sample. SIMS was used on glutaraldehyde fixed tissue as a histological tool for quantification and localization of iodine by sputtering and analysis of secondary ions. Results: The iodine concentration in benign tissue is considerably higher than in malignant samples. XRF measurements showed a medium iodine concentration in healthy thyroid tissue of 0.5 mg/mL. For the cancer patients, the iodine concentration was 0.3 mg/mL in benign tissue while no iodine could be detected in the malignant samples. These findings were consistent with the results from the SIMS investigation that gave a 100 times lower iodine concentration in malignant than in benign tissue. SIMS also showed that the iodine in benign tissue was predominantly located in the follicle lumen, while in the cancer cells low iodine concentration was found intra cellular as well as in the lumen. Conclusion: Iodine concentration in tissue from papillary cancer can be 100 times lower than in normal thyroid tissue. This is in accordance with the empirical knowledge that thyroid cancer should need about 100 times higher activity of in radioiodine treatment. (author)

  9. Quantitative and qualitative analysis of telomerase activity in benign and malignant thyroid tissues

    Objective: To study the status of telomerase activity during the development of thyroid tumors, and to determine whether telomerase activity can be used clinically as a molecular marker in the differential diagnosis of thyroid cancer. Methods: Telomerase activity was measured in 37 thyroid carcinomas, 33 benign thyroid lesions and 30 normal thyroid tissue samples by means of a modified TRAP-PCR. The assay was also applied to 15 fine needle aspirates (FNAs) of thyroid carcinomas to test its sensitivity. Results: Thirty-one of 37 thyroid carcinomas (83.8%), 7 of 33 benign thyroid lesions (21.2%), and 4 of 30 adjacent normal thyroid tissue samples expressed telomerase activity, 15 FNAs also had positive telomerase activity, just as their corresponding tissue specimens. The quantitative analysis showed that the telomerase activity was significantly higher in thyroid carcinomas than that in benign thyroid tissue samples. And medullary carcinomas and anaplastic carcinomas had higher levels of telomerase activity than papillary carcinomas. Conclusions: Telomerase activity is a good marker for thyroid carcinomas. The quantitative TRAP-PCR might have more potential application in the differential diagnosis of tumors and the estimation of tumor progression and prognosis. And this sensitive assay could become a useful new modality for supplementing microscopic cytopathology in the detection of cancer cells in small tissue samples and FNAs

  10. An extremely rare case of testicular malign neoplasm; alveolar subtype of rhabdomyosarcoma with long term follow-up.

    Tumay Ipekci

    2014-09-01

    Full Text Available Testicular neoplasm usually occur in men aged between 15 and 35. These are solid organ tumours and also should be operated when there is a suspicious clinical findings. Testis tumours are levelled after histopathology evaluation. The medical, surgical and follow-up strategies of well know testis tumours, such as seminomas, non-seminom germ cell tumours, have been established. In case of testis tumours rare entities may occur as rhabdomyosarcoma.We here presented a rare case of   alveolar subtype of rhabdomyosarcoma in testis with long term follow-up.

  11. Prospective evaluation of multiparametric ultrasound and quantitative elastosonography in the differential diagnosis of benign and malignant thyroid nodules: Preliminary experience

    Cantisani, Vito, E-mail: vito.cantisani@uniroma1.it [Department of Radiology, Oncology, and Anatomy Pathology, University “La Sapienza”, Policlinico Umberto I, Rome, Itlay (Italy); D’Andrea, Vito [Department of Surgical Sciences, University “La Sapienza”, Rome (Italy); Biancari, Fausto [Department of Surgery, Oulu University Hospital, Oulu (Finland); Medvedyeva, Olena; Di Segni, Mattia; Olive, Matteo [Department of Radiology, Oncology, and Anatomy Pathology, University “La Sapienza”, Policlinico Umberto I, Rome, Itlay (Italy); Patrizi, Gregorio; Redler, Adriano; De Antoni E, Enrico [Department of Surgical Sciences, University “La Sapienza”, Rome (Italy); Masciangelo, Raffaele [Department of Hygiene and Infectious Disease, University “La Sapienza”, Rome (Italy); Frezzotti, Francesca [Department of Surgical Sciences, University “La Sapienza”, Rome (Italy); Ricci, Paolo [Department of Radiology, Oncology, and Anatomy Pathology, University “La Sapienza”, Policlinico Umberto I, Rome, Itlay (Italy)

    2012-10-15

    Purpose: To assess the clinical value of quantitative elastosonography compared with multiparametric ultrasound in differentiating the nature of thyroid nodules. Methods and materials: Ninety-seven consecutive patients (32 males, 65 females, mean age, 54 years, range 20–81 years) with thyroid nodules previously detected at color-Doppler ultrasound (CDUS), were prospectively examined with elastosonography with dedicated quantitative software (Elasto-Q, Toshiba) before surgery. Ultrasound examination and elastosonography were evaluated by two investigators in consensus. US features, color-Doppler pattern, and strain ratio value were evaluated. Sensitivity and specificity of CDUS and sono-elastography were compared using X{sup 2} test and ROC curves. Results: Sensitivity and specificity of hypoechogenicity, irregular margins or suspicious halo features, CDUS blood flow pattern, and strain ratio in the diagnosis of malignant nodules were 56.8%, 62.2%, 54.1% and 97.3% and 71.7%, 93.3%, 28.3%, and 91.7%, respectively. Elastosonography was more sensitive and specific than all ultrasonographic features in predicting malignancy of the thyroid nodules (p < 0.0001). According to elastosonographic features the lesions characterized by strain ratio ≥2 were highly likely to be of malignant nature (p < 0.0001, O.R. 396, 95%, CI: 44–3530). Conclusions: The results of the present study suggest that elastosonography with Q system is a valuable tool in the characterization of thyroid nodules and it seems to be far more accurate than CDUS. These findings as well as those of previous studies support its use in selecting patients who are candidates for surgery.

  12. Patients Candidate for thyroid surgery

    Aim:thyroid scan with sestamibi is used for evaluation of thyroid nodules with the aim of increasing specificity before surgery. In this study we evaluated the role of sestamibi thyroid scan in candidates for thyroid surgery. Methods and patients: during two years, 37 patients were studied with solitary thyroid nodules, referred for thyroid surgery due to malignant or suspicious FNAB results (66/7%), compressive effects or failure of medical therapy. Thyroid scan was preformed after IV injection of 15 mCi of Tc-99 m-methoxy isobutyl isonitrile in 4 phases (angiography-first 10 minutes-15 min and 2-3 hours after injection). Thyroid methoxy isobutyl isonitrile uptake was scaled in 5 scores (0-4) with no uptake as score 0 and hot nodule as score 4. Patients underwent thyroid surgery and results of pathology are correlated with methoxy isobutyl isonitrile uptake. Results: From 37 patients (27 female, 10 male, mean age = 35.5 years +/- 13.6) 16 malignant and 21 benign nodules were detected. In another classification, we had 26 neoplastic and 11 non-neoplastic nodules. methoxy isobutyl isonitrile uptake score 3-4 was noted in 11 out of 16 malignant nodules and 13 out of 21 benign nodules(P=0.37). Sensitivity and specificity of high methoxy isobutyl isonitrile uptake (score 3-4) for diagnosis of malignancy was 68.7% and 38% respectively. The values for sensitivity and specificity were 69.2 % and 30.7% in diagnosis of neoplasm respectively. Washout index (considered as different in uptake scores of late and early phases) was 0.45 in benign and 0.09 in malignant nodules (P = 0.07). The values were 0.26 and 0.37 in neoplastic and non-neoplastic nodules respectively (P = 0.65). Conclusion: thyroid methoxy isobutyl isonitrile scan has a low specificity for differentiating malignant from benign or neoplastic from non-neoplastic nodules in patients who are candidates for thyroid surgery according to clinical evaluation.Analysis of wash out index may increase specificity

  13. [Basic concepts in the use of tumor markers in the diagnosis and follow-up of malignant bladder neoplasms].

    Moreno Sierra, J; Gómez Ruiz, J J; Ortega Heredia, M D; Blanco Jiménez, E; Silmi Moyano, A; Blázquez Izquierdo, J; Corral Rosillo, J; Rodríguez Molina, J; Ramírez Fernández, J C; Resel Estévez, L

    1993-04-01

    The absence of reliable diagnostic elements for the evaluation of malignant bladder tumors and the low sensitivity of the conventional diagnostic methods have prompted studies on the biological behaviour of this tumor type. The well known studies of Gold and Freedman and the recent investigations of Bates and Logo have proposed using tumor markers for early diagnosis and follow-up of different types of malignant tumors. However, the "ideal" tumor marker, one that is sufficiently sensitive and specific, has as yet to be discovered. We reviewed the tumor markers widely utilized to diagnose and follow-up malignant bladder tumors, and describe their main features. It must be pointed out that the lack of sensitivity and specificity of these tumor markers have led to the development of a new generation of tumor markers, such as cytogenetic markers, oncogenes, etc. Undoubtedly, this review of the literature will become obsolete with the advent of subsequent generations of tumor markers. PMID:8512354

  14. VON RECKLINGHAUSENS DISEASE ASSOCIATED WITH PAPILARY THYROID CARCINOMA AND MALIGNANT MELANOMA WITH MULTIPLE METASTASIS CASE REPORT

    D. Niculescu

    2006-04-01

    Full Text Available We present the case of a 56 years old, women, known with Recklinghausens Disease (RD since 15 years old. She was in the evidence of Iasi Endocrynology Clinic with nodulary goitre since 97, being treated with Euthyrox until 2005. Due to symptomatology worsening (asphyxia feeling, agitation, palpitations, insomnia, irritability, dizziness and to thyroid increase the surgical procedure was recommended. A right lobeisthmectomy was performed in 2005, but the Histopathology Exam revealed an occult Papillary Thyroid Carcinoma (PTC pT1NxMxG1 (sclerous infiltrative 3 mm node on joint nodular goitre with metaplasia, hemorrhage, sclero hyalinisation and lymphomatous thyroiditis aspects. She was treated with L Thyroxin, chemotherapy (Cisplatinum, Dacarbazin and radioactive iodine therapy. After oncological evaluation she was addressed to the First Surgery Clinic for thyroidectomy totalisation and the treatment of an umbilical tumour occurred after the fourth cure (June-July 2005. The patient was evaluated by physical exam, ultrasonography and computed tomography (cervical and abdominal which revealed tumours in the cervical region and in the liver. Thyroidectomy totalisation with limphadenectomy and an abdominal laparoscopy and biopsy were performed. The pathologic exam diagnosed multiple metastasis of malignant melanoma (MM localized in the cervical region, in the liver, great omentum and cervical limphatic nodes. The postoperative follow-up revealed multiple bone mestastasis from the malignanat melanoma. The case particularities were: association of RD with 2 primitive malignant tumours (occult PTC and MM, both diagnosed histopathologically and the multiple bone metastasis developed in a short time.

  15. Large Bowel Obstruction in a Young Woman Simulating a Malignant Neoplasm: A Case Report of Actinomyces Infection

    Talvensaari-Mattila, A. (Anne); R. B. Blanco Sequeiros; Karjula, H.; Lappi-Blanco, E.; Nissi, R

    2013-01-01

    Pelvic and intra-abdominal Actinomycosis can be difficult to diagnose preoperatively and it may also mimic many other diseases, including malignancies. We present a patient with pelvic Actinomycosis probably caused by a long-standing intrauterine device (IUD). We emphasize the challenges in diagnostic process and stress that though a rare disease, intra-abdominal Actinomycosis should be suspected in cases with intra-abdominal mass of uncertain etiology. The early recognition may spare the pat...

  16. Large bowel obstruction in a young woman simulating a malignant neoplasm: a case report of actinomyces infection.

    Nissi, R; Blanco Sequeiros, R B; Lappi-Blanco, E; Karjula, H; Talvensaari-Mattila, A

    2013-01-01

    Pelvic and intra-abdominal Actinomycosis can be difficult to diagnose preoperatively and it may also mimic many other diseases, including malignancies. We present a patient with pelvic Actinomycosis probably caused by a long-standing intrauterine device (IUD). We emphasize the challenges in diagnostic process and stress that though a rare disease, intra-abdominal Actinomycosis should be suspected in cases with intra-abdominal mass of uncertain etiology. The early recognition may spare the patient from extensive surgical operation. PMID:23936699

  17. Neoplasms HIV associated Kaposi sarcoma not

    Abstract - The incidence of malignancies in virus carriers acquired immunodeficiency (HIV) has increased in conjunction with the disease during the past decade. 40% of all AIDS patients develop cancer during the course of HIV infection. Kaposi's sarcoma (KS), Non-Hodgkin lymphoma (NHL) and cervical cancer have an impact extremely high in HIV infected patients, and they are considered as disease AIDS-defining stage. Many reports suggest that other neoplasms they can have a high impact on the population of HIV carrier, including head and neck carcinoma, rectal cancer - anal, plasma cytomas, and melanoma lung cancer. Methods - We examined the spectrum of cancer in HIV-infected patients, specifically neoplasms except Kaposi sarcoma diagnosed between 1/1998 - 6/2004. Information on age, sex, factors was gathered risk for AIDS, neoplasms and mortality rate. Results: The total number of patients in our study was 21 patients, what 15 were male (71%) and 6 females (29%); the median age was 36 (29-70). Tumors were reported: 11 Non-Hodgkin lymphomas (52%), 2 Hodgkin's lymphoma (6.6%), 1 medullary thyroid cancer (6.6%), 1 melanoma (6.6%), 1 rectal cancer (5%) and three head and neck cancers (14%), 1 cancer 1 lung and breast cancer. Five of the patients were intravenous drug abusers (24%); 4 patients were homosexual, bisexual March 8 straight, on 6 patients know the data. Conclusions - The spectrum of malignancies associated with infection HIV in our study was similar to that described in other populations. ratio between the immune system and the epidemiology of the virus-induced tumors is to importance to identify new therapeutic approaches in the treatment and / or prevention of these neoplasms

  18. 18F-FDG PET/CT imaging and diagnosis method of small intestine primary malignant neoplasms

    18F-FDG PET/CT data of 44 patients with small intestine disease (malignant, 25; benign, 19) were analyzed retrospectively. All results were proved by pathological, or diagnostic therapy and/or clinical follow-up. Visual and quantitative [intestinal wall thickness (IWT)] and semiquantitative methods [standardized uptake value (SUV)] were used to analyze the imaging features. The SUVmean and IWT were taken as the diagnostic threshold value for malignant when the Youden's index (YI) was maximum. The diagnostic test evaluation was compared with the final diagnostic results. The following results were obtained. (1) The 18F-FDG PET/CT imaging signs of small intestine carcinoma presented as intestinal local mass formation (84.00%), local wall thickening (76.00%), stenosis (25.00%), obstruction (32.00%) and enlargement of mesenteric lymph nodes (72.00%). But the incidence rates of these signs in the benign lesions were 31.58%, 42.11%, 10.53%, 15.79% and 52.63%, respectively. Only the signs of intestinal local mass formation (χ2=10.40, p2=3.90, pmax =0.589, the diagnostic threshold of IWT was 9.5 mm. The sensitivity, specificity and accuracy were 80.00%, 78.95% and 79.55%, respectively. (3) The SUVmean of intestinal malignant and benign lesions was 3.55±1.84 and 6.98±3.62 (t=3.77, pmax =0.379,the diagnostic threshold of SUVmean was 3.65. The sensitivity, specificity and accuracy were 80.00%, 57.89% and 70.48%, respectively. (4) Taking the intestinal mass formation as the diagnostic standard of malignant lesions, the sensitivity, specificity and accuracy were 84.00%, 78.95% and 81.82%, respectively. The YImax was 0.630. (5) Taking the intestinal mass formation and SUVmean of max was 0.855. It can be used as the main evidence to differentiate the small intestine primary malignant and benign lesion with the 18F-FDG PET/CT imaging qualitative and quantitative signs for the intestinal mass formation, at SUVmean <3.65, and local wall thickening or IWT <9.50 mm. (authors)

  19. Risk of malignancy in thyroid incidentalomas detected by (18)f-fluorodeoxyglucose positron emission tomography

    Soelberg, Kerstin Kathrine; Bonnema, Steen Joop; Brix, Thomas Heiberg; Hegedüs, Laszlo

    2012-01-01

    Background: The expanding use of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) has led to the identification of increasing numbers of patients with an incidentaloma in the thyroid gland. We aimed to review the proportion of incidental thyroid cancers found by (18)F-FDG PET...

  20. Patterns of Benign and Malignant Lesions of the Thyroid in Two Wilayahs of Northeastern Algeria

    Guidoum, Mona; Kherfi-Kadi, Hind; Benharkat-Boughaba, Ouahiba; Djemaa-Bendjazia, Aicha; Keghouche, Sihem; Abedi-Ardekani, Behnoush; Azzouz, Amina; Kadi, Yacine; Hainaut, Pierre; Bouslama, Zihad

    2015-01-01

    The aim of this study is to compare histological patterns and to estimate the burden of thyroid cancers in the two Wilayahs (departments) of El-Taref and Guelma in northeast of Algeria (total population 0.9 million), locally reputed as having different rates of endemic thyroid diseases and cancer. A retrospective analysis of central pathology registers and clinical records of patients with thyroid diseases, covering the period 20082012, was conducted. A total of 145 cases of thyroid cancers with histological confirmation were registered in the two Wilayahs during the period, with a female to male ratio of 5.9?:?1. Estimates of crude incidence rates suggested that thyroid cancers were twice as frequent in the Wilayah of Guelma compared to El-Taref (p < 0.05) with a tendency to occur at a younger age in resident of the Wilayah of El-Taref. Diagnoses of thyroid adenoma were more frequent in the Wilayah of Guelma, whereas the prevalence of other thyroid lesions, including goitre, was similar in the two Wilayahs. This first descriptive study on geographic variations in thyroid cancer in Northern Africa suggests that significant differences may occur in relation with environmental and lifestyle exposures. PMID:26681943

  1. Second neoplasms following radiotherapy or chemotherapy for cancer

    Penn, I.

    1982-02-01

    While radiotherapy and antineoplastic chemotherapy often control malignancies they may, paradoxically, cause new cancers to develop as long-term complications. Although almost any type of neoplasm can occur, radiation-induced malignancies are most likely to affect the myelopoietic tissues and the thyroid gland. The former tissues are also most frequently involved by chemotherapy. The combination of intensive radiotherapy and intensive chemotherapy is particularly leukemogenic. Acute myeloid leukemia has occurred with increased frequency following treatment of Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, ovarian cancer, polycythemia vera, carcinoma of the thyroid gland, and carcinoma of the breast. Radiation-induced malignancies usually occur in the field of irradiation. Tumors developing in an irradiated field include a substantial number of soft tissue sarcomas or osteosarcomas. There is a 20-fold increase of second cancers following treatment of childhood malignancies, mostly sarcomas of bone and soft tissues, but including leukemia, and carcinomas of the thyroid gland, skin, and breast. The latent period between radiotherapy and the appearance of a second cancer ranges from 2 years to several decades, often being 10-15 years. With chemotherapy the mean latent period is shorter, approximately 4 years. The mechanism of oncogenesis by radiotherapy or chemotherapy is poorly understood and probably involves a complex interplay of somatic mutation, co-oncogenic effects, depression of host immunity, stimulation of cellular proliferation, and genetic susceptibility.

  2. Second neoplasms following radiotherapy or chemotherapy for cancer

    While radiotherapy and antineoplastic chemotherapy often control malignancies they may, paradoxically, cause new cancers to develop as long-term complications. Although almost any type of neoplasm can occur, radiation-induced malignancies are most likely to affect the myelopoietic tissues and the thyroid gland. The former tissues are also most frequently involved by chemotherapy. The combination of intensive radiotherapy and intensive chemotherapy is particularly leukemogenic. Acute myeloid leukemia has occurred with increased frequency following treatment of Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, ovarian cancer, polycythemia vera, carcinoma of the thyroid gland, and carcinoma of the breast. Radiation-induced malignancies usually occur in the field of irradiation. Tumors developing in an irradiated field include a substantial number of soft tissue sarcomas or osteosarcomas. There is a 20-fold increase of second cancers following treatment of childhood malignancies, mostly sarcomas of bone and soft tissues, but including leukemia, and carcinomas of the thyroid gland, skin, and breast. The latent period between radiotherapy and the appearance of a second cancer ranges from 2 years to several decades, often being 10-15 years. With chemotherapy the mean latent period is shorter, approximately 4 years. The mechanism of oncogenesis by radiotherapy or chemotherapy is poorly understood and probably involves a complex interplay of somatic mutation, co-oncogenic effects, depression of host immunity, stimulation of cellular proliferation, and genetic susceptibility

  3. Lymphoscintigraphy for sentinel lymph node mapping in Japanese patients with malignant skin neoplasms of the lower extremities. Comparison with previously investigated Japanese lymphatic anatomy

    Lymph nodes (LN) and lymphatic drainage were identified by lymphoscintigraphy using 99mTc-phytate in order to map the sentinel lymph nodes (SLNs) in patients with malignant skin neoplasms of the lower extremities, and to compare the results with an atlas of Japanese lymphatic anatomy. Sentinel lymphoscintigraphs of 18 patients with malignant skin neoplasms of the lower extremities (9 men, 9 women; age range 45-84 years, mean age 66 years) were analyzed retrospectively, and the LNs detected were identified as SLNs or secondary nodes. The patterns of lymphatic drainage were divided into three different categories: initial drainage into inguinal LN without visualization of popliteal LNs (inguinal type), initial drainage into popliteal LNs and then into intrapelvic LNs (popliteal type), and initial drainage into both popliteal and inguinal LNs (inguinal and popliteal type). More than half of the cases were the inguinal and popliteal type, as both inguinal and popliteal LNs were identified as SLNs. In the cases in which the hallux and its surrounding area were injected, all were the inguinal type and popliteal LNs were not visualized. In one case, only dynamic images detected lymphatic drainage without visualization of popliteal LNs. In contrast to the previously published literature on Japanese lymphatic anatomy, SLN lymphatic drainage from the skin of the lower extremities was wide and overlapping in many areas. However, in agreement with currently accepted anatomy, only the great saphenous lymphatic vessel drained the skin of the hallux and its surrounding area. The present results suggest that it is important to confirm lymphatic drainage in order to identify SLNs in the lower extremities. The patterns of lymphatic drainage from the skin of the foot were divided into three different categories. In contrast to previously published Japanese lymphatic anatomy, lymphatic drainage from the skin of the lower extremities was wide and overlapping in many areas. However, only the great saphenous lymphatic vessel drained the skin of the hallux and its surrounding area in agreement with currently accepted Japanese lymphatic anatomy. It is important to confirm lymphatic drainage to identify SLNs in the lower extremities. (author)

  4. Role of apparent diffusion coefficient values and diffusion weighted magnetic resonance imaging in differentiation between benign and malignant thyroid nodules

    Full text: Objective: The purpose of the study was to differentiate between benign and malignant thyroid nodules using nodule-spinal cord signal intensity and nodule apparent diffusion coefficient (ADC) ratios on diffusion weighted magnetic resonance imaging. Materials and methods: Forty-four patients (27 females, 17 males; mean age 49) with nodules who underwent diffusion weighted magnetic resonance imaging (DW-MRI) were included in this study. The images were acquired with 0, 50, 400 and 1000 s/mm2 b values. ADC maps were calculated afterwards. Fine needle aspiration biopsies (FNAB) were performed at the same day with DW-MRI acquisition. The diagnosis in patients where malignity was detected after FNAB was confirmed by histopathologic analysis of the operation material. The signal intensities of the spinal cord and the nodule were measured additionally, over b-1000 diffusion weighted images. Nodule /cord signal intensity (SI) ratios were obtained and the digital values were calculated by dividing to ADC values estimated for each nodule. Statistical analysis was performed. Results: The (nodule SI-cord SI)/nodule ADC ratio is calculated in the DW images and a statistically significant relationship was found between this ratio and the histopathology of the nodules (p<0.001). The ratio was determined as 0.27 in benign, and 0.86 in malignant lesions. The result of ROC analysis was statistically significant, and the area under Receiver Operating Characteristic (ROC) curve (100%) was considerably high. The threshold value was calculated as 0.56 according to the ROC analysis. According to this threshold value, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy rates for (nodule SI/cord SI)/ADC ratios in differentiating benign from malignant thyroid nodules are calculated as 100%, 97%, 83%, 100%, and 98%, respectively. Conclusion: We have found that (nodule/cord SI)/ nodule ADC ratio has the highest values for sensitivity and specificity among the tests defined for characterization of nodules.

  5. Preoperative Assessment of TERT Promoter Mutation on Thyroid Core Needle Biopsies Supports Diagnosis of Malignancy and Addresses Surgical Strategy.

    Crescenzi, A; Trimboli, P; Modica, D C; Taffon, C; Guidobaldi, L; Taccogna, S; Rainer, A; Trombetta, M; Papini, E; Zelano, G

    2016-03-01

    In the last decade, several molecular markers have been proposed to improve the diagnosis of thyroid nodules. Among these, mutations in the telomerase reverse transcriptase (TERT) promoter have been correlated to malignant tumors, characterized by highest recurrence and decreased patients' survival. This suggests an important role of TERT mutational analysis in the clinical diagnosis and management of thyroid cancer patients. The aim of the study was to demonstrate the adequacy of core needle biopsy (CNB) for the preoperative assessment of TERT mutational status, to reach a more accurate definition of malignancy and a more appropriate surgical planning. Indeed, CNB is gaining momentum for improving diagnosis of thyroid nodules deemed inconclusive by fine needle aspirate (FNA). The study included 50 patients submitted to CNB due to inconclusive FNA report. TERT mutational status was correlated with BRAF mutation, definitive histology, and post-operative TNM staging of the neoplasia. C228T mutation of the TERT promoter was reported in 10% of the papillary carcinomas (PTC) series. When compared with final histology, all cases harboring TERT mutation resulted as locally invasive PTCs. The prevalence of TERT mutated cases was 17.6% among locally advanced PTCs. TERT analysis on CNB allows the assessment of the pathological population on paraffin sections before DNA isolation, minimizing the risk of false negatives due to poor sampling that affects FNA, and gathering aggregate information about morphology and TERT mutational status. Data indicating a worse outcome of the tumor might be used to individualize treatment decision, surgical option, and follow-up design. PMID:25951319

  6. Predicted risks of second malignant neoplasm incidence and mortality due to secondary neutrons in a girl and boy receiving proton craniospinal irradiation

    The purpose of this study was to compare the predicted risks of second malignant neoplasm (SMN) incidence and mortality from secondary neutrons for a 9-year-old girl and a 10-year-old boy who received proton craniospinal irradiation (CSI). SMN incidence and mortality from neutrons were predicted from equivalent doses to radiosensitive organs for cranial, spinal and intracranial boost fields. Therapeutic proton absorbed dose and equivalent dose from neutrons were calculated using Monte Carlo simulations. Risks of SMN incidence and mortality in most organs and tissues were predicted by applying risks models from the National Research Council of the National Academies to the equivalent dose from neutrons; for non-melanoma skin cancer, risk models from the International Commission on Radiological Protection were applied. The lifetime absolute risks of SMN incidence due to neutrons were 14.8% and 8.5%, for the girl and boy, respectively. The risks of a fatal SMN were 5.3% and 3.4% for the girl and boy, respectively. The girl had a greater risk for any SMN except colon and liver cancers, indicating that the girl's higher risks were not attributable solely to greater susceptibility to breast cancer. Lung cancer predominated the risk of SMN mortality for both patients. This study suggests that the risks of SMN incidence and mortality from neutrons may be greater for girls than for boys treated with proton CSI.

  7. Methodological extensions of meta-analysis with excess relative risk estimates. Application to risk of second malignant neoplasms among childhood cancer survivors treated with radiotherapy

    Although radiotherapy is recognized as an established risk factor for second malignant neoplasms (SMNs), the dose response of SMNs following radiotherapy has not been well characterized. In our previous meta-analysis of the risks of SMNs occurring among children who have received radiotherapy, the small number of eligible studies precluded a detailed evaluation. Therefore, to increase the number of eligible studies, we developed a method of calculating excess relative risk (ERR) per Gy estimates from studies for which the relative risk estimates for several dose categories were available. Comparing the calculated ERR with that described in several original papers validated the proposed method. This enabled us to increase the number of studies, which we used to conduct a meta-analysis. The overall ERR per Gy estimate of radiotherapy over 26 relevant studies was 0.60 (95% CI: 0.30-1.20), which is smaller than the corresponding estimate for atomic bomb survivors exposed to radiation as young children (1.7; 95% CI: 1.1-2.5). A significant decrease in ERR per Gy with increase in age at exposure (0.85 times per annual increase) was observed in the meta-regression. Heterogeneity was suggested by Cochran's Q statistic (P < 0.001), which may be partly accounted for by age at exposure. (author)

  8. Cardioprotective effects of fullerenol C(60)(Oh)(24) on a single dose doxorubicin-induced cardiotoxicity in rats with malignant neoplasm.

    Injac, R; Perse, M; Boskovic, M; Djordjevic-Milic, V; Djordjevic, A; Hvala, A; Cerar, A; Strukelj, B

    2008-02-01

    The therapeutic utility of the anthracycline antibiotic doxorubicin is limited due to its cardiotoxicity. Our aim was to investigate the efficacy of fullerenol C(60)(OH)(24) in preventing single, high-dose doxorubicin-induced cardiotoxicity in rats with malignant neoplasm. Experiment was performed on adult female Sprague Dawley rats with chemically induced mammary carcinomas. The animals were sacrificed two days after the application of doxorubicin and/or fullerenol, and the serum activities of CK, LDH and alpha-HBDH, as well as the levels of MDA, GSH, GSSG, GSH-Px, SOD, CAT, GR, and TAS in the heart, were determined. The results obtained from the enzymatic activity in the serum show that the administration of a single dose of 8 mg/kg in all treated groups induces statistically significant damage. There are significant changes in the enzymes of LDH and CK (p doxorubicin/fullerenol and fullerenol. Comparing all groups with untreated control group, point to the conclusion that in the case of a lower alpha-HBDH/LDH ratio, results in more serious the liver parenchymal damage. The results revealed that doxorubicin induced oxidative damage and that the fullerenol antioxidative influence caused significant changes in MDA, GSH, GSSG, GSH-Px, SOD, CAT, GR, and TAS level in the heart (p fullerenol might be a potential cardioprotector in doxorubicin-treated individuals. PMID:18198920

  9. Progress in thyroid and thyroid tumor scintigraphy

    Imaging methods of thyroid and thyroid tumor were reviewed and re-evaluated. 123I as well as 131I is used for visualizing thyroid and thyroid tumor metastases. Positive images of metastatic lesions using these radiopharmaceuticals are specific to thyroid malignancy. sup(99m)TcO4- is also used for thyroid imaging. 67Ga detected only few cases of malignant thyroid tumor except anaplastic one. On the contrary, 201Tl-chloride is used very often as an imaging agent of thyroid tumor. This sensitivity is good in thyroid cancer. But many false-positive cases were found in thyroid adenoma. In future, more specific and sensitive imaging agent of thyroid malignancy is expected to be found. (author)

  10. The usefulness of serum thyroglobulin levels and Tl-201 scintigraphy in differentiating between benign and malignant thyroid follicular lesions

    The purpose of this study was to compare the diagnostic capabilities of various serum thyroglobulin levels (Tg) and Tl-201 scintigraphy with regard to thyroid follicular lesions. We examined 80 thyroid follicular lesions (benign: 55, malignant: 25) in patients with nodular goiter for whom a pathological diagnosis was made based on surgical findings. Tg was measured by an I-125 (radioimmunoassay) method. In Tl-201 scintigraphy, 74 MBq of Tl-201 chloride was intravenously injected and imaged after 10 minutes (early image) and after 120 minutes (delayed image), and the scintigrams were evaluated both visually and quantitatively, with special attention paid to the part of the nodule with the highest accumulation of Tl-201 chloride. The cutoff levels of Tg for categorizing the lesions as malignant were set at 40, 100, 300, 500, 1,000 and 2,500 μg/l. In Tl-201 scintigraphy, method 1 involved high uptake on both early and delayed images, method 2 involved high uptake on only the early image, and method 3 involved high uptake on only the early image or the same accumulation in comparison with the normal region on the early image, with no washout being quantitatively judged as indicative of malignancy. A summary index of overall test performance can be calculated as the area under the receiver operating characteristic (ROC) curve (Area (Az)). Likelihood ratios for several cutoff levels were also calculated. In the diagnosis, Az of Tl-201 (0.95) was larger than that of Tg (0.65). The sensitivity and accuracy of Tg at each cutoff level (sensitivity: 4.0% to 76.0%, accuracy: 50.0% to 72.5%) were lower than with Tl-201 scintigraphy (methods 1-3, sensitivity: 76.0-100%, accuracy: 77.5-88.8%). The likelihood ratio for the positive results of method 1 for Tl-201 scintigraphy, were greatest in the present study (13.9), and the likelihood ratio for the negative results of method 3 for Tl-201 scintigraphy, (0) was smallest in the present study. Diagnosis based on Tl-201 washout patterns in which quantitative evaluation is combined with visual evaluation appears to be more useful for the differentiation of malignant thyroid follicular lesions than diagnosis by Tg. (author)

  11. Thyroid cancer

    The role of ionizing radiation in the introduction of thyroid carcinoma is discussed. In the treatment of thyroid cancer, radioiodine administration is of value as an ablation procedure, completing the thyroidectomy and as a method to irradiate selectively functioning thyroid carcinoma tissue that cannnot be removed surgically. Results of the clinical management of 155 patients with malignant thyroid tumours are presented. The ablation dose of iodine-131 can be decreased to 40 millicuries thus effectively reducing the patients whole body radiation dose

  12. Thyroid

    In vivo thyroid function testing is conducted with isotopes of iodine, the rate-limiting substrate for thyroid hormonogenesis, or with pertechnetate, an anion which the thyroidal follicular cells will concentrate or trap similarly to iodide, but will not organify. The physical characteristics of these isotopes, their advantages or indications, their disadvantages, and the average radiation dose to the thyroid in the infant, child, and adult are reviewed. The latter is expressed as estimated dose in rads per microcurie administered assuming an uptake of 27 percent and a biological half-life of 68 days. For many years the standard isotope for thyroid studies has been 131I. This isotope, however, has the disadvantage of a high radiation dose to the gland, especially in infants and children. Furthermore the high-energy gamma ray (364 keV) requires low-efficiency, thick septal collimators for scanning. More recently 125I, 123I, and 99/sup m/Tc-pertechnetate have been used. (auth)

  13. THE INCIDENCE OF THYROID MALIGNANCY IN NODULAR GOITER: A RETROSPECTIVE ANALYSIS IN A MEDICAL COLLEGE HOSPITAL

    Praveen Kumar

    2015-09-01

    Full Text Available The incidence of malignancy in nodular goiter has been found to vary from 4% to 17%. Our aim is to determine the incidence of malignancy in nodular goiter by doing the histopathological examination of thyroidectomy specimens. MATERIALS AND METHODS: This retrospective, observational study was carried out on patients who are undergone thyroidectomy for clinically diagnosed nodular goiter in Fr . Muller Medical College Hospital during 2012 - 2014 (3 yrs. All the operated specimens were subjected to a histopathological examination to determine the incidence of malignancy. RESULTS: Among the 258 nodular goitre cases which were studied, 21 (8.1% cases contained malignant foci. Among them, papillary carcinoma was the most common type of malignancy observed. CONCLUSION: The risk of malignancy in nodular goitre should not to be underestimated. Total/ Near - total thyroidectomy is the preferred operation. All the operated specimens should be sent for histopathological examination

  14. Probability of malignancy in non-palpable thyroid nodules. Predictive value of color Doppler ultrasound and cytological correlation

    Objective: To evaluate the diagnostic accuracy of ultrasound and Doppler criteria in the differentiation of malignant nodules, using cytological diagnosis as standard reference. Material and Method: Prospective observational study in 200 patients, between March-September 2008, assessed for known thyroid nodular disease using FNA. The probability of malignancy was categorized as low (0-3), intermediate (4-7) or high (greater than 7). The procedures were performed using Medison Sonoline ultrasound equipment, with a linear transducer (7.5 MHz), and the aspiration was performed with a 25 G needle and sent to cytology immediately. A single sample was needed in 88% of cases. Results: Approximately 96% of the nodules that went to cytology were categorized as low-grade, 3% as intermediate and 1% as high, without significant differences (p>0.5) when compared with the ultrasound score. Sonographic features indicating a high probability of malignancy were found in 2% (n=5) of cases, and the diagnosis was confirmed by cytology in 2 cases. Malignancy criteria such as size (>1 cm), irregular contours, solid echo structure, calcifications, and intranodal Doppler showed variable sensitivity and specificity (S: 32-44% and E: 28-55%) with overlapping confidence intervals within lesions of intermediate and low probability. Low probability lesions showed isoechogenicity, regular contours, lack of calcifications and intralesional Doppler, for a negative predictive value of 62-77%. Conclusion: Our results suggest that overlapping sonographic features between benign and malignant nodules requires final cytological diagnosis in most cases, given the safety of the cytological technique and the short waiting time.

  15. Thyroid effects

    Risk coefficients for thyroid disorders have been developed for both 131I and external x or gamma low-LET radiation. A linear, no-threshold model has been used for thyroid neoplasms. A linear, threshold model has been used for other thyroid disorders. Improvements since the Reactor Safety Study were made possible by relevant new animal and human data. Major changes are as follows. Animal data are used to supplement the human experience where necessary. A specific risk estimate model is used for thyroid neoplasms, which accounts for observed effects of gender and age at exposure on risk. For thyroid cancer, the basis of the risk coefficients is the experience of North Americans following x-irradiation for benign disease in childhood. This recognizes possible differences in susceptibility in people of different heritage. A minimum induction period for thyroid neoplasms following irradiation is used to define periods at risk. An upper bound risk coefficient for cancer induction following exposure to 131I is based on human experience at relatively low dose exposures. While the overall lifetime risks of death due to thyroid cancer are consistent with projections by the ICRP, BEIR III, and UNSCEAR Reports, the current model permits greater flexibility in determining risk for population subgroups. 88 references, 8 tables

  16. Positron Emission Tomography with 2-Deoxy-2-[18F] Fluoro-DGlucose in the Detection of Malignancy in Intraductal Papillary Mucinous Neoplasms of the Pancreas

    Brian KP Goh

    2007-05-01

    Full Text Available A 79-year-old Indian male was admitted with upper abdominal discomfort of 1-year duration which was associated with loss of weight and appetite. Clinical examination of the abdomen did not reveal any palpable masses. Laboratory investigations including a complete blood count, liver function tests and serum amylase were unremarkable. Standard serum tumor markers were within normal limits: carbohydrate antigen (CA 19-9, 13.4 U/mL (reference range: 3-45 U/mL; carcinoembryonic antigen (CEA, 1.4 μg/L (reference range: 0.5-3.5 μg/L and alphafetoprotein, 1.3 μg/L (reference range: 1-10 μg/L. A contrast-enhanced computed tomographic (CT scan demonstrated a cystically dilated and tortuous pancreatic duct measuring 1.9 cm, suggestive of an intraductal papillary mucinous neoplasm (IPMN. The common bile duct was dilated up to the level of the ampulla and a 3.2x2.0 cm heterogeneous soft tissue mass was observed in the head of the pancreas which extended into the duodenum, suggestive of a malignant lesion (Images 1 and 2. Fusion positron emission tomography/computed tomography (PET/CT was subsequently performed with 12.7 mCi of 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG administered intravenously. A whole body PET/CT scan was performed 60 minutes later with CT data used for attenuation correction and anatomical correlation. This confirmed a metabolically active focus within the pancreatic head mass with a standard uptake value (SUVmax of 3.5 compatible with carcinoma (Image 3.

  17. Evaluacin clnica de la salud oral de nios con neoplasias malignas / Clinical Assessment of Oral Health of children with Malignant Neoplasm

    MA, Gordn-Nez; L, Pereira Pinto; BL, Souza; PT, Oliveira; MZ, Fernandes.

    2005-06-01

    Full Text Available Objetivo: Este estudio de carcter descriptivo vis evaluar clnicamente nios con neoplasias malignas y poner de manifiesto la relacin entre el status de salud bucal y la ocurrencia de complicaciones estomatolgicas. Pacientes y mtodos: la salud bucal de 40 nios con neoplasias malignas (grupo I) [...] fue evaluada clnicamente mediante examen fsico extra e intra oral, obtencin del ndice de placa visible, ndice de sangrado gingival e ndice de dientes cariados, ausentes y obturados y simultneamente fueron observadas las complicaciones estomatolgicas desarrolladas en esos pacientes. El status de salud bucal de stos nios fue comparado al de nios saludables (grupo II). Resultados: los nios del grupo I presentaron ndices de sangrado gingival y experiencia de caries menores que los del grupo II, por otro lado, el ndice de placa visible fue ligeramente mayor en los nios del grupo I, sin embargo, slo hubo diferencia estadsticamente significativa en el valor del CAO-D/cao-d entre ambos grupos (p = 0.002). En el grupo I, 16 nios desarrollaron conjuntamente 61 complicaciones estomatolgicas, con predominancia de la mucositis, seguida del sangrado oral espontneo, candidiasis y xerostomia. Conclusin: Pacientes bajo tratamiento antineoplsico, presentando higiene oral deficiente, tienen mayor riesgo de desarrollar complicaciones estomatolgicas. Abstract in english Objective: In this descriptive study were assessment clinically children with malignant neoplasm, to evidence the correlation between oral health status and the occurrence of stomatologic complications. Patients and methods: Were evaluated the oral health conditions of 40 children with malignant neo [...] plasm (group I) through intra and extra oral physic examination, obstention of Visible Plate Index, Gingival Bleeding Index and Decayed, Missed and Filled Teeth Index; simultaneously were observed the stomatologic complications developed in this patients. The oral health status of the children of group I was compared to the healthy children (group II). Results: The children of group I presented Gingival Bleeding Index and caries experience lower than children of group II, in other hand, the Visible Plate Index was lightly greater in children of group I, nevertheless existed statistical difference in the value of the DMF-T/dmf-t between both groups (p = 0.002). In the group I, 16 children developed together 61 stomatologic complications, with predominance of oral mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy. Conclusions: Patients in anti neoplastic therapy with deficient oral hygiene had high risk of develop stomatologic complications.

