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Sample records for malignant thyroid neoplasms

  1. Clinical parameters predictive of malignancy of thyroid follicular neoplasms

    Needle aspiration biopsy is commonly employed in the evaluation of thyroid nodules. Unfortunately, the cytologic finding of a 'follicular neoplasm' does not distinguish between a thyroid adenoma and a follicular cancer. The purpose of this study was to identify clinical parameters that characterize patients with an increased risk of having a thyroid follicular cancer who preoperatively have a 'follicular neoplasm' identified by needle aspiration biopsy. A total of 395 patients initially treated at Vancouver General Hospital and the British Columbia Cancer Agency between the years of 1965 and 1985 were identified and their data were entered into a computer database. Patients with thyroid adenomas were compared to patients with follicular cancer using the chi-square test and Student's t-test. Statistically significant parameters that distinguished patients at risk of having a thyroid cancer (p less than 0.05) included age greater than 50 years, nodule size greater than 3 cm, and a history of neck irradiation. Sex, family history of goiter or neoplasm, alcohol and tobacco use, and use of exogenous estrogen were not significant parameters. Patients can be identified preoperatively to be at an increased risk of having a follicular cancer and accordingly appropriate surgical resection can be planned

  2. 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

  3. IR Spectroscopic signs of malignant neoplasms in the thyroid gland

    Tolstorozhev, G. B.; Skornyakov, I. V.; Butra, V. A.

    2012-03-01

    We use Fourier transform IR spectroscopy to study thyroid tumor tissues which were removed during surgery. The IR spectra of the tissues with pathological foci are compared with data from histologic examination. In the region of N-H, C-H, and C = O stretching vibrations, the IR spectra of the tissues for thyroid cancer are different from the IR spectra of tissues without malignant formations. We identify the spectral signs of thyroid cancer. We show that IR analysis is promising for identification of thyroid pathology at the molecular level.

  4. 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

  5. Vascularity in thyroid neoplasms

    Larsen, Karen Kjaer; Andersen, Niels Frost; Melsen, Flemming;

    2006-01-01

    The aim of the present study was to evaluate the reliability of four different methods (vascular grading, Chalkley count, microvessel density (MVD) and stereological estimation) for quantifying intratumoral microvascularity in thyroid neoplasms, by comparing the variability within and between...... count should be the preferred method for assessing microvascularity in thyroid neoplasms. The diagnostic evaluation revealed a tendency towards higher degree of vascularity in FA compared to both FC and PC for all methods. No statistically significant association was seen between vascular density and...

  6. Does Radioiodine Therapy in Patients with Differentiated Thyroid Cancer Increase the Frequency of Another Malignant Neoplasm?

    Hirosawa, Renata Midori; Marivo, Monica; Luengo, Juliana de Moura Leite; Tagliarini, Jose Vicente; Castilho, Emanuel Cellice; Marques, Mariangela de Alencar; Kiy, Yoshio; Marone, Marilia Martins Silveira; Silveira, Liciana Vaz de Arruda; Mazeto, Glaucia Maria Ferreira da Silva

    2011-01-01

    Objectives. To compare the frequency of another primary malignancy in patients with differentiated thyroid carcinoma (DTC) who received radioiodine therapy or not (131I). Material and Methods. 168 cases of DTC patients were retrospectively evaluated as to the frequency of another neoplasia by comparing patients with and without it, taking into account clinical, laboratory, and therapeutic parameters. Results. Another primary malignancy occurred in 8.9% of patients. Of these, 53.3% showed the malignancy before 131I and 46.7% after it. By comparing both groups, the age at the moment of diagnosis of another neoplasia was 46.1 ± 20.2 years for the group before 131I therapy and of 69.4 ± 11.4 years for the group after it (P = 0.02). Of the 148 patients treated with 131I, 4.7% developed another malignancy. The latter were older (61 ± 17 years) than those who did not show another cancer type (44.1 ± 14.2 years) (P < 0.05). Conclusion. The frequency of another neoplasia found after 131I was similar to that found before 131I. PMID:22084737

  7. 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

  8. 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

  9. 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...