  18. Unusual thyroid tumor in a child

    Malignant neoplasms of the thyroid gland are quite rare in children. Winship, in his classic article, could find only 562 cases in the literature. The histopathological patterns resemble those of the adult tumors. Despite early cervical metastasis, the prognosis in general is favorable, with many long-term survivals. Prior exposure to radiation of the head and neck is a definite pre-disposing factor. Teratomas of the neck are a medical curiosity--less than 100 cases are described in the literature. The vast majority of these are found during the neonatal period, and are benign histologically. These are usually large, cystic, bulky masses which produce mechanical obstruction of the upper airway and digestive tract. Only one of these tumors, described by Pupovac in 1896, has been considered malignant. A six-year-old child was examined with a right thyroid mass of three months' duration. The thyroid scan showed a ''cold nodule''. At surgery, a well-encapsulated mass was found. The pathology showed a predominance of malignant spindle cells, with areas of papillary carcinoma; however, there were well-defined mucous glands present in the tumor. Clinically the child has remained well and asymptomatic. The slides have been extensively reviewed. To my knowledge no such tumor has been prepreviously described. The tumor is considered to be a malignant thyroid tumor growing out of teratomatous tissue

  19. CT of soft-tissue neoplasms

    The computed tomographic scans (CT) of 84 patients with untreated soft-tissue neoplasms were studied, 75 with primary and nine with secondary lesions. Each scan was evaluated using several criteria: homogeneity and density, presence and type of calcification, presence of bony destruction, involvement of multiple muscle groups, definition of adjacent fat, border definition, and vessel or nerve involvement. CT demonstrated the lesion in all 84 patients and showed excellent anatomic detail in 64 of the 75 patients with primary neoplasms. The CT findings were characteristic enough to suggest the histology of the neoplasm in only 13 lesions (nine lipomas, three hemangiomas, one neurofibroma). No malignant neoplasm had CT characteristics specific enough to differentiate it from any other malignant tumor. However, malignant neoplasms could be differentiated from benign neoplasms in 88% of the cases

  20. Long-term follow-up sonography of benign cystic thyroid nodules after a percutaneous ethanol injection: the incidence of malignancy-mimicking nodules

    To evaluate the incidence of malignancy-mimicking sclerosed thyroid nodules, from long-term follow-up ultrasonography (US) after an US-guided percutaneous ethanol injection (PEI). We examined 86 benign cystic thyroid nodules from 80 patients. The nodules were classified into two groups based on whether an aspiration (Group A, n = 26) or non-aspiration (Group B, n 60) of infused ethanol was performed. The final follow-up US over 12 months was performed in all patients. Of the 86 nodules, the cystic portion of 82 (95.3%) cases, from 76 patients, completely disappeared subsequent to the first follow-up US (Group A, n = 24, Group B, n = 58) (Chi-square test, ? > 0.05). Moreover, 46 sclerosed thyroid nodules showed two or more of the 'five sonographic criteria' upon a follow-up US (Group A, n = 13, 50.0%, Group B, n = 32, 53.3%). A higher ratio of the cystic portion of the nodules was associated with a higher incidence of the 'five sonographic criteria' for malignancies detected via a follow-up US (? < 0.01; Student's t-test). For the long-term follow-up US, the 'five sonographic criteria' were observed in half the patients who received US-guided PEI. Also, by acknowledging the possibility that sonographic findings mimic a malignancy, since the sclerosed thyroid nodule, patients may avoid an unnecessary biopsy

  1. Determining pathogenetic connection between disorders of lipid and carbohydrate metabolism and non-malignant pathology of thyroid gland in children , born from parents, Chernobyl accident survivors

    The 92 children aged 12-17 years were examined with the purpose to study the links between carbohydrate and lipid metabolic abnormalities and non-malignant thyroid disorders in descendants of the Chernobyl accident survivors. Clinical, anthropometrical studies and hormonal assays were applied. Carbohydrate and lipid metabolic abnormalities were revealed in every third case of thyroid disease. It confirms our supposition of such a possibility being due to the fact that radiation impact even in low doses can result in pronounced metabolic disorders lading to entire endocrine disregulation. It is relevant in children of the puberty age

  2. Sclerosing Mucoepidermoid Carcinoma of The Thyroid Gland

    Reyhan Ersoy

    2008-05-01

    Full Text Available An extremely rare case of sclerosing mucoepidermoid carcinoma (SMECE of the thyroid in a 22-year-old woman is reported. The patient initially presented with a thyroid nodule. Fine needle aspiration cytology of the nodule showed features of a malignant tumor that was different from the usual types of thyroid carcinoma. Total thyroidectomy and right cervical lymph node dissection were performed, and pathology confirmed SMECE. The patient remains asymptomatic and no further recurrence or metastasis has been noted in the postoperative course of five years. She is the youngest patient with SMECE in literature. In this report, we briefly present the clinical and biologic course of this patient’s neoplasm and also review the associated literature. Turk Jem 2008; 12: 39-41

  3. Oxyphilic carcinoma of the thyroid gland

    Stankov Karmen

    2003-01-01

    Full Text Available Oxyphilic tumors of the thyroid gland are rare tumors characterized by the presence of Hürthle cells - mitochondrion-rich, eosinophilic epithelial cells. Hürthle cell carcinomas (HCC of the thyroid behave in a more aggressive fashion as compared to other well-differentiated thyroid cancers. Many recent studies have been focused on the further elucidation of pathogenesis and the role of mitochondrial hyperplasia in carcinogenesis of these neoplasms. The importance of combining morphological and genetic approaches in the study of HCC has been emphasized by the difficulties encountered in establishing adequate differential diagnostic criteria between benign and malignant forms, as well as by the resistance of HCC to radio and chemotherapy. It has been well documented that the Hürthle cells are characterized by profound aberrations in the nuclear and mitochondrial genome and by alterations in oncogenes, tumor suppressor genes and other key genes involved in energy metabolism, proliferation and apoptosis.

  4. Incidence of malignant neoplasi in single nodules of the thyroid gland

    Two hundred and seventy-two cases are presented of single nodular goiter of the thyroid gland, confirmed by histopathology, diagnosed and teated in the Head and Neck Department of Instituto Nacional do Cancer, Rio de Janeiro, Brazil. This experience demonstrated that the carcinoma occurrence, in these nodes, is low; as a routine, they are ressected-and it is shown that there's need for better selection of patients for surgery. It is believed that there's no doubt about the efficiency of the association of clinical data, scintillography, ultra soud results, suppression therapy and citology of aspiration biopsy in the surgical selection of patients. (Author)

  5. Autoimmune Thyroid Disorders

    B. N. Macharia; M. A. Iddah

    2013-01-01

    Purpose of Review. Studies have been published in the field of autoimmune thyroid diseases since January 2005. The review is organized into areas of etiology, autoimmune features, autoantibodies, mechanism of thyroid cell injury, B-cell responses, and T-cell responses. Also it reviews the diagnosis and the relationship between autoimmune thyroid disease, neoplasm, and kidney disorders. Recent Findings. Autoimmune thyroid diseases have been reported in people living in different parts of the w...

  6. Optimal carbon dioxide insufflation pressure during robot-assisted thyroidectomy in patients with various benign and malignant thyroid diseases

    Kim Hoon

    2012-09-01

    Full Text Available Abstract Background Currently, data are not available concerning a safe insufflation pressure that provides a proper view of the surgical field without adverse metabolic and hemodynamic changes in humans undergoing the robot-assisted thyroidectomy bilateral axillo-breast approach (BABA using the da Vinci robotic surgical system. The purpose of this study was to determine the optimal carbon dioxide (CO2 insufflation pressure in patients with various benign and malignant thyroid diseases when using the da Vinci robotic surgical system. Methods A total of 32 patients underwent thyroid surgery at 6 (n = 15, 9 (n = 15, and 12 (n = 2 mmHg. The partial pressure of carbon dioxide (PaCO2, pH, cardiac output, heart rate, and mean arterial pressure were measured at baseline, 30 min and 1, 1.5, and 2 hours after CO2 insufflation, and 30 min after desufflation. Results CO2 insufflation of 12 mmHg caused severe facial subcutaneous emphysema, hypercarbia, and acidosis during robot-assisted thyroidectomy with BABA. The study was stopped before completion for the patients’ safety in accordance with the study protocol. Applying 6- or 9- mmHg of CO2 insufflation pressure caused increases in PaCO2 and decreases in arterial pH. However, vital signs were stable and pH and PaCO2 were within the physiologic range during the surgery in the 6- and 9-mmHg groups. Conclusions We propose that a CO2 insufflation pressure under 10 mmHg in robot-assisted thyroidectomy with BABA is the optimal insufflation pressure for patient safety.

  7. Cost-effectiveness of 99mTc-MIBI in the evaluation of thyroid nodules for malignancy: a new lease of life for an old radiopharmaceutical?

    For many years it has been known that MIBI (methoxyisobutylisonitrile) scintigraphy can also be used in the diagnostic work-up of scintigraphically cold and therefore suspicious thyroid nodules in connection with fine needle biopsy. Recently, in a comparable meta-analysis in conjunction with a prior 99m-Tc pertechnate thyroid scintigraphy it was shown that MIBI scintigraphy can achieve a very high negative predictive value ranging from 88% to 100% with a mean of 97%. This indicates that a negative MIBI scan will obviate the need to surgically remove the thyroid nodule for definitive histological clarification in the large majority of patients, as the risk of malignancy in such a nodule is very low.

  8. The influence of various amounts of 131-iodine on the proliferation of benign and malignant thyroid cells

    The aim of our work was to find a method to predict the sensitivity of different thyroid diseases towards 131-iodine individually for each patient who is going to have a 131-iodine treatment. We tried to determine the 131-iodine-uptake of benign primary thyroid cells and malignant thyroid (carcinoma) cell-lines (follicular -UCLA RO 82 W-1 and papillary -NPA'87). The following culture dishes were used: 75 cm2-flasks, 24-well plates and Palladium-covered dishes. We incubated 350000 cells per well with 3,7; 9,25; 18,5; 37; and 185 mbq 131-iodine/500 μl Hanks Balanced Salt Solution and 10 (5; 100; 0,1 and 0) μM non-active sodium-iodide for 2 minutes up to 72 hours. The amount of 131-iodine stored by the cells was measured with a Gamma-counter. The ability of the tested two cell-lines to take up 131-iodine was pretty low (about 0,02 % - 0,9 % of the added 131-iodine doses). In addition to that we controlled and determined the cell proliferation by staining them with Trypan-blue and counting using a phase-contrast-microscope. From the cell numbers we collected during 8 days control a growth curve could be prepared. There was a remarkable difference in the growth rate between 131-iodine-incubated (3,7 mbq) and non-incubated cells. The number of the irradiated cells was about 30 % lower. Furthermore we added 10 μM 13-cis retinoic acid to the nutrition media to attempt to rise the extent of the cells differentiation and therefor also the 131-iodine-uptake. Four days preparation with retinoic acid in the media caused a slight increase (10 %) of the 131-iodine-uptake in the RO 82 W-1-cells, 28 days incubation decreased the 131-iodine-uptake significantly (about 30 % - 70 %) and the cells died. After 10 days preparation with retinoic acid the NPA'87-cells also showed a decrease in the 131-iodine-uptake (∼40-50 %) and the cells died. (author)

  9. Comparison of muscle-to-nodule and parenchyma-to-nodule strain ratios in the differentiation of benign and malignant thyroid nodules: Which one should we use?

    Aydin, Ramazan, E-mail: raydin1984@hotmail.com [Department of Radiology, Samsun Education and Research Hospital, Samsun (Turkey); Elmali, Muzaffer, E-mail: muzafel@yahoo.com.tr [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Polat, Ahmet Veysel, E-mail: veyselp@hotmail.com [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Danaci, Murat, E-mail: danacim55@yahoo.com [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Akpolat, Ilkser, E-mail: ilkserakpolat@yahoo.com [Department of Pathology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey)

    2014-03-15

    Objective: The aim of this study is to investigate the diagnostic accuracy of muscle-to-nodule strain ratio (MNSR) in the differentiation of benign and malignant thyroid nodules and to see if there was a difference between MNSR and parenchyma-to-nodule strain ratios (PNSR) in diagnosis. Methods: A total of 106 consecutive patients (88 women and 18 men; age range 19–79 years) with thyroid nodules were prospectively examined using ultrasound and sonoelastography before the fine-needle aspiration biopsy. The mean MNSR and PNSR were calculated for each nodule and the elasticity score was determined according to four-point scoring system. Results: According to the four-point scoring system, 44 of the 83 benign nodules had a score of one or two while 22 of the 23 malignant nodules had a score of three or four (p < 0.001). Using ROC analysis, the best cutoff point for MNSR 1.85 and for PNSR 3.14 was calculated. The sensitivity and specificity for the MNSR were 95.6%, 92.8%, respectively; for the PNSR were 95.6%, 93.4%, respectively, when the best cutoff points were used (p < 0.001). The κ value for the PNSR and MNSR methods was 0.87, which indicated an almost perfect agreement (p < 0.001). Conclusions: Sonoelastography has a high diagnostic accuracy in the differentiation of benign and malignant thyroid nodules. There was no significant difference between MNSR and PNSR in the differentiation of benign and malignant thyroid nodules. Therefore, we think that MNSR could safely be used in situations where PNSR could not be used.

  10. Multiparametric PET imaging in thyroid malignancy characterizing tumour heterogeneity: somatostatin receptors and glucose metabolism

    Traub-Weidinger, Tatjana [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Medical University of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Putzer, Daniel; Bale, Reto [Medical University of Innsbruck, Department of Radiology, Innsbruck (Austria); Guggenberg, Elisabeth von; Dobrozemsky, Georg; Nilica, Bernhard; Kendler, Dorota; Virgolini, Irene Johanna [Medical University of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria)

    2015-12-15

    Radiolabelled somatostatin (SST) analogues have proven useful in diagnosing tumours positive for SST receptor (SSTR). As different subtypes of SSTR are expressed on the tumour cell surface, the choice of appropriate therapeutic SST analogue is crucial. We evaluated the SSTR status of thyroid cancer patients who had signs of progressive disease comparing different SSTR ligands for PET imaging to evaluate possible further therapeutic options. PET with {sup 68}Ga-radiolabelled SSTR ligands DOTA lanreotide (DOTA-LAN), DOTA-Tyr{sup 3} octreotide (DOTA-TOC) and {sup 18}F-FDG was performed in 31 patients with thyroid cancer (TC). These 31 patients comprised 18 with radioiodine non-avid differentiated TC (DTC) including 6 papillary TC (PTC), 8 follicular TC (FTC) and 4 oxyphilic TC (oxyTC), 5 with anaplastic TC (ATC), and 8 with medullary TC (MTC). The PET results were compared in a region-based evaluation. All patients underwent a PET study with {sup 68}Ga-DOTA-LAN, 28 patients with {sup 68}Ga-DOTA-TOC and 28 patients with {sup 18}F-FDG. A lack of SSTR expression was found in 13 of the 31 patients (42 %) with negative results with both SSTR tracers in 12 patients. Ambiguous results with both SSTR tracers were observed in one patient. High tracer uptake in SSTR PET images was seen in seven DTC patients (39 %; two PTC, three FTC, two oxyTC), in four ATC patients (80 %) and in six MTC patients (75 %). Lesions showing aerobic glycolysis on {sup 18}F-FDG PET were found in 24 of 28 patients (86 %) with corresponding positive results with {sup 68}Ga-DOTA-LAN in 35 % and with {sup 68}Ga-DOTA-TOC in 29 %. The heterogeneous SSTR profile of TC tumour lesions needs to be evaluated using different SSTR PET tracers to characterize more closely the SSTR subtype affinities in patients with progressive TC in order to further stratify therapy with SSTR therapeutics. (orig.)

  11. A cohort study of thyroid disease in relation to fallout from nuclear weapons testing

    OBJECTIVE--To estimate individual radiation doses and current thyroid disease status for a previously identified cohort of 4818 schoolchildren potentially exposed to fallout from detonations of nuclear devices at the Nevada Test Site between 1951 and 1958. DESIGN--Cohort analytic study. SETTING--Communities in southwestern Utah, southeastern Nevada, and southeastern Arizona. PARTICIPANTS--Individuals who were still residing in the three-state area (n = 3122) were reexamined in 1985 and 1986, and information on the subjects' and their mothers' milk and vegetable consumption during the fallout period was obtained by telephone interview (n = 3545). After exclusions to eliminate missing data and confounding factors, 2473 subjects were available for analysis. MAIN OUTCOME MEASURES--Individual radiation doses to the thyroid were estimated by combining consumption data with radionuclide deposition rates provided by the US Department of Energy and a survey of milk producers. Relative risk models adjusted for age, sex, and state were fitted using maximum likelihood to period prevalence data for thyroid carcinomas, neoplasms, and nodules. RESULTS--Doses ranged from 0 mGy to 4600 mGy, and averaged 170 mGy in Utah. There was a statistically significant excess of thyroid neoplasms (benign and malignant; n = 19), with an increase in excess relative risk of 0.7% per milligray. A relative risk for thyroid neoplasms of 3.4 was observed among 169 subjects exposed to doses greater than 400 mGy. Positive but nonsignificant dose-response slopes were found for carcinomas and nodules. CONCLUSIONS--Exposure to Nevada Test Site-generated radioiodines was associated with an excess of thyroid neoplasms. The conclusions are limited by the small number of exposed individuals and the low incidence of thyroid neoplasms

  12. Cost-effective and non-invasive automated benign and malignant thyroid lesion classification in 3D contrast-enhanced ultrasound using combination of wavelets and textures: a class of ThyroScan algorithms.

    Acharya, U R; Faust, O; Sree, S V; Molinari, F; Garberoglio, R; Suri, J S

    2011-08-01

    Ultrasound has great potential to aid in the differential diagnosis of malignant and benign thyroid lesions, but interpretative pitfalls exist and the accuracy is still poor. To overcome these difficulties, we developed and analyzed a range of knowledge representation techniques, which are a class of ThyroScan algorithms from Global Biomedical Technologies Inc., California, USA, for automatic classification of benign and malignant thyroid lesions. The analysis is based on data obtained from twenty nodules (ten benign and ten malignant) taken from 3D contrast-enhanced ultrasound images. Fine needle aspiration biopsy and histology confirmed malignancy. Discrete Wavelet Transform (DWT) and texture algorithms are used to extract relevant features from the thyroid images. The resulting feature vectors are fed to three different classifiers: K-Nearest Neighbor (K-NN), Probabilistic Neural Network (PNN), and Decision Tree (DeTr). The performance of these classifiers is compared using Receiver Operating Characteristic (ROC) curves. Our results show that combination of DWT and texture features coupled with K-NN resulted in good performance measures with the area of under the ROC curve of 0.987, a classification accuracy of 98.9%, a sensitivity of 98%, and a specificity of 99.8%. Finally, we have proposed a novel integrated index called Thyroid Malignancy Index (TMI), which is made up of texture features, to diagnose benign or malignant nodules using just one index. We hope that this TMI will help clinicians in a more objective detection of benign and malignant thyroid lesions. PMID:21728394

  13. The Evolution of Biomarkers in Thyroid Cancer—From Mass Screening to a Personalized Biosignature

    Raymon H. Grogan

    2010-05-01

    Full Text Available Thyroid cancer is the most common malignancy of the endocrine system. The diagnosis of thyroid nodules, made by neck examination and ultrasonography, is a common event occurring in over 50% of the patient population over the age of 50. Yet, only 5% of these patients will be diagnosed with cancer. Fine needle aspiration biopsy is the gold standard for diagnosing thyroid nodules. However, 10–15% of these biopsies are inconclusive, ultimately requiring a diagnostic thyroid lobectomy. Consequently, research in thyroid biomarkers has become an area of active interest. In the 40 years since calcitonin was first described as the biomarker for medullary thyroid cancer, new biomarkers in thyroid cancer have been discovered. Advances in genomic and proteomic technologies have defined many of these novel thyroid biomarkers. The purpose of this article is to provide a comprehensive literature review of how these biomarkers have evolved from simple screening tests into a complex array of multiple markers to help predict the malignant potential and genetic signature of thyroid neoplasms.

  14. The Evolution of Biomarkers in Thyroid Cancer—From Mass Screening to a Personalized Biosignature

    Thyroid cancer is the most common malignancy of the endocrine system. The diagnosis of thyroid nodules, made by neck examination and ultrasonography, is a common event occurring in over 50% of the patient population over the age of 50. Yet, only 5% of these patients will be diagnosed with cancer. Fine needle aspiration biopsy is the gold standard for diagnosing thyroid nodules. However, 10–15% of these biopsies are inconclusive, ultimately requiring a diagnostic thyroid lobectomy. Consequently, research in thyroid biomarkers has become an area of active interest. In the 40 years since calcitonin was first described as the biomarker for medullary thyroid cancer, new biomarkers in thyroid cancer have been discovered. Advances in genomic and proteomic technologies have defined many of these novel thyroid biomarkers. The purpose of this article is to provide a comprehensive literature review of how these biomarkers have evolved from simple screening tests into a complex array of multiple markers to help predict the malignant potential and genetic signature of thyroid neoplasms

  15. Diagnostic value of PET/CT combined with ultrasound for differentiating malignant from benign thyroid lesions incidentally found by 18F-FDG PET/CT

    Objective: To investigate the value of 18F-FDG PET/CT combined with ultrasound (US) imaging for differentiating malignant from benign thyroid lesions. Methods: Seventy-three thyroid lesions incidentally found by 18F-FDG PET/CT imaging were enrolled.Final diagnosis was confirmed by histopathology or cytology. Interpretations of PET/CT and US included a subjective classification on a 3-point scale (0: probably benign, 1: uncertain, 2: probably malignant), along with the longest diameter measure and SUVmax of the thyroid lesions. The accuracies of PET/CT, US and PET/CT + US for differentiating malignant from benign thyroid lesions were compared by ROC curve analysis, with a Z test to compare the AUC. The Kappa test, t-test and χ2 test were also used. Results: Of the 73 thyroid lesions, there were 43 (59%) malignant and 30 (41%) benign lesions. The SUVmax of malignant lesions was significantly higher than that of benign lesions (7.0±8.1 vs 4.1±3.8; t=2.062, P=0.043), and the longest diameter of malignant lesions was smaller than that of benign lesions (2.0 ± 1.1 vs 2.7 ± 1.4; t=2.628, P=0.011). To differentiate malignant from benign thyroid lesions, the AUC of SUVmax was 0.580 (95% CI: 0.448-0.713). After analyzing the features of PET and CT images,the AUC of PET/CT was significantly improved to 0.763 (95% CI: 0.647-0.878; Z=2.033, P=0.042). The AUC of US (0.905, 95% CI: 0.826-0.983) and PET/CT + US (0.909, 95% CI: 0.840-0.979) were significantly higher than that of PET/CT (Z =1.992 and 2.112, both P<0.05) or SUVmax (Z=4.120 and 4.276, both P<0.001). The optimal sensitivity, specificity, accuracy, positive predictive value, negative predictive value were 42% (18/43), 83% (25/30), 59% (43/73), 78% (18/23), 50% (25/50) for SUVmax, 79% (34/43), 80% (24/30), 79% (58/73), 85% (34/40), 73%(24/33) for PET/CT, 84% (36/43), 90% (27/30), 86% (63/73), 92%(36/39), 79% (27/34) for US, and 98% (42/43), 67% (20/30), 85% (62/73), 81%(42/52), 95% (20/21) for PET/CT + US, respectively. Agreement was poor for SUVmax (Kappa=0.229, P=0.023), fair for PET/CT (Kappa=0.582, P<0.001), and good for US (Kappa=0.668, P<0.001) and PET/CT + US (Kappa=0.674, P<0.001). Compared with PET/CT, the sensitivity of PET/CT + US was significantly higher (χ2=6.125, P=0.008), while the specificity had no statistical difference (χ2=2.250, P>0.05). Conclusion: By combining PET/CT with US, the diagnostic efficacy is significantly improved in differentiating malignant from benign thyroid lesions found by 18F-FDG PET/CT. (authors)

  16. Neoplasms in persons treated with x-rays in infancy: fourth survey in 20 years

    The incidence of neoplastic disease was determined by a mail survey of 2,872 young adults given x-ray treatments in infancy and of their 5,005 nonirradiated siblings. Newly diagnosed benign and malignant neoplasms appeared more frequently in the irradiated subjects than in their siblings or the age- and sex-matched general population of upstate New York. Only thyroid neoplasms occurred in sufficient numbers to permit statistical analysis for the effects on incidence of sex, age, and dose, and of being in a high-risk group (sub-group C). Thyroid cancers developed earlier in life than did benign neoplasms, especially in boys; benign goiters occurred after smaller doses, predominantly in females. Females had a greater risk of developing thyroid cancer than males--2.3 times for females of all ages and 5 times for young adults. Except for young adult females, there was no definite age effect. The risk of cancer (but not of benign goiter) was proportional to the thyroid dose, with a linear risk coefficient of 2.5/year/million people exposed to 1 rad for the entire irradiated population and 4.0 for subgroup C. The high risk of thyroid cancer in subgroup C may be the result of the high percentage of Jews, who had a 3.4-fold greater risk than non-Jews. Young adult Jewish females had a 17-fold increased risk. An incidental observation was an apparent increased incidence of asthma and rare diseases with abnormal immunologic features in the irradiated population. (auth)

  17. Surgery for Benign Salivary Neoplasms.

    Gillespie, M Boyd; Iro, Heinrich

    2016-01-01

    Salivary neoplasms are relatively infrequent entities that account for only 4% of tumors of the head and neck. Although slow-growing lesions of the preauricular area and submandibular space are often confused with sebaceous cysts, lymph nodes, or lipomas by the non-otolaryngologist, otolaryngologists-head and neck surgeons recognize that all preauricular and submandibular masses should be considered a salivary neoplasm until proven otherwise. Surgery remains the treatment of choice for benign salivary gland neoplasms; however, techniques continue to evolve in order to preserve salivary function and reduce surgical morbidity. The goals of management of benign salivary neoplasms include accurate diagnosis of the lesion, complete surgical extirpation, and functional preservation of adjacent cranial nerves. Accurate diagnosis is aided by appropriate preoperative physical examination, imaging, and fine needle aspiration biopsy. Benign neoplasms typically present as slow-growing, painless, mobile masses without adverse features, such as tissue fixation, ulceration, a cranial nerve deficit, or regional lymphadenopathy. Preoperative imaging with ultrasonography, computed tomography, or magnetic resonance imaging reveals well-circumscribed lesions without an infiltrative growth pattern or associated adenopathy. Fine needle aspiration biopsy may favor a benign neoplasm, supporting the clinical presentation. Surgery for a benign or malignant salivary neoplasm is in essence a false dichotomy since the surgeon can never be completely confident of the diagnosis until the specimen is removed. The surgeon must recognize the significant overlap between benign and malignant salivary masses in terms of clinical presentation, imaging, and cytology, which requires the surgeon to remain vigilant and flexible at the time of surgery should tissue characteristics or frozen section analysis suggest a malignant process. PMID:27093461

  18. HYALINIZING TRABECULAR ADENOMA FEIGNING PAPILLARY CARCINOMA THYROID: CASE REPORT WITH REVIEW OF LITERATURE

    Kandukuri Mahesh

    2014-05-01

    Full Text Available Hyalinizing Trabecular Adenoma (HTA of the thyroid is a rare neoplasm that was first described by Carney in 1987. It is a tumor of follicular derivation with peculiar nuclear, architectural, histochemical, and immunohistochemical features. We report a case of Hyalinizing trabecular adenoma in a 36-year-old woman with enlarged thyroid lobe. Ultrasonographic features and fine needle aspiration cytology (FNAC of the enlarged thyroid was performed and the diagnosis given was Papillary carcinoma of the thyroid. The patient underwent total thyroidectomy, with a histopathological diagnosis of hyalinizing trabecular Adenoma (HTA. We present this case in view of its rarity and to discuss the clinical and diagnostic approach, including the role of FNAC, and the pathologic features of HTA with special reference to the possible differential diagnosis and also review of literature. Although rare cases of malignant Hyalinizing trabecular adenoma (HTA have been documented, this tumor should be considered a benign neoplasm or at most, a neoplasm of extremely low malignant potential, however invasion of the capsule should be considered on histopathology. An awareness of hyalinizing trabecular adenomas and their characteristic features is valuable for their recognition and management as well as for the possible prevention of over diagnosis and over treatment for benign disease

  19. Thyroid metastasis from renal cell carcinomaA case report after 9 years

    Macedo-Alves, D.; Koch, P.; Soares, V.; Gouveia, P.; Honavar, M.; Taveira-Gomes, A.

    2015-01-01

    Introduction The thyroid gland is a rare site of clinically detectable tumor metastasis. As thyroid tumors are usually assumed to be primary in origin, its recognition as a secondary is difficult. Presentation of case We report a case of an 80-year old female who was referred to the Department of Surgery for a symptomatic thyroid nodule. Her medical history included a radical nephrectomy for renal cell carcinoma (RCC) nine years ago. During follow-up a pancreatic nodule was noted suggestive of a neuroendocrine tumor and the von Hippel-Lindau syndrome had to be ruled out. The fine-needle aspiration biopsy (FNAB) guided by ultrasound (US) of the thyroid nodule was inconclusive and a hemithyroidectomy and isthmectomy were performed. Histological examination revealed metastasis of a clear cell carcinoma. Discussion RCC disseminates in an unpredictable manner and can show late recurrences. Although secondary involvement of the thyroid gland by RCC is rare, it is still one of the more common neoplasms to metastasize to this site. There are no specific clinical features and few characteristic findings of metastatic thyroid carcinoma on imaging studies. FNAB is a useful procedure to diagnose metastatic thyroid cancer, but one should remain suspicious when the result for malignant cells is negative or indeterminate. After thyroidectomy the diagnosis of RCC is confirmed immunohistochemically. There is a clear survival benefit if a surgical approach to the thyroid metastasis is chosen. Conclusion Thyroid metastasis should be considered in patients with a thyroid nodule and positive history for RCC. PMID:26421840

  20. HYALINISING TRABECULAR TUMOR- THYROID

    Bharath; Vijayalaxmi

    2013-01-01

    ABSTRACT: BACKGROUND: Hyalinising trabecular tumors of thyroid is an in teresting but uncommon neoplasm of thyroid. This is presented bec ause of its peculiar morphologic features, including encapsulation, trabecular pattern and marke d hyalinization. OBJECTIVES: To know the morphologic feature and its histological behavio r. METHOD: Hemithyroidectomy specimen was received with fixative. The specimen was grossed , bits were taken from appropriate area...

  1. Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions

    Purpose: Evaluation of accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of different thyroid lesions. Patients and methods: This is a retrospective study of 296 diagnosed cases of thyroid nodules referred to cytology unit, pathology department, NCI, who underwent FNAC for diagnosis. The results were categorized according to the recent Bethesda classification into: insufficient for diagnosis, benign, atypical follicular lesion of undetermined significance, follicular neoplasm, suspicious for malignancy, and malignant sampling. The final histologic diagnosis and/or clinico-radiologic follow-up assessment for non-neoplastic lesions were considered the gold standard. Results: The study included 296 cases presented with thyroid nodules who underwent diagnostic thyroid FNAC. Female to male ratio was 5.2:1, and the median age was 44 years. Ninety-eight cases (33.1%) were diagnosed as benign, 40 cases (13.5%) as follicular lesion of undetermined significance, 49 cases (16.5%) as follicular neoplasm, 30 cases (10.1%) as suspicious for malignancy, 58 cases (19.5%) as malignant, and 21 cases (7.1%) as unsatisfactory. Nodular hyperplasia represented the majority of benign cases (89.8%), while papillary carcinoma was the most frequent malignant lesion (72.4%). Cytologic diagnoses were compared with their corresponding final histologic ones. FNAC achieved a sensitivity of 92.8, a specificity of 94.2%, a positive predictive value of 94.9%, a negative predictive value of 91.8%, a false positive rate of 7.2%, a false negative rate of 5.8%, and a total accuracy of 93.6%.

  2. Percutaneous alcohol injection (PAI) of thyroid nodule

    Percutaneous alcohol injection (PAI) is a new sclerosing method for treatment of diseases such as cyst, malignant tumor and benign neoplasm. Percutaneous alcohol injection of 26 cases (adenomatous goiter 23 cases, follicular adenoma 2 cases and recurrent papillary carcinoma 1 case) of thyroid nodules were done with 23-G needle under the guidance of ultrasonography. After then, we followed up thyroid function test, ultrasonographical size and volume of nodules, cytologic examination and complications of treatment. The results were as follows: 1. With 0.5-1 cc alcohol injection, the mean volume of thyroid nodules were reduced after PAI to 59% (N=26) at 1 month, and to 33% (N=14, cases of additional PAI) at 6 month, of the base line volume (100%) before PAI. 2. There were no significant changes at 1 and 6 months follow-up of TFT after PAI in all cases as compared with base line studies. 3. In conclusion, ultrasonic guided PAI for thyroid nodule is simple, useful and cost-effective method, and recommendable in cases of mixed and solid nodules resistant to medical treatment, refuse of surgery because of cosmetic problem and recurrent malignant tumors

  3. Additional value of FDG PET/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms of the pancreas with mural nodules

    This study aimed at determining the additional value of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms (IPMNs) of the pancreas with mural nodules. This retrospective review of medical records was approved by our institutional review board. The preoperative PET/CT images of 16 non-diabetic patients with surgically proven IPMN, where mural nodules of 3 mm or larger were shown by preoperative contrast-enhanced CT, were retrospectively evaluated. The 16 patients were divided into two groups: 7 patients with benign IPMN [adenoma (n=1) and borderline tumor (n=6)] and 9 patients with malignant IPMN [carcinoma in situ (CIS) (n=8) and invasive carcinoma (n=1)]. Nuclear medicine physician blinded to the pathologic assessment of malignancy of IPMN set a spherical volume of interest (VOI) over the mural nodules on PET/CT images and recorded the peak standardized uptake value (SUVmax) in the VOI, referring the contrast-enhanced CT images. Statistical differences in the size of mural nodule, the diameter of main pancreatic duct (MPD), and SUVmax of the tumors between benign IPMNs and malignant IPMNs were compared using the Mann-Whitney U test. Statistical significance was set at pmax of the malignant IPMNs with mural nodules of 3 mm or larger was higher than that of benign IPMNs (2.7±0.6 vs. 1.9±0.3, p<0.01). Meanwhile, there was no significant difference in mural nodule diameter and MPD diameter between the two groups. FDG PET/CT showed an excellent diagnostic accuracy for the differentiation between malignant and benign IPMNs with mural nodules: the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy in malignant IPMN with mural nodule of FDG PET/CT were 77.8, 100, 100, 77.8, and 87.5 for the cutoff value of 2.3; and 100, 57.1, 75.0, 100, and 81.3 for the cutoff value of 2.0, respectively. The result of this study indicates that FDG PET/CT can provide additional information for the differentiation between benign and malignant IPMNs of the pancreas with mural nodules. (author)

  4. Small intestinal neoplasms.

    Gill, S S; Heuman, D M; Mihas, A A

    2001-10-01

    Small intestinal neoplasms are uncommonly encountered in clinical practice. They may occur sporadically, in association with genetic diseases (e.g., familial adenomatous polyposis coli or Peutz-Jeghers syndrome), or in association with chronic intestinal inflammatory disorders (e.g., Crohn's disease or celiac sprue). Benign small intestinal tumors (e.g., leiomyoma, lipoma, hamartoma, or desmoid tumor) usually are asymptomatic but may present with intussusception. Primary malignancies of the small intestine-including adenocarcinoma, leiomyosarcoma, carcinoid, and lymphoma-may present with intestinal obstruction, jaundice, bleeding, or pain. Extraintestinal neoplasms may involve the intestine via contiguous spread or peritoneal metastasis. Hematogenous metastases to the intestine from an extraintestinal primary are unusual and are most typical of melanoma. Because the small intestine is relatively inaccessible to routine endoscopy, diagnosis of small intestinal neoplasms is often delayed for months after onset of symptoms. When the diagnosis is suspected, enteroclysis is the most useful imaging study. Small bowel endoscopy (enteroscopy) is increasingly widely available and may permit earlier, nonoperative diagnosis. PMID:11588539

  5. Unusual Presentation of Cystic Papillary Thyroid Carcinoma

    Vijayraj S. Patil; Abhishek Vijayakumar; Neelamma Natikar

    2012-01-01

    Papillary thyroid carcinoma is the most common thyroid malignancy, accounting for 80% of all thyroid cancers. The most common presentation of thyroid cancer is an asymptomatic thyroid mass or a nodule. Usually as thyroid enlarges, it extends in to mediastinum. Papillary thyroid carcinoma presentation as multiple true cystic swelling extending from neck to anterior chest wall in subcutaneous plane is not present in the literature. We present a rare case of cystic papillary thyroid carcinoma wh...

  6. Late cutaneous metastases to the face from malignant pleural mesothelioma: A case report and review of the literature

    Lawrence Julia

    2009-11-01

    Full Text Available Abstract Background Malignant Mesothelioma is a rare primary neoplasm affecting the serosal membranes. During its relative short course, this malignant neoplasm can give local and, rarely, distant haematogenous metastases in different organs. The reported metastatic sites include liver, lung, heart, brain, thyroid, adrenals, kidneys, pancreas, bone, soft tissue, skin and lymph nodes. Case Presentation We report a sixty one year-old man with a history of malignant pleural epithelioid mesothelioma treated with six cycles of Pemetrexed and Carboplatin completed 03/11/04 followed by radiotherapy to the drain site 250 Kv/TD20Gy/5F completed 13/12/2004. Then he developed multiple facial skin lesions 4 years later. These lesions were proved to be metastatic malignant sarcomatoid mesothelioma. Conclusion Mesothelioma metastases should be suspected in any known Mesothelioma patient with newly developed skin lesion.

  7. Correlation of FDG-PET in the thyroid nodules with ultrasonographic and pathologic results

    Yoo, E. H.; Yun, M. J.; Kim, E. K.; Park, J. S.; Lee, J. D. [Yonsei University Medical Center, Seoul (Korea, Republic of)

    2005-07-01

    To assess the aspect of fluorine-18-fluorodeoxyglucose (FDG) in the thyroid nodules and to find the correlation between ultrasonographic (US), pathologic and positron emission tomography (PET) results. We performed a retrospective review of patients who had pathologically confirmed thyroid neoplasm and who had undergone FDG-PET imaging from 9/2004 to 8/2005. There were 41 and 35 patients (9 men + 67 women, 52 years (29-76)) were confirmed to have papillary thyroid cancer by surgery and adenomatous hyperplasia by aspiration. 34 of the 41 patients underwent after US-guided aspiration biopsy, excepting 7 cases of thyroid incidentaloma (3 papillary cancers and 4 adenomatous hyperplasias) on PET. With the presence of perithyroidal extension and lymph node metastasis of papillary cancers in the pathologic report, malignant nodules were grouped to progressed and limited. We compared US findings and surgical results between thyroid nodules with and without FDG uptake on PET. 23 of the 41 papillary cancers and 9 of the 35 AHs showed increased FDG uptake. SUV of 23 papillary carcinoma and 9 AHs were similar (6.39{+-}6.14 and 5.3{+-}2.97). The size of thyroid nodules with FDG uptake was slightly larger than nodules without FDG uptake in both papillary cancer and AH. There are no remarkable difference of US findings between thyroid nodules with and without increased FDG uptake. 13 of 16 malignant nodules with SUV = 2 and 4 of 7 nodules with SUV < 2 were belonged to progressed group. There was significant difference of SUV and nodular between progressed and limited groups. Nodular size and SUV were positively correlated with each other (R = 0.56, P < 0, Pearson correlation). Thyroid nodules of increased FDG uptake are not necessarily indicative of malignant tumors. There are no remarkable US differences of thyroid nodules between with and without increased FDG uptake on PET. However, large malignant nodules show tendency to present increased FDG uptake and to be progressed.

  8. Correlation of FDG-PET in the thyroid nodules with ultrasonographic and pathologic results

    To assess the aspect of fluorine-18-fluorodeoxyglucose (FDG) in the thyroid nodules and to find the correlation between ultrasonographic (US), pathologic and positron emission tomography (PET) results. We performed a retrospective review of patients who had pathologically confirmed thyroid neoplasm and who had undergone FDG-PET imaging from 9/2004 to 8/2005. There were 41 and 35 patients (9 men + 67 women, 52 years (29-76)) were confirmed to have papillary thyroid cancer by surgery and adenomatous hyperplasia by aspiration. 34 of the 41 patients underwent after US-guided aspiration biopsy, excepting 7 cases of thyroid incidentaloma (3 papillary cancers and 4 adenomatous hyperplasias) on PET. With the presence of perithyroidal extension and lymph node metastasis of papillary cancers in the pathologic report, malignant nodules were grouped to progressed and limited. We compared US findings and surgical results between thyroid nodules with and without FDG uptake on PET. 23 of the 41 papillary cancers and 9 of the 35 AHs showed increased FDG uptake. SUV of 23 papillary carcinoma and 9 AHs were similar (6.39±6.14 and 5.3±2.97). The size of thyroid nodules with FDG uptake was slightly larger than nodules without FDG uptake in both papillary cancer and AH. There are no remarkable difference of US findings between thyroid nodules with and without increased FDG uptake. 13 of 16 malignant nodules with SUV = 2 and 4 of 7 nodules with SUV < 2 were belonged to progressed group. There was significant difference of SUV and nodular between progressed and limited groups. Nodular size and SUV were positively correlated with each other (R = 0.56, P < 0, Pearson correlation). Thyroid nodules of increased FDG uptake are not necessarily indicative of malignant tumors. There are no remarkable US differences of thyroid nodules between with and without increased FDG uptake on PET. However, large malignant nodules show tendency to present increased FDG uptake and to be progressed

  9. Anaplastic thyroid cancer, tumorigenesis and therapy.

    O'Neill, J P

    2010-03-01

    Anaplastic thyroid cancer (ATC) is a fatal endocrine malignancy. Current therapy fails to significantly improve survival. Recent insights into thyroid tumorigenesis, post-malignant dedifferentiation and mode of metastatic activity offer new therapeutic strategies.

  10. Diagnostic value of PET and PET-CT for thyroid nodule

    18F-FDG PET and PET-CT has become an important tool in the postoperative management of de-differentiated thyroid cancer. But the value of this method in the preoperative diagnosis of thyroid nodules is unclear.Various groups of investigators have explored the potential role of 18F-FDG PET and PET-CT in patients with benign and malignant thyroid neoplasms especially those with indeterminate fine needle aspiration cytology findings. With the increasing demand for 18F-FDG PET and PET-CT,clinicians are faced with the challenge of managing an increasing number of 18F-FDG PET and PET-CT detected thyroid incidentally because their significance remains unclear. The standardized uptake value of 18F-FDG is the most common semi-quantitative index and can be used to characterize malignant and benign thyroid nodules by describing the metabolism of glucose. This article reviewed the value of SUV in differential diagnosis of malignant and benign thyroid nodules. (authors)

  11. Late bone metastasis from an apparently benign oncocytic follicular thyroid tumor

    Boronat, Mauro; Cabrera, Juan J; Perera, Carmen; Isla, Concepcin; Nvoa, Francisco J

    2013-01-01

    A man underwent total thyroidectomy for goiter when he was 62 years old. The pathology report informed on a 5.5?cm oncocytic follicular adenoma and a 3.5?mm papillary microcarcinoma. Due to the papillary tumor, he was treated with ablative radioiodine therapy and suppressive doses of levothyroxine. After uneventful follow-up for 9 years, increased levels of serum thyroglobulin were detected. Further imaging studies including a whole body scan (WBS) after an empirical dose of 200?mCi 131I were negative. Two years later, a 99mTc SestaMIBI WBS and a 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography showed a well-delimited focal uptake in the right femur. A bone biopsy of the lesion demonstrated metastasis of follicular thyroid carcinoma. Retrospective histological reexamination of available material from the primary oncocytic thyroid tumor failed to reveal definitive traits of malignancy. Learning points Oncocytic follicular thyroid tumors are a relatively uncommon variant of follicular thyroid neoplasms mostly composed of distinctive large oxyphilic cells (Hrthle cells).Criteria for the distinction between benign and malignant oncocytic neoplasms are not different from those used in the diagnosis of ordinary follicular tumors.Some cases of apparently benign oncocytic neoplasms have been found to develop malignant behavior.Search to rule out vascular and capsular invasion should be particularly exhaustive in histological assessment of oncocytic thyroid tumors.Even so, long-term surveillance remains appropriate for patients with large apparently benign oncocytic tumors. PMID:24616777

  12. 131I treatment for thyroid cancer and the risk of developing salivary and lacrimal gland dysfunction and a second primary malignancy: a nationwide population-based cohort study

    The aim of this study was to determine the prevalence of salivary and lacrimal gland dysfunction and a second primary malignancy in patients from Taiwan with thyroid cancer after radioiodine therapy. This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database from 2000 to 2011. A total of 1,834 thyroid cancer patients treated with 131I therapy and 1,834 controls (thyroid cancer without 131I therapy) selected by 1:1 matching on a propensity score were enrolled. The cumulative 131I dose in each patient was calculated. A Cox proportional hazards model was applied to estimate the effect of radiation from the 131I therapy on the risk of salivary and lacrimal gland impairment as well as second primary malignancies in terms of hazard ratios (HRs) and 95 % confidence intervals (CIs). In patients treated with 131I therapy and in controls, the incidence rates of salivary gland dysfunction were 6.76 and 1.01 per 10,000 person-years, respectively (HR 6.81, 95 % CI 0.74 - 55.3), the incidence rates of keratoconjunctivitis sicca (KCS) were 13.6 and 16.3 per 10,000 person-years, respectively (HR 0.84, 95 % CI 0.41 - 1.73), and the incidence rates of second primary malignancy were 76.7 and 62.4 per 10,000 person-years, respectively (HR 1.23, 95 % CI 0.88 - 1.72). The risk of salivary secretion impairment significantly increased with increasing administered doses (HR 14.3, 95 % CI 1.73 - 119.0). However, there was no increase in the incidence of KCS or secondary cancer in patients treated with higher doses. 131I therapy insignificantly increased the risk of salivary gland dysfunction and second primary malignancy. In patients with higher cumulative doses, an increase in the incidence of salivary gland dysfunction was observed. By contrast, we did not find an association between 131I treatment and KCS development. (orig.)

  13. Asbestos-related malignancy

    Antmann, K.; Aisner, J.

    1986-01-01

    This book contains 20 chapters. Some of the chapter titles are: The Radiology of Asbestosis and Related Neoplasms; Computed Tomography and Malignant Mesothelioma; Radiation Therapy for Pleural Mesothelioma; and Radiation Therapy of Peritoneal Mesothelioma.

  14. Asbestos-related malignancy

    This book contains 20 chapters. Some of the chapter titles are: The Radiology of Asbestosis and Related Neoplasms; Computed Tomography and Malignant Mesothelioma; Radiation Therapy for Pleural Mesothelioma; and Radiation Therapy of Peritoneal Mesothelioma

  15. Papillary thyroid microcarcinoma in a thyroid pyramidal lobe

    We report an extremely rare case of papillary thyroid microcarcinoma (PTMC) in the thyroid pyramidal lobe (TPL). A 48-year-old woman underwent ultrasound-guided fine-needle aspiration for a small thyroid nodule in the right lobe in local clinic, and it revealed a malignant cytology. On preoperative ultrasonography for tumor staging in our hospital, another small suspiciously malignant hypoechoic nodule was detected in the left TPL. Total thyroidectomy and central nodal dissection were performed. Histopathology confirmed PTMCs in the left TPL and both thyroid lobes. Ultrasonography for TPL should be required for complete evaluation of possible multifocality of thyroid malignancy.

  16. Papillary thyroid microcarcinoma in a thyroid pyramidal lobe

    Ha, Tae Kwan; Kim, Dong Wook; Park, Ha Kyoung; Jung, Soo Jin [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-12-15

    We report an extremely rare case of papillary thyroid microcarcinoma (PTMC) in the thyroid pyramidal lobe (TPL). A 48-year-old woman underwent ultrasound-guided fine-needle aspiration for a small thyroid nodule in the right lobe in local clinic, and it revealed a malignant cytology. On preoperative ultrasonography for tumor staging in our hospital, another small suspiciously malignant hypoechoic nodule was detected in the left TPL. Total thyroidectomy and central nodal dissection were performed. Histopathology confirmed PTMCs in the left TPL and both thyroid lobes. Ultrasonography for TPL should be required for complete evaluation of possible multifocality of thyroid malignancy.

  17. Automated screening of pigmentary skin neoplasms

    We have analysed the clinical symptoms and the malignization signs of pigmented skin neoplasms. We have estimated the complex of clinical parameters which could be measured for the purpose of skin screening diagnostic via digital image processing. Allowable errors of clinical parameter characterization have been calculated, and the origin of these errors has been discussed. Proposed technique for automated screening of pigmentary skin neoplasms should become an effective tool for early skin diagnostics

  18. Neck neoplasms: MR imaging. Part I. Initial evaluation.

    Glazer, H S; Niemeyer, J H; Balfe, D M; Devineni, V R; Emami, B; Hayden, R E; Aronberg, D J; Levitt, R G; Ward, M P; Sagel, S S

    1986-08-01

    Untreated neoplasms of the neck (tumors of the oropharynx, supraglottic area, carotid body, and thyroid, in addition to malignant lymphadenopathy) were evaluated in 23 patients with magnetic resonance (MR) imaging. The results were compared with computed tomographic (CT) scans in 20 patients. Contrast between tumor and fat was best on relatively T1-weighted images (500/30-35 [TR msec/TE msec]), whereas separation of tumor and muscle was best with relatively T2-weighted pulse sequences (1,500/90). Balanced images (1,500/30-35) provided best overall image quality and best demonstrated vascular anatomy. MR imaging was usually superior to CT in showing the relationship of tumor mass to muscle. MR imaging and contrast material-enhanced CT were equivalent in most patients in defining vascular anatomy, but MR imaging was superior when intravenous contrast material was not administered. However, CT was more helpful in showing bone and cartilage anatomy, and in some patients CT also was better in showing airway abnormalities. Despite these limitations, MR imaging is a promising imaging technique for studying neoplasms of the neck. PMID:3726111

  19. Metastatic neoplasms of the central nervous system

    Metastatic neoplasms to the central nervous system are often encountered in the practice of surgical neuropathology. It is not uncommon for patients with systemic malignancies to present to medical attention because of symptoms from a brain metastasis and for the tissue samples procured from these lesions to represent the first tissue available to study a malignancy from an unknown primary. In general surgical pathology, the evaluation of a metastatic neoplasm of unknown primary is a very complicated process, requiring knowledge of numerous different tumor types, reagents, and staining patterns. The past few years, however, have seen a remarkable refinement in the immunohistochemical tools at our disposal that now empower neuropathologists to take an active role in defining the relatively limited subset of neoplasms that commonly metastasize to the central nervous system. This information can direct imaging studies to find the primary tumor in a patient with an unknown primary, clarify the likely primary site of origin in patients who have small tumors in multiple sites without an obvious primary lesion, or establish lesions as late metastases of remote malignancies. Furthermore, specific treatments can begin and additional invasive procedures may be prevented if the neuropathologic evaluation of metastatic neoplasms provides information beyond the traditional diagnosis of ''metastatic neoplasm.'' In this review, differential cytokeratins, adjuvant markers, and organ-specific antibodies are described and the immunohistochemical signatures of metastatic neoplasms that are commonly seen by neuropathologists are discussed

  20. Differentiated thyroid carcinoma in lingual thyroid.

    Sturniolo, Giacomo; Violi, Maria Antonia; Galletti, Bruno; Baldari, Sergio; Campenn, Alfredo; Vermiglio, Francesco; Moleti, Mariacarla

    2016-01-01

    The lingual thyroid is the most common form of thyroid ectopy. The ectopic tissue may display any disease affecting the thyroid, including malignancies, which have an estimated incidence of less than 1%. To date only 51 cases of lingual thyroid cancer were reported. Analogously to what observed in orthotopic thyroid, papillary carcinoma is the predominant histotype in lingual thyroid carcinoma. The higher frequency of lingual follicular thyroid carcinoma previously reported is possibly related to histological misclassification in some early reports, prior to the standardization of histological typing of differentiated thyroid carcinomas. Nonetheless, the frequency of the follicular histotype is not negligible, accounting for about one-third of the reported cases. Both natural history and prognosis of lingual thyroid carcinoma are poorly known, likely because of the rarity of the disease and the heterogeneity in the therapeutic approach. However, among the cases more recently reported, surgical excision of the mass, either alone or followed by radioiodine ablation, is the first-line approach, with only two cases treated by radioiodine alone. The nonsignificant rate of neoplastic transformation in lingual thyroid should encourage efforts to obtain a widely accepted consensus for the management of this rare condition, along with standardization of either diagnostic or therapeutic handling of malignancies arising in ectopic thyroid. PMID:25987346

  1. TROP-2 expression in papillary thyroid carcinoma: Potential Diagnostic Utility.

    Simms, Anthony; Jacob, Reuben P; Cohen, Cynthia; Siddiqui, Momin T

    2016-01-01

    TROP-2 is a type I transmembrane glycoprotein which is over-expressed in various malignancies, and is related to epithelial cell adhesion molecule (EpCAM), also called TROP-1, gp40, and KSA. In this study, we evaluated TROP-2 expression in papillary thyroid carcinoma (PTC) and compared it to other thyroid neoplastic and non-neoplastic lesions. Immunohistochemical (IHC) evaluation for TROP-2 was performed on 137 thyroid fine needle aspiration (FNA) cell blocks (CB) which included classic PTC (64), follicular variant PTC (FVPTC) (10), anaplastic thyroid carcinoma (AC) (2), medullary carcinoma (MC) (8), follicular neoplasms (FN) (8), Hurthle cell neoplasms (HCN) (9), follicular lesion of uncertain significance (FLUS) (12), and benign thyroid nodule (BTN) (24). IHC for TROP-2 expression was also performed on 331 BTN and malignant tumor tissue sections in tissue microarray (TMA). Membranous staining in >5% of tumor cells was considered positive. TROP-2 stained 61 of 64 PTC CB, 7 of 10 FVPTC CB, and 9 of 12 FLUS CB. All other cases were negative for TROP-2. TROP-2 showed a sensitivity of 95.31% and specificity of 89% for classic PTC in FNA CB. In TMA samples, TROP-2 stained 54 of 60 classic PTC cases and hence showed a high sensitivity and specificity. All BTN in CB and TMA were negative. We conclude that TROP-2 is a highly sensitive and specific IHC marker for identifying classic PTC. TROP-2 may play an important role in diagnosing classic PTC, especially in equivocal cases. This study also identifies a strong role for TROP-2 in separating PTC from BTN. PMID:26481593

  2. The Role of Insulin-Like Growth Factor 1 in the Development of Benign and Malignant Thyroid Nodules

    Ayşe Karadayı

    2012-06-01

    Full Text Available Objective: This study aims to investigate the role of IGF-1 in the development of nodular thyroid disease. Material and Methods: A total number of 100 consecutive patients operated for nodular thyroid disease in our institution were included in this prospective study. In addition to classical pathological examinations, nodules and extranodular healthy tissues were sampled and immunochemically stained for IGF-1. The materials were independently evaluated using an Allred Scoring System ranging from 0 to 8. If the score was ≥1, the tissue was accepted as IGF-1 positive.Results: IGF-1 positivity was observed in 88% and 58% of the samples obtained from nodules and extranodular healthy tissues, respectively. Allred 8-unit scores were higher in benign nodules (n=89; 4.1±2.3 and papillary carcinomas (n=7; 6.7±1.3, than in extranodular healthy tissues in the same patients (2.3±2.3 and 3.3±1.9, respectively; and higher in papillary carcinomas than in benign nodules, when the scores were compared to each other (p<0.01 for all comparisons. Conclusions: Allred 8-unit scores for IGF-1 increase in the presence of benign thyroid nodules, papillary cancer. The results of our study support the findings of previous studies demonstrating the role of IGF-1 in the development of thyroidal nodules.

  3. Mixed primary squamous cell carcinoma, follicular carcinoma, and micropapillary carcinoma of the thyroid gland: A case report.

    Dong, Su; Song, Xue-Song; Chen, Guang; Liu, Jia

    2016-08-01

    Primary squamous cell carcinoma of the thyroid gland is rare, and mixed squamous cell and follicular carcinoma is even rarer still, with only a few cases reported in the literature. The simultaneous presentation of three primary cancers of the thyroid has not been reported previously. Here we report a case of primary squamous cell carcinoma of the thyroid, follicular thyroid carcinoma, and micropapillary thyroid carcinoma. A 62-year-old female patient presented with complaints of pain and a 2-month history of progressively increased swelling in the anterior region of the neck. Fine-needle-aspiration cytology of both lobes indicated the possibility of the presence of a follicular neoplasm. Total thyroidectomy with left-sided modified radical neck dissection was performed. Postoperative pathological examination confirmed the diagnosis of thyroid follicular carcinoma with squamous cell carcinoma and micropapillary carcinoma of the thyroid. Thyroid-stimulating hormone suppressive therapy with l-thyroxine was administered. Radioiodine and radiotherapy also were recommended, but the patient did not complete treatment as scheduled. The patient remained alive more than 9 months after operation. The present case report provides an example of the coexistence of multiple distinct malignancies in the thyroid. PMID:26589365

  4. TERT Promoter Mutations Are Predictive of Aggressive Clinical Behavior in Patients with Spitzoid Melanocytic Neoplasms

    Lee, Seungjae; Barnhill, Raymond L.; Dummer, Reinhard; Dalton, James; Wu, Jianrong; Pappo, Alberto; Bahrami, Armita

    2015-01-01

    Spitzoid neoplasms constitute a morphologically distinct category of melanocytic tumors, encompassing Spitz nevus (benign), atypical Spitz tumor (intermediate malignant potential), and spitzoid melanoma (fully malignant). Currently, no reliable histopathological criteria or molecular marker is known to distinguish borderline from overtly malignant neoplasms. Because TERT promoter (TERT-p) mutations are common in inherently aggressive cutaneous conventional melanoma, we sought to evaluate thei...

  5. Investigation of thyroid nodules in the female population in Cyprus and in Romania

    Andra Piciu

    2015-09-01

    Full Text Available Background and aims. The most common thyroid disorders, with an increasing detection worldwide, are the thyroid nodules and thyroiditis, which leads to an increase of thyroid cancer incidence . In two different countries with a different exposure to risk factors for thyroid cancer, such as Cyprus and Romania, the rank of thyroid cancer among other neoplasms is very different: the 3rd most prevalent cancer among females in Cyprus and the 12th in Romania, respectively. Environmental chemicals, such as bisphenol A have a proven effect on the thyroid function. However, the relation between the exposure to the endocrine disruptor and the development of thyroid nodules, with a potential of malignant transformation has not been previously studied. The aim of the study was to investigate the potential factors that lead to the difference of thyroid nodules incidence in the mentioned countries.Methods. A pilot case-control study has been conducted in 2014-2015 in the Prof. Dr. Ion Chiricu?? Institute of Oncology, Cluj-Napoca, Romania and the Endocrinology Department of Archbishop Makarios III Hospital, Nicosia, Cyprus. Females older than 20 years with no medical history were recruited. Cases were women with ultrasound-confirmed thyroid nodules of size >3mm. Controls were women without thyroid nodules after ultrasound confirmation. All participants provided blood samples for measurements of the thyroid stimulating hormone (TSH, free thyroxin (FT4, anti- thyroglobulin (ATg and anti-thyroid peroxidase (ATPO; urine samples. Demographics, anthropometrics and other relevant information were provided through the administration of a questionnaire.Results. In Romania we selected 51 patients with thyroid nodules (case group and 41 without thyroid nodules (control group and in Cyprus 57 cases, respectively 65 controls. After the statistical analysis of the data collected we observed statistically significant differences between the populations of the two countries regarding BMI and the value of the thyroid hormones and antibodies.Conclusions. Using the data observed in this study, differences were found between Cyprus and Romania among females with thyroid nodules the BMI, and the level of thyroid hormones had statistically significant differences. This study reports preliminary data, further analysis of environmental exposures to chemical factors that might have a certain influence over the thyroid in the two countries will follow.

  6. The Challenge of Cancer Genomics in Rare Nervous System Neoplasms: Malignant Peripheral Nerve Sheath Tumors as a Paradigm for Cross-Species Comparative Oncogenomics.

    Carroll, Steven L

    2016-03-01

    Comprehensive genomic analyses of common nervous system cancers provide new insights into their pathogenesis, diagnosis, and treatment. Although analogous studies of rare nervous system tumors are needed, there are major barriers to performing such studies. Cross-species comparative oncogenomics, identifying driver mutations in mouse cancer models and validating them in human tumors, is a promising alternative. Although still in its infancy, this approach is being applied to malignant peripheral nerve sheath tumors (MPNSTs), rare Schwann cell-derived malignancies that occur sporadically, after radiotherapy, and in neurofibromatosis type 1. Studies of human neurofibromatosis type 1-associated tumors suggest that NF1 tumor suppressor loss in Schwann cells triggers cell-autonomous and intercellular changes, resulting in development of benign neurofibromas; subsequent neurofibroma-MPNST progression is caused by aberrant growth factor signaling and mutations affecting the p16(INK4A)-cyclin D1-CDK4-Rb and p19(ARF)-Mdm2-p53 cell cycle pathways. Mice with Nf1, Trp53, and/or Cdkn2a mutations that overexpress the Schwann cell mitogen neuregulin-1 or overexpress the epidermal growth factor receptor validate observations in human tumors and, to various degrees, model human tumorigenesis. Genomic analyses of MPNSTs arising in neuregulin-1 and epidermal growth factor receptor-overexpressing mice and forward genetic screens with Sleeping Beauty transposons implicate additional signaling cascades in MPNST pathogenesis. These studies confirm the utility of mouse models for MPNST driver gene discovery and provide new insights into the complexity of MPNST pathogenesis. PMID:26740486

  7. Diagnosis of malignancy in thyroid nodules by factor analysis of spectral and dynamic structures: A simultaneous dual-isotope dynamic study with thallium-201 and iodine-131

    The aim of this study was to identify malignant thyroid nodules using iodine-123 and thallium-201 simultaneous dynamic acquisition. The image sequences acquired were processed by factor analysis of spectral and dynamic structures (FASDS). Some 49 patients were investigated, and their diagnoses were confirmed by histological examination. Data processing enables the estimation of the spectra of the two isotopes and the evaluation of the kinetics and spatial structures related to each tracer. The superimposition of thallium and iodide sum images allowed us to delineate the nodule accurately. Two groups were defined: 21 patients who had 201Tl uptake in the nodule, and 28 who had none. In the first group, 5 nodules were carcinomas, whereas all nodules in the second group were benign. The results of the 201Tl dynamic study improved the diagnosis of carcinoma as the number of false-positive cases decreased. FASDS succeeds in extracting spectral and kinetic information, proving its usefulness in clinical diagnosis. (orig.)

  8. Axillary node metastasis from differentiated thyroid carcinoma with hrthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

    Chiofalo Maria

    2012-02-01

    Full Text Available Abstract Background Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Case presentation Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with "signet ring cells" and Hrthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Discussion and Conclusion Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. "Signet ring cell" is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare "signet ring cells" carcinomas so far described.

  9. Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

    Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with 'signet ring cells' and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. 'Signet ring cell' is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare 'signet ring cells' carcinomas so far described

  10. Value of the Diffusion-Weighted MRI in the Differential Diagnostics of Malignant and Benign Kidney Neoplasms – Our Clinical Experience

    Diffusion-weighted imaging (DWI) is an MRI modality using strong bipolar gradients to create a sensitivity of the signal to the thermally-induced Brownian motions of water molecules and in vivo measurement of molecular diffusion. The apparent diffusion coefficient (ADC) is a quantitative parameter calculated from DWI images which is used as a measure of diffusion. DWI allows to obtain comprehensive information on morphological and functional state of the kidney during a single examination without contrast medium administration. The purpose of the study was to evaluate the value of DWI in differentiating benign and malignant solid kidney tumors based on the initial stage of the study. The study included 19 adult patients with pathologically verified renal tumors: 9 patients with clear cell subtype of the renal cell carcinoma, 5 patients with oncocytoma and 5 patients with angiomyolipoma (AML). In addition, 5 healthy volunteers with completely normal findings according to kidney ultrasound were included into this study and set as reference. All patients underwent renal MR imaging which included DWI with subsequent ADC measurement. MR imaging was performed with a 1.5 T body scanner using an eight-channel phased-array body coil. The mean ADC value of ccRCC was significantly lower than that of normal renal parenchyma (2.11±0.25×10−3 mm2/s vs. 3.36±0.41×10−3 mm2/s, p<0.01). There was a significant difference in ADC between the malignant and benign renal lesions: in patients with angiomyolipoma the ADC value was 2.36±0.32×10−3 mm2/s vs. 2.11±0.25×10−3 mm2/s; p<0.05 and in patients with oncocytoma – 2.75±0.27×10−3 mm2/s vs. 2.11±0.25×10−3 mm2/s; p<0.05. The difference in ADC values in patients with high and low ccRCC grades was observed. DWI can be used to characterize renal lesions; the ADC of a renal lesion can be potentially used as an additional parameter to help determine the appropriate clinical management

  11. Burkitts primary thyroid lymphoma coexistence with Hashimoto's thyroiditis

    Th primary thyroid lymphoma is a rare neoplasm, above all in children. We present a case of a child with Burkitt's thyroid lymphoma as the only manifestation of this disease, associated to lymphocytic thyroiditis. Clinically, it initiated as a rapidly growing goiter with compressive symptomatology. The X-ray findings are described: hypoechoic and hypodense multiple nodes that affect the right thyroid lobe and isthmus, with extraglandular extension to the vascular space and to the mediastinum. The differential diagnosis is considered with other more frequent thyroid pathologies in this age group. (Author) 14 refs

  12. Thyroid cancer is the most common cancer associated with acromegaly.

    Gullu, Bennur Esen; Celik, Ozlem; Gazioglu, Nurperi; Kadioglu, Pinar

    2010-09-01

    The aim of the study was to screen the malignancy in an acromegalic patient group and to determine whether there was any increased risk and the incidence of malignancy and its association with disease characteristics such as duration of disease, latency in diagnosis, and GH and IGF-1 levels. One hundred-five (65 female, 40 male) patients with acromegaly followed and treated at Cerrahpasa Medical School, Endocrinology and Metabolism outpatient clinic between 1983 and 2007 were included in this study. The patients were screened with colonoscopy, mammography, and thyroid and prostate ultrasonography (US). Malignancy was detected in 16 (15%) patients. Thyroid cancer was found in 5 patients (4.7%), breast cancer in 3 (2.8%), colon cancer in 2 (1.9%), lung cancer in 2 (1.9%), cervix cancer in 1 (0.9%), myelodysplastic syndrome (MDS) in 1 (0.9%), cholangiocarcinoma in 1 (0.9%), and multiple endocrine neoplasm (MEN) type 1 in 1 patient (0.9%). Cancer was more common in the male patients (P = 0.046) and high levels of GH increased the risk of cancer development (P = 0.046). In this series, the most commonly detected cancer types were thyroid followed by breast and colon cancers. Although high levels of initial GH seemed to increase the risk of cancer development in acromegalic patients, age, gender, age at the time of diagnosis, duration of disease, and initial IGF-I levels were not associated with cancer development. PMID:20217483

  13. Multikinase inhibitors in the treatment of thyroid cancer: specific role of lenvatinib

    Stjepanovic N

    2014-04-01

    Full Text Available Neda Stjepanovic, Jaume CapdevilaDepartment of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, SpainAbstract: Thyroid cancers are the most frequent neoplasms of the endocrine system and in the initial stages their prognosis is excellent. However, few therapeutic options are available for advanced or metastatic disease. In the last decade, a better understanding of the molecular events involved in the tumorigenesis of thyroid cancers has led to development of new targeted agents for the management of advanced and refractory disease. Multikinase inhibitors that are able to block pathways involved in the proliferation, invasion, and neoangiogenesis of thyroid cancer have been the most widely studied. After an international effort to identify and recruit sufficient patients, four placebo-controlled studies of multikinase inhibitors have been completed. These trials have led to the approval of the first agents with activity in advanced medullary thyroid cancers, which will probably change the landscape of treatment for iodine-refractory differentiated thyroid cancer in the near future. The purpose of this paper is to review the development of targeted agents for thyroid malignancy, with a special focus on lenvatinib, a multikinase inhibitor.Keywords: thyroid cancer, lenvatinib, tyrosine kinase inhibitors, multikinase inhibitors, targeted therapies

  14. Uncommon presentations of common pancreatic neoplasms: a pictorial essay.

    D'Onofrio, Mirko; De Robertis, Riccardo; Capelli, Paola; Tinazzi Martini, Paolo; Crosara, Stefano; Gobbo, Stefano; Butturini, Giovanni; Salvia, Roberto; Barbi, Emilio; Girelli, Roberto; Bassi, Claudio; Pederzoli, Paolo

    2015-08-01

    Pancreatic neoplasms are a wide group of solid and cystic lesions with different and often characteristic imaging features, clinical presentations, and management. Among solid tumors, ductal adenocarcinoma is the most common: it arises from exocrine pancreas, comprises about 90% of all pancreatic neoplasms, and generally has a bad prognosis; its therapeutic management must be multidisciplinary, involving surgeons, oncologists, gastroenterologists, radiologists, and radiotherapists. The second most common solid pancreatic neoplasms are neuroendocrine tumors: they can be divided into functioning or non-functioning and present different degrees of malignancy. Cystic pancreatic neoplasms comprise serous neoplasms, which are almost always benign, mucinous cystic neoplasms and intraductal papillary mucinous neoplasms, which can vary from benign to frankly malignant lesions, and solid pseudopapillary tumors. Other pancreatic neoplasms, such as lymphoma, metastases, or pancreatoblastoma, are rarely seen in clinical practice and have different and sometimes controversial managements. Rare clinical presentations and imaging appearance of the most common pancreatic neoplasms, both solid and cystic, are more frequently seen and clinically relevant than rare pancreatic tumors; their pathologic and radiologic appearances must be known to improve their management. The purpose of this paper is to present some rare or uncommon clinical and radiological presentations of common pancreatic neoplasms providing examples of multi-modality imaging approach with pathologic correlations, thus describing the histopathological bases that can explain the peculiar imaging features, in order to avoid relevant misdiagnosis and to improve lesion management. PMID:25772002

  15. ROLE OF ULTRASOUND IN THYROID DISORDERS

    Janani Parkkunam; Balasubramanian Thiagarajan

    2015-01-01

    Ultrasonography has established itself has a useful tool in evaluating and managing thyroid disorders. This article provides an overview of basic principles of ultrasound, how it is used in different thyroid disorders, different sonographic pattern of thyroid disorders, comparative features of malignant and benign nodule, ultrasound features of diffuse thyroid disorders and congenital thyroid disorders, ultrasound guided FNAC, advanced techniques of ultrasound in thyroid imaging.

  16. Atypical fibroxanthoma: An unusual skin neoplasm in xeroderma pigmentosum

    Ranjana Bandyopadhyay

    2012-01-01

    Full Text Available Xeroderma pigmentosum (XP is a rare autosomal recessive disorder related to defective deoxyribonucleic acid (DNA repair. Various cutaneous manifestations related to ultraviolet (UV damage characterize the clinical course. Primary malignant cutaneous neoplasms like squamous cell carcinoma, basal cell carcinoma and malignant melanoma have been reported. Atypical fibroxanthoma is a rare dermal neoplasm occurring in UV-damaged skin. We report an unusual case of atypical fibroxanthoma in a 20-year-old male with XP.

  17. Diagnosis of bone metastasis from thyroid carcinoma

    Bechsgaard, Thor; Lelkaitis, Giedrius; Jensen, Karl E; Ewertsen, Caroline

    2015-01-01

    (MRI), but histology revealed a metastasis from thyroid carcinoma, although the patient had no previous history of thyroid malignancy and resection of the thyroid gland was without malignancy. Ultrasound-guided biopsy was possible due to cortical destruction and the multidisciplinary approach with re...

  18. Histopathological audit of salivary gland neoplasms

    Salivary gland neoplasms are uncommon but important presentation to general surgeons. Objective: To analyze the relative frequency and distribution of Salivary gland neoplasms in our division. Setting: Department of surgery and pathology, Peoples Medical University hospital and GMMMC hospital Sukkur. Study design: Descriptive (case series) Subjects and methods: A total of 40 patients registered for salivary gland tumors from oct 2008 to 0ct 2013 were included in the study. A thorough history, clinical examination, routine haematological and biochemical studies were done in all patients. FNAC was done in all cases. All patients were subjected to surgical intervention on standard rules. Each resected specimen was sent for histopathology. Information about age, gender and tumor location was obtained from clinical record and frequency of different neoplasms was studied from histopathological report. All data was collected on especially designed proforma. Data analysis was done using spss version 17. Results: A total of 40 patients were registered for salivary gland neoplasms. 28 patients (70%) had parotid lesions, 10 patients (25%) had submandibular gland involvement and 2 patients ( 5%) had minor salivary gland tumors. Patients were between 15 - 80 years of age( mean age =34.7 years) 24 patients(60%) were male and 16 (40%) were female,with male to female ratio of 1.5:1.32 . 22 (80%) had benign lesions and 8 patients (20%) had malignant lesions. Pleomorphic adenoma was the most common benign tumor affecting the parotid gland. Adenocarcinoma represented as the most prevelant parotid malignancy. Benign neoplasms occurred in third and fourth decades of life and malignant neoplasms were diagnosed in sixth and seventh decades of life. Conclusion:Salivary gland neoplasms are uncommon but they have occasioned much interest and debate because of broad histological spectrum. The data presented in this study is corroborated with most of the studied literature worldwide. (author)

  19. Evaluación clínica de la salud oral de niños con neoplasias malignas Clinical Assessment of Oral Health of children with Malignant Neoplasm

    MA Gordón-Núñez

    2005-06-01

    Full Text Available Objetivo: Este estudio de carácter descriptivo visó evaluar clínicamente niños con neoplasias malignas y poner de manifiesto la relación entre el status de salud bucal y la ocurrencia de complicaciones estomatológicas. Pacientes y métodos: la salud bucal de 40 niños con neoplasias malignas (grupo I fue evaluada clínicamente mediante examen físico extra e intra oral, obtención del índice de placa visible, índice de sangrado gingival e índice de dientes cariados, ausentes y obturados y simultáneamente fueron observadas las complicaciones estomatológicas desarrolladas en esos pacientes. El status de salud bucal de éstos niños fue comparado al de niños saludables (grupo II. Resultados: los niños del grupo I presentaron índices de sangrado gingival y experiencia de caries menores que los del grupo II, por otro lado, el índice de placa visible fue ligeramente mayor en los niños del grupo I, sin embargo, sólo hubo diferencia estadísticamente significativa en el valor del CAO-D/cao-d entre ambos grupos (p = 0.002. En el grupo I, 16 niños desarrollaron conjuntamente 61 complicaciones estomatológicas, con predominancia de la mucositis, seguida del sangrado oral espontáneo, candidiasis y xerostomia. Conclusión: Pacientes bajo tratamiento antineoplásico, presentando higiene oral deficiente, tienen mayor riesgo de desarrollar complicaciones estomatológicas.Objective: In this descriptive study were assessment clinically children with malignant neoplasm, to evidence the correlation between oral health status and the occurrence of stomatologic complications. Patients and methods: Were evaluated the oral health conditions of 40 children with malignant neoplasm (group I through intra and extra oral physic examination, obstention of Visible Plate Index, Gingival Bleeding Index and Decayed, Missed and Filled Teeth Index; simultaneously were observed the stomatologic complications developed in this patients. The oral health status of the children of group I was compared to the healthy children (group II. Results: The children of group I presented Gingival Bleeding Index and caries experience lower than children of group II, in other hand, the Visible Plate Index was lightly greater in children of group I, nevertheless existed statistical difference in the value of the DMF-T/dmf-t between both groups (p = 0.002. In the group I, 16 children developed together 61 stomatologic complications, with predominance of oral mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy. Conclusions: Patients in anti neoplastic therapy with deficient oral hygiene had high risk of develop stomatologic complications.

  20. Sonographic Elastography of the Thyroid Gland

    Menzilcioglu, Mehmet Sait; Duymus, Mahmut; Avcu, Serhat

    2016-01-01

    Summary Thyroid gland disorders include benign and malignant thyroid nodules and diffuse thyroid disorders. The incidence of malignant thyroid nodules is low and the prognosis is good. The diagnosis of thyroid cancer and diffuse parenchymal disorders is generally based on clinical manifestations and histopathological evaluation. Ultrasonography has its place in the diagnostics and follow-up of thyroid disorders. Ultrasonographic elastography is a new, developing method that shows increase in clinical practice. In this study, we aimed to review the data on thyroid ultrasound elastography. PMID:27103947

  1. Evaluation of diffuse thyroid diseases and thyroid nodules by CT

    Imanishi et al. have previously reported that the changes in CT values reveal not only the change in iodine concentration in thyroid follicles, but also represent secondary changes in follicular content and follicular cells and/or interstitial structures. Thus, we performed thyroid CT without contrast material in 138 controls, 417 cases with diffuse thyroid diseases, and 279 cases with thyroid nodules, and evaluated the CT images based on the relation between the change in CT values and pathological changes. In 89% of the controls and 43% of patients with diffuse thyroid diseases, the thyroid CT revealed diffuse high density. In contrast, the 94% of thyroids that demonstrated diffuse low density were from patients with diffuse thyroid diseases. Eighty-four percent of malignant nodules and 64% of benign nodules had inhomogeneous densities, and only 26% of benign thyroid nodules had homogeneous density. However, 71% of nodules that showed high and low densities with regular and clear borders, and 82% of nodules that showed papillary proliferation in a cyst pattern were benign. Although only 58% of nodules with calcification were malignant, 66% of nodules with calcification in the central portion, and 86% of nodules with calcification of a disseminated and convergent pattern in distribution were malignant. Sixty-two percent of thyroids that surrounded nodules had chronic thyroiditis, hypoplasia and/or adenomatous goiter. Thus, unclear borders between a nodule and the surrounding thyroid tissue did not increase the possibility of malignancy. However, the unclear and/or lobulated border between a nodule and extra thyroid tissue increased the possibility of malignancy. We concluded that thyroid CT without contrast material is useful for the diagnosis of thyroid diseases. (author)

  2. Second malignancies in children: the usual suspects?

    The aim of this article is to provide an up to date review of second malignant neoplasms (SMN's) following treatment for childhood cancer, referring to their incidence, the role of genetic factors, and how the primary malignancy and treatment received influence the type, site and prognosis of SMN's. The role of genetic factors will be discussed as far as they impact upon a predisposition to later development of SMN's. The primary malignancies that have important associations with SMN's will then be discussed, in particular Hodgkin's disease, retinoblastoma and acute lymphoblastic leukaemia. The important second malignancies will be highlighted, including tumours of the CNS and thyroid, osteosarcoma, secondary acute myeloid leukaemia and melanoma. Emphasis will be put upon identifying which patients are most likely to suffer from these tumours. An important part of the article are case histories. These are provided in combination with illustrations as a useful adjunct to the text, with a particular emphasis on radiological features, diagnosis and screening. Finally, the important but different roles of causal agents, in particular chemotherapy and radiotherapy are highlighted

  3. Second malignancies in children: the usual suspects?

    Moppett, John; Oakhill, Anthony E-mail: anthony.oakhill@nildram.co.uk; Duncan, Andrew W

    2001-06-01

    The aim of this article is to provide an up to date review of second malignant neoplasms (SMN's) following treatment for childhood cancer, referring to their incidence, the role of genetic factors, and how the primary malignancy and treatment received influence the type, site and prognosis of SMN's. The role of genetic factors will be discussed as far as they impact upon a predisposition to later development of SMN's. The primary malignancies that have important associations with SMN's will then be discussed, in particular Hodgkin's disease, retinoblastoma and acute lymphoblastic leukaemia. The important second malignancies will be highlighted, including tumours of the CNS and thyroid, osteosarcoma, secondary acute myeloid leukaemia and melanoma. Emphasis will be put upon identifying which patients are most likely to suffer from these tumours. An important part of the article are case histories. These are provided in combination with illustrations as a useful adjunct to the text, with a particular emphasis on radiological features, diagnosis and screening. Finally, the important but different roles of causal agents, in particular chemotherapy and radiotherapy are highlighted.

  4. Salivary Gland Neoplasms in Children and Adolescents.

    Bradley, Patrick J; Eisele, David W

    2016-01-01

    Salivary gland neoplasms (SGNs) in children are uncommon. Epithelial SGNs (ESGNs) comprise the majority (95%), with the remaining being mesenchymal SGNs (MeSGNs). Pleomorphic adenoma is the most frequently encountered benign neoplasm, mucoepidermoid carcinoma is the most frequent malignant ESGN, and rhabdomyosarcoma is the most frequent malignant MeSGN. ESGN presents in the second decade, whereas MeSGN presents in the first and second decades. Swelling without pain or neurological signs is the main presentation of both benign and malignant neoplasms. Making an accurate preoperative histological diagnosis is important, so a needle biopsy or a perioperative frozen section is useful when there is doubt about the disease status of the patient; the excised tumour margin is also important. Surgical excision should aim to achieve clear margin excision in benign and malignant ESGNs, minimising the need for adjuvant radiotherapy and maximising the long-term likelihood of patient cure. Benign ESGNs are uncommon, and excision is curative, whereas malignant ESGN and MeSGN should be managed by a multidisciplinary paediatric oncology team. PMID:27093697

  5. Chronic myeloproliferative neoplasms and subsequent cancer risk

    Frederiksen, H.; Farkas, Dora Kormendine; Christiansen, C.F.; Sørensen, H.T.; Hasselbalch, H.C.

    2011-01-01

    Patients with chronic myeloproliferative neoplasms, including essential thrombocythemia (ET), polycythemia vera (PV), and chronic myeloid leukemia (CML), are at increased risk of new hematologic malignancies, but their risk of nonhematologic malignancies remains unknown. In the present study, we...... assessed the risk of both types of malignancies after an ET, PV, or CML diagnosis. We linked 2 population-based nationwide registries, the Danish National Registry of Patients, covering all Danish hospitals and the Danish Cancer Registry, and assessed subsequent cancer risk in a cohort of all 7229 patients...... diagnosed with a chronic myeloproliferative neoplasm during 1977-2008. We compared the incidence of subsequent cancer in this cohort with that expected on the basis of cancer incidence in the general population (standardized incidence ratio). Overall, ET, PV, and CML patients were at increased risk of...

  6. The follicular variant of papillary thyroid carcinoma: characteristics of preoperative ultrasonography and cytology

    Jung Hyun Yoon

    2016-01-01

    Full Text Available Purpose: The goal of this study was to validate the ultrasonography (US and cytopathological features that are used in the diagnosis of the follicular variant of papillary thyroid carcinoma (FVPTC and to characterize the role of BRAFV600E mutation analysis in the diagnosis of FVPTC. Methods: From May 2012 to February 2014, 40 thyroid nodules from 40 patients (mean age, 56.2 years; range, 26 to 81 years diagnosed with FVPTC were included in this study. The US features of the nodules were analyzed and the nodules were classified as probably benign or suspicious for malignancy. Twenty-three thyroid nodules (57.5% underwent BRAFV600E mutation analysis. Clinical information and histopathologic results were obtained by reviewing the medical records of the patients. Results: Thirty nodules (75.0% were classified as suspicious for malignancy, while 10 (25.0% were classified as probably benign. Seven of the eight nodules (87.5% with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS cytology showed suspicious US features, while one of the two nodules (50.0% with follicular neoplasm cytology presented suspicious US features. Five of the 23 nodules (21.7% that underwent BRAFV600E mutation analysis had positive results, all of which were diagnosed as suspicious for malignancy or malignant based on cytology. None of the nodules with benign, AUS/FLUS, or follicular neoplasm cytology were positive for the BRAFV600E mutation. Conclusion: US features allow nodules to be classified as suspicious for malignancy, and the presence of suspicious US features in nodules with ambiguous cytology may aid in the diagnosis of FVPTC. BRAFV600E mutation analysis is of limited value in the diagnosis of FVPTC.

  7. Activation of tumor cell proliferation by thyroid hormone in a mouse model of follicular thyroid carcinoma

    Lu, C; Zhu, X.; Willingham, MC; Cheng, S-y

    2011-01-01

    Thyroid cancers are the most common malignancy of the endocrine system in humans. To understand the molecular genetic events underlying thyroid carcinogenesis, we have generated a mouse model that spontaneously develops follicular thyroid carcinoma similar to human thyroid cancer (ThrbPV/PV mouse). This mutant mouse harbors a dominantnegative mutated thyroid hormone receptor β (denoted PV). The PV mutation was identified in a patient with resistance to thyroid hormone (TH). ThrbPV/PV mice exh...

  8. Abdominal-pelvic actinomycosis mimicking malignant neoplasm.

    Pusiol, Teresa; Morichetti, Doriana; Pedrazzani, Corrado; Ricci, Francesco

    2011-01-01

    Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly. The resection of retroperitoneal mass, distal ileum appendicectomy, right hemicolectomy, and right salpingo-oophorectomy was performed. The postoperative period was uneventful. Penicillin therapy was given for six months without any complication. The retroperitoneal mass measured 4.5 × 3.5 × 3 cm, surrounded adjacent organs and histologically showed inflammatory granulomatous tissue, agglomeration of filaments, and sulfur granules of Actinomyces, with positive reaction with periodic acid Schiff. Right tubo-ovarian abscess was present. Abdominalpelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intrauterine device. PMID:21904441

  9. Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm

    Teresa Pusiol; Doriana Morichetti; Corrado Pedrazzani; Francesco Ricci

    2011-01-01

    Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly...

  10. [Autoimmune thyroiditis and thyroid cancer].