  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. Metastases of Renal Cell Carcinoma to the Thyroid Gland with Synchronous Benign and Malignant Follicular Cell-Derived Neoplasms

    Carlos Zamarrón

    2013-01-01

    Full Text Available Clear cell renal cell carcinoma (CCRCC is the most common origin for metastasis in the thyroid. A 51-year-old woman was referred to our hospital for a subcarinal lesion. Ten years before, the patient had undergone a nephrectomy for CCRCC. Whole-body fluorodeoxyglucose positron emission tomography revealed elevated values in the thyroid gland, while the mediastinum was normal. An endoscopic ultrasonography-guided fine-needle aspiration biopsy of the mediastinal mass was consistent with CCRCC, and this was confirmed after resection. The thyroidectomy specimen also revealed lymphocytic thyroiditis, nodular hyperplasia, one follicular adenoma, two papillary microcarcinomas, and six foci of metastatic CCRCC involving both thyroid lobes. Curiously two of the six metastatic foci were located inside two adenomatoid nodules (tumor-in-tumor. The metastatic cells were positive for cytokeratins, CD10, epidermal growth factor receptor, and vascular endothelial growth factor receptor 2. No BRAF gene mutations were found in any of the primary and metastatic lesions. The patient was treated with sunitinib and finally died due to CCRCC distant metastases 6 years after the thyroidectomy. In CCRCC patients, a particularly prolonged survival rate may be achieved with the appropriate therapy, in contrast to the ominous prognosis typically found in patients with thyroid metastases from other origins.

  12. Radiological and surgical management of thyroid neoplasms.

    Takami, H; Ikeda, Y; Miyabe, R; Okinaga, H; Kameyama, K; Fukunari, N

    2004-01-01

    Recent advances in the radiological diagnosis in thyroid neoplasms have been achieved by high-resolution ultrasonography and color-Doppler, and the ultrasound-guided fine-needle aspiration biopsy and ultrasound-guided percutaneous ethanol injection therapy have been developed on the basis of these modalities. Ultrasonography and ultrasound-guided fine-needle aspiration biopsy have made minimally invasive thyroid surgery possible. The surgical procedures are classified into three main categories according to the approach, and each approach has its own advantages and disadvantages. Surgeons have to select the most suitable approach from one of these categories of approaches for each patient with a thyroid neoplasm. PMID:15271417

  13. 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.

  14. Radiation induced thyroid neoplasms 1920 to 1987: A vanishing problem

    Radiation for benign diseases has been implicated as an etiologic factor in thyroid cancer. From 1930-60, over 2 million children may have been exposed to therapeutic radiation and it is estimated that up to 7% may develop thyroid cancer after a 5-40 year latency. Thyroid stimulating hormone, secondary to radioinduced hypothyroidism, has been implicated as causative in animals. Such data has led to expensive screening programs in high risk patients. Because of a decline in irradiation for benign diseases in children over the last 2 decades, we questioned whether the incidence of radiation induced thyroid neoplasms (RITN) was also decreasing. Twenty-six of 227 patients (11%) with thyroid malignancies seen at our institution from 1974-87 had a history of previous head and neck irradiation. These included 13 papillary, 3 follicular, and 7 mixed carcinomas as well as 2 lymphomas and 1 synovial cell sarcoma. None of these 26 patients had abnormal thyroid function tests at presentation. Mean latency from irradiation to the diagnosis of thyroid cancer was 25.4 years (6-55 year range). Compared to the reported increasing incidence of RITN from 1940-70, there appears to be a significant decrease since 1970. Based on our analysis, the use of expensive screening programs in high risk populations may no longer be warranted. Additionally, the routine use of thyroid replacement in previously irradiated chemically hypothyroid patients is not recommended.30 references

  15. Radiation induced thyroid neoplasms 1920 to 1987: A vanishing problem

    Mehta, M.P.; Goetowski, P.G.; Kinsella, T.J.

    1989-06-01

    Radiation for benign diseases has been implicated as an etiologic factor in thyroid cancer. From 1930-60, over 2 million children may have been exposed to therapeutic radiation and it is estimated that up to 7% may develop thyroid cancer after a 5-40 year latency. Thyroid stimulating hormone, secondary to radioinduced hypothyroidism, has been implicated as causative in animals. Such data has led to expensive screening programs in high risk patients. Because of a decline in irradiation for benign diseases in children over the last 2 decades, we questioned whether the incidence of radiation induced thyroid neoplasms (RITN) was also decreasing. Twenty-six of 227 patients (11%) with thyroid malignancies seen at our institution from 1974-87 had a history of previous head and neck irradiation. These included 13 papillary, 3 follicular, and 7 mixed carcinomas as well as 2 lymphomas and 1 synovial cell sarcoma. None of these 26 patients had abnormal thyroid function tests at presentation. Mean latency from irradiation to the diagnosis of thyroid cancer was 25.4 years (6-55 year range). Compared to the reported increasing incidence of RITN from 1940-70, there appears to be a significant decrease since 1970. Based on our analysis, the use of expensive screening programs in high risk populations may no longer be warranted. Additionally, the routine use of thyroid replacement in previously irradiated chemically hypothyroid patients is not recommended.30 references.