    Krátký, Jan; Jiskra, Jan

    2015-10-01

    Association between autoimmune thyroiditis (CLT) and thyroid cancer remains not clear. Although both diseases often occur simultaneously in histological samples, it is not yet clear whether CLT can be regarded as a risk factor for thyroid malignancy. This review focus on the known epidemiological and molecular genetics links between both diseases. Most studies have shown a significant association between thyroid cancer and positive antibodies to thyroglobulin and histological evidence of CLT, as well. Both disorders share some risk factors (greater incidence in women, in areas with adequate supply of iodine and in patients after radiotherapy of the neck) and molecular genetics linkage. For example: RET/PTC rearrangements could be more often found in carcinomas associated with CLT, but this mutation could be found in benign lesions such as CLT, as well. CLT seems to be a positive prognostic factor in patients with differentiated thyroid cancer. It is associated with less invasive forms of tumor, lower occurrence of infiltrated lymphatic nodes and a lower risk of recurrence. PMID:26486481

  11. Multikinase inhibitors in the treatment of thyroid cancer: specific role of lenvatinib.

    Stjepanovic, Neda; Capdevila, Jaume

    2014-01-01

    Thyroid cancers are the most frequent neoplasms of the endocrine system and in the initial stages their prognosis is excellent. However, few therapeutic options are available for advanced or metastatic disease. In the last decade, a better understanding of the molecular events involved in the tumorigenesis of thyroid cancers has led to development of new targeted agents for the management of advanced and refractory disease. Multikinase inhibitors that are able to block pathways involved in the proliferation, invasion, and neoangiogenesis of thyroid cancer have been the most widely studied. After an international effort to identify and recruit sufficient patients, four placebo-controlled studies of multikinase inhibitors have been completed. These trials have led to the approval of the first agents with activity in advanced medullary thyroid cancers, which will probably change the landscape of treatment for iodine-refractory differentiated thyroid cancer in the near future. The purpose of this paper is to review the development of targeted agents for thyroid malignancy, with a special focus on lenvatinib, a multikinase inhibitor. PMID:24748771

  12. Neoplasms in dogs receiving low-level gamma radiation during pre- and postnatal development

    Beagle dogs were given whole-body exposure to 60Co gamma radiation at one of six ages of pre- or postnatal life. Four-hundred and eighty dogs, 120 for each age at exposure, received 20 R at 8, 28 or 55 days postcoitus (dpc) or at 2 days postpartum (dpp). Similarity 480 dogs, in groups of 120, were exposed to 100 R at these same ages. Exposures of 100 R were also given to 118 dogs at 70 dpp and 231 dogs at 365 dpp. An additional 359 dogs were sham-irradiated. Mean values for each age at exposure ranged from 15.6 to 17.5 rads for 20 R exposures and from 80.8 to 88.3 rads for exposure to 100 R. Mortality due to neoplasia during the initial ten years of the experiment was examined. Twenty dogs died or were killed because of neoplasia, 19 having been irradiated. Tumours in these 19 irradiated dogs included five malignant lymphomas, eight carcinomas (two of mammary origin, two of prostatic origin, and one each of oral mucosa, ovary, urinary bladder, and thyroid origin), four sarcomas (two haemangiosarcomas, one fibrosarcoma and one mast cell sarcoma), one astrocytoma, and one hepatocellular adenoma. Neoplasms occurred in all irradiated groups except 8 dpc (20 and 100 R) and 70 dpp (100 R). Eleven neoplasms developed in dogs irradiated perinatally (55 dpc or 2 dpp) with 20 or 100 R. Four of the tumours in the perinatally irradiated dogs were detected before two years of age. The earliest death was at three months, due to an astrocytoma. Preliminary analyses point to findings of particular interest: (1) the preponderance of neoplasms causing death or euthanasia occurred in irradiated dogs; (2) the unusual finding of four deaths due to neoplasia before two years of age in perinatally irradiated dogs; and (3) the occurrence of five malignant lymphomas in this relatively small irradiated population

  13. Second Malignancy in Pediatric Patients: Imaging Findings and Differential Diagnosis

    N. Tayari

    2010-05-01

    Full Text Available Therapeutic advances in the treatment of pediatric neoplasms have improved the prognosis but have also increased the risk of developing rare second malignancies."nPrimary neoplasms which are often associated with second malignancies include lymphoma, retinoblas-toma, medulloblastoma and leukemia. The most common second malignancies are central nervous system (CNS tumors, sarcomas, thyroid and parathyroid gland carcinoma and leukemia, particularly acute myeloblastic leukemia. Genetic predisposition, chemotherapy, and especially radiation therapy are included as pathogenic factors in second malignancies. We know all survivors of childhood cancer should have lifelong follow-up, preferably with US, magnetic resonance imaging and other procedures with no ionizing radiation. A new progressive lesion may represent recurrence of the primitive neoplastic process, late radiation injury, or more infrequently, a second malignancy. Differential diagnosis may be very difficult and the outcome is often fatal. "nTreatment protocols should be modified to reduce the risk of second malignancies without compromising the effectiveness of initial therapy. "nClinicians should individualize treatment for patients who are genetically predisposed. In addition, radiologists should be familiar with the long-term consequences of antineoplastic therapy."nIn a report of new England journal of medicine in 2007, 357:227-2284 by Dr. Brenner and Hall, 2% of all carcinomas in U.S.A are due to more use of CT exam and children are three to four times more sensitive to ionization radiation. "nSo all the radiologists and clinicians should be aware of the complications and should recommend follow up exams in children who have had previous treatments for such carcinomas.

  14. Issues related to radioactive iodine ablation in patients with differentiated thyroid carcinoma undergoing thyroid surgery

    Differentiated thyroid carcinoma (DTC) is the most common malignant tumor of thyroid gland, including papillary thyroid carcinoma, follicular thyroid carcinoma and the mixed type. Treatment methods include surgery, radioactive iodine treatment and endocrine treatment, in which radioactive iodine treatment for thyroid carcinoma is an important part of the treatment or procedure. With the ongoing research and exploration of radiation treatment, the recombinant human thyroid stimulating hormone assisted in radioactive iodine ablation of thyroid remnants, radioactive iodine to remove a lot of residual thyroid tissue, the radioactive iodine dose selection and other aspects of knowledge and practice are constantly updated. This paper summarizes recent progess in the radioactive iodine ablation. (authors)

  15. Positron emission tomography thyroid incidentaloma: Is it different in Indian subcontinent?

    R Vaish

    2016-01-01

    Full Text Available Background: Positron emission tomography (PET forms an integral part in work-up and follow-up of various malignancies. With the increased use of PET in oncology, finding of an incidental focal thyroid uptake (incidentaloma is not unusual and presents a diagnostic challenge. Aim: The aim of the following study is to evaluate the frequency and radio-pathologic correlation of focal 18-fluoro deoxyglucose uptake (FDG on PET within the thyroid from a large series. Materials and Methods: Retrospective review of 37,000 consecutive patients who underwent FDG-PET at tertiary cancer center in India. Radiological, pathological, PET scan and follow-up details were evaluated. Statistical analyzes were carried out using Mann Whitney test and Pearson correlation. Results: Abnormal thyroid uptake was seen in 78 (0.2% patients. Nearly 61 (0.16% scans had focal and 17 (0.04% had diffuse FDG uptake. A total of 57 patients with focal uptake were available for further evaluation. No further evaluation was done in 24 (42.1% patients who had advanced index malignancy. Of the remaining 33 patients 26 were benign and seven were a cause for concern (four primary thyroid cancers, one follicular neoplasm with hurthle cell change and two metastatic cancers. There was no significant correlation in Standardized uptake value (SUV max of benign and malignant lesion (P = 0.5 on Mann Whitney or size (r = 0.087 Pearson correlation co-efficient P= 0.667. Conclusion: Incidence of PET incidentaloma is low in this large cohort of Indian patients. Nearly 27% of focal incidentaloma were malignant. There was no correlation between the SUVmax, size and malignancy.

  16. SNP Array in Hematopoietic Neoplasms: A Review

    Jinming Song

    2015-12-01

    Full Text Available Cytogenetic analysis is essential for the diagnosis and prognosis of hematopoietic neoplasms in current clinical practice. Many hematopoietic malignancies are characterized by structural chromosomal abnormalities such as specific translocations, inversions, deletions and/or numerical abnormalities that can be identified by karyotype analysis or fluorescence in situ hybridization (FISH studies. Single nucleotide polymorphism (SNP arrays offer high-resolution identification of copy number variants (CNVs and acquired copy-neutral loss of heterozygosity (LOH/uniparental disomy (UPD that are usually not identifiable by conventional cytogenetic analysis and FISH studies. As a result, SNP arrays have been increasingly applied to hematopoietic neoplasms to search for clinically-significant genetic abnormalities. A large numbers of CNVs and UPDs have been identified in a variety of hematopoietic neoplasms. CNVs detected by SNP array in some hematopoietic neoplasms are of prognostic significance. A few specific genes in the affected regions have been implicated in the pathogenesis and may be the targets for specific therapeutic agents in the future. In this review, we summarize the current findings of application of SNP arrays in a variety of hematopoietic malignancies with an emphasis on the clinically significant genetic variants.

  17. Primary bone neoplasms in dogs: 90 cases

    Maria E. Trost

    2012-12-01

    Full Text Available A retrospective study of necropsy and biopsy cases of 90 primary bone tumors (89 malignant and one benign in dogs received over a period of 22 years at the Laboratrio de Patologia Veterinria, Universidade Federal de Santa Maria, was performed. Osteosarcoma was the most prevalent bone tumor, accounting for 86.7% of all malignant primary bone neoplasms diagnosed. Most cases occurred in dogs of large and giant breeds with ages between 6 and 10-years-old. The neoplasms involved mainly the appendicular skeleton, and were 3.5 times more prevalent in the forelimbs than in the hindlimbs. Osteoblastic osteosarcoma was the predominant histological subtype. Epidemiological and pathological findings of osteosarcomas are reported and discussed.

  18. Ultrasonographic Findings of Papillary Thyroid Cancer with or without Hashimoto's Thyroiditis

    This study was designed to compare the ultrasonographic features of papillary thyroid carcinoma with and without Hashimoto's thyroiditis. This retrospective study included 190 patients with papillary thyroid carcinoma which was proven by neck surgery. The difference in the ultrasonographic findings between papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis were calculated statistically. Hashimoto's thyroiditis was diagnosed in 61 of 190 patients following neck surgery. The incidence of coexisting papillary thyroid carcinoma with Hashimoto's thyroiditis was significantly higher in women (p=0.0026). In addition, the frequency of macrocalcification in patients with Hashimoto's thyroiditis was also significantly higher (p=0.0009). Conversely,other ultrasonographic findings including the shape, margin, echogenicity and calcifications, for patients with papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis, were not statistically significant. We also found that patients with Hashimoto's thyroiditis who showed no calcification on ultrasonography tended not to detect the papillary carcinoma at a higher frequency. On ultrasonography, macrocalcifications occurred more frequently in patients with Hashimoto's thyroiditis than those without Hashimoto's thyroiditis. Malignant thyroid nodules without calcifications in patients with Hashimoto's thyroiditis more often could not be detected. Therefore, it is important carefully examine patients with Hashimoto's thyroiditis

  19. Ultrasonographic Findings of Papillary Thyroid Cancer with or without Hashimoto's Thyroiditis

    Park, Jun Young; Lee, Tae Hyun; Park, Dong Hee [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2010-04-15

    This study was designed to compare the ultrasonographic features of papillary thyroid carcinoma with and without Hashimoto's thyroiditis. This retrospective study included 190 patients with papillary thyroid carcinoma which was proven by neck surgery. The difference in the ultrasonographic findings between papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis were calculated statistically. Hashimoto's thyroiditis was diagnosed in 61 of 190 patients following neck surgery. The incidence of coexisting papillary thyroid carcinoma with Hashimoto's thyroiditis was significantly higher in women (p=0.0026). In addition, the frequency of macrocalcification in patients with Hashimoto's thyroiditis was also significantly higher (p=0.0009). Conversely,other ultrasonographic findings including the shape, margin, echogenicity and calcifications, for patients with papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis, were not statistically significant. We also found that patients with Hashimoto's thyroiditis who showed no calcification on ultrasonography tended not to detect the papillary carcinoma at a higher frequency. On ultrasonography, macrocalcifications occurred more frequently in patients with Hashimoto's thyroiditis than those without Hashimoto's thyroiditis. Malignant thyroid nodules without calcifications in patients with Hashimoto's thyroiditis more often could not be detected. Therefore, it is important carefully examine patients with Hashimoto's thyroiditis

  20. Emerging therapies for thyroid carcinoma.

    Walsh, S

    2012-02-01

    Thyroid carcinoma is the most commonly diagnosed endocrine malignancy. Its incidence is currently rising worldwide. The discovery of genetic mutations associated with the development of thyroid cancer, such as BRAF and RET, has lead to the development of new drugs which target the pathways which they influence. Despite recent advances, the prognosis of anaplastic thyroid carcinoma is still unfavourable. In this review we look at emerging novel therapies for the treatment of well-differentiated and medullary thyroid carcinoma, and advances and future directions in the management of anaplastic thyroid carcinoma.

  1. Follicular thyroid carcinoma masquerading as subacute thyroiditis diagnosis using ultrasonography and radionuclide thyroid angiography

    The rare presentation of a follicular thyroid carcinoma mimicking the clinical and radionuclide features of subacute thyroiditis is described. Granulomatous thyroiditis was initially suspected on the clinical basis. Repeat fine needle aspiration cytology was suggestive of acinar proliferation with hyperfunction. Ultrasonography revealed a solid nodule with a peripheral sonolucent halo. Radionuclide angiography showed intense arterial flow of Tc-99m pertechnetate through the right lobe thyroid enlargement suggestive of malignant thyroid pathology. Surgical excision and histopathological examination revealed a follicular carcinoma involving the right lobe. 31 refs., 4 figs

  2. Uterine adenosarcomas are mesenchymal neoplasms.

    Piscuoglio, Salvatore; Burke, Kathleen A; Ng, Charlotte Ky; Papanastasiou, Anastasios D; Geyer, Felipe C; Macedo, Gabriel S; Martelotto, Luciano G; de Bruijn, Ino; De Filippo, Maria R; Schultheis, Anne M; Ioris, Rafael A; Levine, Douglas A; Soslow, Robert A; Rubin, Brian P; Reis-Filho, Jorge S; Weigelt, Britta

    2016-02-01

    Uterine adenosarcomas (UAs) are biphasic lesions composed of a malignant mesenchymal (ie stromal) component and an epithelial component. UAs are generally low-grade and have a favourable prognosis, but may display sarcomatous overgrowth (SO), which is associated with a worse outcome. We hypothesized that, akin to breast fibroepithelial lesions, UAs are mesenchymal neoplasms in which clonal somatic genetic alterations are restricted to the mesenchymal component. To characterize the somatic genetic alterations in UAs and to test this hypothesis, we subjected 20 UAs to a combination of whole-exome (n = 6), targeted capture (n = 13) massively parallel sequencing (MPS) and/or RNA sequencing (n = 6). Only three genes, FGFR2, KMT2C and DICER1, were recurrently mutated, all in 2/19 cases; however, 26% (5/19) and 21% (4/19) of UAs harboured MDM2/CDK4/HMGA2 and TERT gene amplification, respectively, and two cases harboured fusion genes involving NCOA family members. Using a combination of laser-capture microdissection and in situ techniques, we demonstrated that the somatic genetic alterations detected by MPS were restricted to the mesenchymal component. Furthermore, mitochondrial DNA sequencing of microdissected samples revealed that epithelial and mesenchymal components of UAs were clonally unrelated. In conclusion, here we provide evidence that UAs are genetically heterogeneous lesions and mesenchymal neoplasms. Copyright 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. PMID:26592504

  3. Vascular encasement by pancreatobiliary neoplasms

    This paper reports that vascular encasement is common with pancreatobiliary malignancy. This study was performed to determine the value of gradient-echo (GRE) MR imaging in the detection of mesenteric vessel encasement. Fifteen patients with known pancreatobiliary tumors underwent dynamic CT and gradient-echo and spin-echo MR imaging. Imaging findings were correlated with clinical/surgical follow-up. GRE MR imaging provides useful adjunctive information to dynamic CT and conventional spin-echo (SE) MR imaging in patients with pancreatobiliary neoplasms. It excels at diagnosing mesenteric venous compression and occlusion. It does not, however, significantly add information regarding celiac arterial abnormalities to that available with dynamic CT. Dyamic Ct, SE Mr imaging, and GRE MR imaging all fall short of enabling diagnosis of pancreatobiliary tumor adherence to the abdominal vasculature

  4. Second malignancies in pediatric patients: imaging findings and differential diagnosis.

    Vzquez, Elida; Castellote, Amparo; Piqueras, Joaquim; Ortuno, Pedro; Snchez-Toledo, Jos; Nogus, Pere; Lucaya, Javier

    2003-01-01

    Therapeutic advances in the treatment of pediatric neoplasms have improved the prognosis but have also increased the risk of developing rare second malignant neoplasms (SMNs). Primary neoplasms that are often associated with SMNs include lymphoma, retinoblastoma, medulloblastoma, neuroblastoma, and leukemia. The most common SMNs are central nervous system (CNS) tumors, sarcomas, thyroid and parotid gland carcinomas, and leukemia, particularly acute myeloblastic leukemia. Genetic predisposition, chemotherapy, and especially radiation therapy are implicated as pathogenic factors in SMN. All survivors of childhood cancer should have lifelong follow-up, preferably with magnetic resonance imaging, which does not require ionizing radiation and provides greater anatomic detail and resolution in the head and neck region and the CNS. A new or progressive lesion may represent recurrence of the primitive neoplastic process, late radiation injury, or, more infrequently, an SMN. Differential diagnosis can be very difficult, and outcome is often fatal. Treatment protocols should be modified to reduce the risk for SMN without compromising the effectiveness of initial therapy. Clinicians should individualize treatment for patients who are genetically predisposed to SMN. In addition, radiologists should be familiar with the long-term consequences of antineoplastic therapy to facilitate diagnosis and anticipate adverse outcomes. PMID:12975507

  5. Malignant tumors of childhood

    This book contains 34 papers about malignant tumors. some of the titles are: Invasive Cogenital Mesoblastic Nephroma, Leukemia Update, Unusual Perinatal Neoplasms, Lymphoma Update, Gonadal Germ Cell Tumors in Children, Nutritional Status and Cancer of Childhood, and Chemotherapy of Brain tumors in Children

  6. Thyroid Cancer Cell Lines: Critical Models to Study Thyroid Cancer Biology and New Therapeutic Targets

    RebeccaESchweppe

    2012-01-01

    Thyroid cancer is the most common endocrine malignancy and the incidence is rising. Currently, there are no effective treatments for patients with advanced forms of thyroid cancer. Anaplastic thyroid represents the most severe form of the disease with 95% mortality at 6 months. It is therefore critical to better understand the mechanisms involved in thyroid cancer development and progression in order to develop more effective therapeutic strategies. Cell lines derived from thyroid tumors ...

  7. A case of papillary microcarcinoma of the thyroid with abundant colloid (masquerading as colloid goiter with papillary hyperplasia): Cytological evaluation with histopathological correlation

    Muthalagan, Elancheran; Subashchandrabose, Priya; Sivasubramanian, Priya Banthavi; Venkateswaran, Sarada

    2015-01-01

    Papillary thyroid carcinoma (PTC) is the most common malignant neoplasm of the thyroid. On fine-needle aspiration (FNA) cytology smears of conventional PTC, the background usually shows scanty, bubble gum-like colloid. But the macrofollicular variant and papillary microcarcinoma reveals abundant thin colloid in the background. We report a case of papillary carcinoma of thyroid in a 37-year-old female with abundant thin colloid, obscuring the nuclear morphology in many clusters, along with the presence of typical nuclear features within occasional clusters in FNA cytology and hence, masquerading as colloid goiter with papillary hyperplasia. Histopathological examination of the total thyroidectomy specimen revealed papillary microcarcinomatous focus in a background of nodular hyperplasia. The differential diagnosis of PTC should be entertained even in colloid-rich FNA smears if the typical nuclear features are present. Hence, a meticulous search for any fragment with nuclear features of PTC is mandatory before labeling the smears as benign nodular hyperplasia.

  8. A case of papillary microcarcinoma of the thyroid with abundant colloid (masquerading as colloid goiter with papillary hyperplasia: Cytological evaluation with histopathological correlation

    Elancheran Muthalagan

    2015-01-01

    Full Text Available Papillary thyroid carcinoma (PTC is the most common malignant neoplasm of the thyroid. On fine-needle aspiration (FNA cytology smears of conventional PTC, the background usually shows scanty, bubble gum-like colloid. But the macrofollicular variant and papillary microcarcinoma reveals abundant thin colloid in the background. We report a case of papillary carcinoma of thyroid in a 37-year-old female with abundant thin colloid, obscuring the nuclear morphology in many clusters, along with the presence of typical nuclear features within occasional clusters in FNA cytology and hence, masquerading as colloid goiter with papillary hyperplasia. Histopathological examination of the total thyroidectomy specimen revealed papillary microcarcinomatous focus in a background of nodular hyperplasia. The differential diagnosis of PTC should be entertained even in colloid-rich FNA smears if the typical nuclear features are present. Hence, a meticulous search for any fragment with nuclear features of PTC is mandatory before labeling the smears as benign nodular hyperplasia.

  9. Computed tomography in the evaluation of thyroid disease

    Traditionally, thyroid imaging has been performed primarily using radionuclide scanning. High-resolution computed tomography (CT) was performed in 18 patients to evaluate the CT appearance of various thyroid abnormalities including diffuse toxic goiter, multinodular goiter, Hashimoto thyroiditis, thyroid adenoma, and malignant thyroid tumors. CT images of the thyroid were correlated with radionuclide scanning, surgical findings, and clinical and laboratory results. CT provided a complementary method for evaluation of the thyroid by defining the morphology of the thyroid gland and more precisely defining the anatomic extent of thyroid abnormalities in relation to the normal structures of the neck and mediastinum

  10. Therapeutic Approach to Cystic Neoplasms of the Pancreas.

    Al Efishat, Mohammad; Allen, Peter J

    2016-04-01

    Management of cystic neoplasms of the pancreas is challenging as it relies on radiologic and cyst fluid markers to discriminate between benign and pre-cancerous lesions, however their ability to predict malignancy is limited. While asymptomatic serous cystadenomas can be managed conservatively, mucinous cystic neoplasms and intraductal papillary mucinous neoplasms are more difficult to manage. A selective approach, based on the preoperative likelihood of high-grade dysplasia or invasive disease, is the standard of care. Research is focusing on the development of pre-operative markers for identifying high risk lesions, which will spare patients with low-risk or benign lesions the risks of pancreatectomy. PMID:27013369

  11. Clinical presentation of thyroid cancer

    The clinical manifestation of thyroid cancer (TC) as seen at the Nuclear Medicine Department, where the patients investigated prior to diagnosis of disease are clinically suspected to harbor malignancy and mostly referred for scintigraphic investigations are presented

  12. Thyroid nodules in acromegaly

    Amelia Rogozinski

    2012-07-01

    Full Text Available OBJECTIVE: We made a prospective study evaluating the prevalence of thyroid nodular disease in acromegalic patients. SUBJECTS AND METHODS: Thyroid ultrasound and ultrasound-guided fine needle aspiration biopsy were performed when nodules were detected. Nodules were characterized by cytology and histopathology. RESULTS: We found high prevalence of nodular thyroid disorder, 23/34 (67% in acromegalic patients. High risk and malignant cytology were significantly higher in acromegalic patients than in our non-acromegalic population (25% vs. 9%. Differentiated thyroid carcinoma was present in 11% of the acromegalic patients. CONCLUSIONS: We strongly recommend periodic thyroid evaluation by ultrasound in patients with acromegaly. Fine needle aspiration biopsy should be performed in nodules larger than 10 mm, and in all suspicious nodules, regardless of the size.

  13. A molecular computational model improves the preoperative diagnosis of thyroid nodules

    Tomei Sara

    2012-09-01

    Full Text Available Abstract Background Thyroid nodules with indeterminate cytological features on fine needle aspiration (FNA cytology have a 20% risk of thyroid cancer. The aim of the current study was to determine the diagnostic utility of an 8-gene assay to distinguish benign from malignant thyroid neoplasm. Methods The mRNA expression level of 9 genes (KIT, SYNGR2, C21orf4, Hs.296031, DDI2, CDH1, LSM7, TC1, NATH was analysed by quantitative PCR (q-PCR in 93 FNA cytological samples. To evaluate the diagnostic utility of all the genes analysed, we assessed the area under the curve (AUC for each gene individually and in combination. BRAF exon 15 status was determined by pyrosequencing. An 8-gene computational model (Neural Network Bayesian Classifier was built and a multiple-variable analysis was then performed to assess the correlation between the markers. Results The AUC for each significant marker ranged between 0.625 and 0.900, thus all the significant markers, alone and in combination, can be used to distinguish between malignant and benign FNA samples. The classifier made up of KIT, CDH1, LSM7, C21orf4, DDI2, TC1, Hs.296031 and BRAF had a predictive power of 88.8%. It proved to be useful for risk stratification of the most critical cytological group of the indeterminate lesions for which there is the greatest need of accurate diagnostic markers. Conclusion The genetic classification obtained with this model is highly accurate at differentiating malignant from benign thyroid lesions and might be a useful adjunct in the preoperative management of patients with thyroid nodules.

  14. A molecular computational model improves the preoperative diagnosis of thyroid nodules

    Thyroid nodules with indeterminate cytological features on fine needle aspiration (FNA) cytology have a 20% risk of thyroid cancer. The aim of the current study was to determine the diagnostic utility of an 8-gene assay to distinguish benign from malignant thyroid neoplasm. The mRNA expression level of 9 genes (KIT, SYNGR2, C21orf4, Hs.296031, DDI2, CDH1, LSM7, TC1, NATH) was analysed by quantitative PCR (q-PCR) in 93 FNA cytological samples. To evaluate the diagnostic utility of all the genes analysed, we assessed the area under the curve (AUC) for each gene individually and in combination. BRAF exon 15 status was determined by pyrosequencing. An 8-gene computational model (Neural Network Bayesian Classifier) was built and a multiple-variable analysis was then performed to assess the correlation between the markers. The AUC for each significant marker ranged between 0.625 and 0.900, thus all the significant markers, alone and in combination, can be used to distinguish between malignant and benign FNA samples. The classifier made up of KIT, CDH1, LSM7, C21orf4, DDI2, TC1, Hs.296031 and BRAF had a predictive power of 88.8%. It proved to be useful for risk stratification of the most critical cytological group of the indeterminate lesions for which there is the greatest need of accurate diagnostic markers. The genetic classification obtained with this model is highly accurate at differentiating malignant from benign thyroid lesions and might be a useful adjunct in the preoperative management of patients with thyroid nodules

  15. Thyroid Nodules

    ... Your Body in Balance › Thyroid Nodules Fact Sheet Thyroid Nodules March 2010 Download PDFs English Espanol Hindi ... Singer, MD Leonard Wartofsky, MD What is the thyroid gland? The thyroid gland is a butterfly-shaped ...

  16. Thyroid Antibodies

    ... limited. Home Visit Global Sites Search Help? Thyroid Antibodies Share this page: Was this page helpful? Also known as: Thyroid Autoantibodies; Antithyroid Antibodies; Antimicrosomal Antibody; Thyroid Microsomal Antibody; Thyroid Peroxidase Antibody; ...

  17. Thyroid Surgery

    ... are already on thyroid medication for low thyroid (Hashimoto’s thyroiditis). If you have your entire (total) or ... TSH injection prior to RAI. Goiter Graves’ Disease Hashimoto’s Thyroiditis Hyperthyroidism (Overactive) Hypothyroidism (Underactive) Iodine Deficiency Low ...

  18. Thyroid Disease

    ... tests. Testing the level of thyroid stimulating hormone (TSH) in your blood can help your doctor figure out if your thyroid is overactive or underactive. TSH tells your thyroid to make thyroid hormones. Depending ...

  19. Differential diagnostics and surgical indications of cold thyroid nodules

    Balazs, G.; Fazakas, S.; Szikorszky, M., L.; Hajer, G.; Csaky, G.

    1974-01-01

    The incidence of thyroid carcinoma, of thyroid tumours of potential malignancy and of thyroiditis was studied on the basis of the histological features of cold nodules observed in 300 thyroids from a population of a flat area with endemic goitre. Clinical parameters have been designed for use in the differentiation of cold nodules and the timing of surgery.

  20. Local molecular analysis of indeterminate thyroid nodules

    Gill, Mandeep S.; Nayan, Smriti; Kocovski, Linda; Cutz, Jean-Claude; Archibald, Stuart D.; Jackson, Bernard S.; Young, James E. M.; Gupta, Michael K.

    2015-01-01

    Background Thyroid nodules are common but only a minority are malignant. Molecular testing can assist in helping determine whether indeterminate nodules are suspicious for malignancy or benign. The objective of the study was to determine if the analysis of mutations (BRAF, NRAS, KRAS and HRAS) using readily available molecular techniques can help better classify indeterminate thyroid nodules. Methods A retrospective cohort of consecutive patients undergoing diagnostic thyroid surgery were ana...

  1. Malignant salivary gland tumours

    Thompson, S.H. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Oral Pathology)

    1982-08-01

    The most frequent malignant salivary gland tumours are the mucoepidermoid tumour, adenoid cystic carcinoma and adenocarcinoma. The major salivary glands and the minor glands of the mouth and upper respiratory tract may potentially develop any of these malignant lesions. Malignant lesions most frequently present as a palpable mass and tend to enlarge more rapidly than benign neoplasms. Pain, paresthesia, muscle paralysis and fixation to surrounding tissue are all ominous signs and symptoms. The only reliable means of differential diagnosis of these lesions is biopsy and histologic analysis. Therapy involves surgery or a combination of surgery and radiation therapy. The ultimate prognosis is governed by the intrinsic biologic behaviour of the neoplasms, the extent of disease and adequate clinical therapy.

  2. Malignant salivary gland tumours

    The most frequent malignant salivary gland tumours are the mucoepidermoid tumour, adenoid cystic carcinoma and adenocarcinoma. The major salivary glands and the minor glands of the mouth and upper respiratory tract may potentially develop any of these malignant lesions. Malignant lesions most frequently present as a palpable mass and tend to enlarge more rapidly than benign neoplasms. Pain, paresthesia, muscle paralysis and fixation to surrounding tissue are all ominous signs and symptoms. The only reliable means of differential diagnosis of these lesions is biopsy and histologic analysis. Therapy involves surgery or a combination of surgery and radiation therapy. The ultimate prognosis is governed by the intrinsic biologic behaviour of the neoplasms, the extent of disease and adequate clinical therapy

  3. Thyroid lesions diagnosis by Fourier transformed infrared absorption spectroscopy (FTIR)

    Thyroid nodules are a common disorder, with 4-7% of incidence in the Brazilian population. Although the fine needle aspiration (FNA) is an accurate method for thyroid tumors diagnosis, the discrimination between benign and malignant neoplasm is currently not possible in some cases with high incidence of false negative diagnosis, leading to a surgical intervention due to the risk of carcinomas. The aim of this study was to verify if the Fourier Transform infrared spectroscopy (FTIR) can contribute to the diagnosis of thyroid carcinomas and goiters, using samples of tissue and aspirates. Samples of FNA, homogenates and tissues of thyroid nodules with histopathological diagnosis were obtained and prepared for FTIR spectroscopy analysis. The FNA and homogenates samples were measured by μ-FTIR (between 950 . 1750 cm-1), at a nominal resolution of 4 cm-1 and 120 scans). Tissue samples were analyzed directly by ATR-FTIR technique, at a resolution 2 cm-1, with 60 scans in the same region. All spectra were corrected by the baseline and normalized by amides area (1550-1640 cm-1) in order to minimize variations of sample homogeneity. Then, spectra were converted into second derivatives using the Savitzk-Golay algorithm with a 13 points window. The Ward's minimum variance algorithm and Euclidean distances among the points were used for cluster analysis. Some FNA samples showed complex spectral pattern. All samples showed some cell pellets and large amount of hormone, represented by the bands of 1545 and 1655 cm-1. Bands in 1409, 1412, 1414, 1578 and 1579 cm-1 were also found, indicating possible presence of sugar, DNA, citric acid or metabolic products. In this study, it was obtained an excellent separation between goiter and malign lesion for the samples of tissues, with 100% of specificity in specific cluster and 67% sensibility and 50 of specificity. In homogenate and FNA samples this sensibility and specificity were lower, because among these samples, it were included many types of thyroid lesions. To obtain a more precise diagnosis for FNA of follicular thyroid the sample size should be increased. The results of this study suggest that FTIR spectroscopy may be useful for discriminate thyroid carcinomas from goiters in tissue samples. (author)

  4. Mucoepidermoid carcinoma of the thyroid with concomitant papillary carcinoma: comparison of findings on fine-needle aspiration biopsy and histology.

    Nath, Vikas; Parks, Graham E; Baliga, Mithra; Hartle, Edgar O; Geisinger, Kim R; Shenoy, Veena

    2014-12-01

    We report two cases of mucoepidermoid carcinoma (MEC) of the thyroid gland coexisting with, and possibly arising in, papillary thyroid carcinoma (PTC). In the first case, CT-guided fine-needle aspiration (FNA) was performed on a paratracheal mass representing extrathyroidal invasion of a right thyroid lobe tumor. The aspirate showed papillary fronds and cells in honeycombed arrangements with fine chromatin, enlarged nuclei, nuclear grooves, and intranuclear inclusions in a background of mucus and blood; a diagnosis of PTC was rendered initially. However, examination of histologic sections of the mass showed nests of malignant squamous cells with interspersed mucous cells and extracellular mucin, concordant with MEC, as well as PTC. A retrospective review of the FNA specimen identified MEC. In the second case, ultrasound-guided FNA was performed on a right thyroid lobe nodule. The aspirate contained two populations of epithelial cells: larger cells showing foci of both squamous and glandular differentiation that were interpreted as MEC and smaller follicular cells with nuclear changes characteristic of PTC; both were addressed in the diagnostic report. Primary MEC of the thyroid is a rare neoplasm typically exhibiting indolent clinical behavior, although our first case demonstrated extensive local invasion. It is thought to arise from squamous metaplasia associated with PTC, Hashimoto thyroiditis, or other inflammatory or neoplastic processes. In thyroid FNAs, the presence of neoplastic mucous cells and extracellular mucin plus malignant squamous cells is diagnostic of MEC. As MEC is thought to arise in PTC, the finding of the latter in these aspiration specimens is not unexpected. PMID:25307114

  5. Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules

    Dobrinja, Chiara; Bernardi, Stella; Fabris, Bruno; Eramo, Rita; Makovac, Petra; Bazzocchi, Gabriele; Piscopello, Lanfranco; Barro, Enrica; de Manzini, Nicolò; Bonazza, Deborah; Pinamonti, Maurizio; Zanconati, Fabrizio; Stacul, Fulvio

    2015-01-01

    Background. Radiofrequency ablation (RFA) has been recently advocated as an effective technique for the treatment of symptomatic benign thyroid nodules. It is not known to what extent it may affect any subsequent thyroid surgery and/or histological diagnosis. Materials and Methods. RFA was performed on 64 symptomatic Thy2 nodules (benign nodules) and 6 symptomatic Thy3 nodules (follicular lesions/follicular neoplasms). Two Thy3 nodules regrew after the procedure, and these patients accepted to undergo a total thyroidectomy. Here we present how RFA has affected the operation and the final pathological features of the surgically removed nodules. Results and Conclusions. RFA is effective for the treatment of Thy2 nodules, but it should not be recommended as first-line therapy for the treatment of Thy3 nodules (irrespective of their mutational status), as it delays surgery in case of malignancy. Moreover, it is unknown whether RFA might promote residual tumor progression or neoplastic progression of Thy3 lesions. Nevertheless, here we show for the first time that one session of RFA does not affect subsequent thyroid surgery and/or histological diagnosis. PMID:26265914

  6. Medullary carcinoma of the thyroid

    Medullary thyroid carcinoma is a biologically distinct form of thyroid cancer and accounts for 5-10% of all thyroid neoplasms. Twenty percent of MTC can occur in a familial setting either by itself or as part of the multiple endocrine neoplasm syndromes. A disciplined approach is necessary in the work-up of these patients to rule out coexistent endocrine tumors (pheochromocytomas and parathyroid). Cacitonin is a sensitive tumor marker secreted by MTC that is of prognostic value and important in the follow-up of patients. Surgery is the mainstay of treatment with a total thyroidectomy and centre compartment clearance being the minimum for patients without cervical adenopathy. Radiotherapy has a limited role and is only indicated as a palliative measure in patients with advanced/metastatic disease not amenable to surgery

  7. {sup 131}I treatment for thyroid cancer and the risk of developing salivary and lacrimal gland dysfunction and a second primary malignancy: a nationwide population-based cohort study

    Ko, Kuan-Yin [National Taiwan University Hospital, Department of Nuclear Medicine, Taipei (China); Kao, Chia-Hung [China Medical University, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, Taichung (China); China Medical University Hospital, Department of Nuclear Medicine and PET Center, Taichung (China); Lin, Cheng-Li [China Medical University Hospital, Management Office for Health Data, Taichung (China); China Medical University, College of Medicine, Taichung (China); Huang, Wen-Sheng [Changhua Christian Hospital, Department of Nuclear Medicine, Changhua (China); Yen, Ruoh-Fang [National Taiwan University Hospital, Department of Nuclear Medicine, Taipei (China); National Taiwan University College of Medicine, Department of Radiology, Taipei (China)

    2015-07-15

    The aim of this study was to determine the prevalence of salivary and lacrimal gland dysfunction and a second primary malignancy in patients from Taiwan with thyroid cancer after radioiodine therapy. This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database from 2000 to 2011. A total of 1,834 thyroid cancer patients treated with {sup 131}I therapy and 1,834 controls (thyroid cancer without {sup 131}I therapy) selected by 1:1 matching on a propensity score were enrolled. The cumulative {sup 131}I dose in each patient was calculated. A Cox proportional hazards model was applied to estimate the effect of radiation from the {sup 131}I therapy on the risk of salivary and lacrimal gland impairment as well as second primary malignancies in terms of hazard ratios (HRs) and 95 % confidence intervals (CIs). In patients treated with {sup 131}I therapy and in controls, the incidence rates of salivary gland dysfunction were 6.76 and 1.01 per 10,000 person-years, respectively (HR 6.81, 95 % CI 0.74 - 55.3), the incidence rates of keratoconjunctivitis sicca (KCS) were 13.6 and 16.3 per 10,000 person-years, respectively (HR 0.84, 95 % CI 0.41 - 1.73), and the incidence rates of second primary malignancy were 76.7 and 62.4 per 10,000 person-years, respectively (HR 1.23, 95 % CI 0.88 - 1.72). The risk of salivary secretion impairment significantly increased with increasing administered doses (HR 14.3, 95 % CI 1.73 - 119.0). However, there was no increase in the incidence of KCS or secondary cancer in patients treated with higher doses. {sup 131}I therapy insignificantly increased the risk of salivary gland dysfunction and second primary malignancy. In patients with higher cumulative doses, an increase in the incidence of salivary gland dysfunction was observed. By contrast, we did not find an association between {sup 131}I treatment and KCS development. (orig.)

  8. A rare case of thyroid metastasis from pancreatic adenocarcinoma.

    Kelly, Michael E

    2012-02-01

    CONTEXT: Thyroid metastasis from pancreatic adenocarcinoma is extremely rare, with only two previous cases in the literature. We report a case of pancreatic adenocarcinoma metastasising to the thyroid. We review the incidence, diagnosis, and management of this rare occurrence. CASE REPORT: A 38-year-old man with a synchronous 6-month history of thyroid swelling, presented with epigastric pain and signs of obstructive jaundice. He was investigated by abdominal computerised tomography and endoscopic retrograde cholangiopancreatography. The diagnosis of pancreatic neoplasm was made. His thyroid neoplasm was investigated at another tertiary centre and thought to be a papillary neoplasm. He underwent a pancreaticoduodenectomy and recovered well post-operatively. Eight weeks later he had a total thyroidectomy. Histology confirmed that the thyroid mass was both morphologically and immunophenotypically similar to the pancreatic neoplasm. CONCLUSION: This case demonstrates the importance of a full investigation when a patient with suspected neoplastic history presents with a thyroid nodule. We outline the crucial role that immunohistochemistry plays in detecting and classifying primary and secondary thyroid neoplasms. The detection of a solitary thyroid metastasis from pancreatic adenocarcinoma may indicate a poor prognosis, and it is debatable whether resection of the primary should be undertaken when it presents with a solitary metastasis.

  9. Sweet syndrome and its association with hematopoietic neoplasms

    Soto, Rodrigo; Levy, Yair

    2015-01-01

    The Sweet syndrome, or acute febrile neutrophilic dermatosis, is rare and has characteristic clinical, physical, and pathologic findings: abrupt onset of pyrexia, elevated neutrophil count, tender erythematous skin lesions, and a diffuse infiltrate of mature neutrophils in the reticular dermis with edema in the papillary dermis. The Sweet syndrome can be further classified based on the clinical setting: classical, malignancy-associated, and drug-induced. Diagnosis can alert the clinician to the presence of an underlying malignancy or the recurrence of a malignancy. The most commonly associated malignancy is acute myelogenous leukemia. We present three cases of Sweet syndrome associated with hematopoietic neoplasms. PMID:25552802

  10. Anti-apoptotic gene transcription signature of salivary gland neoplasms

    Development of accurate therapeutic approaches to salivary gland neoplasms depends on better understanding of their molecular pathogenesis. Tumour growth is regulated by the balance between proliferation and apoptosis. Few studies have investigated apoptosis in salivary tumours relying almost exclusively on immunohistochemistry or TUNEL assay. Furthermore, there is no information regarding the mRNA expression profile of apoptotic genes in salivary tumors. Our objective was to investigate the quantitative expression of BCL-2 (anti-apoptotic), BAX and Caspase3 (pro-apoptotic genes) mRNAs in salivary gland neoplasms and examine the association of these data with tumour size, proliferative activity and p53 staining (parameters associated with a poor prognosis of salivary tumours patients). We investigated the apoptotic profile of salivary neoplasms in twenty fresh samples of benign and seven samples of malignant salivary neoplasms, using quantitative real time PCR. We further assessed p53 and ki-67 immunopositivity and obtained clinical tumour size data. We demonstrated that BCL-2 mRNA is overexpressed in salivary neoplasms, leading to an overall anti-apoptotic profile. We also found an association between the anti-apoptotic index (BCL-2/BAX) with p53 immunoexpression. A higher proliferative activity was found in the malignant tumours. In addition, tumour size was associated with cell proliferation but not with the transcription of apoptotic genes. In conclusion, we show an anti-apoptotic gene expression profile in salivary neoplasms in association with p53 staining, but independent of cell proliferation and tumour size

  11. Appearance of Hürthle cell carcinoma soon after surgical extirpation of Hürthle cell adenoma and follicular adenoma of the thyroid gland

    Hürthle cell neoplasms could be benign (Hürthle cell adenoma) or malignant (Hürthle cell carcinoma). Hürthle cell carcinoma is a rare tumour, representing 5% of all differentiated thyroid carcinomas. The cytological evaluation of Hürthle cell neoplasms by fine needle aspiration biopsy (FNAB) is complicated because of the presence of Hürthle cells in both Hürthle cell adenoma and Hürthle cell carcinoma. Thus, the preoperative distinction between these two entities is very difficult and possible only with pathohistological findings of the removed tumour. A 57-year old female patient was admitted at our Department, for investigation of nodular thyroid gland. She was euthyroid and FNAB of the nodules in both thyroid lobes were consistent of Hürthle cell adenoma with cellular atypias. After thyroidectomy the histopathology revealed Hürthle cell adenoma with high cellular content and discrete cellular atypias in the left lobe and follicular thyroid adenoma without cellular atypias in the right lobe. One year after substitution therapy, a palpable tumour on the left side of the remnant tissue was found, significantly growing with time, presented as hot nodule on 99mTc-sestamibi scan and conclusive with Hürthle cell adenoma with marked cellularity on FNAB. Tumorectomy was performed and well-differentiated Hürthle cell carcinoma detected. The patient received ablative dose of 100 mCi 131I. No signs of metastatic disease are present up to date. The differences between Hürthle cell adenomas and Hürthle cell carcinomas could be clearly made only by histopathological evaluation. Patients with cytological diagnosis of Hürthle cell neoplasms should proceed to total thyroidectomy, especially if tumour size is > 1cm, FNAB findings comprise cellular atypias and/or multiple bilateral nodules are detected in the thyroid gland

  12. Panorama of neoplasms of upper GI tract: a 5 year research study

    T.C.S. Suman Kumar

    2015-06-01

    Results: we have received 120 specimens regarding the upper gastrointestinal system. Among these 120 specimens, 71 specimens were endoscopic biopsies and 49 specimens were surgically resected specimens. Out of 71 Endoscopic biopsies 28 biopsies were malignant among which 2 was esophagus and 26 were stomach. Out of 49 surgically resected specimens 1 was benign and 32 were malignant tumors. Out of 59 neoplasms of stomach there were single cases each of Sub mucosal Lipoma, Malignant lymphoma, GIST and 56 cases of Adenocarcinoma and its variants were noted. Conclusion: Most of the neoplasms are of stomach (97%. All the neoplasms are malignant except one benign lesion sub mucous lipoma of stomach. Most of the neoplasms of stomach were Adenocarcinoma (96.5%. Both tumors of esophagus were squamous cell carcinoma occurred after 50 years of age. [Int J Res Med Sci 2015; 3(6.000: 1313-1320

  13. Criterios ecogrficos diagnsticos de neoplasia maligna en el ndulo tiroideo: correlacin con la puncin por aspiracin con aguja fina y la anatoma patolgica Ultrasound diagnostic criteria of malignancy in a thyroid nodule: correlation with fine needle aspiration and pathology

    Andrs Ignacio Chala

    2013-03-01

    Full Text Available Introduccin. La ecografa de tiroides ha mejorado la certeza diagnstica para neoplasia maligna del ndulo tiroideo. Es importante definir qu ndulos requieren biopsia por aspiracin con aguja fina (BACAF para disminuir el costo de un procedimiento innecesario y evitar que pase inadvertido el diagnstico de neoplasia maligna. Objetivo. Validar los criterios ecogrficos de neoplasia maligna que indican la puncin por aspiracin con aguja fina de tiroides. Materiales y mtodos. Se dise un estudio prospectivo a tres aos para evaluar la concordancia entre los hallazgos ecogrficos y la puncin por aspiracin con aguja fina de tiroides comparada con el estudio final de histopatologa. Se evalu la sensibilidad, la especificidad, el valor diagnstico positivo y negativo, la concordancia medida por el coeficiente kappa y el coeficiente de correlacin. Resultados. Se estudiaron 1.467 pacientes, 10,2 % hombres y 89,8 % mujeres, con edades entre los 10 y los 95 aos; el tamao promedio del ndulo fue de 16 mm. Un total de 623 requirieron tiroidectoma; al resto se les hizo seguimiento por ecografa. Se presentaron 269 carcinomas papilares, 14 foliculares, 4 indiferenciados, 159 bocios, 74 adenomas y 101 tiroiditis. Se obtuvo sensibilidad de 86,4 %, especificidad de 89,4 %, valor diagnstico de un resultado positivo de 87,5 % y uno negativo de 84,1 %. Los hallazgos ecogrficos relacionados con cncer fueron: hipoecogenicidad, microcalcificaciones, papilas y flujo intranodular. Individualmente, la concordancia fue baja, pero con la combinacin de hipoecogenicidad, microcalcificaciones y papilas fue media y, con la adicin de aumento del flujo intranodular, result alta. Conclusiones. La combinacin de hipoecogenicidad, microcalcificaciones, papilas y alto flujo intranodular tiene alta concordancia con neoplasia maligna; sin embargo, cada criterio por separado no la tiene, y no pueden usarse individualmente para predecir o descartar neoplasia maligna.Introduction. Thyroid ultrasound has improved the diagnostic accuracy in the diagnosis of malignant neoplasia in thyroid nodules. It is important to define which nodules require fine needle aspiration so as to diminish the costs of unnecessary procedures and at the same time avoid unnoticed malignancy. Objective. To validate the echographic criteria of malignant neoplasia that validate fine needle aspiration of the thyroid nodule. Material and methods. Three-year prospective study to assess correlation between the ultrasound findings and fine needle aspiration with pathology findings, including sensibility, specificity, positive predictive value, negative predictive value, and concordance measured by Kappa coefficient, and correlation coefficient. Results. The study included 1,467 patients, 10,2% males and 89,8% females, with ages ranging from 10 years to 95 years; average size of the nodule was 16 mm; 623 patients required thyroidectomy, while the remainder were followed by ultrasound. There were 269 papillary carcinomas, 14 follicular carcinomas, 4 anaplastic carcinomas, 159 goiters, 74 adenomas, and 101 thyroiditis. Sensibility was 86,4%, specificity was 89,4%, positive predictive value 87,5%, and negative predictive value 84,1%. Ultrasound findings related with cancer were hypoechogenicity, microcalcifications, papillae, and intranodal flow; when adding intranodal flow, concordance was high. Conclusions. The combination of hypoechogenicity, microcalcifications, papillae and high intranodal flow exhibit high concordance with malignancy; however, echographic criteria considered individually does not, and those individual criteria cannot be used to predict or rule out malignant neoplasia.

  14. Diagnostic value of fine needle aspiration biopsy in 'cold' thyroid nodules

    In this study fined needle aspiration (FNA) was performed to ascertain a preoperative diagnosis in patients with cold thyroid nodules. A brief clinical history comprising of general physical and local examination was recorded on a proforma. Fine needle aspiration of thyroid nodules were performed with 5 ml disposable syringe (22g needle). Local anesthesia was not used. Four slides were prepared in each case, two were fixed in 95% alcohol for Pananicolau's stain and the Haematoxylin and Eosin while other two slides were air dried for May Grunwald Giemsa stains. Surgical specimens were received at the Department of Pathology and processed as per routine. Cytological and histological reporting was done separately and independently. Special stains were performed when required. A total of 91 patients were studied, in 14 cases aspirate was unsatisfactory and in 21 cases surgery was not performed. In 56 patient, histological correlation was available. Forty were reported benign, out of which 37 proved correct on histological examination. Of the eleven smears reported as follicular neoplasm, 9 proved correct and 2 reported as 'suspicious' and 3 as 'malignant' also proved malignant on histological examination. Sensitivity was 86.36% and specificity was 100%. Efficiency of the test was 94.9%. Fine needle aspiration biopsy was found to be simple and valuable technique for a reliable preoperative diagnosis of thyroid nodules. (author)

  15. HYALINISING TRABECULAR TUMOR- THYROID

    Bharath

    2013-01-01

    Full Text Available ABSTRACT: BACKGROUND: Hyalinising trabecular tumors of thyroid is an in teresting but uncommon neoplasm of thyroid. This is presented bec ause of its peculiar morphologic features, including encapsulation, trabecular pattern and marke d hyalinization. OBJECTIVES: To know the morphologic feature and its histological behavio r. METHOD: Hemithyroidectomy specimen was received with fixative. The specimen was grossed , bits were taken from appropriate areas & processed in Histokinette, embedded in paraffin and t he serial sections were stained with Hematoxylin & Eosin. RESULTS: Histologically, showed encapsulated cellular growth , composed of follicular cells arranged in trabecular and foll icular pattern. They are separated by fibrous bands and areas of abundant hyalinization seen. The nuclei of the cells were vesicular with indistinct nucleoli, having pale vacuolated cytoplasm . CONCLUSION: Hyalinizing trabecular tumor is an uncommon neoplasm with its peculiar morph ologic features. It is sometimes mistaken for other neoplasm like- Papillary carcinom a, insular carcinoma & paraganglioma.. Hence histologic evaluation of cytomorphologic featu res is important for definitive diagnosis

  16. Cystic renal neoplasms and renal neoplasms associated with cystic renal diseases in adults: cross-sectional imaging findings.

    Katabathina, Venkata S; Garg, Deepak; Prasad, Srinivasa R; Vikram, Raghu

    2012-01-01

    Cystic renal neoplasms in adults are a heterogeneous group of tumors with characteristic histogenesis, pathological findings, and variable biological profiles. They include disparate entities that are either biologically benign (lymphangioma, cystic nephroma, and mixed epithelial and stromal tumor) or malignant (cystic renal cell carcinoma, multilocular cystic renal cell carcinoma, and primary renal synovial sarcoma). Renal cystic diseases are characterized by cystic changes of the kidneys due to hereditary, developmental, or acquired etiology. Cystic renal diseases such as acquired cystic kidney disease, von Hippel-Lindau disease, and tuberous sclerosis are associated with the development of a wide spectrum of benign and malignant renal neoplasms. Most cystic renal tumors and cystic disease-associated renal neoplasms show characteristic cross-sectional imaging findings that permit accurate diagnosis. In addition, cross-sectional imaging is pivotal in the follow-up and surveillance of adult cystic tumors of the kidney. PMID:23192202

  17. Insights into the posttranslational structural heterogeneity of thyroglobulin and its role in the development, diagnosis, and management of benign and malignant thyroid diseases.

    Xavier, Ana Carolina W; Maciel, Rui M B; Vieira, José Gilberto H; Dias-da-Silva, Magnus R; Martins, João R M

    2016-02-01

    Thyroglobulin (Tg) is the major glycoprotein produced by the thyroid gland, where it serves as a template for thyroid hormone synthesis and as an intraglandular store of iodine. Measurement of Tg levels in serum is of great practical importance in the follow-up of differentiated thyroid carcinoma (DTC), a setting in which elevated levels after total thyroidectomy are indicative of residual or recurrent disease. The most recent methods for serum Tg measurement are monoclonal antibody-based and are highly sensitive. However, major challenges remain regarding the interpretation of the results obtained with these immunometric methods, particularly in patients with endogenous antithyroglobulin antibodies or in the presence of heterophile antibodies, which may produce falsely low or high Tg values, respectively. The increased prevalence of antithyroglobulin antibodies in patients with DTC, as compared with the general population, raises the very pertinent possibility that tumor Tg may be more immunogenic. This inference makes sense, as the tumor microenvironment (tumor cells plus normal host cells) is characterized by several changes that could induce posttranslational modification of many proteins, including Tg. Attempts to understand the structure of Tg have been made for several decades, but findings have generally been incomplete due to technical hindrances to analysis of such a large protein (660 kDa). This review article will explore the complex structure of Tg and the potential role of its marked heterogeneity in our understanding of normal thyroid biology and neoplastic processes. PMID:26909485

  18. Diagnostic value of 99Tcm-MIBI imaging for thyroid nodules

    Objective: The imaging results and its false positive and false negative cases were analysed by semi-quantitative method in order to evaluate the value of 99Tcm-MIBI imaging for the diagnosis of thyroid nodules objectively. Methods: The imaging results of 269 cases, which was confirmed by pathology or biopsy, were analysed. The uptake ratio (UR) of T/N was calculated at 5 and 60 min after 99Tcm-MIBI injection. The false positive and false negative imaging results were analysed. Results: The UR value of 162 cases of benign group was 0.806 +- 0.192 and 0.847 +- 0.189, respectively at the time of 5 and 60 min, whereas 107 cases of malignant group was 1.839 +- 0.734 and 1.675 +- 0.551, respectively. There was a significant UR difference between two groups at two time points (P 99Tcm-MIBI imaging for the thyroid nodules was 89.24%, 93.82% and 87.36%, respectively. The false positive and false negative rate was 15.78% and 12.09%. The positive and negative prognostic value was 77.57% and 93.83%. Conclusions: The benign and malignant thyroid nodules can be differentiated primarily with 99Tcm-MIBI semi-quantitative imaging. But it has no specificity for various thyroid neoplasms. The thyroid adenomas and multi-nodular goiter have a slightly higher rate of false positive. So the imaging results must be analysed carefully and the blood imaging and clinical information should be referred to

  19. Treatment Option Overview (Myelodysplastic/Myeloproliferative Neoplasms)

    ... Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment (PDQ®)–Patient Version General Information About Myelodysplastic/ Myeloproliferative ...

  20. Treatment Options for Myelodysplastic/Myeloproliferative Neoplasms

    ... Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment (PDQ®)–Patient Version General Information About Myelodysplastic/ Myeloproliferative ...

  1. Thyroid Tests

    ... having the scan for other health problems. Nuclear medicine tests. Nuclear medicine tests of the thyroid include a thyroid ... A thyroid scan is a type of nuclear medicine imaging. Nuclear medicine uses small amounts of radioactive material to ...

  2. Postpartum Thyroiditis

    ... to be an autoimmune disease very similar to Hashimoto’s thyroiditis. In fact, these two disorders cannot be ... from one another on pathology specimens. As in Hashimoto’s thyroiditis, postpartum thyroiditis is associated with the development ...

  3. Thyroid Problems

    ... producing a hormone knows as thyroid-stimulating hormone (TSH). Most people who have an underactive thyroid gland ... levels of T4 and high blood levels of TSH. Hyperthyroidism Also known as overactive thyroid and thyrotoxicosis, ...

  4. Papillary Carcinoma in Median Aberrant Thyroid (Ectopic) - Case Report

    Hebbar K, Ashwin; K, Shashidhar; Deshmane, Vijaya Laxmi; Kumar, Veerendra; Arjunan, Ravi

    2014-01-01

    Median ectopic thyroid may be encountered anywhere from the foramen caecum to the diaphragm. Non lingual median aberrant thyroid (incomplete descent) usually found in the infrahyoid region and malignant transformation in this ectopic thyroid tissue is very rare. We report an extremely rare case of papillary carcinoma in non lingual median aberrant thyroid in a 25-year-old female. The differentiation between a carcinoma arising in the median ectopic thyroid tissue and a metastatic papillary ca...

  5. Thyroid carcinoma in children

    Thyroid cancer is rare in children, with only 3-6% of thyroid malignancies occurring in children, and constitutes but 6% of head and neck tumors. Over 95% thyroid cancer are differentiated, and 10% of these occur in children of adolescents. Any of the histologic types that occur in adults may be in children, but they are most often differentiated thyroid carcinomas. The etiologies of thyroid carcinoma are unknown, but factors considered in pathogenesis include irradiation, sex and age. The incandesce of thyroid carcinoma in a solitary coddle in a child has been described as high as 70%. History and /or physical examination alone are unlikely to advance the diagnosis, and with exception of plasma CT in medullary thyroid carcinoma, blood studies are unhelpful in the diagnosis of thyroid carcinoma. Radiographs and ultrasound imaging are helpful in planning treatment and follow-up, but are unlikely to be needed for initial diagnosis. One of the main indication of thyroid scan in the pediatric group is thyroid nodule. FNAB is established as the most effective method of diagnosis in adults, although in children it may be less reliable. While radionuclide scintigraphy may be considered for initial screening, FNAB is well established and its specificity allows it to negate the need for a substantial number of operation. Treatment of differentiated thyroid carcinoma in children is more controversial. Some authors maintain that modified or subtotal thyroidectomy is appropriation this disease, others maintain that total thyroidectomy is required Nevertheless, radioiodine therapy is considered to be standard in the treatment of iodine-avid thyroid carcinomas for ablation of the thyroid remnant following surgery and for treatment of iodine-avid distant diseases. The front-line treatment of medullary thyroid carcinoma is aggressive surgery. Total thyroidectomy is indicated, In general treatment with chemotherapy, extemal radiation and I-131 are not helpful, however radioactive idiom therapy may be helpful in patients with normal postoperative calcitonin levels in preventing recurrence. At this time, the concomitant use of I-131 whole body scintigraphy, serum thyroglobulin. and neck ultrasonography appears to be the most practical and efficacious methods of long-term follow-up. Ultrasound and or are being added to the armament atrium as it becomes clear that patient with a negative whole body iodine image and measurable serum T g may have recurrent disease that is amenable to surgical removal and/or further radiotherapy

  6. Risk factors for neoplasms

    A broad survey is given of risk factors for neoplasms. The main carcinogenic substances (including also ionizing radiation and air pollution) are listed, and are correlated with the risk factors for various cancers most frequently explained and discussed in the literature. The study is intended to serve as a basis for a general assessment of the incidence of neoplasms in children, and of cancer mortality in the entire population of Bavaria in the years 1983-1989, or 1979-1988, respectively, with the principal idea of drawing up an environment-related health survey. The study therefore takes into account not only ionizing radiation as a main risk factor, but also other risk factors detectable within the ecologic context, as e.g. industrial installations and their effects, refuse incineration plants or waste dumps, or the social status. (orig./MG)

  7. [Hematologic neoplasms and pregnancy].

    Tartas, N; Chacón, R; Sánchez Avalos, J C

    1995-01-01

    Hematologic neoplasms diagnosed during pregnancy, present significant difficulties in patient management. Besides the strictly medical facts, moral, ethical and religious issues should be strongly considered. For the optimal management of individual situations an integrated multidisciplinary approach is mandatory. Hodgkin's disease, acute leukemias, non Hodgkin's lymphoma and less frequently chronic myelogenous leukemia have been reported in pregnant women. Curative treatment for most of these diseases include intensive chemotherapy regimens. Potential damage to the fetus is a major concern, due to the teratogenic effects of antimetabolites, alkylating agents and radiation therapy. Effect of pregnancy in each of these neoplasms is discussed. Although some rules of management exist, dangerous generalizations should be avoided. Particular obstetric considerations such as timing of delivery, and therapeutic abortion should be carried out on an individual basis. The emotional impact of the situation must not be underestimated. PMID:7565054

  8. Occupation and lymphoid neoplasms.

    La Vecchia, C.; E. Negri; D'Avanzo, B; Franceschi, S.

    1989-01-01

    The relationship between occupation and exposure to a number of occupational agents and lymphoid neoplasms was investigated in a case-control study of 69 cases of Hodgkin's disease, 153 non-Hodgkin's lymphomas, 110 multiple myelomas and 396 controls admitted for acute diseases to a network of teaching and general hospitals in the greater Milan area. Among the cases, there was a significant excess of individuals ever occupied in agriculture and food processing: the multivariate relative risks ...

  9. Acquired hemophilia in malignancy.

    Reeves, Brandi N; Key, Nigel S

    2012-04-01

    Acquired hemophilia is a rare but potentially morbid complication in patients with cancer. It may be seen in patients with hematologic neoplasms (usually lymphoproliferative disorders) or with solid tumors. Although the presence of an underlying malignancy portends a worse outcome, the literature suggests that the usual principles of treatment, including immunosuppression, apply to these patients. However, appropriate consideration should be given to the choice of agents, depending on individual risk factors for complications such as thrombosis and infection. PMID:22682137

  10. "Periportal neoplasms"-a CT perspective: review article.

    Singh, Anuradha; Chandrashekhara, S H; Handa, Nayha; Baliyan, Vinit; Kumar, Pawan

    2016-04-01

    The periportal space is a potential space surrounding the portal vein and its intrahepatic branches. A variety of neoplasms can involve the periportal region, whether primary or secondary, owing to contiguous spread from surrounding hepatic parenchyma or from adjacent organs. CT plays an important role in not only diagnosing these lesions but also determining the extent of the disease. Most of the malignancies leading to the periportal spread manifest as periportal hypodensity either distinctly or in contiguity with the primary tumour. Even in known malignancies, periportal hypodensity commonly results from non-neoplastic causes like periportal oedema; hence, a knowledge of the imaging findings to ascertain its presence as well as to conclude the definite neoplastic spread is prudent. Periportal spread of neoplasm may suggest locally aggressive or disseminated disease (in extrahepatic malignancies), which may change management accordingly. PMID:26800313

  11. Clinical application of EBCT in the diagnosis of cardiac neoplasms

    Objective: To probe the clinical utilization of electron beam CT (EBCT) in the diagnosis of cardiac neoplasms. Methods: Between July 1995 and Feb 1999. EBCT was performed in 12024 patients in our hospital. 40 (0.33%) patients were diagnosed as cardiac neoplasms. Retrospective analysis of 22 patients confirmed by operation, autopsy or follow-up was done. In this group, there were 13 males and 9 females, age ranged from 5 months to 72 years old (averaged 41.9 years). 17 patients had both contrast single slice mode (contrast SSM) and movie mode, 3 patients only SSM, 1 patient movie mode and 1 patient plain SSM. Results: Accurate localization and quantitative diagnoses were made in all the 22 patients and correct histopathological diagnosis was made in 10 patients with myxoma. EBCT provided characteristic clues to proper histopathological determination in 6 of the 7 patients with non-myxomatous benign neoplasms. In the 5 patients with malignant masses, 4 patients acquired distinct histopathological classifications, and involvement of the adjacent anatomic structures was revealed. Conclusion: Because of excellent temporal, spatial and density resolution, EBCT has not only high accuracy in the diagnosis of myxoma, but also possesses advantage superior to echocardiography in the definition of non-myxomatous benign and malignant neoplasms, which are difficult to diagnose histopathologically using echocardiography. EBCT is also valuable for assessment of involvement of neighbouring organs. In the diagnosis of cardiac neoplasm without specific features, this method is limited and difficult

  12. Cribriform-Morular Variant of Papillary Thyroid Carcinoma

    Bahar AKKAYA

    2009-09-01

    Full Text Available Cribriform-morular variant of papillary thyroid carcinoma is a rare histological subtype of papillary thyroid carcinoma. This subtype is commonly reported in patients with familial adenomatous polyposis. However, cases not associated with polyposis have also been reported. The differential diagnosis of this entity from other aggressive thyroid neoplasms is important. A 29-year old man presented with a solitary mass in the left thyroid lobe underwent total thyroidectomy. Pathologic examination of the specimen revealed cribriform-morular variant of papillary thyroid carcinoma. After diagnosis, colonoscopy revealed a normal colon without polyposis. Herein, we report a case not associated with polyposis and discuss with the literature.

  13. “Focal thyroid inferno” on color Doppler ultrasonography: A specific feature of focal Hashimoto's thyroiditis

    Purpose: To evaluate color-Doppler features predictive of focal Hashimoto's thyroiditis. Materials and methods: A total of 521 patients with 561 thyroid nodules that underwent surgeries or gun biopsies were included in this study. These nodules were divided into three groups: focal Hashimoto's thyroiditis (104 nodules in 101 patients), benignity other than focal Hashimoto's thyroiditis (73 nodules in 70 patients), and malignancy (358 nodules in 350 patients). On color Doppler sonography, four vascularity types were determined as: hypovascularity, marked internal flow, marked peripheral flow and focal thyroid inferno. The χ2 test was performed to seek the potential vascularity type with the predictive ability of certain thyroid pathology. Furthermore, the gray-scale features of each nodule were also studied. Results: The vascularity type I (hypovascularity) was more often seen in focal Hashimoto's thyroiditis than other benignity and malignancy (46% vs. 20.5% and 19%). While the type II (marked internal flow) showed the opposite tendency (26.9% [focal Hashimoto's thyroiditis] vs. 45.2% [other benignity] and 52.8% [malignancy]). However, type III (marked peripheral flow) was unable to predict any thyroid pathology. Importantly, type IV (focal thyroid inferno) was exclusive to focal Hashimoto's thyroiditis. All 8 type IV nodules appeared to be solid, hypoechoic, and well-defined. Using “focal thyroid inferno” as an indicator of FHT, the diagnostic sensitivity and specificity were 7.7% and 100% respectively. Conclusions: The vascularity type of “focal thyroid inferno” is specific for focal Hashimoto thyroiditis. Recognition of this particular feature may avoid unnecessary interventional procedures for some solid hypoechoic thyroid nodules suspicious of malignancy.

  14. Preoperative thyroid scintigraphy: pro routine investigation

    Thyroid scintigraphy using Tc-99m-pertechnetate is indicated to differentiate regional function whenever parenchymal lesions are shown by ultrasound. Using quantitatively evaluated thyroid scans it is possible to early detect autonomously functioning thyroid tissue and to quantify its functional mass as well. Clinical indications for thyroid imaging using radioiodine are to determine the nature of a mass in the substernal area, in the neck or in the tongue, to detect thyroid malignant growth and functioning metastases as well, and to follow therapy of disease. (author)

  15. Association between systemically administered radioisotopes and subsequent malignant disease

    There is a long history recording the association of x radiation and the subsequent development of malignant tumors. For systemically administered isotopes this came into prominence when Martland discovered the association between cancer, particularly of the bone, and ingestion of radioactive isotopes by radium dial painters. This association was amplified by the development of cancer in patients given thorotrast as a contrast medium for diagnostic radiologic examination. Acute leukemia was reported 30 years ago in patients with polycythemia vera treated with 32P. Acute leukemia also occurs in patients with polycythemia vera treated only with phlebotomy or drugs. A controlled study is now underway to provide a more definite answer to question what is the incidence of acute leukemia in patients with polycythemia vera treated by phlebotomy alone, chlorambucil, or 32P. 131I for the treatment of hyperthyroidism probably does not induce cancer, but in the doses used for thyroid cancer there was an increased incidence of neoplasms (12/200 in one study). This was higher than the expected incidence of neoplasms. The doses of radioactive isotopes used currently for diagnostic purposes have not induced cancer, but it is difficult and probably impossible to verify this with absolute certainty

  16. Burkitts primary thyroid lymphoma coexistence with Hashimoto's thyroiditis; Linfoma Burkitt primario tiroideo. Coexistencia con tiroiditis de Hashimoto

    Higuera, A. [Hospital Alto Guadalquivir. Andujar Jaen (Spain); Vicente, J.; Lazaro, J. C. [Hospital Universitario Reina Sofia. Cordoba (Spain)

    2000-07-01

    Th primary thyroid lymphoma is a rare neoplasm, above all in children. We present a case of a child with Burkitt's thyroid lymphoma as the only manifestation of this disease, associated to lymphocytic thyroiditis. Clinically, it initiated as a rapidly growing goiter with compressive symptomatology. The X-ray findings are described: hypoechoic and hypodense multiple nodes that affect the right thyroid lobe and isthmus, with extraglandular extension to the vascular space and to the mediastinum. The differential diagnosis is considered with other more frequent thyroid pathologies in this age group. (Author) 14 refs.

  17. Disseminated encephalomyelitis-like central nervous system neoplasm in childhood.

    Zhao, Jianhui; Bao, Xinhua; Fu, Na; Ye, Jintang; Li, Ting; Yuan, Yun; Zhang, Chunyu; Zhang, Yao; Zhang, Yuehua; Qin, Jiong; Wu, Xiru

    2014-08-01

    A malignant neoplasm in the central nervous system with diffuse white matter changes on magnetic resonance imaging (MRI) is rare in children. It could be misdiagnosed as acute disseminated encephalomyelitis. This report presents our experience based on 4 patients (3 male, 1 female; aged 7-13 years) whose MRI showed diffuse lesions in white matter and who were initially diagnosed with acute disseminated encephalomyelitis. All of the patients received corticosteroid therapy. After brain biopsy, the patients were diagnosed with gliomatosis cerebri, primitive neuroectodermal tumor and central nervous system lymphoma. We also provide literature reviews and discuss the differentiation of central nervous system neoplasm from acute disseminated encephalomyelitis. PMID:23872916

  18. Expression of the RET/PTC fusion gene as a marker for papillary carcinoma in Hashimoto's thyroiditis

    Wirtschafter, A; Schmidt, R; Rosen, D; Kundu, N; Santoro, M; Fusco, A; Multhaupt, H; Atkins, J P; Rosen, M R; Keane, W M; Rothstein, J L

    1997-01-01

    Hashimoto's thyroiditis is an inflammatory disease of the thyroid gland with autoimmune etiology. Patients afflicted with Hashimoto's have a higher risk of thyroid malignancies such as papillary thyroid carcinoma. In the present study, we investigated the frequency of papillary thyroid carcinoma ...

  19. The results of combined therapy malignant neoplasms of maxillary sinus at Oncology Center in Poznan; Ocena wynikow leczenia skojarzonego chorych na nowotwory zlosliwe zatoki szczekowej w materiale Wielkopolskiego Centrum Onkologii

    Adamiak, E.; Cerkaska-Gluszak, B.; Gorny, A. [Wielkopolskie Centrum Onkologii im. M. Sklodowskiej-Curie, Poznan, (Poland)

    1994-12-31

    Between 1985-1989 22 patients with malignant neoplasma maxillary sinus have been treated. At the first stage the surgical resection of maxilla was performed. Most of the patients (77%) had histopathological diagnosis of carcinoma planoepitheliale, 13% carcinoma solidum and 4% carcinoma adenoides cysticum. All patients had adjuvant therapy by Co-60 irradiation. Single fraction dose of 2 Gy/T 5 times a week up to total dose of 60-70 Gy/T has been applied. In the follow-up period of minimum 36 months the free-symptoms survival rate of 18%. (author) 5 refs, 3 tabs, 1 fig

  20. Estrogens and Stem Cells in Thyroid Cancer

    GiorgioStassi

    2014-07-01

    Full Text Available Recent discoveries highlight the emerging role of estrogens in the initiation and progression of different malignancies through their interaction with stem cell compartment. Estrogens play a relevant role especially for those tumors bearing a gender disparity in incidence and aggressiveness, as occurs for most thyroid diseases. Although several experimental lines suggest that estrogens promote thyroid cell proliferation and invasion, their precise contribution in stem cell compartment still remains unclear. This review underlines the interplay between hormones and thyroid function, which could help to complete the puzzle of gender discrepancy in thyroid malignancies. Defining the association between estrogen receptors status and signaling pathways by which estrogens exert their effects on thyroid cells is a potential tool that provides important insights in pathogenetic mechanisms of thyroid tumors.

  1. The value of whole body 18F-fluorodeoxyglucose PET in detecting thyroid incidentaloma

    Along with positron emission tomography (PET) is widely use, the abnormal uptake of thyroid region is discovered. A lot of these thyroid incidentalomas are malignances. As functional image, PET not only can find the thyroid incidentalomas but also can distinguish the malignant from benign. (authors)

  2. In vivo fluorescence of medullary carcinoma of the thyroid: a technology with potential to improve visualization of malignant tissue at surgical resection.

    Johnson, Terence E; Luiken, George A; Quigley, Michael M; Xu, Mingxu; Hoffman, Robert M

    2008-08-01

    Medullary carcinoma of the thyroid requires aggressive treatment because of its potential to metastasize and because of the current limitations of preoperative localization and systemic therapy. If these tumors could be made to fluoresce in vivo with tagged fluorophore antibodies against tumor antigens, surgeons would be able to obtain additional information in the operating room to facilitate a more complete resection. Based on the success of our previous work in breast and colon cancer models, we conducted an animal study of in vivo tumor fluorescence of a human medullary thyroid cell line in which bright tumor fluorescence is visible during dissection. To accomplish this, we used an inexpensive and commercially available handheld, blue (470 nm), light-emitting diode flashlight and filtered goggles (520 nm). This procedure, which we call the fluorescent antibody-assisted surgical technique (FAAST), is easy to perform, requires no complex or expensive technical equipment, and has the potential to be applied to a wide variety of tumors. To the best of our knowledge, this is the first experiment of its kind to be reported in the literature. PMID:18712683

  3. Positron emission tomography detected thyroid incidentaloma

    Goddard, J.; Gaunt, A; Markham, DH

    2013-01-01

    We describe the case of a 48-year-old woman who presented with a thyroid lesion incidentally detected on positron emission tomography/computed tomography for a suspicious lung lesion. Subsequent clinical examination and investigations revealed a 3cm nodule in the left lower pole of the thyroid. Fine needle aspiration was indeterminate for malignancy. A left hemithyroidectomy was performed and histology confirmed a benign thyroid adenoma with an incidental micropapillary carcinoma. The literat...

  4. Differentiated thyroid carcinoma: nuclear medicine studies

    Verkooijen, Ronald B.T.

    2009-01-01

    The therapy of choice in patients suffering from differentiated thyroid cancer (DTC), subdivided into papillary and follicular thyroid carcinoma, is (near-)total thyroidectomy. This is routinely followed by the administration of radioiodine (RaI)-131 (131I) to destroy any remaining benign or malignant thyroid tissue, so-called ablation. This thesis has addressed some important clinical questions, related to the application of conventional (131I) and experimental therapies with radionuclides i...

  5. Primary papillary thyroid carcinoma previously treated incompletely with radiofrequency ablation

    Kim Hoon

    2010-01-01

    Full Text Available Radiofrequency ablation (RFA recently has been applied to benign thyroid nodules, mainly for the cosmetic reasons, and limited cases of local recurrences or focal distant metastases of well-differentiated thyroid cancer, in the high-risk reoperative condition or for the palliative purpose. But no report has been made on the RFA for primary thyroid cancer to date. We report on a patient with primary papillary carcinoma of thyroid gland who had undergone RFA before the cytological diagnosis of malignancy, later referred and treated with robotic surgery successfully. We can learn the following lessons from our case; (1 the RFA for operable primary thyroid malignancy should be avoided, because of the possibility of remnant viable cancer and undetectable nodal metastasis, and (2 robotic or endoscopic thyroid surgery may be a feasible operative method for benign or malignant thyroid nodules previously treated with RFA.

  6. The Study on the Thyroid Disease

    Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1982-09-15

    Several recent advances in our knowledge of thyroid physiology have broad application to the diagnosis and management of thyroid disorders. For in the thyroid, more than other end-ocrine organs, pathophysiology can be translated directly into the diagnosis and management of thyroid disease. Graves' disease is a syndrome including goiter with hyperthyroidism, exophthalmos and dermatopathy. The pathogenesis of Graves' disease is not yet clearly identified, but various autoantibodies to the thyroid gland and immunapathalogic studied indicate that autoimmune processes are involved in the pathogenesis of the disease. The diagnosis and management of Graves' disease are largely dependent on radionuclide technique as radioimmunoassay, radioactive iodine therapy and so on. Several laboratory tests are also developed to determine the remission of this disease including TRH stimulation test, T{sub 3}, suppression test and detection of thyroid stimulating immunoglobulins. Autoimmune thyroiditis is almost certainly a primary immunologic disease and the incidence tends to increase recently, mainly due to the application of biopsy technique is thyroid diseases. Thyroid nodules have been a great challenge to physicians because of the possibility of malignancy. But recently, cytologic examination of thyroid aspirate provides a very simple and also reliable diagnostic method in patients with thyroid nodules. In 163 patients with thyroid nodules, only 19.3% was revealed to be malignant. Therefore cytologic examination of thyroid aspirate and thyroid biopsy should be included in the diagnosis of nodular patients prior to surgical intervention. In this paper, a comprehensive review is presented on the pathogenesis, clinical features, laboratory findings and therapeutic modalities of various thyroid diseases on the basis of over 80 researches performed during the past 20 years at radioisotope clinic, Seoul National University Hospital.

  7. Update on epidemiology classification, and management of thyroid cancer

    Heitham Gheriani

    2006-06-01

    Full Text Available Thyroid cancer represents approximately 0.5–1% of all human malignancy1. In the UK the incidence of thyroid cancer is 2-3 per 100,000 populations 2. In geographical areas of low iodine intake and in areas exposed to nuclear disasters the incidence of thyroid cancer is higher. Benign thyroid conditions are much more common. In the UK approximately 8 % of the population have nodular thyroid disease2. Nodular thyroid disease increases with age and is also more common in females and in geographical areas of low iodine intake. Primary thyroid malignancy can be broadly divided into 2 groups. The first group, which generally have much better prognosis, are the well-differentiated thyroid carcinoma, which includes papillary carcinoma, follicular carcinoma and Hürthle cell tumours. The second group includes the poorly differentiated thyroid carcinoma like medullary thyroid carcinoma and the anaplastic thyroid carcinoma. Other rare tumours such as sarcomas, lymphomas and the extremely rare primary squamous cell carcinoma of the thyroid should be included in the second group. Secondary or metastatic thyroid cancer can be from breast, lung, colon and kidney malignancies.

  8. What Is Thyroid Cancer?

    ... Topic Key statistics for thyroid cancer What is thyroid cancer? Cancer starts when cells in the body ... structure and function of the thyroid gland. The thyroid gland The thyroid gland is below the thyroid ...

  9. Neoplasms in irradiated populations

    The paper describes the results of three prospective studies which have been ongoing for 25 years. The study populations include: (1) persons treated with x rays in infancy for alleged enlargement of the thymus gland; (2) persons treated in childhood with x rays and/or radium for lymphoid hyperplasia of the nasopharynx; and (3) women treated with x rays for acute postpartum mastitis. The studies have resulted in the quantification of risk for radiogenic thyroid and breast cancer for periods up to 40 years post irradiation

  10. Incidental renal neoplasms

    Rabjerg, Maj; Mikkelsen, Minne Nedergaard; Walter, Steen; Marcussen, Niels

    2014-01-01

    part of kidney tumors. They have a more favorable prognosis than symptomatic tumors and seem to be discovered in an earlier phase. Needle core biopsy is an accurate technique for distinguishing between malignant and benign tumors and is recommendable for smaller incidental tumors. Screening may help...

  11. [Paediatric malignant liver tumours].

    Brugires, Laurence; Branchereau, Sophie; Laithier, Vronique

    2012-02-01

    Tumours and pseudotumours of the liver are a heterogeneous group of neoplasm including 60% of malignant tumours. Malignant liver tumours account for less than 2% of the lesions in children and vary considerably in incidence throughout the paediatric age range, with hepatoblastoma, rhabdoid tumour of the liver, hemangioendothelioma, biliary tract rhabdomysosarcoma and mesenchymal hamartoma in the first two years of life and hepatocellular carcinoma, focal nodular hyperplasia, and undifferentiated sarcoma in older children and adolescents. Treatment of malignant epithelial tumours is based on the surgical resection of the tumour associated with pre- and postoperative chemotherapy including cisplatinum. Modalities of the treatment are adapted to risk factors. Survival rates at three years are over 80% for localised hepatoblastoma whereas they are less than 30% in hepatocellular carcinomas. The role of targeted therapies still has to be defined. PMID:22266074

  12. Obesity and gastrointestinal neoplasms

    Izabela Binkowska-Borgosz

    2014-10-01

    Full Text Available Being overweight or obese is a significant public health problem in the 21st century due to its scale, common existence and its cause-effect association with multiple diseases. Excessive accumulation of adipose tissue in humans is regarded as a major risk factor for development of cardiovascular and skeletal diseases. However, data from recent years have revealed that obesity is also strongly associated with increased risk of the majority of cancers in humans, including those originating from the gastrointestinal tract. During the last few year this association has been thoroughly proven and supported by several epidemiological analyses. The authors present i the current state of knowledge regarding key (pathomechanisms that link metabolism of human adipose tissue to development/progression of neoplasms (especially in the gastrointestinal tract, as well as ii the results of selected clinical studies in which the influence of obesity on risk of gastrointestinal cancer development has been addressed.

  13. Gestational trophoblastic neoplasms

    Twenty-four women with suspected gestational trophoblastic neoplasms were evaluated prospectively to identify imaging algorithms optimal for treatment planning. All underwent chest radiography, chest CT, hepatic and cranial CT or MR imaging, and pelvic MR imaging. Ten also underwent pelvic CT, 13 pelvic US. The most sensitive imaging combination was chest CT, hepatic and cranial CT or MR imaging, and pelvic MR imaging. However, correct assignment to ACOG therapeutic categories was achieved by means of history, physical examination, beta subunit of human chorionic gonadotropin measurements, and chest radiography in 81% of patients. Hepatic and cranial imaging defined the need for radiation therapy. Chest CT was needed only when chest radiographs were negative. Pelvic imaging aided diagnosis but did not assist in treatment planning

  14. Application of CD56, P63 and CK19 immunohistochemistry in the diagnosis of papillary carcinoma of the thyroid

    Alowami Salem

    2008-02-01

    Full Text Available Abstract Papillary carcinoma of the thyroid (PTC is the commonest thyroid cancer. In the recent decades an obvious increase in the incidence of PTC has occurred. The pathological diagnosis of PTC is usually an easy diagnosis in the majority of cases. However since the introduction of follicular variant of PTC and the wide threshold range in interpretation of the clearly set pathological criteria for diagnosis of PTC, between pathologists including experts, the diagnosis in some cases became quite difficult. Unfortunately some cases are unjustifiably over-called as follicular variant of PTC as a result of the wide inter observable variability between pathologists, including thyroid pathologists. Ancillary studies such as immmunohistochemistry may be helpful, but till now there is no 100% consistent marker(s, that distinct between PTC and other follicular thyroid lesions and tumors. We assessed expression of antibodies against CD56, CK19, P63 and E-Cadherin in PTC and other follicular thyroid lesions and neoplasms. A total of 175 cases were studied. The neoplastic cases included 75 carcinomas (72 papillary, 2 follicular, 1 Hurthle cell and 35 adenomas (32 follicular and 3 Hurthle cell. The non-neoplastic thyroids included 65 cases, (25 nodular hyperplasia, 5 thyrotoxic hyperplasia (Grave's disease, 19 lymphocytic thyroiditis and 6 Hashimoto's thyroiditis. All cases were evaluated by immunohistochemistry for the expression of the above mentioned markers. The markers' patterns and intensities of staining were scored. Positive expression of the markers equal or >10% of the follicular epithelium within the tumor or lesional cells was considered positive. An expression of Our results showed CD56 positive in all the lesions and tumors except for PTC in all cases (100%. CD56 was negative in all PTC cases (100%. CK 19 showed positive expression in PTC accounting for 85% of cases and in 26% of non PTC lesions/tumors. P63 showed selective focal positivity in PTC cases, in contrast to other non PTC lesions/tumors. P63 expression was in 70% of cases of PTC and was consistently absent in all the non PTC cases. E-Cadherin showed consistent non discriminatory expression in all cases included in the study. We concluded that a panel consisted of CD56, CK19 and P63 is of value in distinction of PTC from other thyroid follicular lesion. P63 is a specific but less sensitive marker for PTC than CK19. CD56 is more specific and sensitive marker than CK19, however it is a negative rather than a positive marker for PTC. E-Cadherin is of no value in the diagnosis of thyroid follicular lesions/tumors. We recommend application of a panel composed of CK19, P63 and CD56 by a group of expert thyroid pathologists on a large series of follicular malignant thyroid neoplasms of uncertain malignant.

  15. The thyroid nodule. Thyrotropin and peripheral thyroid hormones; Der Schilddruesenknoten. TSH und periphere Hormone

    Zimny, M. [Klinikum Hanau (Germany). Inst. fuer Nuklearmedizin

    2008-09-15

    Thyrotropin, free triodothyronine and thyroxine represent the standard serological parameters for the diagnostic work-up of the thyroid but only a minority of thyroid nodules present with subclinical or overt thyroid disorders. Besides a review of the regulation and principle of function of thyroid hormones as well as the effects of subclinical or overt hyperthyroidism, the significant role of these parameters beyond the assessment of hyperthyroidism in thyroid nodules is discussed. There is evidence that the level of thyrotropin within the normal range is predictive for the relevance of autonomous functioning nodules and the risk of malignancy of non-functioning thyroid nodules. Furthermore, the ratio of triodothyronine and thyroxine indicates the etiology of hyperthyroidism. Thyrotropin represents the main parameter to determine the adequate dose of thyroid hormone therapy of thyroid nodules. (orig.)