  16. Transcatheter therapy for malignant neoplasms.

    Coldwell, D M; Mortimer, J E

    1989-01-01

    Interventional radiology has developed into a subspecialty with application in the treatment and palliation of patients with advanced malignant diseases. A directed catheter delivers high concentrations of chemotherapy directly into the tumor bed. Embolic particles may be injected to stop hemorrhage or to occlude the blood supply of a cancer, resulting in pain relief or tumor shrinkage. These techniques can be incorporated into a multidisciplinary approach to cancer.

  17. Simultaneous Occurrence of Different Follicular Neoplasms within the Same Thyroid Gland

    Şefika Burçak Polat

    2016-06-01

    Full Text Available Purpose: Neoplasms of the thyroid gland are classified according to the cells they originate from and commonly develop from cells of follicular origin. The most common differentiated thyroid cancers (DTC are papillary and follicular carcinomas. Coexistence of two different histological types of primary follicular thyroid neoplasm is a rare condition. There are previous reports of concomitant medullary and papillary thyroid cancers. However, there is scarce data about the simultaneous occurrence of the two different histological types of primary follicular thyroid tumors and this is the first study on that subject. Material and Method: From January 2007 to September 2014, our institutional database was reviewed for patients who underwent thyroid surgery for various indications. Medical records and cytopathology reports of those patients were examined retrospectively. Simultaneous neoplasms of follicular origin were noted. Results: A total of 3.700 patients were operated. Histopathological examination revealed a benign pattern in 2.686 (73% patients and a malignant pattern in 1.014 (27% patients. Among the patients with the diagnosis of DTC, only 20 (1.9% had a concomitant neoplasm within the same thyroid gland. Discussion: Such simultaneous tumors may be a part of a familial tumor syndrome or an unidentified novel gene mutation playing role in the pathogenesis of more than one type of tumor. Based on the current evidence, the synchronous occurrence of those neoplasms in a given patient is likely coincidental in the literature. Further studies on larger patient population with standardized genetic characterization are needed.

  18. Synchronous malignancies of breast and thyroid gland: A case report and review of literature

    Agarwal Dwarka

    2007-01-01

    Full Text Available The relationship and coincidence of breast cancer with thyroid disorders is a subject of extensive debate and controversy. Many studies have shown that thyroid diseases are common among women with breast cancer. We present a case of concomitant malignancy of breast and thyroid with review of literature on the association of breast with thyroid neoplasm. The potential association and plausible mechanisms of breast carcinoma development after or before the thyroid carcinoma should be evaluated in larger cohorts of patients.

  19. US-guided biopsy of nonpalpable recurrent or metastatic cervical thyroid malignancy

    In 16 patients with a history of thyroidectomy performed for malignancy, high-frequency (10-MHz) US-guided biopsy of nonpalpable, sonographically detected neck masses was performed. The masses biopsied ranged in size from 6 mm to 3 cm. Eleven biopsies were positive for neoplasm. All 11 patients underwent surgical exploration, and neoplasms were confirmed in ten. In five patients biopsies were negative for neoplasm, and no malignancy was found on subsequent follow-up. There were no biopsy complications. US-guided biopsy of nonpalpable, sonographically detected neck masses is an effective and safe technique for documenting or excluding recurrent or metastatic cervical thyroid malignancy

  20. Molecular Markers in Differential Diagnostics of Follicular Neoplasms of the Thyroid

    E Troshina

    2006-06-01

    Full Text Available Ultrasound-guided fine-needle aspiration biopsy (FNAB is a basic method of morphological diagnostics at the preoperative examination, although it has some limitations. In 10-30 % of the cases, cytological examination results defined as indefinite or suspicious to malignant nodules, including follicular neoplasm, as according to the results of a cytological examination it does not appear to be possible to make the difference between follicular attendance the molecular markers adenomas and follicular cancer. Molecular medicine progress let us put an additional examination in a cytological, or surgical aspirates with the molecular markers. The most effective molecular markers in the clinical practice are thyroid peroxidases (TPO, telomerase and galectin-3. The application FNAB with the following immunocytochemistry examination in the thyroid tissue let us improve a differential diagnostics between benign and malignant nodules of the thyroid.

  1. 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)

  2. 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

  3. 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

  4. The solitary thyroid nodule: diagnosis and management of malignant disease

    Lawson, W.; Biller, H.F.