  16. Technetium-99m scintimammography in the diagnosis of malignant breast tumors

    Jauković Ljiljana

    2004-01-01

    Full Text Available Background. Technetium-99m (99mTc tetrofosmin scintigraphy is a new imaging method for the diagnosis of various malignancies, such as lung, thyroid, and most frequently breast neoplasms. The aim of this study was to evaluate the diagnostic reliability of 99mTc-Tetrofosmin breast scintigraphy in the detection of malignant breast disease. Methods. 99mTc -Tetrofosmin scintimammography (SMM was performed in 28 patients with 30 breast lesions suspicious for malignancy. Standard mammography (MM was also done. After surgery, the results of SMM and MM were compared to definitive histopathological findings as the "gold standard". After intravenous injection of radiotracer, SMM was performed in prone and supine views of the thorax, using large field-of-view Gamma camera. Results. The results of SMM were interpreted visually and semiquantitatively, and evaluated as positive or negative. Sensitivity, specificity and accuracy, positive (PPV and negative predictive value (NPV were obtained in relation to histopathology. After comparing the results of SMM and MM, SMM was proved more sensitive (95% for SMM vs. 80% for MM, while the specificity of both methods was similar. Conclusion. The results of this study indicate that the contribution of SMM as a nuclear medicine procedure has its place in the diagnostic protocol for patients suspected of malignant breast cancer.

  17. Correlacin entre biopsia rpida operatoria y biopsia diferida de tiroides: Revisin de 10 aos en el Hospital Barros Luco-Trudeau Concordance between intraoperative frozen section and deferred biopsy for the diagnosis of malignant thyroid lesions

    GASTN ASTROZA E

    2006-12-01

    Full Text Available La biopsia rpida intraoperatoria es un examen esencial en el curso de una tiroidectoma para decidir la magnitud del procedimiento resectivo. Un patlogo experimentado va a redundar en un alto grado de concordancia en el resultado entre la biopsia rpida y el de la biopsia diferida. Para analizar cmo se dio esta concordancia en nuestro hospital, revisamos retrospectivamente 351 tiroidectomas, de las 795 realizadas en los ltimos 10 aos en nuestro Servicio. Para esta seleccin, excluimos aquellos procedimientos que no contaban con ambos tipos de biopsia. Se inform como proceso maligno por la biopsia rpida en 88 pacientes, lo que coincidi con la biopsia diferida en 75 pacientes (85,2%. En el resto (13 pacientes 14,8% la biopsia rpida inform malignidad y el resultado final fue benigno. En 263 pacientes la biopsia rpida inform lesin benigna, presentndose una concordancia en 238 pacientes (90,5%. Por tanto, en el resto (25 pacientes 9,5% el estudio diferido inform malignidad. Se calcul la sensibilidad y especificidad de la biopsia rpida intraoperatoria en relacin a patologa tirodea, obtenindose una sensibilidad de 75% y una especificidad de 94,8%. De los falsos negativos informados por biopsia rpida, el carcinoma papilar fue el tipo histolgico ms frecuente encontrado (15/25. Se concluye que si bien se obtuvo una buena especificidad lo que se acompaa de un bajo nmero de tiroidectomas totales en vano, la sensibilidad (75% pudo haber sido mayor, lo que oblig en los pacientes errneamente catalogados en una primera instancia como benignos a ser sometidos a una segunda intervencin. Es necesario buscar la forma de optimizar estos resultados, para as disminuir el nmero de pacientes que deben ser reintervenidosBackground: Intraoperative frozen section s essential procedure during thyroidectomy, to decide magnitude of the excision. There is usually a good concordance between fast and deferred biopsy results in hands of experimented pathologists. Aim: To assess the concordance between fast and deferred thyroid biopsies. Material and methods: Prospective study of 351 thyroidectomies, performed to 312 women and 39 men, aged 13 to 83 years, in which a fast and a deferred biopsy, were performed. Results: Intraoperative frozen section diagnosed a total of 88 malignant lesions, that were confirmed with the deferred biopsy in 75 cases (85.2%. In 13 (14.8% patients with a malignant lesion diagnosed with the fast biopsy, the final result was benign. In 263 cases, the fast biopsy reported a benign lesion, that was corroborated with the deferred biopsy in 238 patients (90,5%. In 25 of these patients (9.5%, the deferred biopsy showed a malignant lesion. Therefore, the sensitivity and specificity of the fast biopsy were 75 and 95%, respectively. Papillary carcinoma was the most common pathological finding in 15 of 25cases. Conclusions: intraoperative frozen section thyroid has a high specificity for the diagnosis of malignant lesions, but sensitivity must be improved

  18. Ectopic thyroid tissue in the adrenal gland: report of a case.

    Casadei, Gian Piero; Bertarelli, Claudia; Giorgini, Eleonora; Cremonini, Nadia; de Biase, Dario; Tallini, Giovanni

    2015-04-01

    Foci of ectopic thyroid tissue are uncommon. Most sites of thyroid ectopia are confined to the neck region. The presence of ectopic thyroid tissue outside the migration pathway of the primitive thyroid in other locations is exceptional. Given that any disease of the thyroid gland may also affect ectopic thyroid tissue, pathologists has to recognize benign or malignant conditions that may develop in the ectopic focus. We present the case of a 32-year-old woman with ectopic thyroid parenchyma in the adrenal gland. Clinically, postoperative thyroid ultrasound echography and computed tomography scans did not reveal any thyroid tumor. The ectopic tissue was a cyst bordered by mature follicular thyroid structures and was histologically benign, without the molecular alterations associated with malignant tumors of follicular cell derivation (BRAFV600E, N-RAS, H-RAS, K-RAS). Review of the literature reveals that adrenal ectopic thyroid tissue is nearly always cystic and has distinctive pathologic features. PMID:24997195

  19. Pulmonary Neuroendocrine Tumor with Thyroid Gland Metastasis: Case Report

    Cristina Corina Pop Radu

    2015-04-01

    Full Text Available Neuroendocrine tumors (NET represent approximately 20% of all primary neoplasms of the lung. Histologic confirmation is important for treatment and prognosis determination. NET are classified according to four subtypes in the lung: typical carcinoid tumor (TC, atypical carcinoid tumor (AC, small cell carcinoma (SCC, and large cell neuroendocrine carcinoma (LCNEC. TC is low-grade, AC is intermediate-grade, and SCC and LCNEC are high-grade malignancies. Case report: A 57 years old woman, affected by a cervical anterior tumor and a proliferative tissue below the glottis was referred to our Endocrinology Department from ENT service for a second opinion. An ultrasound scan of the neck showed a polynodular goiter with bilaterally lymph nodes enlargement with suspicious malignancy characters. She had undergone surgery for the cervical anterior mass and for the laryngeal biopsy. Histopathological examination results were consistent with a SCC; neoplastic cells showed immunoreactivity to synaptophysin, neuron specific enolase and chromogranin. The serum levels of serotonin, cromogranin A, calcitonin, carcinoembryonic antigen, ACTH, PTH, TSH, FT4 were normal. Fine needle aspiration biopsy of her left thyroid lobe nodule was performed and the cytopathological exam was compatible with a neuroendocrine tumor metastasis. Thoracic and abdominal computed tomography was normal at that moment. Chest CT revealed the primary pulmonary tumor at 6 months after presentation. The therapeutic option for advanced or metastatic NETs is mainly palliation of symptoms; options need to be individualized and, therefore, rely on the knowledge of multidisciplinary teams.

  20. Malignant Struma Ovarii in a Postmenopausal Asymptomatic Woman: A Case Report

    Behiye P?nar ilesiz Gksedef

    2011-09-01

    Full Text Available Introduction: Struma ovarii is an ovarian tumor that consists predominantly thyroid tissue and accounts for only 2% of all mature teratomas. It is usually a benign condition - malignant transformation has been reported to occur in about 5% of all struma ovarii cases. Case: A 58-year-old postmenopausal woman attended our outpatient clinic for her annual gynecologic exam, on which a palpable ovary was incidentally found. Ultrasound and magnetic resonance imaging work-up showed two-centimeter solid mass on the right ovary. Laparoscopic salpingo-oophorectomy was performed; the histology report revealed a focus of thyroid papillary carcinoma in a struma ovarii. The patient underwent surgical staging procedure according to the ovarian cancer guideline. The tumor was in stage 1A, thus, no further treatment was indicated apart from follow-up. Conclusion: Malignant struma ovarii is a rare neoplasm of the ovary. Surgical staging should be included in the treatment, like in the other germ cell ovarian tumors. (The Medical Bulletin of Haseki 2011;49: 117-9

  1. Silent thyroiditis

    ... of the thyroid gland. The disorder can cause hyperthyroidism , followed by hypothyroidism . ... earliest symptoms result from an overactive thyroid gland (hyperthyroidism). These symptoms may last for up to 3 ...

  2. Thyroid storm

    Thyrotoxic storm; Hyperthyroid storm; Accelerated hyperthyroidism ... Thyroid storm occurs in people with untreated hyperthyroidism. It is usually brought on by a major stress such as trauma, heart attack, or infection. Thyroid storm is very rare.

  3. Thyroid Cancer

    ... body work normally. There are several types of cancer of the thyroid gland. You are at greater ... imaging tests, and a biopsy to diagnose thyroid cancer. Treatment depends on the type of cancer you ...

  4. Neoplasms in young dogs after irradiation during development

    To study the lifetime effects of irradiation during development, 1680 beagle dogs were given single, whole body exposures to 60Co gamma radiation at one of 6 pre- or postnatal ages. Four groups of 120 dogs each (480 or 29%) received 0.16 or 0.83 Gy at early prenatal times, 8 or 28 days postcoitus (dpc). Four groups of 120 dogs each (29%) received 0.16 or 0.83 Gy in the perinatal period at 55 dpc or 2 days postpartum (dpp). Groups of 120 and 240 dogs (21%) received 0.83 Gy at later postnatal times, 70 or 365 dpp, respectively. A group of 360 dogs (21%) were sham-irradiated. The youngest dogs are now 12 years old. Through 4 years of age, 20 dogs had neoplasms diagnosed. Five malignancies and one benign tumor were seen in the first two years, including the only fatal malignancies which occurred in 4 perinatally irradiated dogs. Up to two years of age, the other non-fatal malignancy and benign tumor were found in dogs irradiated at 365 dpp and 55 dpc. The remaining 14 neoplasms, 12 benign and 2 non-fatal malignant, were diagnosed between two and four years of age. Respective numbers of these benign and non-fatal malignant tumors found in control, perinatally irradiated, and all other irradiated dogs were 2 and 0; 5 and 1; and 5 and 1. Eight of the benign lesions were minute papillomas of the eyelids which were more frequent in the perinatally irradiated dogs. Overall, 71% (5 of 7) of the malignancies seen in the first four years of life occurred in the 29% of the dogs irradiated in the perinatal period. Sixty-seven percent (8 of 12) of all neoplasms, excluding eyelid papillomas, also occurred in perinatally irradiated dogs. These data suggest an increased risk for neoplasia after perinatal irradiation

  5. Molecular biology of Philadelphia-negative myeloproliferative neoplasms

    Paulo Vidal Campregher

    2012-01-01

    Full Text Available Myeloproliferative neoplasms are clonal diseases of hematopoietic stem cells characterized by myeloid hyperplasia and increased risk of developing acute myeloid leukemia. Myeloproliferative neoplasms are caused, as any other malignancy, by genetic defects that culminate in the neoplastic phenotype. In the past six years, since the identification of JAK2V617F, we have experienced a substantial increase in our knowledge about the genetic mechanisms involved in the genesis of myeloproliferative neoplasms. Mutations described in several genes have revealed a considerable degree of molecular homogeneity between different subtypes of myeloproliferative neoplasms. At the same time, the molecular differences between each subtype have become clearer. While mutations in several genes, such as JAK2, myeloproliferative leukemia (MPL and LNK have been validated in functional assays or animal models as causative mutations, the roles of other recurring mutations in the development of disease, such as TET2 and ASXL1 remain to be elucidated. In this review we will examine the most prevalent recurring gene mutations found in myeloproliferative neoplasms and their molecular consequences.

  6. Ultrasonographic Prevalence of Thyroid Incidentaloma in Bushehr, Southern Iran

    Mohammadi, A.; E Amirazodi; S. Masudi; Pedram, A.

    2009-01-01

    Background/Objective: Thyroid nodule is one of the most common endocrine disorders. 5%- 10% of thyroid nodules undergo malignant degeneration. The objective of this study was to determine the prevalence of thyroid incidentaloma in Bushehr, southern Iran."nPatients and Methods: A total of 1503 consecutive 15 to 65-year-old patients who were referred to Fatemeh Zahra Hospital for any ultrasonographic examination other than the thyroid gland were included in this study. All patients underwe...

  7. Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser

    Baek, Jung Hwan; Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Valcavi, Roberto [Endocrinology Division and Thyroid Disease Center, Arcispedale Santa Maria Nuova, Reggio Emilia (Italy); Pacella, Claudio M. [Diagnostic Imaging and Interventional Radiology Department, Ospedale Regina Apostolorum, Albano Laziale-Rome (IT); Rhim, Hyun Chul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Na, Dong Kyu [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of)

    2011-10-15

    Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation.

  8. Intraductal papillary mucinous neoplasm and the pancreatic incidentaloma

    Kent, Tara S.; Charles M Vollmer Jr; Callery, Mark P.

    2010-01-01

    Asymptomatic pancreatic lesions (APL) are a commonly encountered problem in today’s pancreatic surgical practices. Current literature regarding etiologies and incidence of APLs, particularly intraductal papillary mucinous neoplasm (IPMN), is presented. APLs constitute a wide spectrum of pathology (solid/cystic, benign/premalignant/malignant) but, overall, IPMN is now the most common diagnosis. The Sendai Guidelines and their function as a basis for risk stratification in branch duct IPMN are ...

  9. Papillary cystic neoplasm of the pancreas in a teenage boy

    We present a case of a 13-year-old boy with a left-sided abdominal mass which proved to be a papillary cystic neoplasm of the pancreas. This low-grade malignant lesion of young patients is very rare, and exceedingly rare in males. The prognosis following resection of this tumor is good. We present the ultrasound and computed tomographic picture of this lesion, as well as the gross and microscopic pathology. (orig.)

  10. Risk of myeloid neoplasms after solid organ transplantation

    Morton, Lindsay M.; Gibson, Todd M; Clarke, Christina A.; LYNCH, CHARLES F.; Anderson, Lesley A.; Pfeiffer, Ruth; Landgren, Ola; Weisenburger, Dennis D.; Engels, Eric A.

    2014-01-01

    Solid organ transplant recipients have elevated cancer risks, due in part to pharmacologic immunosuppression. However, little is known about risks for hematologic malignancies of myeloid origin. We linked the US Scientific Registry of Transplant Recipients with 15 population-based cancer registries to ascertain cancer occurrence among 207,859 solid organ transplants (19872009). Solid organ transplant recipients had significantly elevated risk for myeloid neoplasms, with standardized incidenc...

  11. Genomic alterations in Myeloproliferative Neoplasms and Myelodysplastic Syndromes

    Borze, Ioana

    2011-01-01

    Myeloproliferative neoplasms (MPN) and myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematopoietic disorders whose etiology and molecular pathogenesis are poorly understood. During the past decade, enormous developments in microarray technology and bioinformatics methods have made it possible to mine novel molecular alterations in a large number of malignancies, including MPN and MDS, which has facilitated the detection of new prognostic, predictive and therapeutic bioma...

  12. Malignancy-associated pruritus.

    Rowe, B; Yosipovitch, G

    2016-01-01

    Malignancy-associated pruritus can be the result of a neoplasm's local effect on tissue or due to the systemic reaction to malignancy. A systemic reaction to malignancy has been termed 'paraneoplastic itch' and can be the first sign of an underlying malignancy. Paraneoplastic itch is most commonly caused by lymphoproliferative malignancies, and severity of itch correlates with stage of disease in Hodgkin's lymphoma and polycythemia vera. Non-melanoma skin cancer is the most common type of malignancy-associated pruritus, and recent data indicate that pruritus is associated with more than one-third of non-melanoma skin cancers. Cutaneous T-cell lymphomas (CTCL), particularly more advanced stages, cause intractable pruritus and recent investigations into the pathophysiology of CTCL-associated itch have implicated cyotokine interleukin-31 as a putative mediator. Treatments that reduce itch in CTCL patients, such as histone deacetylase inhibitors (HDACi), Mogamulizumab, a novel monoclonal antibody against chemokine receptor type-4, and oral corticosteroids, have demonstrated a correlation between their anti-pruritic effect and reduced serum levels of interleukin-31. PMID:26416212

  13. A comparison of lymphocytic thyroiditis with papillary thyroid carcinoma showing suspicious ultrasonographic findings in a background of heterogeneous parenchyma

    Sang Yu Nam; Jung Hee Shin; Eun Young Ko; Soo Yeon Hahn

    2014-01-01

    Purpose: The aim of this study was to compare ultrasonographic features in patients with lymphocytic thyroiditis (LT) and papillary thyroid carcinoma (PTC) having suspicious thyroid nodule(s) in a background of heterogeneous parenchyma and to determine the clinical and radiological predictors of malignancy. Methods: We reviewed the cases of 100 patients who underwent ultrasonography between April 2011 and October 2012, and showed suspicious thyroid nodule(s) in a background of heterogeneous p...

  14. The prognosis and treatment of primary thyroid cancer occurred in breast cancer patients: comparison with ordinary thyroid cancer

    Park, Chang Min; Lee, Young Don; Oh, Eun Mee; Kim, Kwan-Il; Park, Heung Kyu; Ko, Kwang-Pil; Chung, Yoo Seung

    2014-01-01

    Purpose Due to the increased prevalence of thyroid cancer, it has been frequently detected in breast cancer patients recently. The aim of this study was to evaluate the clinicopathologic characteristics of thyroid cancer in breast cancer patients with respect to prognosis and treatment. Methods From August 1998 to September 2012, 101 breast cancer patients were diagnosed with thyroid cancer (BT group). One hundred ninety-three female patients with a thyroid malignancy that underwent thyroidec...

  15. Cellular apoptosis susceptibility (CAS) is overexpressed in thyroid carcinoma and maintains tumor cell growth: A potential link to the BRAFV600E mutation.

    Holzer, Kerstin; Drucker, Elisabeth; Oliver, Scott; Winkler, Juliane; Eiteneuer, Eva; Herpel, Esther; Breuhahn, Kai; Singer, Stephan

    2016-04-01

    Thyroid carcinoma is among the most common malignant endocrine neoplasms with a rising incidence. Genetic alterations occurring in thyroid cancer frequently affect the RAS/RAF/MEK/ERK-pathway such as the oncogenic, kinase-activating BRAFV600E mutation. Nuclear transport receptors including importins and exportins represent an important part of the nuclear transport machinery providing nucleo-cytoplasmic exchange of macromolecules. The role of nuclear transport receptors in the development and progression of thyroid carcinomas is largely unknown. Here, we studied the expression and function of the exportin cellular apoptosis susceptibility (CAS) in thyroid carcinogenesis and its link to the BRAFV600E mutation. By using immunohistochemistry (IHC) we found significantly increased IHC scores of CAS in primary papillary (PTC) and medullary (MTC), but not in follicular (FTC) thyroid carcinoma compared to non-tumorous (NT) thyroid tissue. Interestingly, metastases of the aforementioned subtypes including FTC showed a strong CAS positivity. Among PTCs we observed that CAS immunoreactivity was significantly higher in the tumors harboring the BRAFV600E mutation. Furthermore, depletion of CAS by RNAi in the BRAFV600E-positive PTC cell line B-CPAP led to reduced tumor cell growth measured by crystal violet assays. This phenotype could be attributed to reduced proliferation and increased cell death as assayed by BrdU ELISAs and immunoblotting for PARP-cleavage, respectively. Finally, we found additive effects of CAS siRNA and vemurafenib treatment in B-CPAP cells. Collectively, these data suggest that CAS overexpression in thyroid carcinoma depends on the subtype and the disease stage. Our findings also indicate that CAS maintains PTC cell proliferation and survival. Targeting CAS could represent a potential therapeutic approach particularly in combination with BRAF inhibitors such as vemurafenib in BRAFV600E-positive tumors. PMID:26892809

  16. Epidemiology of thyroid diseases in Africa

    Anthonia Okeoghene Ogbera

    2011-01-01

    Full Text Available Background: Thyroid disorders are common endocrine disorders encountered in the African continent. Environmental and nutritional factors are often implicated in the occurrence of some thyroid disorders that occur in this part of the world. This is a narrative review that seeks to document the pattern, prevalence, and management of thyroid disorders in the continent. Materials and Methods: The search engine used for this review were PubMed and Google scholar. All available articles on thyroid disorders from the sub-African continent, published until May 2011, were included. Results: Iodine deficiency disorders (IDD which top the list of thyroid disorders and remain the commonest cause of thyroid disorders in the continent is often affected not only by the iodine status in the region but sometimes also by selenium deficiency and thiocyanate toxicity. The reported prevalence rates of endemic goiter range from 1% to 90% depending on the area of study with myxedematous cretinism still a prominent feature of IDD in only a few regions of the continent. The extent of autoimmune thyroid disorders remains unknown because of underdiagnosis and underreporting but the few available studies note a prevalence rate of 1.2% to 9.9% of which Graves diseases is the commonest of these groups of disorders. Rarer causes of thyroid dysfunction such as thyroid tuberculosis and amiodarone related causes are also documented in this review. The onset of new thyroid diseases following amiodarone usage was documented in 27.6% of persons treated for arrhythmia. Reports on thyroid malignancies (CA in Africa abound and differentiated thyroid malignancies are noted to occur more commonly than the other forms of thyroid CA. The documented prevalence rates of thyroid CA in the African continent are as follows (papillary: 6.7-72.1%, follicular: 4.9-68%, anaplastic: 5-21.4%, and medullary: 2.6%-13.8%. For the differentiated thyroid CA, there is a changing trend toward the more frequent occurrence of papillary CA compared to follicular CA and this may be attributable to widespread iodization programs. Our review shows that diagnosis and evaluation of thyroid disorders are reliant in most regions of the continent on clinical acumen and suboptimal diagnostic facilities and expertise are what obtain in many practices. The frequently employed management options of thyroid disorders in the continent are pharmacological and surgical treatment modalities. Conclusion: Diagnosis and management of thyroid disorders in the African continent remain suboptimal. Thyroid registries may be helpful to determine the scope of the burden of thyroid disorders since this knowledge may help change policies on the approach to the management of these disorders.

  17. A Case of Myxoid Adrenocortical Neoplasm: Computed Tomography and Magnetic Resonance Imaging Characteristics

    Hiroki Fukuhara; Vladimir Bilim; Hiroya Ohtake; Yoshie Yahagi; Yoshihiko Tomita

    2013-01-01

    Myxoid adrenocortical neoplasms are rare; to our knowledge, only 56 cases have been reported in the literature. Therefore, distinguishing benign from malignant cases is challenging. Although the histopathological features of myxoid adrenocortical neoplasia have been amply demonstrated, their imaging characteristics are yet to be reported. We describe here these characteristics for such a neoplasm. Our patient, a 70-year-old male, was found to have a 3-cm left adrenal incidentaloma through a n...

  18. Thyroid abscess.

    Rohondia O

    1995-04-01

    Full Text Available Thyroid abscess arising from Acute Suppurative Thyroiditis (AST is a rare clinical disorder. The ability of the thyroid gland to resist infection is well known and infection in the thyroid gland is rare, particularly so with the advent of widespread usage of antibiotics. An internal pharyngeal fistula (Pyriform sinus fistula is the most common underlying abnormality in patients with AST. We report a case of an adult male who presented with a thyroid abscess. The causal organism was found to be Staphylococcus aureus. Intravenous antibiotics and, incision and drainage of the abscess led to an uncomplicated recovery.

  19. Intracardiac ectopic thyroid (struma cordis).

    Besik, Josef; Szarszoi, Ondrej; Bartonova, Anastazie; Netuka, Ivan; Maly, Jiri; Urban, Marian; Jakabcin, Jozef; Pirk, Jan

    2014-03-01

    A 67-year-old male with a history of gastrointestinal malignancy was found to have a tumor in the right ventricular outflow tract. The tumor was surgically removed, and the histological diagnosis was thyroid struma. We review the literature on this rare cardiac tumor. PMID:24267947

  20. MALIGNANCY IN LARGE COLORECTAL LESIONS

    Carlos Eduardo Oliveira dos SANTOS

    2014-09-01

    Full Text Available Context The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion Objectives To evaluate the malignancy of colorectal lesions ≥20 mm. Methods Between 2007 and 2011, 76 neoplasms ≥20 mm in 70 patients were analyzed Results The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm ± 6.2 mm (range: 20 to 50 mm. Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3% lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5% and IV (53.9% pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma, with no difference in morphology and site. Only one lesion (1.3% invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001. The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%. Conclusions Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions.

  1. Primary Malignant Melanoma of the Mediastinum: Radiologic and Pathologic Correlation in Two Case

    Park, Sun-Young; Kim, Mi Young; Chae, Eun Jin

    2012-01-01

    Primary malignant melanoma of the anterior mediastinum is extremely rare, accounting for 0.1-0.5% of all primary malignant neoplasms. These tumors may be mistakenly diagnosed as lymphomas, thymic carcinomas and malignant germ-cell tumors of the mediastinum. We describe two cases of primary malignant melanomas of the anterior mediastinum and report their CT and pathology findings.

  2. Primary Malignant Melanoma of the Mediastinum: Radiologic and Pathologic Correlation in Two Case

    Primary malignant melanoma of the anterior mediastinum is extremely rare, accounting for 0.1-0.5% of all primary malignant neoplasms. These tumors may be mistakenly diagnosed as lymphomas, thymic carcinomas and malignant germ-cell tumors of the mediastinum. We describe two cases of primary malignant melanomas of the anterior mediastinum and report their CT and pathology findings.

  3. Neoplasms of the liver

    Primary Liver Cancer is perhaps the most prevalent malignancy in the world, particularly in South East Asia and Africa. After the discovery of hepatitis B virus as a cause of chronic liver disease often terminating cirrhosis and hepatocellular carcinoma, and, more recently, the integration of viral DNA into host chromosomal DNA, the progress made in this field has been remarkable. This book contains 35 chapters and covers all topical aspects, such as oncogenes, epidemiology, carcinogenic role of hepatitis viruses, histopathology, new imaging techniques and new treatment modalities that include ultrasound-guided intratumor injections of ethanol and targeting chemotherapy

  4. CC-486 (Oral Azacitidine) Bioequivalence Study in Patients With Solid Tumor or Hematologic Malignancies

    2016-03-10

    Hematological Neoplasms; Non-Hodgkin's Lymphoma; Hodgkin's Lymphoma; Lymphoma; Multiple Myeloma; Acute Myeloid Leukemia; Leukemia; Myelodysplastic Syndromes; Neoplasms; Melanoma; Breast Cancer; Metastatic Breast Cancer; Non-Small Cell Lung Cancer; Small Cell Lung Cancer; Renal Cell Carcinoma; Glioblastoma Multiforme; Osteosarcoma; Sarcoma; Thyroid Cancer; Genitourinary

  5. Thyroid and Weight

    ... Medicine Graves’ Disease Thyroid and Weight Thyroiditis Thyroid Cancer Thyroid Disease in the Older Patient Goiter Thyroid Hormone Treatment Thyroid Disease and Pregnancy Thyroid and Weight Resources Thyroid and Weight Brochure PDF En Español La Tiroides y el Peso El folleto de La Tiroides ...

  6. Multiple neoplasms, single primaries, and patient survival

    Amer MH

    2014-03-01

    Full Text Available Magid H Amer Department of Medicine, St Rita's Medical Center, Lima, OH, USA Background: Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. Methods: This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Results: Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284, and three or more primaries (n=38. Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%, with a tendency to develop thrombosis (20.2%, had a strong family history of similar cancer (22.3%, and usually presented with earlier stage 0 through stage II disease (78.9%. When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001. Five-year survival rates were higher for metachronous cancers (95% than for synchronous primaries (59% and single primaries (59%. The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991. Conclusion: Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent clinical behavior with longer survival rates, possibly related to genetic predisposition. Keywords: genetic susceptibility, incidence study, hereditary, multiple primary neoplasms, survival analysis, prognosis

  7. Use of the gamma probe and of 99mTc-DMSA (V) in the identification of the neck recurrence of medullary carcinoma thyroid

    Medullary carcinoma of the thyroid, a malignant neoplasm of para follicular C cells, represent about 5-10% of thyroid tumors. The symptoms are related to local invasion and hormonal secretion. The clinical course is variable, from indolent cases to extremely aggressive. Many radionuclide imaging have been described to locate metastasis of medullary cancer. Tl-201 and Tc-99m (V)DMS A showed to be useful in the evaluation o persistent elevated serum calcitonin levels. On the other hand, the use of the 131 I-Mibg, that is the isotope more used, has not been demonstrating efficiency in identifying metastasis. Our objective is to report a case of a patient with medullary thyroid carcinoma in which the follow-up use DMS A(V) demonstrated a recurrence no identified for other methods. A 34-year-old man had a diagnosis of medullary thyroid carcinoma and has submitted a total thyroidectomy and neck lymph node dissection. He presented elevated serum calcitonin levels and DMS A(V) scintigraphy demonstrated focal area of pathologic uptake at the medline of the neck, but the surgical exploration was negative. He persisted with high calcitonin levels and it was used a new DMS A(V). On this occasion he was submitted to the radio-guided surgery that located the recurrence and it was confirmed with anatomo-pathologic exam. This case allowed to demonstrate that the use of radionuclide associated to the gamma-probe is promising, allowing a precise surgical approach. (author)

  8. Simulants of Malignant Melanoma

    Piérard-Franchimont, Claudine; Delvenne, Philippe

    2015-01-01

    During the recent period, dermoscopy has yielded improvement in the early disclosure of various atypical melanocytic neoplasms (AMN) of the skin. Beyond this clinical procedure, AMN histopathology remains mandatory for establishing their precise diagnosis. Of note, panels of experts in AMN merely report moderate agreement in various puzzling cases. Divergences in opinion and misdiagnosis are likely increased when histopathological criteria are not fine-tuned and when facing a diversity of AMN types. Furthermore, some AMN have been differently named in the literature including atypical Spitz tumor, metastasizing Spitz tumor, borderline and intermediate melanocytic tumor, malignant Spitz nevus, pigmented epithelioid melanocytoma or animal-type melanoma. Some acronyms have been further suggested such as MELTUMP (after melanocytic tumor of uncertain malignant potential) and STUMP (after Spitzoid melanocytic tumor of uncertain malignant potential). In this review, such AMN at the exclusion of cutaneous malignant melanoma (MM) variants, are grouped under the tentative broad heading skin melanocytoma. Such set of AMN frequently follows an indolent course, although they exhibit atypical and sometimes worrisome patterns or cytological atypia. Rare cases of skin melanocytomas progress to loco regional clusters of lesions (agminate melanocytomas), and even to regional lymph nodes. At times, the distinction between a skin melanocytoma and MM remains puzzling. However, multipronged immunohistochemistry and emerging molecular biology help profiling any malignancy risk if present. PMID:26779311

  9. Simulants of Malignant Melanoma.

    Piérard, Gérald E; Piérard-Franchimont, Claudine; Delvenne, Philippe

    2015-02-10

    During the recent period, dermoscopy has yielded improvement in the early disclosure of various atypical melanocytic neoplasms (AMN) of the skin. Beyond this clinical procedure, AMN histopathology remains mandatory for establishing their precise diagnosis. Of note, panels of experts in AMN merely report moderate agreement in various puzzling cases. Divergences in opinion and misdiagnosis are likely increased when histopathological criteria are not fine-tuned and when facing a diversity of AMN types. Furthermore, some AMN have been differently named in the literature including atypical Spitz tumor, metastasizing Spitz tumor, borderline and intermediate melanocytic tumor, malignant Spitz nevus, pigmented epithelioid melanocytoma or animal-type melanoma. Some acronyms have been further suggested such as MELTUMP (after melanocytic tumor of uncertain malignant potential) and STUMP (after Spitzoid melanocytic tumor of uncertain malignant potential). In this review, such AMN at the exclusion of cutaneous malignant melanoma (MM) variants, are grouped under the tentative broad heading skin melanocytoma. Such set of AMN frequently follows an indolent course, although they exhibit atypical and sometimes worrisome patterns or cytological atypia. Rare cases of skin melanocytomas progress to loco regional clusters of lesions (agminate melanocytomas), and even to regional lymph nodes. At times, the distinction between a skin melanocytoma and MM remains puzzling. However, multipronged immunohistochemistry and emerging molecular biology help profiling any malignancy risk if present. PMID:26779311

  10. Simulants of malignant melanoma

    Gérald E. Piérard

    2015-08-01

    Full Text Available During the recent period, dermoscopy has yielded improvement in the early disclosure of various atypical melanocytic neoplasms (AMN of the skin. Beyond this clinical procedure, AMN histopathology remains mandatory for establishing their precise diagnosis. Of note, panels of experts in AMN merely report moderate agreement in various puzzling cases. Divergences in opinion and misdiagnosis are likely increased when histopathological criteria are not fine-tuned and when facing a diversity of AMN types. Furthermore, some AMN have been differently named in the literature including atypical Spitz tumor, metastasizing Spitz tumor, borderline and intermediate melanocytic tumor, malignant Spitz nevus, pigmented epithelioid melanocytoma or animal-type melanoma. Some acronyms have been further suggested such as MELTUMP (after melanocytic tumor of uncertain malignant potential and STUMP (after Spitzoid melanocytic tumor of uncertain malignant potential. In this review, such AMN at the exclusion of cutaneous malignant melanoma (MM variants, are grouped under the tentative broad heading skin melanocytoma. Such set of AMN frequently follows an indolent course, although they exhibit atypical and sometimes worrisome patterns or cytological atypia. Rare cases of skin melanocytomas progress to loco regional clusters of lesions (agminate melanocytomas, and even to regional lymph nodes. At times, the distinction between a skin melanocytoma and MM remains puzzling. However, multipronged immunohistochemistry and emerging molecular biology help profiling any malignancy risk if present.

  11. Radioisotope diagnosis of thyroid diseases

    Described are the following radioisotope methods of investigating the functions of the thyroid gland: studying the dynamics of 131I buildup in the thyroid gland within various periods of time; the investigation of the percent of 131I excretion with urine; the investigation of the level of albumen-bound 131I in plasma; the method of determination of the organic phase of iodine metabolism by the conversion degree of inorganic 131I into organic. The problem of complex investigation of all phases of 131I metabolism is considered. Possible mistakes in the interpretation of radioisotope tests are analyzed. Investigated is the method of radiometry of the whole body and separate organs for the estimation of all phases of iodine metabolism and thyroid harmones in patients with mode euthyroid and diffuse euthyroid goitre with hypothyrosis and vegetovascular dystonia. Suggested is the method of thyroid gland scanning with 131I and 75Se-methionine to identify the nature of neoplasms in the modern diagnostics of cancer and other diseases of the thyroid gland

  12. Thyroid Scan and Uptake

    ... News Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake Thyroid scan and uptake uses ... the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is a ...

  13. Thyroid Disease and Teens

    ... How Can I Help a Friend Who Cuts? Thyroid Disease KidsHealth > For Teens > Thyroid Disease Print A ... other parts of your body. continue What Is Thyroid Disease? Thyroid disease occurs when the thyroid gland ...

  14. Thyroid Disorders Overview

    ... and Symptoms Hypothyroidism Thyroid Nodules Lifestyle and Prevention Thyroid Disorders The thyroid gland is located at the ... lives, and must be closely monitored by physicians. Thyroid Nodules Thyroid disorders can also occur because of ...

  15. Thyroid Disorders (For Kids)

    ... Sledding, Skiing, Snowboarding, Skating Crushes What's a Booger? Thyroid Disorders KidsHealth > For Kids > Thyroid Disorders Print A ... the world is a thyroid? What Is the Thyroid? The thyroid (say: THYE-royd) is a gland, ...

  16. Papillary thyroid carcinoma presenting as an asymptomatic pelvic bone metastases

    Siddiq S

    2010-05-01

    Full Text Available Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites.We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma.Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.

  17. Glypican-3 expression in gastrointestinal and pancreatic epithelial neoplasms.

    Mounajjed, Taofic; Zhang, Lizhi; Wu, Tsung-Teh

    2013-04-01

    Glypican-3 (GPC3) is a plasma membrane-bound proteoglycan that can be overexpressed in certain malignancies but has been particularly linked to hepatocellular carcinoma (HCC). GPC3 is currently used as an immunohistochemical marker for HCC, but its expression in epithelial neoplasms of the gastrointestinal (GI) tract and pancreas, a common source of liver metastasis, has not been studied in detail. In this study, we examined GPC3 immunoreactivity in 98 neoplasms of the GI tract including 30 adenocarcinomas (ADCA), 29 squamous cell carcinomas (esophageal and anal), and 39 neuroendocrine carcinomas, and 60 neoplasms of the pancreas including 22 ADCA, 26 pancreatic neuroendocrine neoplasms, and 12 pancreatic acinar cell carcinomas. Two control groups of 32 HCCs and 16 intrahepatic cholangiocarcinomas were also stained with GPC3. Although most (7/12, 58.5%) acinar cell carcinomas were GPC3 positive, pancreatic ADCA and neuroendocrine neoplasms were GPC3 negative. In addition, 27.5%, (8/29) of squamous cell carcinomas, 20% (6/30) of ADCA, and 2.5% (1/39) of neuroendocrine carcinomas of the GI tract were immunoreactive for GPC3. HCC was positive for GPC3 in 75% (24/32) of cases but cholangiocarcinoma was negative. While significant correlation between GPC3 positivity and poor differentiation was observed in HCC only, GPC3 expression did not correlate with tumor size. In conclusion, 14% of GI tract and pancreatic carcinomas/neoplasms (particularly pancreatic acinar cell carcinoma) can express GPC3 by immunohistochemistry. As these tumors commonly metastasize to the liver, this offers a potential pitfall in differentiating between HCC and metastatic carcinoma when evaluating tumors involving the liver. PMID:23079207

  18. The value of sonography in thyroid diagnostics

    Since the introduction of the gray scale-technique, sonography has gained a definitive position in thyroid diagnostics. Sonography should be combined with scintigraphy and fine needle-aspiration biopsy according to the underlaying thyroid disease. As a rule, a combination of sonography and scintigraphy is recommended for basic thyroid examinations, except for cases of normally sized thyroid glands, pregnancy or young patients. Follow-up examinations should be based on sonography alone, unless autonomy is suspected, which should be examined by suppressive scintigraphy during thyroid hormone therapy. After surgery or radio-iodine therapy, the follow-up should be based on both scintigraphy and sonography. Metastases of thyroid malignancies always have to be examined for their radio-iodine uptake. The positive effects of sonography suitably combined with scintigraphy and fine needle-aspiration biopsy have been reflected in the decreasing number of indications for surgical intervention in our patients with nodular goitres. (orig.)

  19. Co-occurrence of papillary thyroid carcinoma and mucosa-associated lymphoid tissue lymphoma in a patient with long-standing hashimoto thyroiditis.

    Nam, Yoon Jeong; Kim, Bo Hyun; Lee, Seong Keun; Jeon, Yun Kyung; Kim, Sang Soo; Jung, Woo Jin; Kahng, Dong Hwahn; Kim, In Ju

    2013-12-01

    Papillary thyroid carcinoma (PTC) is a common affliction of the thyroid gland, accounting for 70% to 80% of all thyroid cancers, whereas mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid gland is uncommon. The simultaneous occurrence of both malignancies is extremely rare. We report the case of a patient with both PTC and MALT lymphoma in the setting of Hashimoto thyroiditis. An 81-year-old female patient was first admitted with goiter and hoarseness, which was attributed to an ultrasonographic thyroid nodule. Subsequent fine-needle aspirate, interpreted as suspicious of papillary thyroid cancer, prompted total thyroidectomy. MALT lymphoma was an incidental postsurgical finding, coexisting with PTC in the setting of Hashimoto thyroiditis. Although the development of MALT lymphoma is very rare, patients with longstanding Hashimoto thyroiditis should undergo careful surveillance for both malignancies. PMID:24396701

  20. Correlacin entre biopsia rpida operatoria y biopsia diferida de tiroides: Revisin de 10 aos en el Hospital Barros Luco-Trudeau / Concordance between intraoperative frozen section and deferred biopsy for the diagnosis of malignant thyroid lesions

    GASTN, ASTROZA E; MIGUEL, GONZLEZ P; PABLO, PALADINES Z; RAL, CASAS C.

    2006-12-01

    Full Text Available La biopsia rpida intraoperatoria es un examen esencial en el curso de una tiroidectoma para decidir la magnitud del procedimiento resectivo. Un patlogo experimentado va a redundar en un alto grado de concordancia en el resultado entre la biopsia rpida y el de la biopsia diferida. Para analizar c [...] mo se dio esta concordancia en nuestro hospital, revisamos retrospectivamente 351 tiroidectomas, de las 795 realizadas en los ltimos 10 aos en nuestro Servicio. Para esta seleccin, excluimos aquellos procedimientos que no contaban con ambos tipos de biopsia. Se inform como proceso maligno por la biopsia rpida en 88 pacientes, lo que coincidi con la biopsia diferida en 75 pacientes (85,2%). En el resto (13 pacientes 14,8%) la biopsia rpida inform malignidad y el resultado final fue benigno. En 263 pacientes la biopsia rpida inform lesin benigna, presentndose una concordancia en 238 pacientes (90,5%). Por tanto, en el resto (25 pacientes 9,5%) el estudio diferido inform malignidad. Se calcul la sensibilidad y especificidad de la biopsia rpida intraoperatoria en relacin a patologa tirodea, obtenindose una sensibilidad de 75% y una especificidad de 94,8%. De los falsos negativos informados por biopsia rpida, el carcinoma papilar fue el tipo histolgico ms frecuente encontrado (15/25). Se concluye que si bien se obtuvo una buena especificidad lo que se acompaa de un bajo nmero de tiroidectomas totales en vano, la sensibilidad (75%) pudo haber sido mayor, lo que oblig en los pacientes errneamente catalogados en una primera instancia como benignos a ser sometidos a una segunda intervencin. Es necesario buscar la forma de optimizar estos resultados, para as disminuir el nmero de pacientes que deben ser reintervenidos Abstract in english Background: Intraoperative frozen section s essential procedure during thyroidectomy, to decide magnitude of the excision. There is usually a good concordance between fast and deferred biopsy results in hands of experimented pathologists. Aim: To assess the concordance between fast and deferred thyr [...] oid biopsies. Material and methods: Prospective study of 351 thyroidectomies, performed to 312 women and 39 men, aged 13 to 83 years, in which a fast and a deferred biopsy, were performed. Results: Intraoperative frozen section diagnosed a total of 88 malignant lesions, that were confirmed with the deferred biopsy in 75 cases (85.2%). In 13 (14.8%) patients with a malignant lesion diagnosed with the fast biopsy, the final result was benign. In 263 cases, the fast biopsy reported a benign lesion, that was corroborated with the deferred biopsy in 238 patients (90,5%). In 25 of these patients (9.5%), the deferred biopsy showed a malignant lesion. Therefore, the sensitivity and specificity of the fast biopsy were 75 and 95%, respectively. Papillary carcinoma was the most common pathological finding in 15 of 25cases. Conclusions: intraoperative frozen section thyroid has a high specificity for the diagnosis of malignant lesions, but sensitivity must be improved

  1. Diagnostic accuracy between fine needle aspiration biopsy (FNA and pathological examination of the thyroid

    Jerso Menegassi

    2013-08-01

    Full Text Available INTRODUCTION: Despite the fact that the fine needle aspiration biopsy (FNA is commonly used in the initial evaluation and distinction of benign and malignant lesions of thyroid nodules, it may yield variable results, inasmuch as it is contingent on the pathologist's analysis and expertise in collecting appropriate samples. OBJECTIVE: To check the diagnostic accuracy between FNA and pathological examination of thyroid nodules, both performed in a diagnostic pathology service. METHODS: Retrospective study carried out in a diagnostic pathology service in Chapecó, Santa Catarina, Brazil. All patients who underwent FNA and pathological examination in the period from January 1st 2005 to December 31 2010 were included in this study. RESULTS: 1,172 FNA were conducted during this period and 265 patients underwent both FNA and pathological examination. Most patients were female (85%, with mean age 47.75 years (standard deviation [SD] = 14.93 years. Cytopathological examinations yielded the following results: benignity (43.77 %, suspected malignancy (23.77%, follicular neoplasm (5.28%, atypical follicular lesion of undetermined significance (1.51% and unsatisfactory sample (1.51%. In the pathological examination, the most predominant diagnoses were colloid goiter (38.87%, follicular adenoma (22.64% and classic papillary carcinoma (18.87%. In satisfactory samples (n = 261, the following results were obtained: diagnostic accuracy (89.66%, sensitivity (82.14%, specificity (93.22%, negative predictive value (91.67% and positive predictive value (75.19%. CONCLUSION: We concluded that FNA provides a good predictive value for benign thyroid, constituting a reliable and effective tool for diagnosis and surgical indication.

  2. Both F-18 FDG-avidity and Malignant Shape of Cervical Lymph Nodes on PET/CT after Total Thyroidectomy Predict Resistance to High-dose I-131 Therapy in Patients with Papillary Thyroid Cancer

    Byung Hyun Byun

    2013-03-01

    Full Text Available Objective: Resistance of metastatic lymph nodes (LNs to high dose I-131 therapy is associated with high morbidity in patients with differentiated thyroid cancer. We evaluated the role of F-18 FDG PET/CT in the prediction of resistance to high dose I-131 therapy in patients with papillary thyroid cancer. Methods: The subjects were 307 patients who underwent total or near total thyroidectomy followed by high dose (5.55-6.66 GBq I-131 therapy. We divided the patients into three subgroups by visual assessment of regional LNs: FDG-avid LNs with a malignant shape on CT (PET/CT-positive group, FDG-avid LNs with a benign shape on CT (PET/CT-intermediate group and no FDG-avid lesion (PET/CT-negative group. We measured the maximum SUV (SUVmax of FDG-avid LNs in each patient. The presence or absence of focal increased uptake of I-131 was evaluated by whole body scan (WBS, and was denoted as WBS-positive group or WBS-negative group, respectively. Resistance to therapy was defined as presence of thyroglobulin (Tg in serum (Tg ≥1.0 ng/ml 3-6 months after I-131 therapy. Univariate and multivariate analyses were performed to determine the relationship between resistance to I-131 therapy and various clinico-pathologic variables. Results: PET/CT-positive, intermediate, and negative groups included 20 (6.5%, 44 (14.3% and 243 (79.2% patients, respectively. The mean SUVmax was significantly higher in the PET/CT-positive group than that of the PET/CT-intermediate group (4.6 vs. 2.7, P <0.001. Univariate analysis revealed that the PET/CT-positive group (P <0.001, T2-4 stage (P <0.001, N1b stage (P = 0.001, lower dose (5.55 GBq of I-131 (P <0.001, and the WBS-positive group (P = 0.029 were associated with resistance to therapy. In multivariate analysis, the PET/CT-positive group, lower dose of I-131, N1b stage, and T2-4 stage remained significant with odds ratios of 10.07 (P <0.001, 3.82 (P <0.001, 3.58 (P = 0.001, and 2.53 (P = 0.009, respectively. Conclusion: FDG-avidity and malignant shape of cervical LNs on pre-therapy FDG PET/CT were a strong risk factors predicting resistance to high dose I-131 therapy. A lower dose of administered I-131 (5.55 GBq and more extensive tumors (T2-4 and N1b were also associated with resistance to high dose I-131 therapy.

  3. Photon-deficient finding in sternum on bone scintigraphy in patients with malignant disease

    The sternum is known as a common site of bone metastasis in a variety of neoplasms. Sternal metastasis is usually visualized as hot spot on bone scintigraphy. However, photon deficiency in the sternum on bone scintigraphy is reported in few cases with malignancy. We undertook a retrospective analysis to clarify the clinical significance of photon deficiency in the sternum in 12 patients with malignancy. Twelve patients (five breast cancer, two multiple myeloma, one lung cancer, one renal cell cancer, one hepatocellular carcinoma, one malignant lymphoma, and one thyroid cancer) showing cold sternal metastasis on bone scintigraphy were identified among 9,430 patients in whom bone scintigraphy was performed. Except for two cases with pathologically confirmed sternal metastasis, all patients showed lytic change in the sternum on tomography or CT scan. Six cases of solitary sternal metstasis showed partial effect of systemic therapy (chemotherapy, humoral therapy, and radiation therapy) and surgical treatment. It is necessary to keep in mind that this type of lesion may occur as a manifestation of metastatic disease. (author)

  4. Intraductal papillary mucinous neoplasm of pancreas

    Norman Oneil Machado

    2015-01-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs of the pancreas are neoplasms that are characterized by ductal dilation, intraductal papillary growth, and thick mucus secretion. This relatively recently defined pathology is evolving in terms of its etiopathogenesis, clinical features, diagnosis, management, and treatment guidelines. A PubMed database search was performed. All the relevant abstracts in English language were reviewed and the articles in which cases of IPMN could be identified were further scrutinized. Information of IPMN was derived, and duplication of information in several articles and those with areas of persisting uncertainties were excluded. The recent consensus guidelines were examined. The reported incidence of malignancy varies from 57% to 92% in the main duct-IPMN (MD-IPMN and from 6% to 46% in the branch duct-IPMN (BD-IPMN. The features of high-risk malignant lesions that raise concern include obstructive jaundice in a patient with a cystic lesion in the pancreatic head, the findings on radiological imaging of a mass lesion of >30 mm, enhanced solid component, and the main pancreatic duct (MPD of size ≥10 mm; while duct size 5-9 mm and cyst size <3 mm are considered as "worrisome features." Magnetic resonance imaging (MRI and endoscopic ultrasound (EUS are primary investigations in diagnosing and following up on these patients. The role of pancreatoscopy and the analysis of aspirated cystic fluid for cytology and DNA analysis is still to be established. In general, resection is recommended for most MD-IPMN, mixed variant, and symptomatic BD-IPMN. The 5-year survival of patients after surgical resection for noninvasive IPMN is reported to be at 77-100%, while for those with invasive carcinoma, it is significantly lower at 27-60%. The follow-up of these patients could vary from 6 months to 1 year and would depend on the risk stratification for invasive malignancy and the pathology of the resected specimen. The understanding of IPMN has evolved over the years. The recent guidelines have played a role in this regard.

  5. MIBI-SPECT in hypofunctioning thyroid nodules for detection of thyroid carcinoma; MIBI-SPECT bei kalten Knoten zur Schilddruesenkarzinomdetektion

    Schmidt, M.; Schicha, H. [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2010-12-15

    The clinical usefulness of Tc-99m-MIBI in hypofunctioning thyroid nodules for detection of thyroid carcinoma is presented. Tc-99m-MIBI is a lipophilic cation and a non-specific radiopharmaceutical for tumour imaging. It has become an important imaging technique for the assessment of hypofunctioning thyroid nodules because of its high negative predictive value excluding malignant thyroid tumours. After injection of Tc-99m-MIBI either a single-phase protocol with late planar and SPECT images about 1-2 h post injection or a double-phase protocol with early (about 15-30 min p.i.) and late images (about 2 h p.i.) were reported. Findings include a reduced, an isointense or an increased Tc-99m-MIBI accumulation in the thyroid nodule in comparison to the paranodular thyroid tissue and in comparison to pertechnetate thyroid scintigraphy. A 'Match' between pertechnetate and Tc-99m-MIBI scintigraphy is a concordantly decreased uptake in the thyroid nodule in comparison to the normal thyroid gland. This finding has a negative predictive value of >97% to exclude differentiated thyroid cancer. A definite 'Mismatch' means a cold thyroid nodule on pertechnetate scintigraphy and an increased uptake of Tc-99m-MIBI in comparison to the MIBI-uptake of the paranodular thyroid tissue. The positive predictive value of this finding for malignancy varies between studies and is in the range of <10-65% (Cologne data: 19%) depending on the prevalence of malignant thyroid tumours in the patient population studied. An isointense uptake was not associated with thyroid malignancy according to 'Cologne' data. Further studies are desirable for better characterization of the method. (orig.)

  6. Risk of myeloid neoplasms after solid organ transplantation.

    Morton, L M; Gibson, T M; Clarke, C A; Lynch, C F; Anderson, L A; Pfeiffer, R; Landgren, O; Weisenburger, D D; Engels, E A

    2014-12-01

    Solid organ transplant recipients have elevated cancer risks, owing in part to pharmacologic immunosuppression. However, little is known about risks for hematologic malignancies of myeloid origin. We linked the US Scientific Registry of Transplant Recipients with 15 population-based cancer registries to ascertain cancer occurrence among 207?859 solid organ transplants (1987-2009). Solid organ transplant recipients had a significantly elevated risk for myeloid neoplasms, with standardized incidence ratios (SIRs) of 4.6 (95% confidence interval 3.8-5.6; N=101) for myelodysplastic syndromes (MDS), 2.7 (2.2-3.2; N=125) for acute myeloid leukemia (AML), 2.3 (1.6-3.2; N=36) for chronic myeloid leukemia and 7.2 (5.4-9.3; N=57) for polycythemia vera. SIRs were highest among younger individuals and varied by time since transplantation and organ type (Poisson regression Pcancer registries (log-rank P<0.0001). Our novel finding of increased risks for specific myeloid neoplasms after solid organ transplantation supports a role for immune dysfunction in myeloid neoplasm etiology. The increased risks and inferior survival should heighten clinician awareness of myeloid neoplasms during follow-up of transplant recipients. PMID:24727673

  7. Diffuse Pancreatic Mucinous Cystic Neoplasm Treated by Total Pancreatectomy

    Hongyi Chen

    2015-05-01

    Full Text Available Context Multifocal or diffuse mucinous cystic neoplasm are uncommon and may be difficult to distinguish from multifocal intra-ducal mucinous neoplasm or diffuse serous cystadenoma. Case report A forty-seven-year old lady with vague abdominal pain was noted to have cystic lesions ranging from 5 to 20 mm throughout her pancreas. The cysts had enlarged over several years of observation. There was no evidence of pancreatic duct dilatation or communication with the pancreatic duct on magnetic resonance imaging. Cyst fluid analysis for carcinoembryonic antigen and amylase were non-diagnostic. A total pancreatectomy was performed, with histology confirming numerous cysts lined by mucus producing cells, without obvious ovarian-like stroma. The stroma did however demonstrate positive staining for oestrogen receptor and smooth muscle actin. These findings were most consistent with a mucinous cystic neoplasm, despite the apparent absence of typical ovarian like stroma. Conclusion Multifocal or diffuse pancreatic mucinous cystic neoplasm are uncommon and may be suspected when imaging demonstrates multiple pancreatic cysts without communication with the pancreatic duct or pancreatic duct dilation. Surgical resection is indicated due to the increased risk of malignancy.

  8. Increased 18F-FDG uptake mimicking thyroid cancer in a patient with Hashimoto's thyroiditis

    We report the case of a 68-year-old patient with a known paravertebral malignant schwannoma, sent to us for postoperative staging. A combined whole-body PET/CT scan showed only poor 18F-fluorodeoxyglucose uptake in the region of the primary tumor but distinct increased fluorodeoxyglucose uptake in the left and right thyroid gland. Thyroid sonography showed two hypoechogenic nodules. Ultrasound-guided fine-needle aspiration biopsy of one nodule showed oxyphil transformed cells, compatible with malignancy. Based on these findings, the patient underwent a subtotal thyroidectomy. Histopathology of the specimen revealed a chronic follicular Hashimoto's thyroiditis. This case demonstrates that Hashimoto's thyroiditis can mimic thyroid cancer in PET but also in sonography and fine-needle aspiration biopsy. (orig.)

  9. Screening of colorectal neoplasm

    In Germany approximately 29,000 people died of colorectal carcinoma (CRC) in 2002; the risk of getting CRC is 4-6% in Germany, rising with age from the 50th year of life. About one third of all people over 50 years of age have polyps with the potential for malignant transformation in the colorectum, which is a sufficiently high prevalence rate to justify screening. In contrast to most other cancer diseases, in the case of CRC it is possible to prevent the cancer and not only to detect it at an early stage. Application of the test for occult blood in persons between their 45th and 80th years can reduce the mortality of CRC by 14%. We can assume that already regular sigmoidoscopies with consistent performance of polypectomy when needed could reduce the incidence of CRC by 50-70%. There is no doubt that coloscopy is the technique of choice for secondary prevention, as it unites the possibility of complete diagnosis and treatment with a justifiably low level of risk. The economic advantages of an avoidance strategy compared with the treatment of CRC, which is certainly expensive, have been documented. On the basis of all the data reported, in the case of CRC preventive strategies can be emphatically recommended. (orig.)

  10. ROLE OF ULTRASONOGRAPHY & COLOR DOPPLER IN THE EVALUATION OF THYROID NODULES WIT H HISTOPATHOLOGICAL CORRELATION

    Raghu Teja

    2015-02-01

    Full Text Available PURPOSE OF THE STUDY: 1. To identify morphologic patterns on sonography , those are predictive of benign thyroid nodules and malignant thyroid nodules. 2. To evaluate the efficacy of sonography in differentiating benign and malignant thyroid nodules in comparison with histopathology. MATERIALS AND METHODS: HRS of thyroid was performed in 60 patients with clinically palpable STN , referred to Department of Radiodiagnosis , R. L. Jssalappa Hospital and Research Centre , Tamaka , Kolar , Karnataka over a period of 24months , using SIEMENS ACCUSON X 300 and SIEMENS G 50 with 5 - 10 MHz transducers . Thyroid sonographic findings relevant to benign or malignant thyroid nodules were recorded and these findings w ere compared with histopathology reports. RESULTS: Out of 60 cases of solitary thyroid nodules evaluated at sonography , 41 were diagnosed to be benign thyroid nodules. 19 were malignant thyroid nodules. After histopathological evaluation , 43 cases were fou nd to be benign thyroid nodules and 17 were malignant thyroid nodules. Among benign thyroid nodules , follicular adenoma 55.8% (24 caseswas most common followed by nodular hyperplasia 27.9% (12 casesand colloid nodule 16.3%(7 cases. Among malignant nodul es , papillary carcinoma 88.2% (15 cases was most common followed by follicular carcinoma 11.8% (2 cases. CONCLUSION: Thyroid nodules were more common in the females of age group 31 45 years. Sonography is a safe , fairly accurate investigation to differentiate benign from malignant thyroid nodules with sensitivity of 82.3 % and specificity of 88.3 %. KEY WORDS: solitary thyroid nodu le; high resolution sonography; histopathology.

  11. Surgeons overestimate the risk of malignancy in thyroid nodules. Evaluation of subjective estimates using a Bayesian analysis Los cirujanos sobreestiman el riesgo de malignidad de los nódulos tiroideos. Evaluación de los estimados subjetivos usando un análisis bayesiano

    Alvaro Sanabria

    2011-06-01

    Full Text Available Introduction. Thyroid nodules are the most common endocrine condition treated by surgeons. The main purpose of the evaluation of a thyroid nodule is to rule out a carcinoma. Medical decisions concerning thyroid nodules are highly influenced by subjective beliefs.
    Objective. To assess the subjective probabilities of malignancy that are as-signed to the clinical characteristics of a patient with a thyroid nodule in order to determine the degree of influence that these probabilities have on the final clini-cal suspicion of malignancy compared with objective data.
    Material and methods. A Bayesian analysis was designed to predict the risk of malignancy of a thyroid nodule based on the causal relationship between the demographic and clinical risk factors that are detected during the first consulta-tion. A model with demographic and clinical variables using general surgeons as experts was developed.
    Results. The highest probability of malignancy (94% was assigned to the pooled case of a male who was older than 60 years, with dysphonia, dysphagia, accelerated growth rate of the nodule and previous neck radiotherapy and who had a relative with thyroid cancer as well as multiple nodules that were larger than 1 cm and with hard consistency and palpable neck lymph nodes. For low risk cases in which the nodule characteristics are not suggestive of malignancy, the probability of malignancy assigned by clinicians was 33.59%; for high risk cases this was 75.54%.
    Conclusion. Surgeons make diagnostic decisions based on subjective beliefs that do not necessarily correspond to the objective measures of the characteris-tics of the nodules.
    Introducción. Los nódulos tiroideos son la condición endocrina más frecuente para los cirujanos. El principio de la evaluación de un nódulo tiroideo es determinar si este corresponde a un carcinoma. Las decisiones médicas sobre los nódulos tiroideos son influenciadas fuertemente por consideraciones subjetivas.
    Objetivo. Determinar las probabilidades subjetivas asignadas a las característi-cas clínicas de un paciente con un nódulo tiroideo, para evaluar el grado de in-fluencia de estas probabilidades en la sospecha clínica final de malignidad en comparación con los datos objetivos.
    Materiales y métodos. Se diseñó un análisis bayesiano para predecir el riesgo de malignidad en un nódulo tiroideo basado en la relación causal conocida de factores clínicos y demográficos durante la primera consulta. Se desarrolló un modelo con las variables clínicas y demográficas usando como expertos a los ci-rujanos.
    Resultados. La mayor probabilidad de malignidad (94% se asignó al caso clíni-co de un hombre mayor de 60 años, con disfonía y disfagia, nódulo de creci-miento rápido, antecedentes de radioterapia cervical y familiar con cáncer de ti-roides, con nódulos múltiples, mayores de 1 cm de consistencia dura y con adenomegalias cervicales palpables. Para los casos de bajo riesgo, con nódulos sin características de malignidad, la probabilidad de malignidad asignada por los clínicos fue de 33,59%, para los de alto riesgo fue de 75,54%.
    Conclusión. Los cirujanos toman decisiones diagnósticas basadas en creen-cias subjetivas que no necesariamente corresponden con los datos objetivos de las características de nódulos.

  12. Characterization of Malignant Melanoma Using Vibrational Spectroscopy

    Ziad Hammody; Ranjit Kumar Sahu; Shaul Mordechai; Emanuela Cagnano; Shmuel Argov

    2005-01-01

    Malignant melanoma, a malignant neoplasm of epidermal melanocytes is the third most common skin cancer. In many cases, melanoma develops from nevus, which is considered as the nonmalignant stage. Fourier transform infrared microspectroscopy (FTIR-MSP), which is based on characteristic molecular vibrational spectra of cells, was used to investigate spectral differences between melanoma, nevus, and the corresponding normal epidermis. In the present work, FTIR-MSP was performed on formalin-fixed...

  13. Synchronous Renal Cell Carcinoma and Gastrointestinal Malignancies

    Dafashy, Tamer J.; Cameron K. Ghaffary; Keyes, Kyle T.; Joseph Sonstein

    2016-01-01

    While renal cell carcinoma is the most commonly diagnosed neoplasm of the kidney, its simultaneous diagnosis with a gastrointestinal malignancy is a rare, but well reported phenomenon. This discussion focuses on three independent cases in which each patient was diagnosed with renal cell carcinoma and a unique synchronous gastrointestinal malignancy. Case 1 explores the diagnosis and surgical intervention of a 66-year-old male patient synchronously diagnosed with clear cell renal cell carcinom...

  14. Hyperfunction thyroid nodules: Their risk for becoming or being associated with thyroid cancers

    To retrospectively evaluate the risk of thyroid cancer in patients with hyperfunctioning thyroid nodules through ultrasonographic-pathologic analysis. Institutional review board approval was obtained and informed consent was waived. From 2003 to 2007, 107 patients consecutively presented with hot spots on thyroid scans and low serum thyroid-stimulating hormone levels. Among them, 32 patients who had undergone thyroid ultrasonography were analyzed in this study. Thyroid nodules depicted on ultrasonography were classified based on size and categorized as benign, indeterminate, or suspicious malignant nodules according to ultrasonographic findings. The thyroid nodules were determined as either hyperfunctioning or coexisting nodules and were then correlated with pathologic results. In 32 patients, 42 hyperfunctioning nodules (mean number per patient, 1.31; range, 1-6) were observed on thyroid scans and 68 coexisting nodules (mean, 2.13; range, 0-7) were observed on ultrasonography. Twenty-five patients (78.1%) had at least one hyperfunctioning (n = 17, 53.1%) or coexisting (n = 16, 50.0%) nodule that showed a suspicious malignant feature larger than 5 mm (n = 8, 25.0%), or an indeterminate feature 1 cm or greater (n = 20, 62.5%) in diameter, which could have been indicated by using fine needle aspiration (FNA). Seven patients were proven to have 11 thyroid cancers in 3 hyperfunctioning and 8 coexisting nodules. All of these had at least one thyroid cancer, which could have been indicated by using FNA. The estimated minimal risk of thyroid cancer was 6.5% (7/107). Patients with hyperfunctioning nodules may not be safe from thyroid cancer because hyperfunctioning nodules can coexist with thyroid cancer nodules. To screen out these cancers, ultrasonography should be performed.

  15. Human benign and malignant prostatic neoplasms: cytoplasma protein studies

    Bryś, Magdalena; Marciniak, Dorota; Nawrocka, Agnieszka; Krajewska, Wanda

    1999-01-01

    Białka frakcji cytosolowej oraz frakcji błon plazmatycznych komórek łagodnego rozrostu stercza oraz raka tego gruczołu analizowano za pomocą jednokierunkowej elektroforezy w żelu poliakryloamidowym z SDS (PAGE-SDS). Prawidłową tkankę stercza, łagodny rozrost (BPH ang. benign prostatic hyperplasia) oraz raka prostaty (PCA, ang. prostatic carcinoma) pozyskiwano w wyniku częściowej elektroresekcji przezcewkowej lub całkowitej prostatektomii. Rozdziały elektroforetyczne białek wyba...

  16. Studies of heterotransplantation of transplantable human urogenital malignant neoplasms, 6

    Radiotherapeutic effects were studied using human urinary bladder cancer (NM-B-1) and human prostatic cancer (Pro-1) transplantable to nude mice. NM-B-1 is a poorly differentiated transitional cell carcinoma and Pro-1 is a poorly differentiated adenocarcinoma. In both the 24th to 27th passage of NM-B-1 and the 35th to 38th passage of Pro-1, the successful transplantation rates were almost 100 per cent and the growth rates were similar and stable. Two weeks after subcutaneous transplantation of the tumor, electron beam irradiation was performed locally using a linear accelerator. The therapeutic effects were evaluated on the tumor growth curve, as well as light and electron microscopic findings. The standard deviations of the tumor volumes were relatively small in all radiated groups and this study seemed applicable to radiosensitivity test. On the tumor growth curve, significant tumor regressive effects were observed statistically in a dose of 12 Gy for NM-B-1 and 6 Gy or more for Pro-1, respectively, and dose-dependency was seen in the effects. Stromal degeneration and destruction of cancer cells were demonstrated by light and electron microscopy in both NM-B-1 and Pro-1 two weeks after irradiation of 18 Gy. (author)

  17. Frequent hypermethylation of DBC1 in malignant lymphoproliferative neoplasms

    Grønbæk, Karin Elmegård; Ralfkiaer, U.; Dahl, C.; Hother, C.; Burns, J.S.; Kassem, M.; Worm, J.; Ralfkiaer, E.M.; Knudsen, L.M.; Hokland, P.; Guldberg, P.

    2008-01-01

    follicular lymphomas, 5 of 5 mantle cell lymphomas, 4 of 4 small lymphocytic lymphomas, 1 of 2 lymphoplasmacytoid lymphomas, and in 12 of 12 acute lymphoblastic leukemias, but was unmethylated in 1 case of splenic marginal zone lymphoma, in 12 of 12 multiple myelomas, in 24 of 24 reactive lymph nodes, and in...... 12 of 12 samples of blood lymphocytes from random donors. DBC1 hypermethylation was associated with transcriptional silencing in lymphoma cell lines, and reexpression of this gene could be induced by treatment with the demethylating agent, 5-aza-2'-deoxycytidine. Our data suggest that...

  18. Radiogenic Risk of Malignant Neoplasms for Techa Riverside Residents

    As a result of releases of liquid radioactive waste into the Techa River from the Mayak PA in the 1950s, residents of the riverside villages were for decades exposed to external and internal radiation resulting from consumption of locally produced food and river water. Presented in the paper is a brief description of the radiation conditions, organization of medical follow-up of the exposed population, principles for dose estimation, epidemiological analyses of cancer mortality and incidence for residents of the Techa RIverside villages. The estimates of excess relative risk of radiation-related leukemia and solid cancer mortality and incidence obtained for members of the Techa River cohort point to a clear-cut dependence of the rates on radiation exposure. Attributive risk of cancer incidence characterizing the proportion of radiation-related cancer cases among the total cancers was comparable with that for mortality: 3.2% derived for cancer incidence and 2.5% for cancer mortality. Based on the non-CLL leukemia excess relative risk (ERR) estimates calculated using the linear dose-effect model and the nature of the cohort, it was estimated that 31 (60%) out of 49 leukemia death cases (with the exclusion of 12 cases of chronic lymphatic leukemia) can be related to a long-term radiation exposure due to the contamination of the Techa River.

  19. Thyroid dysfunction following external irradiation to the neck

    Thyroid function after radiation therapy to the neck was studied in 120 patients, 110 of whom were suffered from malignant lymphomas. No patients had clinical symptoms from thyroid dysfunction, but 9 patients were given thyroid hormone after examination of thyroid function test. TSH elevation rate for 95 patients irradiated to the hole neck by dosage was 0 %, 24 %, 47 % and 47 %, for less than 30 Gy, 30 - 39 Gy, 40 - 49 Gy and 50 Gy or more, respectively. The effects of lymphangiography and systemic combination chemotherapy on the thyroid function were also disscussed. (author)

  20. Lingual thyroid

    Ectopic thyroid is caused by an alteration in the embryological migration of the gland. Its most common location is the base of the tongue, and it is generally discovered by chance. We present a case of lingual ectopic thyroid gland diagnosed by computerized tomography (CT) and confirmed by isotopic study

  1. Thyroid scintigraphy

    The progress made in ultrasonography and improved in vitro tests has changed the field of application for scintigraphy of the thyroid. Thyroid scanning itself has been improved by the use of isotopes with better imaging properties and less radiation burden (99mTc, 123I) and by gamma cameras for imaging. Scintigraphy yields real topographic and functional information on the gland, in addition to which ultrasonography gives morphological data only. This holds true especially for autonomous nodular goiter with iodine deficiency. The goal of thyroid imaging is always to match the appropiate diagnostic procedure with all the clinical data available. When optimized techniques (gamma camera, on-line processor) are used thyroid scintigraphy is useful for the diagnosis, adequate therapy and follow-up of various thyroid disorders. (orig.)

  2. ANAPLASTIC THYROID CARCINOMA

    AugustoTaccaliti

    2012-07-01

    Full Text Available Thyroid cancers represent about 1% of all human cancers. Differentiate thyroid carcinomas (DTCs, papillary and follicular cancers, are the most frequent forms, instead Anaplastic Thyroid Carcinoma (ATC is estimated to comprise 1-2% of thyroid malignancies and it accounts for 14% to 39% of thyroid cancer deaths. The annual incidence of ATC is about 1-2 cases/million, with the overall incidence being higher in Europe (and area of endemic goiter than in USA. ATC has a more complex genotype than DTCs, with chromosomal aberrations present in 85100% of cases. A small number of gene mutations have been identified, and there appears to be a progression in mutations acquired during dedifferentiation. The mean survival time is around 6 months from diagnosis an outcome that is frequently not altered by treatment. ATC presents with a rapidly growing fixed and hard neck mass, often metastatic local lymph nodes appreciable on examination and/or vocal paralysis. Symptoms may reflect rapid growth of tumor with local invasion and/or compression. The majority of patients with ATC die from aggressive local regional disease, primarily from upper airway respiratory failure. For this reason, aggressive local therapy is indicated in all patients who can tolerate it. Although rarely possible, complete surgical resection gives the best chance of long-term control and improved survival. Therapy options include surgery, external beam radiation therapy, tracheostomy, chemotherapy, and investigational clinical trials. Multimodal or combination therapy should be useful. In fact, surgical debulking of local tumor, combined with external beam radiation therapy and chemotherapy as neoadjuvant (before surgery or adjuvant (after surgery therapy, may prevent death from local airway obstruction and as best may slight prolong survival. Investigational clinical trials in phase I or in phase II are actually in running and they include antiangiogenetic drugs, multi-kinase inhibitor drugs.

  3. Adenocarcinoma with Intraductal Papillary Mucinous Neoplasm Arising in Jejunal Heterotopic Pancreas

    Song, Ju Young; Han, Jee Young; Choi, Sun Keun; KIM, LUCIA; Choi, Suk Jin; Park, In Suh; Chu, Young Chae; Kim, Kyu Ho; Kim, Joon Mee

    2012-01-01

    A 74-year-old man suffered from jejunal perforation and adhesion to sigmoid colon due to adenocarcinoma associated with intraductal papillary mucinous neoplasm (IPMN) arising in a jejunal heterotopic pancreas. The jejunal lesion showed direct extension to the sigmoid colon, which was mistaken as sigmoid colon cancer by surgeons. Malignant transformation is a rare complication of a heterotopic pancreas. About half of malignancies in reported cases were ductal adenocarcinoma arising in the stom...

  4. Blastic plasmacytoid dendritic cell neoplasm with absolute monocytosis at presentation

    Jaworski JM

    2015-02-01

    Full Text Available Joseph M Jaworski,1,2 Vanlila K Swami,1 Rebecca C Heintzelman,1 Carrie A Cusack,3 Christina L Chung,3 Jeremy Peck,3 Matthew Fanelli,3 Micheal Styler,4 Sanaa Rizk,4 J Steve Hou1 1Department of Pathology and Laboratory Medicine, Hahnemann University Hospital/Drexel University College of Medicine, Philadelphia, PA, USA; 2Department of Pathology, Mercy Fitzgerald Hospital, Darby, PA, USA; 3Department of Dermatology, Hahnemann University Hospital/Drexel University College of Medicine, Philadelphia, PA, USA; 4Department of Hematology/Oncology, Hahnemann University Hospital/Drexel University College of Medicine, Philadelphia, PA, USA Abstract: Blastic plasmacytoid dendritic cell neoplasm is an uncommon malignancy derived from precursors of plasmacytoid dendritic cells. Nearly all patients present initially with cutaneous manifestations, with many having extracutaneous disease additionally. While response to chemotherapy initially is effective, relapse occurs in most, with a leukemic phase ultimately developing. The prognosis is dismal. While most of the clinical and pathologic features are well described, the association and possible prognostic significance between peripheral blood absolute monocytosis (>1.0 K/µL and blastic plasmacytoid dendritic cell neoplasm have not been reported. We report a case of a 68-year-old man who presented with a rash for 4–5 months. On physical examination, there were multiple, dull-pink, indurated plaques on the trunk and extremities. Complete blood count revealed thrombocytopenia, absolute monocytosis of 1.7 K/µL, and a negative flow cytometry study. Biopsy of an abdominal lesion revealed typical features of blastic plasmacytoid dendritic cell neoplasm. Patients having both hematologic and nonhematologic malignancies have an increased incidence of absolute monocytosis. Recent studies examining Hodgkin and non-Hodgkin lymphoma patients have suggested that this is a negative prognostic factor. The association between blastic plasmacytoid dendritic cell neoplasm and absolute monocytosis has not been described and may, in fact, have prognostic value. Keywords: blastic, plasmacytoid, dendritic, monocytosis

  5. Molecular diagnostics of myeloproliferative neoplasms

    Langabeer, S. E.; Andrikovics, H.; Asp, J.; Bellosillo, B.; Carillo, S.; Haslam, K.; Kjaer, L.; Lippert, E.; Mansier, O.; Leibundgut, E. O.; Percy, M. J.; Porret, N.; Palmqvist, L.; Schwarz, J.; McMullin, M. F.; Schnittger, S.; Pallisgaard, N.; Hermouet, S.

    2015-01-01

    Since the discovery of the JAK2 V617F mutation in the majority of the myeloproliferative neoplasms (MPN) of polycythemia vera, essential thrombocythemia and primary myelofibrosis ten years ago, further MPN-specific mutational events, notably in JAK2 exon 12, MPL exon 10 and CALR exon 9 have been ...

  6. Drugs Approved for Myeloproliferative Neoplasms

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for myeloproliferative neoplasms. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  7. Gastrointestinal Surgery of Neuroendocrine Neoplasms

    Hansen, Carsten Palnæs; Olsen, Ingrid Holst; Knigge, Ulrich

    2015-01-01

    Surgery is the only treatment that may cure the patient with gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) and should always be considered as the first-line treatment if radical resection can be achieved. Even in cases where radical surgery is not possible, palliative resection may...

  8. Pediatric liver neoplasms: a radiologic-pathologic correlation

    Only 1-2 % of all pediatric tumors occur in the liver. Two thirds of these tumors are malignant and almost all of the tumors cause clinical symptoms due to their mass effects. Besides the poor prognosis in most of the malignant tumors, for further treatment the origin and nature of the neoplasm has to be known. Due to the mostly unimpeded growth into the peritoneal cavity, the origin of the tumors is primarily often unclear and can non-invasively only be determined by advanced imaging techniques. The display of the macro- and microhistological key features of primary pediatric liver neoplasms, including hepatoblastoma (HB), infantile hemangioendothelioma (IHE), mesenchymal hamartoma (MH), undifferentiated (embryonal) sarcoma (UES), and hepatocellular carcinoma (HCC), together with their imaging representation by ultrasound, computed tomography, and magnetic resonance imaging, may deepen the understanding of the underlying pathology and its imaging appearance. Furthermore, in many cases sufficient information may be provided not only to differentiate benign from malignant tumors, but also to guide for adequate treatment. (orig.)

  9. Value of thyroid scintigraphy using thallium 201

    The value of thallium-201 scintigraphy in the differential diagnosis of cold thyroid nodules demonstrated on the thyroid scan with technetium-99m was emphasized. From the clinical results it can be deduced that if a cold nodule is positive with thallium-201 the lesion has a high percentage of being a high risk of malignancy. This information might be quite valuable in selecting patients for operation

  10. The impact of ruxolitinib treatment on inflammation-mediated comorbidities in myelofibrosis and related neoplasms

    Bjørn, Mads Emil; Hasselbalch, Hans Carl

    2015-01-01

    The inflammation-mediated comorbidities in myelofibrosis (MF) and related neoplasms (MPNs) likely reflect the concurrent immune deregulation and systemic inflammatory nature of the MPNs, emphasizing the link between chronic systemic inflammation, immune deregulation, and the malignant clone. JAK1......-2 inhibitors in MF-patients reduce constitutional symptoms and splenomegaly, but also taget autoimmune and inflammation-mediated comorbidities....

  11. The impact of ruxolitinib treatment on inflammation-mediated comorbidities in myelofibrosis and related neoplasms

    Bjørn, Mads Emil; Hasselbalch, Hans Carl

    2015-01-01

    Key clinical message The inflammation-mediated comorbidities in myelofibrosis (MF) and related neoplasms (MPNs) likely reflect the concurrent immune deregulation and systemic inflammatory nature of the MPNs, emphasizing the link between chronic systemic inflammation, immune deregulation, and the malignant clone. JAK1-2 inhibitors in MF-patients reduce constitutional symptoms and splenomegaly, but also taget autoimmune and inflammation-mediated comorbidities.

  12. Lingual thyroid

    Marina ?or?e

    2007-01-01

    Full Text Available Lingual thyroid is a rare congenital malformation that occurs more frequently in the female population. It occurs because of the error in transcriptional factors, the key for the normal differentiation of thyrocyte, so the thyroid gland tissue does not descend normally down the thyroglossal duct to the final position in the neck. Due to that, it can entirely or partially remain at the base of the tongue. This is the most frequent localization of the ectopic tissue while it can remain in the sublingual, suprahyoid and infrahyoid area as well. This disease can be diagnosed in the asymptomatic phase, as well as in the phase of compensatory and manifest hypothyroidism. In the ectopic thyroid gland, all diseases of the thyroid gland can occur as in the usual localization in the neck. The authors show a 6-year old patient, who had a routine medical examination for the inflamed throat, during which a vascular tumefaction was discovered at the base of the tongue. A cyst at the base of the tongue was suspected, but additional examination showed that it was an ectopic thyroid tissue marked as a lingual thyroid gland. Diagnosis of this disease starts with the laboratory analysis of the thyroid status. The next step involves scintigraphy of the thyroid gland with technetium-pertechnetate (99mTc or radioactive iodine (123I. The therapy of the compensatory hypothyroidism is suppressive therapy with levothyroxine and in the manifest hypothyroidism it is hormone substitution therapy with levothyroxine. Although there are recommended age-related daily doses, they should not be accepted as final, but rather prescribed according to the individual thyroid status. .

  13. Intradural extramedullary metastasis from papillary carcinoma of thyroid

    Akhavan, Ali; Mehrabaniyan, Mohammad Reza; Jarahi, Mohammadreza; Navabii, Hossein

    2012-01-01

    Although spinal metastasis is a common finding in malignancies, however intradural extramedullary metastasis is very rare. This paper presents a 71-year-old woman, known case of papillary carcinoma of thyroid with intradural extramedullary metastasis in thoracic spine.

  14. Somatostatin receptor expression in thyroid disease.

    Atkinson, Helen; England, James A; Rafferty, Amy; Jesudason, Vim; Bedford, Karen; Karsai, Laszlo; Atkin, Stephen L

    2013-06-01

    Somatostatin analogues are commercially available and used for the management of acromegaly and neuroendocrine tumours, but the expression of the receptors as a target in thyroid disease has not been explored. To assess somatostatin (SST) and somatostatin receptor (SSTR1-5) expression in both normal and thyroid disorders, as a potential target for somatostatin analogue therapy, 67 thyroid tissue specimens were reviewed: 12 differentiated thyroid carcinomas, 14 follicular adenomas, 17 multinodular goitres, 14 Graves disease, 10 Hashimotos thyroiditis specimens and five normal thyroids. Tissue was immunostained for SST and SSTR1-5. Positivity and the degree of positivity were recorded by double-blinded observers. Somatostatin receptor expression was highly expressed in normal tissue for SSTR1, 3, 4 and 5 (5 of 5, 4 of 5, 4 of 5 and 5 of 5 respectively) whilst SST and SSTR 2a and b were not expressed at all. The commonest receptor expressed for all pathological subtypes grouped together was SSTR2b (63 specimens). The commonest receptors expressed in differentiated thyroid cancer were SSTR5 (11 of 12 specimens) and SSTR2b (10 of 12 specimens). The commonest receptor expressed in benign disease was SSTR2b (53 of 55 specimens). SSTR5 was significantly under-expressed in Graves disease (P thyroid tissue. SSTR 2a and 2b appear absent in normal tissue and present in benign and malignant thyroid tissue (P < 0.02). This suggests that focussed SSTR2 treatment may be a potential therapeutic target. PMID:23672766

  15. RARE METASTASES OF MALIGNANT MELANOMA

    Marija Trenki?-Boinovi?

    2014-09-01

    Full Text Available Melanomas are malignant neoplasms that originate from melanocytes. The most common are on the skin and mucous membranes. Choroidal melanomas are quite different from cutaneous melanomas with regard to presentation, metastases, and treatment. We report two cases of metastatic gastric malignant melanoma of the eye and skin, with reference to the literature. The first patient was a woman aged 23 years, who underwent gastrectomy 22 months after enucleation of the eye due to malignant choroid melanoma. The second patient was a man, 72 years old, who underwent surgery 28 months before because of malignant melanoma of the skin of the forehead. Paraffin sections, 4 ?m thick were stained using a classic method, as well as immunohistochemical DAKO APAAP method, using a specific S - 100 antibody and Melan A antibodies. The stomach is considered a rare place for the development of metastases. Metastases in the stomach are often limited to the submucosal as well as the serousmuscular layer, as noted in one of our patients. Metastatic melanoma of the gastrointestinal tract should be suspected in any patient with a history of malignant melanoma and new gastrointestinal symptoms. Because of the similarity between certain common histopathological types of malignant melanoma, primarily achromatic, and types of primary cancers of the stomach, the following immunohistochemical studies are needed: Melan A and S - 100 protein ( markers of malignant melanoma , as well as mucins: MUC5AC, MUC2 and CDX2 ( markers of different types of primary gastric carcinoma.

  16. Thyroid Incidentalomas: Epidemiology, Risk Stratification with Ultrasound and Workup

    Russ, Gilles; Leboulleux, Sophie; Leenhardt, Laurence; Hegedüs, Laszlo

    2014-01-01

    A thyroid incidentaloma is an unexpected, asymptomatic thyroid tumor fortuitously discovered during the investigation of an unrelated condition. The prevalence rate is 67% with ultrasonography (US) imaging, 15% with computed tomography (CT) or magnetic resonance imaging (MRI) of the neck, and 1-2% with fluorodeoxyglucose (FDG) positron emission tomography. In the absence of a history of external beam radiation or familial medullary thyroid cancer, the risk of malignancy ranges between 5 and 1...

  17. SYNCHRONOUS PAPILLARY THYROID CARCINOMA AND SECONDARY HYPERPARATHYROIDISM: CASE REPORT

    Daniela Sala , (2,(3, (4 (5

    2011-11-01

    Full Text Available Papillary thyroid carcinoma (PTC is the most frequent form of thyroid cancer, and the association with primary hyperparathyroidism have been well described. Although, a synchronous PTC and renal hyperparathyroidism (HPT is a rare event, with pathogenetic interest ,often detected only by surgery. We suggest that the association between thyroid carcinomas and renal hyperparathyroidism should be always considered, highlighting several factors that may favour malignant transformation.

  18. Thyroid metastasis as initial presentation of clear cell renal carcinoma

    César Pablo Ramírez-Plaza

    2015-01-01

    Conclusion: The possibility of finding of an incidental metastatic tumor in the thyroid gland from a previous unknown and non-diganosed primary (as CCRC in our case was is rare and account only for less than 1% of malignancies. Nonetheless, the thyroid gland is a frequent site of metastasis and the presence of “de novo” thyroid nodules in oncologic patients must be always considered and studied.

  19. Acute airway failure secondary to thyroid metastasis from renal carcinoma

    Lastilla Gaetano; Gurrado Angela; Lissidini Germana; Testini Mario; Ianora Amato; Fiorella Raffaele

    2008-01-01

    Abstract Background Secondary involvement of the thyroid gland by malignant metastases is uncommon. Acute respiratory crisis due to infiltration of the upper airways is a recognised complication of anaplastic thyroid carcinoma or thyroid lymphoma. Renal cell carcinoma is a tumour that metastasizes diffusely and in an unpredictable manner. Case presentation We report a case of a 73-year-old man with a painful neck mass, dyspnoea, stridor and dysphonia that was evaluated in emergency. A right r...