    While few solitary thyroid nodules are carcinomatous, it is essential to identify and preferentially select those that are for surgery. Clinical, biochemical, serologic, radiographic, scintigraphic, sonographic, biopsy, and even therapeutic evaluation may be necessary to choose those patients with the greatest probability of malignancy. The benefits and limitations of each diagnostic modality are discussed, and the importance of fine-needle aspiration is stressed. After the operative confirmation of malignancy, the prognosis in any given case depends on 1) the histologic type of the neoplasm, 2) its size and extent, 3) the presence of angioinvasiveness, 4) the tendency toward multicentricity of the lesion, 5) the age and sex of the patient, and 6) whether distant metastases are present. These factors influence the extent of surgery required for well-differentiated carcinomas. Meticulous dissection and preservation of the recurrent laryngeal nerves and the parathyroid glands along with their blood supply are important if total thyroidectomy for papillary carcinoma is to be employed with an acceptable operative morbidity to optimize survival. The value of the adjunctive use of thyroid hormone and radioactive iodine is also discussed. Finally, the clinical behaviors and treatments of undifferentiated carcinomas, sarcomas, lymphomas, and neoplasms metastatic to the thyroid gland are reviewed.

  5. Neoplasm

    2005-01-01

    2005175 The value of apparent diffusion coefficients (ADCs) in the diagnosis of malignant bone neoplasms. MA Ling(马玲), et al. Dept Diag Radi-ol, 1st Affili Hosp Sun Yat-sen Univ, Guangzhou 510080. Chin J Radiol, 2004;38(11):1129-1134. Objective: To evaluate the value of apparent diffusion coefficients (ADCs) in the diagnosis of malignant bone neoplasms. Methods: Eighteen cases with

  6. DIAGNOSTIC VALIDITY OF CYTOLOGICAL IMPRINT IN THYROID FOLLICULAR NEOPLASM

    I Pustaka

    2013-09-01

    Full Text Available Background: Preoperative fine needle aspiration biopsy/FNAB examination, imprint cytology and frozen section intraoperative has big implications for diagnosis and surgical strategy of thyroid nodules with follicular neoplasm cytology. FNAB and frozen section has its limitations, it is difficultto detect the presence of capsular and/or vascular invasion of thyroid follicular carcinoma. Whereas imprint cytology can preserve cellular overview (especially the cell nucleus, including the capsular and/or vascular invasion. In addition, imprint cytology is faster than frozen section. Frozen sectionexamination could not indicate the presence of capsular and/or vascular invasion in most cases so that imprint cytology is used to replace frozen section as an alternative.Method: This research is a diagnostic test study using a descriptive design. This is a prospective study to assess the sensitivity, specificity, NPV, and PPV of imprint cytology in patients with thyroid follicular neoplasm cytology. Results: In our study; sensitivity, specificity, PPV, NPV, and accuracy of imprint cytology for follicular neoplasm was found as 84.21%, 95.45%, 94.12%, 87.50% and 90.24% respectively. The outcome was based on likelihood ratio value of 18.21 and the ROC curve, area under the curve obtained at 0.879 and Kappa value of 0.802.Conclusion: Imprint cytology has a value of a gooddiagnostic validity in the diagnosis of follicular neoplasm of thyroid nodules with sensitivity and specifity values of 84.21% and 95.45%. Imprint cytology is a technique that is simple, inexpensive, and has good reliability so that it can be used instead of frozen section.

  7. 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

  8. 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

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

    Schmiegelow, K.; Levinsen, Mette Frandsen; Attarbaschi, Andishe;

    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...

  10. Characteristics and Outcomes of Second Malignant Neoplasms after Childhood Cancer Treatment: Multi-Center Retrospective Survey.

    Koh, Kyung-Nam; Yoo, Keon Hee; Im, Ho Joon; Sung, Ki Woong; Koo, Hong Hoe; Kim, Hyo Sun; Han, Jung Woo; Yoon, Jong Hyung; Park, Hyeon Jin; Park, Byung-Kiu; Baek, Hee Jo; Kook, Hoon; Lee, Jun Ah; Lee, Jae Min; Lee, Kwang Chul; Kim, Soon Ki; Park, Meerim; Lee, Young-Ho; Lyu, Chuhl Joo; Seo, Jong Jin