  20. Malignant chondroid syringoma of the pinna

    Chondroid syringoma (CS) represents the cutaneous counterpart of mixed tumor (pleomorphic adenoma) of salivary glands. The malignant counterpart of CS, termed as “malignant CS” is a malignant eccrine neoplasm which lacks distinctive clinical features, often delaying initial diagnosis. Unlike its benign counterpart which often localizes in the head and neck region, malignant CS most often encountered in the trunk and the extremities. We report a rare case of an aggressive malignant CS of the left pinna with cervical lymph node metastasis. Our patient, to the best of our knowledge, possibly is the first case of malignant CS of the pinna and the fourth to arise in the head and neck region. The diagnostic challenges with an added emphasis on the role of positron emission tomography-computed tomography in aiding the management of this rare tumor are discussed

  1. Dose-response relationships for radiation-induced thyroid cancer and thyroid nodules: Evidence for the prolonged effects of radiation on the thyroid

    The risk of developing thyroid cancer and other thyroid neoplasms after radiation exposure is well known, but specific modifiers of the dose-response relationship are not. The authors have identified 4,296 subjects who received treatment before their sixteenth birthday with orthovoltage radiation for benign conditions in the head and neck area. Individual thyroid dose estimates were calculated for 3,843 subjects. Of the 2,634 subjects who have been found, 1,043 have developed thyroid nodules of all types, and 309 have developed thyroid cancer. The radiation dose-response relationship was consistent with a linear excess relative risk model for thyroid cancer and thyroid nodules within the range of observed doses. Women developed thyroid cancer and thyroid nodules at a higher rate, but the slopes of the dose-response curves were the same for men and women. Age at radiation exposure was a significant factor of the risk, with a lower age at exposure associated with a higher risk. To determine the effect of the wide publicity and the screening program, which began in 1974, the authors compared the dose-response relationship for cases diagnosed before and after 1974. The overall rates increased dramatically after 1974, but the estimates of the slopes of the dose-response curves were not statistically different. The slope of the dose-response curve for thyroid neoplasms appears to have reached a maximum 25-29 yr after radiation exposure, but the dose response continued to be elevated at the end of follow-up. These data are consistent with the tumorigenic effects of radiation lasting at least 40 yr

  2. Medullary carcinoma of thyroid

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC ... The cause of medullary carcinoma of the thyroid (MTC) is unknown. Unlike other types of thyroid cancer, MTC is less likely to be caused by radiation therapy to the neck given ...

  3. 201Tl scintigraphy in postoperative detection of thyroid cancer: a comparative study with 131I

    201Tl scintigraphy was performed to visualize malignant lesions postoperatively in 28 patients with thyroid cancer. The results were compared with those of 131I and/or /sup 99m/Tc pertechnetate scintigraphy. Of eight patients who had malignant lesions and no normal thyroid tissue, 201Tl concentration was observed in seven, while 131I concentration was observed in only three. All of four patients who had malignant lesions and did have remaining normal thyroid tissue showed concentrations of 201Tl. 201Tl scintigraphy can be performed without any preparation and may be useful in depicting residual and recurrent lesions regardless of the presence of normal thyroid tissue

  4. Iodide and thyroide protection against irradiation by radioiodine

    In case of contamination by radioactive iodine, the critical organ is the thyroid. Its exposure, even at low doses, may induce late injuries (hypothyroidism, benign or malignant tumour). Prevention of thyroid irradiation by administration of iodide is efficient provided it occurs early, which requires this has been provided for. The administration of iodide at a dose of 100 mg during 10 days is recommended

  5. Cellular schwannoma: a benign neoplasm sometimes overdiagnosed as sarcoma

    A case of cellular schwannoma originating in the left lumbar paraspinal region is described. The diagnosis was originally made on needle biopsy material. The histological examination is usually not sufficient to correctly diagnose this benign neoplasm. Bone erosion, neurological symptoms, caused by compression of the spinal roots, together with hypercellularity, pleomorphism and an occasional increase in mitotic activity, may lead to an erroneous diagnosis of malignancy. Immunohistochemistry and ultrastructural analysis are helpful in confirming the diagnosis. The recognition of this entity avoids unnecessary overtreatment of these patients. (orig.)

  6. Thyroid cancer

    Special place in oncology belongs to thyroid cancer as it is a cancer originating from hormonally active tissue. 90 % of endocrine neoplasia are represented by thyroid cancer. It is a relatively rare cancer and due to its heterogeneity it encompasses spectrum of therapeutic approaches with interdisciplinary management which includes various implications for prognosis and lethality. Generally, the prognosis for patients with differentiated thyroid cancer is good, a 10 years survival rate is at 85 %. Standard treatment includes surgical therapy, TSH suppressive therapy and ablation of the thyroid remnant with radioactive iodine. Patients with recurrent disease, disseminated disease present at the time of diagnosis, patients unsuitable for surgical treatment or for treatment with radioiodine still remain a therapeutic challenge. As there is no effective systematic treatment there is a hope for new therapy with multiple kinase inhibitors such as vandetanib, sorafenib, cabozantinib a lenvatinib which is based on promising results of several studies. (author)

  7. The transcription factor LMO2 is a robust marker of vascular endothelium and vascular neoplasms and selected other entities.

    Gratzinger, Dita; Zhao, Shuchun; West, Robert; Rouse, Robert V; Vogel, Hannes; Gil, Elena Cubedo; Levy, Ronald; Lossos, Izidore S; Natkunam, Yasodha

    2009-02-01

    The transcription factor LMO2 is involved in vascular and hematopoietic development and hematolymphoid neoplasia. We have demonstrated that LMO2 is expressed nearly ubiquitously in native and neoplastic vasculature, including lymphatics. LMO2 reactivity is otherwise virtually absent in nonhematolymphoid tissues except in breast myoepithelium, prostatic basal cells, and secretory phase endometrial glands. Vasculature is LMO2- in adult and fetal heart, brain of older adults, hepatic sinusoids, and hepatocellular carcinoma. LMO2 is uniformly expressed in benign vascular and lymphatic neoplasms and in most malignant vascular neoplasms with the exception of epithelioid vascular neoplasms of pleura and bone. Among nonvascular neoplasms, LMO2 reactivity is present in giant cell tumor of tendon sheath, juvenile xanthogranuloma, a subset of gastrointestinal stromal tumors, small round blue cell tumors, and myoepithelial-derived neoplasms. The restricted expression pattern, nuclear localization, and crisp staining of LMO2 in paraffin blocks make it an attractive candidate for the diagnostic immunohistochemistry laboratory. PMID:19141387

  8. Imaging Pediatric Plasmacytoid Dendritic Cell Neoplasm With FDG PET/CT: Atypical Presentation of a Rare Disease.

    Martineau, Patrick; Pelletier-Galarneau, Matthieu; Turpin, Sophie; Lambert, Raymond

    2016-05-01

    Blastic plasmacytoid dendritic cell neoplasm is a rare malignancy characterized by cutaneous involvement and hematological dissemination. Most affected patients are older, usually in the sixth or seventh decade of life, and this condition has rarely been described in the pediatric population. This report presents the case of a 9-year-old boy with blastic plasmacytoid dendritic cell neoplasm and demonstrates the utility of FDG PET/CT for staging and treatment follow-up. PMID:26859216

  9. Incidental Follicular Thyroid Carcinoma Detected on F-18 FDG PET CT Imaging for Breast Cancer Staging: A Case Report

    Cheen Hoe,, Alex KHOO; HAMZAH, Fadzilah; Abdul KHADER, Mohamed Ali

    2014-01-01

    The detection rate of thyroid incidentalomas is increasing; in fact, as many as 2.3% of patients undergoing FDG PET-CT for other indications have been found to have thyroid incidentalomas. The risk of malignancy in these thyroid incidentalomas can be as high as 47%. The increased uptake and the focal uptake pattern of F-18 fluorodeoxyglucose (FDG) in the thyroid during positron emission tomography (PET)-computed tomography (CT), and the calcification of the thyroid incidentaloma, are associat...

  10. Postirradiation sarcoma (malignant fibrous histiocytoma) following cervix cancer

    A case of postirradiation sarcoma is described. The tumor, a malignant fibrous histiocytoma, occurred in the radiation field 11 years following postoperative external beam radiation therapy (7,000 rad) for carcinoma of the cervix. Reports of postirradiation malignant fibrous histiocytoma are rare, and the occurrence of this neoplasm following treatment for cervix cancer has not previously been described. The literature concerning postirradiation bone and soft tissue sarcomas is briefly reviewed, with special attention to malignant fibrous histiocytomas. (author)

  11. Fine needle aspiration cytology: sensitivity and specificity in thyroid lesions

    Background: Thyroid enlargement is one of the common problems in patients presenting at outpatients department of ENT particularly in females. Thyroid nodules are common, thyroid cancer is uncommon and the most common way for it to present is as a solitary thyroid nodule. This study was conducted to evaluate the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) in thyroid diseases. Method: This prospective analytic study was conducted at ENT Department of Karachi Medical and Dental College/Abbasi Shaheed Hospital during year 2004-8. One hundred and five cases were enrolled who underwent thyroid surgery after complete evaluation by history, clinical examination, Thyroid profile, Thyroid Scintigraphy, Ultrasound neck and FNAC. In cases which were revealed malignant by FNAC, CT scan were done to see the extent of disease and neck node status. Surgery was done in all cases and specimens sent for histopathology. Results: Male to female ratio of the patients was 1:8.5. Most common lesion was benign nodule (96). Malignant lesions were 9 in FNAC. In histopathology, the benign nodules were 92, and malignant cases were 13. Sensitivity of FNAC was 61.53% and specificity was 98.9%. Conclusion: FNAC in Thyroid has high sensitivity and specificity. (author)

  12. Application of the Thyroid Imaging Reporting and Data System in thyroid ultrasonography interpretation by less experienced physicians

    To verify the usefulness of the Thyroid Imaging Reporting and Data System (TI-RADS) for thyroid nodule diagnosis by less experienced physicians. From March 2012 to May 2012, ultrasonography-guided fine needle aspiration was performed in 204 thyroid nodules in 195 consecutive patients by four less experienced radiologists (<1 year in thyroid imaging). The number of suspicious ultrasonography features and the total risk score of each thyroid nodule were calculated according to the previous two models suggested by Kwak et al. The Delong method was used to compare the areas under the curve (AUCs) of the two models. Associations between the two models and the risk of malignancy were analyzed using penalized B-splines and the Cochran-Armitage trend test. Among 204 thyroid nodules, 65 were malignant and 139 were benign. The probability of malignancy tended to increase as the number of suspicious ultrasonography features, and the sum of risk scores increased. There was no significant difference in the AUCs of the two models (P=0.673). The Cochran-Armitage trend test demonstrated an increased risk of malignancy as the number of suspicious ultrasonography features and the total risk score increased (P=0.001). Both the number of suspicious ultrasonography features and the total risk score are applicable and show comparable results in the risk stratification of thyroid nodules by less experienced radiologists in thyroid imaging.

  13. Molecular markers for thyroid cancer

    The importance of the study of the thyroid nodule lies in excluding the possibility of a malignant lesion because the majority of lesions are benign but there is a malignancy risk of 5 to 10%. Most of them are well differentiated carcinomas originating in the follicular epithelium. In spite of the fact that the majority are benign lesions, distinguishing them from carcinomas is crucial to treatment and adequate follow-up. Fine-needle biopsy allows making the diagnosis in most of cases. However, this method is restricted, particularly when diagnosing follicular lesions. In an effort to improve the diagnostic accuracy of biopsy and to provide new diagnosing criteria, a number of molecular markers have been put forward, some of which has wide range of approval whereas others still awaits to be validated for further implementation. This article presented an updated review of molecular markers with higher number of evidence, more accessible and potentially usable from a methodological viewpoint for diagnosis of the thyroid nodule before surgery. The importance of the study of the thyroid nodule lies in excluding the possibility of a malignant lesion because the majority of lesions are benign but there is a malignancy risk of 5 to 10%. Most of them are well differentiated carcinomas originating in the follicular epithelium. In spite of the fact that the majority are benign lesions, distinguishing them from carcinomas is crucial to treatment and adequate follow-up. Fine-needle biopsy allows making the diagnosis in most of cases. However, this method is restricted, particularly when diagnosing follicular lesions. In an effort to improve the diagnostic accuracy of biopsy and to provide new diagnosing criteria, a number of molecular markers have been put forward, some of which has wide range of approval whereas others still awaits to be validated for further implementation. This article presented an updated review of molecular markers with higher number of evidence, more accessible and potentially usable from a methodological viewpoint for diagnosis of the thyroid nodule before surgery

  14. PATTERNS OF ESOPHAGEAL NEOPLASMS IN A REFERRAL DIAGNOSTIC C ENTRE OF BANGALORE

    Zubair

    2013-11-01

    Full Text Available ABSTRACT: INTRODUCTION: Benign tumors of the esophagus are rare and are usually more bothersome than harmful. Carcinoma of esophagus is the sixth most common cancer in the world. The objective of this study was to understand the patterns of benign and malignant neoplasms encountered in oesophageal biopsies and to correlate with age, gender and clinical details. METHODS: A retrospective study was done in a referral diagnostic centre over a period of four years. The patient’s age, gender, clinical details and endoscopy findings were noted. The biopsy was done on patients with weight loss and dysphagia. Special stains and Immunohistochemistry wer e done wherever necessary. Statistical analysis used: Chi square test and Fishers exact test were employed. Ethics: The study was approved by the Institutional Review Board. RESULTS: A total of 1110 consecutive oesophageal biopsies (13 resected specimens a nd 1097 endoscopic biopsies were seen of which neoplasms accounted for 914 cases while 196 cases were non neoplastic. The malignant neoplasms (96.2% far outnumbered the benign neoplasms in biopsy. Squamous cell carcinoma was the predominant histologic ty pe (83.5% of oesophageal neoplasm whereas adenocarcinoma constituted only 14.5% of all neoplasms in our study. Nine cases of small cell carcinoma, one case of adeno - squamous carcinoma and three cases of sarcomatoid carcinoma were noted. One case each of g ranular cell tumour, leiomyoma, gastrointestinal stromal tumour, non Hodgkin’s lymphoma and malignant melanoma were observed. CONCLUSIONS: Malignant neoplasms far outnumbered benign neoplasms in biopsy. Male gender and age above 50 years were important ris k factors. The mean age was similar for both the genders. Squamous cell carcinoma was the most common malignancy across all age groups in the referral diagnostic laboratory of Bangalore Barrett's esophagus is a consequence of chronic gastro esophageal refl ex disorder which is the most important risk factor for adenocarcinoma of esophagus. Mesenchymal tumours of the esophagus are rare. Epidemiological factors governing the distribution of lesion need to be studied further.

  15. Thyroid Metastasis in Pyramidal Lobe from Renal Cell Carcinoma: A Case Report

    Jung, Hyung Seok; Kim, Dong Wook; Kim, Sang Su [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Jung, Soo Jin [Dept. of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2011-06-15

    Thyroid metastasis is rare. The most common primary malignancy of thyroid metastasis worldwide is known to be renal cell carcinoma, but the most common primary malignancy in South Korea is breast cancer. Many studies have reported that primary renal cell carcinoma is almost unilateral and thyroid metastasis from renal cell carcinoma is a nearly ipsilateral, single lesion. We report a case of pyramidal lobe metastasis from renal cell carcinoma.

  16. Mandibular metastasis from follicular variant of papillary carcinoma of thyroid: Report of an uncommon initial presentation

    Subrata Pal

    2014-01-01

    Full Text Available Follicular carcinomas of thyroid have more prone to metastasize through hematogenous route and commonly involve bone, whereas papillary carcinomas spread through lymphatics. However, mandibular metastasis from thyroid malignancy is rare. Few cases have been reported until now. We are presenting a case of metastatic carcinoma of mandible and gingiva from follicular variant of papillary carcinoma of thyroid and interestingly secondary malignancy identified before the diagnosis of primary tumor.

  17. Thyroid cancer - diagnosis, treatment and late results

    The aim of the study is an analysis of late results of surgical treatment for thyroid carcinoma and valuation of used diagnostic methods in patients operated in 2. Surgical Department, Medical Academy in Gdansk in 1970-1985. 102 patients were operated for thyroid carcinoma, it is 4 % of all operations performed on thyroid gland. 99 patients were questioned, except 3 cases of early postoperative death. Information was obtained in 81 cases and 54 of them were later investigated clinically. According to his pathological type 4 groups were distinguished: I - 33 papillary cancer, II - 35 follicular cancer, III - 3 medullary cancer, IV - 10 anaplastic cancer. Usefulness of scintigraphy, thin needle aspiration biopsy and intraoperative histopathological examination were evaluated. In cases of well-differentiated thyroid cancer the serum thyroglobulin level was also determined. Late studies were performed 5 to 20 years after surgery. Results and survival rates were analyzed statistically drafting survival curve lines under ''life table'' Kaplan-Meier method in dependence on histopathological type of neoplasm, degree clinical advance, surgical and supplementary treatment. It has been concluded that the histopathological type, progression of neoplasm and the age of patients are decisive prognostic in the long term results. (author)

  18. Cardiac effects of noncardiac neoplasms

    Clinically significant cardiovascular abnormalities may occur as secondary manifestations of noncardiac neoplasms. The principal cardiac effects of noncardiac tumors include the direct results of metastases to the heart or lungs, the indirect effects of circulating tumor products (causing nonbacterial thrombotic endocarditis, myeloma-associated amyloidosis, pheochromocytoma-associated cardiac hypertrophy and myofibrillar degeneration, and carcinoid heart disease), and the undesired cardiotoxicities of chemotherapy and radiotherapy. 89 references

  19. Thyroid lesions diagnosis by Fourier transformed infrared absorption spectroscopy (FTIR); Diagnostico de lesoes da tireoide pela espectroscopia de absorcao no infravermelho por transformada de Fourier - FTIR

    Albero, Felipe Guimaraes

    2009-07-01

    Thyroid nodules are a common disorder, with 4-7% of incidence in the Brazilian population. Although the fine needle aspiration (FNA) is an accurate method for thyroid tumors diagnosis, the discrimination between benign and malignant neoplasm is currently not possible in some cases with high incidence of false negative diagnosis, leading to a surgical intervention due to the risk of carcinomas. The aim of this study was to verify if the Fourier Transform infrared spectroscopy (FTIR) can contribute to the diagnosis of thyroid carcinomas and goiters, using samples of tissue and aspirates. Samples of FNA, homogenates and tissues of thyroid nodules with histopathological diagnosis were obtained and prepared for FTIR spectroscopy analysis. The FNA and homogenates samples were measured by {mu}-FTIR (between 950 . 1750 cm{sup -1}), at a nominal resolution of 4 cm{sup -1} and 120 scans). Tissue samples were analyzed directly by ATR-FTIR technique, at a resolution 2 cm{sup -1}, with 60 scans in the same region. All spectra were corrected by the baseline and normalized by amides area (1550-1640 cm{sup -1}) in order to minimize variations of sample homogeneity. Then, spectra were converted into second derivatives using the Savitzk-Golay algorithm with a 13 points window. The Ward's minimum variance algorithm and Euclidean distances among the points were used for cluster analysis. Some FNA samples showed complex spectral pattern. All samples showed some cell pellets and large amount of hormone, represented by the bands of 1545 and 1655 cm{sup -1}. Bands in 1409, 1412, 1414, 1578 and 1579 cm{sup -1} were also found, indicating possible presence of sugar, DNA, citric acid or metabolic products. In this study, it was obtained an excellent separation between goiter and malign lesion for the samples of tissues, with 100% of specificity in specific cluster and 67% sensibility and 50 of specificity. In homogenate and FNA samples this sensibility and specificity were lower, because among these samples, it were included many types of thyroid lesions. To obtain a more precise diagnosis for FNA of follicular thyroid the sample size should be increased. The results of this study suggest that FTIR spectroscopy may be useful for discriminate thyroid carcinomas from goiters in tissue samples. (author)

  20. Molecular mechanisms of cholangiocarcinogenesis: are biliary intraepithelial neoplasia and intraductal papillary neoplasms of the bile duct precursors to cholangiocarcinoma?

    Bickenbach, Kai; Galka, Eva; Roggin, Kevin King

    2009-04-01

    Cholangiocarcinoma (CC) is a rare, malignant neoplasm that can develop from any site within the intrahepatic or extrahepatic biliary tree. Although the key steps of cholangiocarcinogenesis remain unknown, it has been hypothesized that CC may develop through two key premalignant precursor lesions: biliary intraepithelial neoplasia (BilIN) and intraductal papillary neoplasm of the bile duct (IPNB). These lesions probably are analogous to pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasm, respectively. This article outlines the molecular basis of cholangiocarcinogenesis through the BilIN and IPNB pathways. It highlights the genetic mutations that alter cellular proliferation, tumor suppression, and impairment of critical mucinous, cell-adhesion, and matrix proteins. PMID:19306808

  1. Mouse models of thyroid cancer: A 2015 update.

    Kirschner, Lawrence S; Qamri, Zahida; Kari, Suresh; Ashtekar, Amruta

    2016-02-01

    Thyroid cancer is the most common endocrine neoplasm, and its rate is rising at an alarming pace. Thus, there is a compelling need to develop invivo models which will not only enable the confirmation of the oncogenic potential of driver genes, but also point the way towards the development of new therapeutics. Over the past 20 years, techniques for the generation of mouse models of human diseases have progressed substantially, accompanied by parallel advances in the genetics and genomics of human tumors. This convergence has enabled the development of mouse lines carrying mutations in the genes that cause thyroid cancers of all subtypes, including differentiated papillary and follicular thyroid cancers, poorly differentiated/anaplastic cancers, and medullary thyroid cancers. In this review, we will discuss the state of the art of mouse modeling of thyroid cancer, with the eventual goal of providing insight into tumor biology and treatment. PMID:26123589

  2. Effects of potassium iodide (KI) protective dose on the course of thyroid diseases diagnosed at the Outpatient Endocrinologic Clinic in Lodz, 1986, before Chernobyl accident

    2521 patients of the Lodz Outpatient Endocrinologic Clinic (2290 females, 231 males; inhabitants of the central region of Poland were included in the study. The obtained results indicate that: 1) KI administration neither increased the number of exacerbations of hyperthyroidism nor affected the onset of new cases of that disease in 1986. 2) The same can be said about the cases of thyroiditis and hypothyroidism. 3) No increase of ATMA or ATG antibodies ''prevalence, as well as no elevation of those antibodies'' titres after KI prophylactic dose were observed in the patients with Grave's disease and chronic thyroiditis, when compared to persons who did not take Lugol's iodine. 4) The course of the majority of diseases diagnosed in 1986, evaluated with use of the, so called, test for analysis of trends, became unchanged. 5) There were adverse side effects noted after KI in 32 patients out of all the examined 774 patients (i.e., in 4.13%); five of the affected patients required medical care. 6) After iodine tincture; side effects occurred in three patients in the group of 35 patients included in the examination, i.e., in 8.57%; none of the affected patients required medical care. 7) Our results, comprising the four year observation period after Chernobyl accident, do not indicate any increased incidence of malignant neoplasms of the thyroid gland, what confirms the apparent theoretical data; much longer observation time is necessary to reveal phenomena of scholastic type (10-15 years). (author). 30 refs, 11 figs, 14 tabs

  3. The rare intracellular RET mutation p.Ser891Ala in an apparently sporadic medullary thyroid carcinoma: a case report and review of the literature

    Carla Brauner Blom

    2012-11-01

    Full Text Available Medullary thyroid carcinoma (MTC is a malignant tumor originating from parafollicular C-cells and accounts for 4-10% of all thyroid carcinomas. MTC develops in either sporadic (75% or hereditary form (25%. Mutations in the RET proto-oncogene are responsible for hereditary MTC and the rate of heritable disease among apparently sporadic MTC (sMTC cases varies from 6 to 15%. RET genetic testing is now considered fundamental in MTC management but the extent of the molecular analysis required to exclude inherited disease is still controversial. While the screening of all known mutation loci is recommended by some authors, the high costs associated with a full analysis should be also taken into consideration. Here, we illustrate and discuss this controversial issue by reporting a patient who present all characteristic features of sMTC, and in whom a standard genetic analysis by restriction enzyme restriction excluded hereditary disease. Nevertheless, an extensive molecular analysis that included all codons was prompted by the diagnosis of thyroid neoplasm in a patient's sister, and identified the rare intracellular RET p.Ser891Ala mutation. Arq Bras Endocrinol Metab. 2012;56(8:586-91

  4. [Thyroid's metastasis of tonsillar squamous cell carcinoma].

    Scanelli, Giovanni; Aimoni, Claudia; Marchetti, Elisabetta; Geminiani, Matteo; Pastore, Antonio

    2005-09-01

    The authors describe the case of a 58 years old man, affected by squamous cell carcinoma of the tonsil, who underwent left tonsillectomy with bilateral neck dissection, followed by radiotherapy. After a 6 months period, the patient began to suffer from dysphonia, dysphagia and loss of weight: a painless neoformation was detected at the right lobe of the tyhroid, resulted a metastasis of the tonsillar neoplasm. The search for intranodular thyroglobulin was negative; the patient underwent thyroidectomy which showed a massive infiltration of the right cricothyroid space, cricoid and thyroid wing cartilage necrosis and intralaryngeal tumor infiltration. The authors describe the thyroid metastasis treatment, present an up-to-date review of the literature and suggest a thyroid careful clinical evaluation in every patient with a previous history of oropharyngeal cancer. PMID:16229323

  5. A case of myxoid adrenocortical neoplasm: computed tomography and magnetic resonance imaging characteristics

    Hiroki Fukuhara

    2013-09-01

    Full Text Available Myxoid adrenocortical neoplasms are rare; to our knowledge, only 56 cases have been reported in the literature. Therefore, distinguishing benign from malignant cases is challenging. Although the histopathological features of myxoid adrenocortical neoplasia have been amply demonstrated, their imaging characteristics are yet to be reported. We describe here these characteristics for such a neoplasm. Our patient, a 70-year-old male, was found to have a 3-cm left adrenal incidentaloma through a non-enhanced computed tomography. Attenuation measurements were 22 Hounsfield units on precontrast imagery, and percentage enhancement washout was 92%. Magnetic resonance imaging showed no loss of signal intensity in T1-weighted out-of-phase images, but high signal intensity on T2-weighted and diffusion-weighted images. Left adrenalectomy was performed and the pathological diagnosis was confirmed as myxoid adrenocortical neoplasm. The imaging characteristics reported here will be beneficial to the differential diagnosis of myxoid adrenocortical neoplasms based upon image analysis and will help distinguish benign from malignant neoplasms.

  6. Study of mutated p53 protein by immunohistochemistry in urothelial neoplasm of urinary bladder.

    Roychowdhury, Anadi; Dey, Ranjan K; Bandyapadhyay, Anjali; Bhattacharya, Palash; Mitra, Rita Basu; Dutta, Riju

    2012-06-01

    It is difficult to predict which urothelial neoplasm would subsequently recur or progress to muscle invasive tumours or produce metastasis.The aim and objective of the study were to evaluate the scope of immunohistochemical expression of p53 in human urothelial neoplasms with regard to grade, stage and outcome of the patients. Eighteen consecutive patients were taken and urothelial tumour samples were obtained from transurethral resection or surgical excision. Histopathological examinations were performed and the grading was done according to the WHO/ISUP consensus classification of urothelial neoplasms. Immunohistochemical staining for p53 was performed on formalin fixed paraffin embedded tissue sections with appropriate positive and negative control. It was found 3 patients with papillary urothelial neoplasm of low malignant potential (PUNLMP), 5 cases of papillary low grade urothelial carcinoma, 10 patients with papillary high grade urothelial carcinoma including 2 cases of invasive urothelial carcinoma. All three PUNLMP cases showed negative results. Four out of 5 low grade papillary urothelial carcinoma had nuclear p53 accumulation, while all of the 10 papillary high grade carcinoma had high p53 index. The finding of negative p53 staining in PUNLMPs and high p53 index in high grade papillary urothelial carcinomas and invasive carcinomas support the notion that mutation of p53 gene might be unrelated to the development of urothelial neoplasms but definitely play a crucial role in progression of the malignancy. PMID:23360043

  7. Spectrum of Intestinal Neoplasms: A study of 400 cases

    Aminder Singh

    2015-02-01

    Full Text Available Objective: The present study is a five-year analysis of all the tumors of small and large intestine received in the Pathology Department of Dayanand Medical College and Hospital, Ludhiana. Methods: All the cases were grossly and microscopically examined and were staged according to Astler Coller Staging and classified and subtyped according to WHO classification. The important differences between the small and large intestine tumors were also analyzed. Results: There were 400 cases out of which 356 were in large intestine while 44 were in the small intestine. There were only 56 benign neoplasms while 344 were malignant tumors. Adenomas were the most common benign tumors while majority of malignant tumors were adenocarcinomas. Lymphomas, mesenchymal tumors, and carcinoid tumors were much more common in a small intestine as compared to large intestine. Majority of adenocarcinomas were located in the large intestine with most of them being moderately differentiated having Astler Coller Stage B II. Mucinous carcinomas had the worst prognosis as compared to adenocarcinomas. Anal canal had mainly squamous cell carcinomas. Conclusions: Tumors of large intestine were much commoner than of small intestine. There was a higher incidence of tumor in males with M:F ratio of 2.2:1. Mean age of presentation of benign tumor was younger, i.e., 32.6 years when compared to 54.5 years for malignant tumors. Tubular adenoma was the most common benign tumor and adenocarcinoma the commonest malignant neoplasm. [J Interdiscipl Histopathol 2015; 3(1.000: 19-23

  8. Thyroid dysfunction can predict response to immunotherapy with interleukin-2 and interferon-2 alpha.

    Reid, I.; Sharpe, I.; J. McDevitt; Maxwell, W; Emmons, R.; Tanner, W. A.; Monson, J R

    1991-01-01

    Thyroid dysfunction is a well-recognised side-effect of treatment with interleukin-2 (IL2). We assessed the correlation between the development of abnormal thyroid function and tumour response in 13 patients receiving IL2 and interferon-2 alpha (IFN2 alpha) for advanced malignancy. Seven patients had normal thyroid function during treatment, and all of these patients have since died of progressive disease. Of six patients who did develop thyroid dysfunction during treatment, one patient has d...

  9. Thyroid Carcinoma Presenting as Hot nodule on Technetium-99m Pertechnetate Thyroid Scintigraphy

    In general, hot nodules on technetium scan are regarded as benign tumors, and usually no further work up for malignancy is indicated, if they are truly autonomous. The authors experienced two cases of thyroid carcinoma presenting as hot nodule on technetium-99m pertechnetate thyroid scintigraphy. One case with papillary carcinoma, and other case with follicular carcinoma are presented in addition to a review of the literature.

  10. Fine needle aspiration biopsy diagnosis of metastatic neoplasms of the breast. A three-case report

    Raquel Garza-Guajardo

    2005-09-01

    Full Text Available Abstract Metastases to the breast are unusual lesions that make up approximately 2% of all malignant mammary neoplasms and may mimic both benign and malignant primary neoplasms from a clinical point of view, as well as in imaging studies. Arriving at a correct diagnosis is therefore essential in order to establish appropriate management. We present three cases of metastatic neoplasms diagnosed through fine needle aspiration biopsy and immunocytochemistry. The cytological diagnoses were: medulloblastoma in an 18-year-old woman, melanoma in a 26-year-old man, and an exceptional case of ovarian sarcoma originating from a granulosa cell tumor with metastases to both breasts. A metastatic disease should be considered in the differential diagnosis of a palpable mass in the breast, especially if there is a history of an extramammary malignant neoplasm. Fine needle aspiration biopsy is the method of choice for the management of these cases. Whenever possible the exam of the material obtained should be compared to the previous biopsy, which is usually enough to arrive at a correct diagnosis, thus preventing unnecessary surgical procedures.

  11. Post treatment thyroid dysfunction and obesity in children with acute lymphoblastic leukemia and non-Hodgkin’s lymphoma: a brief report

    Ali Ghasemi

    2014-04-01

    Conclusion: Regarding to effects of thyroid dysfunction on short stature and obesity in adolescent with ALL and NHL, we suggest to have more attention about growth, thy-roid test to avoid late side effect of malignancy treatment.

  12. Stemness is derived from thyroid cancer cells

    RishengMa

    2014-07-01

    Full Text Available Background: One hypothesis for thyroid cancer development is its derivation from thyroid cancer stem cells (CSCs. Such cells could arise via different paths including from mutated resident stem cells within the thyroid gland or via epithelial to mesenchymal transition (EMT from malignant cells since EMT is known to confer stem-like characteristics. Methods: To examine the status of stemness in thyroid papillary cancer we employed a murine model of thyroid papillary carcinoma and examined the expression of stemness and EMT using qPCR and histochemistry in mice with a thyroid-specific knock-in of oncogenic Braf (LSL-Braf(V600E/TPO-Cre. This construct is only activated at the time of thyroid peroxidase (TPO expression in differentiating thyroid cells and cannot be activated by undifferentiated stem cells which do not express TPO. Results: There was decreased expression of thyroid specific genes such as Tg and NIS and increased expression of stemness markers such as Oct4, Rex1, CD15 and Sox2 in the thyroid carcinoma tissue from 6 week old BRAFV600E mice. The decreased expression of the epithelial marker E-cadherin and increased EMT regulators including Snail, Slug, and TGF-β1 and TGF-β3, and the mesenchymal marker vimentin demonstrated the simultaneous progression of EMT and the CSC-like phenotype. Stemness was also found in a derived cancer thyroid cell line in which overexpression of Snail caused up-regulation of vimentin expression and up regulation of stemness markers Oct4, Rex1, CD15 with enhanced migration ability of the cells. Conclusions: Our findings support our earlier hypothesis that stemness in thyroid cancer is derived via EMT rather than from resident thyroid stem cells. In mice with a thyroid-specific knock-in of oncogenic Braf (LSL-Braf(V600E/TPO-Cre the neoplastic changes were dependent on thyroid cell differentiation and the onset of stemness must have been derived from differentiated thyroid epithelial cells.

  13. DNA Cytometry and Nuclear Morphometry in Ovarian Benign, Borderline and Malignant Tumors

    Amina A. Gamal el Din

    2015-10-01

    CONCLUSION: We suggest that DNA ploidy and nuclear area combined, may be adjuncts to histopathology; in ovarian serous and mucinous benign, borderline and malignant neoplasms; identifying the aggressive borderline tumours.

  14. Multi-targeted approach in the treatment of thyroid cancer

    Scott N Pinchot

    2008-08-01

    Full Text Available Scott N Pinchot, Rebecca S Sippel, Herbert Chen11Endocrine Surgery Research Laboratories, Department of Surgery, University of Wisconsin Madison, Wisconsin, USAAbstract: While accounting for only 1% of solid organ malignancies (9% in women, thyroid carcinoma is the most common malignancy of the endocrine system. Although most patients have a favorable prognosis, over 1,500 people will die from thyroid carcinoma each year. The spectrum of disease types range from papillary thyroid cancer, which is a well-differentiated indolent tumor, to anaplastic carcinoma, a poorly differentiated fulminant cancer. With advances in diagnostic methods, surgical techniques, and clinical care of patients with thyroid carcinoma, the current management of thyroid cancer demands a multidisciplinary approach. The majority of patients with well-differentiated thyroid carcinoma of follicular cell origin are cured with adequate surgical management; however, some thyroid malignancies such as medullary thyroid carcinoma (MTC or poorly differentiated thyroid carcinomas frequently metastasize, precluding patients from a curative resection. As such, novel palliative and therapeutic strategies are needed for this patient population. Here, we explore the current management of thyroid carcinoma, including surgical management of the primary tumor, lymph node disease, and locoregional recurrence. Likewise, we explore the application of current molecular techniques, reviewing nearly two decades of data that have begun to elucidate critical genetic pathways and therapeutic drug targets which may be important in specific thyroid tumor types.Keywords: thyroid carcinoma; vascular endothelial growth factor receptor (VEGFR; epidermal growth factor receptor (EGFR; RET tyrosine kinase (RTK; glycogen synthase kinase-3? (GSK-3?

  15. Relationship between prognostic score and thyrotropin receptor (TSH-R) in papillary thyroid carcinoma: immunohistochemical detection of TSH-R.

    K.Tanaka; Inoue, H.; Miki, H.; Masuda, E.; Kitaichi, M; Komaki, K.; Uyama, T.; Monden, Y

    1997-01-01

    We have demonstrated the expression of thyrotropin receptor (TSH-R) in thyroid neoplasms (13 adenomas, 21 papillary carcinomas, two follicular carcinomas) and adjacent normal thyroid using the monoclonal antibody against human TSH-R and have also demonstrated a relationship between prognostic scores and the expression of TSH-R. Among the adenomas, eight showed an intensity similar to that of normal thyroid and five showed a higher intensity than normal. Two tumours exhibited heterogeneous dis...

  16. Secondary ovarian neoplasms in children: imaging features with histopathologic correlation

    McCarville, M.B. [Dept. of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, TN (United States); Hill, D.A. [Dept. of Pathology, St. Jude Children' s Research Hospital, Memphis, TN (United States); Miller, B.E. [Dept. of Obstetrics and Gynecology, Univ. of Tennessee, Memphis (United States); Pratt, C.B. [Dept. of Hematology-Oncology, St. Jude Children' s Research Hospital, Memphis (United States)

    2001-05-01

    Background. Although the pathologic features and imaging appearance of childhood primary ovarian neoplasms have been well described, little information is available about the malignancies that may secondarily involve the ovary. Objective. To determine the relationship between the imaging features and the histopathology of secondary ovarian neoplasms in children treated at our institution. Materials and methods. We searched our institutional database for codes indicating metastatic ovarian disease. Of the 35 patients with such codes, 18 had pathologically proven secondary ovarian disease. From their medical records we recorded demographic data, presenting symptoms, and evidence of endocrine dysfunction. We reviewed the pre-oophorectomy imaging and the subsequent pathologic specimens. Results. One-third of the patients had bilateral pelvic masses; another third had large masses indistinguishable from the ovaries. Twelve (67 %) had either ascites, peritoneal implants, matted bowel, adenopathy, pleural effusions, or some combination of these. Five (28 %) had other metastatic disease. Primary tumors included colon adenocarcinoma (9), Burkitt's lymphoma (3), alveolar rhabdomyosarcoma (3), Wilms' tumor (1), neuroblastoma (1), and retinoblastoma (1). Conclusion. Although rare, secondary ovarian tumors should be considered in the differential diagnosis of children with ovarian masses. Bilateral ovarian masses or large masses indistinguishable from the ovaries, particularly in the presence of other metastatic foci, may help distinguish primary from secondary ovarian malignancies. (orig.)

  17. The thyroid gland and the process of aging; what is new?

    Gesing Adam

    2012-11-01

    Full Text Available Abstract The endocrine system and particular endocrine organs, including the thyroid, undergo important functional changes during aging. The prevalence of thyroid disorders increases with age and numerous morphological and physiological changes of the thyroid gland during the process of aging are well-known. It is to be stressed that the clinical course of thyroid diseases in the elderly differs essentially from that observed in younger individuals, because symptoms are more subtle and are often attributed to normal aging. Subclinical hypo- and hyperthyroidism, as well as thyroid neoplasms, require special attention in elderly subjects. Intriguingly, decreased thyroid function, as well as thyrotropin (TSH levels progressively shifting to higher values with age may contribute to the increased lifespan. This short review focuses on recent findings concerning the alterations in thyroid function during aging, including these which may potentially lead to extended longevity, both in humans and animals.

  18. Thyroid neoplasia following irradiation in adolescent and young adult survivors of childhood cancer

    Objectives: To describe a cohort of survivors of childhood malignancy at risk of developing thyroid abnormality, and propose guidelines for management of such patients. 142 patients who had received irradiation to the thyroid from the 1970s onwards, who attended the late-effects clinic from May 1989 to December 1998 were included in this study. Thyroid palpation by an endocrinologist or surgeon, serum thyroid-stimulating hormone assay and thyroid ultrasound examination were performed on all subjects and, depending on findings, some subjects proceeded to fine-needle biopsy or surgery (total thyroidectomy). A few patients required adjuvant I-131 administration. 49 subjects (24 of 65 patients who received scatter irradiation to the thyroid and 25 of 78 patients who received direct irradiation) had thyroid surgery. Of these, 12 in the scatter and six in the direct irradiation group were found to have thyroid malignancy. Fifty subjects with abnormal ultrasound results remain under surveillance. Having a palpable thyroid was predictive of malignancy, but age at original diagnosis, sex, current age, time since irradiation, radiation dose, nodule type and nodal involvement were not. It was concluded that there is a significant risk of cancer in thyroid glands exposed to radiation as part of therapy for childhood cancer. This risk is greater for patients who received scatter (versus direct) irradiation. Nodular change is usually not apparent for many years, so lifelong surveillance is necessary. Palpation alone is not sufficient to detect thyroid cancer and thyroid ultrasound examination is recommended

  19. Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma: a Histological Type With Difficult Diagnosis

    The papillary thyroid carcinoma is the most frequent thyroid neoplasm and usually it is a non aggressive tumor; nevertheless, some histological variants such as the diffuse sclerosing variant are more aggressive producing locoregional invasion and distant metastasis. This specific variant challenges the pathological diagnosis since the architectural and cytological characteristics might be confusing, particularly regarding benign lesions such as the lymphocytic thyroiditis. We present a case report of a patient at the National Cancer Institute of Colombia with a lung metastasis from a diffuse sclerosing papillary thyroid carcinoma. The difficulties for diagnosis, for both clinical and pathology experts, are illustrated as well as their relevance for determining the biological course of the disease.

  20. Incidentally found thyroid nodules in women with no previous thyroid disease: its significance

    Kim, Eun Kyung; Park, Cheong Soo; Chung, Woung Youn; Oh, Ki Keun; Lee, Jong Tae; Yoo, Hyung Sik [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    2002-05-01

    To determine the prevalence of thyroid nodules discovered incidentally at ultrasonography and to reassess their significance. During a six-month period and using a high-frequency transducer, 1033 subjects with suspected breast disease underwent a prospective study of the thyroid. We determined the prevalence of thyroid nodules according to age, and the malignancy rate. Focal thyroid nodules were detected in 291 women (28.2%), their prevalence increasing with age (p<0.01). The nodules, totalling 337, were single in 260 cases (89.3%) and multiple in 31 (10.7%); 271 were less than 1 cm in diameter, 53 were 1-2 cm, and 13 were more than 2 cm (mean, 7.1(range, 2-34) mm); 126 (37.4%) were pure cysts, 62 (18.4%) were mixed, and 149 (44.2%) were solid. Of the 149 solid nodules, 139 were hypoechoic. Eighty women (with 106 nodules) underwent fine-needle aspiration bipsy, and 35 (with 45 nodules) underwent surgery. It was discovered, finally, that 29 women (2.8%) had 35 malignancies, of which 33 were papillary carcinomas and two were carcinomas which had metastasized from a breast malignancy. Eleven women (37.9%) had extrathyroidal invasion and 6 (20.7%) had cervical lymph node metastasis despite incidentaloma. The prevalence of incidentally found thyroid nodules was 28.2%. Since the malignancy rate of these was relatively high, at 10.4%, the clinical significance of this finding should be reassessed.