    2016-08-01

    This retrospective study investigated the clinical characteristics and outcomes of second malignant neoplasms (SMNs) in survivors of childhood cancer from multiple institutions in Korea. A total of 102 patients from 11 institutions who developed SMN after childhood cancer treatment between 1998 and 2011 were retrospectively enrolled. The most common primary malignant neoplasms (PMNs) were central nervous system (CNS) tumors (n = 17), followed by acute lymphoblastic leukemia (n = 16), non-Hodgkin lymphoma (n = 13), and osteosarcoma (n = 12). The most common SMNs were therapy-related myeloid neoplasms (t-MNs; acute myeloid leukemia [AML], 29 cases; myelodysplastic syndrome [MDS], 12 cases), followed by thyroid carcinomas (n = 15) and CNS tumors (n = 10). The median latency period was 4.9 years (range, 0.5-18.5 years). Among 45 patients with solid tumors defined as an SMN, 15 (33%) developed the lesion in a field previously subjected to radiation. The 5-year overall survival (OS) rate of patients with an SMN was 45% with a median follow-up time of 8.6 years. Patients with AML, MDS, and CNS tumors exhibited the poorest outcomes with 5-year OS rates of 18%, 33%, and 32%, respectively, whereas those with second osteosarcoma showed comparable outcomes (64%) to patients with primary counterpart and those with second thyroid carcinoma had a 100% OS rate. Further therapeutic efforts are recommended to improve the survival outcomes in patients with SMNs, especially in cases with t-MNs and CNS tumors. PMID:27478336

  11. 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.

  12. 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

  13. Food habits in atomic bomb survivors suffering from malignant neoplasms

    Food habits were surveyed in patients admitted to 13 hospitals in Nagasaki prefecture and other prefectures to compare the incidence of malignant neoplasms according to the food intake between atomic bomb exposed group and non-exposed group. The incidence of malignant neoplasms was significantly higher in male patients having the low intake of milk and salted fish than in those having the high intake of them in atomic bomb exposed group, while it was significantly higher in male patients having the low intake of potatoes and milk and in female patients having the low intake of boiled fish paste than in those having the high intake of them in non-exposed group. (Namekawa, K.)

  14. Malignancies associated with intraductal papillary mucinous neoplasm of the pancreas

    Terumi Kamisawa; Yuyang Tu; Naoto Egawa; Hitoshi Nakajima; Kouji Tsuruta; Atsutake Okamoto

    2005-01-01

    AIM: As intraductal papillary mucinous neoplasm (IPMN)has a favorable prognosis, associated malignancies have potential significance in these patients. We examined the incidence and characteristics of pre-existing, coexisting and subsequent malignancies in patients with IPMN. METHODS: Seventy-nine cases of IPMN were diagnosed by detection of mucous in the pancreatic duct during endoscopic retrograde pancreatography. Histological diagnosis was confirmed in 30 cases (adenoma (n = 19)and adenocarcinoma (n = 11). Other primary malignancies associated with IPMN, occurring in the prediagnostic or postdiagnostic period, were investigated. Postdiagnostic follow-up period was 3.3±0.5 years (range, 0.2-20 years).RESULTS: Other 40 malignancies occurred in 28 patients (35%). They were found before (n = 15), at (n = 19) and after (n = 6) the diagnosis of IPMT. Major associated malignancies were gastric cancer (n = 12), colonic cancer (n = 7), esophageal cancer (n = 4), pulmonary cancer (n = 4), and independent pancreatic cancer (n = 3).Pancreatic cancer was synchronous with IPMN in two patients and metachronous in one (3 years after diagnosis of IPMN). Thirty-one lesions were treated surgically or endoscopically. Fourteen patients died of associated cancers. Development of other malignancies was related to age (71.9±8.2 vs66.8±9.3, P<0.05), but not to gender or site of the tumor.CONCLUSION: IPMN is associated with a high incidence of other malignancies, particularly gastric and colonic cancers. Common genetic mechanisms between IPMN and other associated malignancies might be present. Clinicians should pay attention to the possibility of associated malignancies in preoperative screening and follow-up of patients with IPMN.

  15. 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.

  16. Four primary malignant neoplasms in a single patient

    A 60-year-old Caucasian male, with a previous history of a 10-year occupational exposure to ionizing radiation, chemical carcinogens, and a long history of tobacco and alcohol abuse, developed synchronous squamous cell carcinoma of the floor of the mouth and adenocarcinoma of the lung. Four years later, squamous cell carcinoma of the larynx followed by squamous cell carcinoma of the tongue were diagnosed. In this case report, we suggest that increased exposure to multiple carcinogenic factors may result in an increased incidence of both synchronous and metachronous primary malignant neoplasms

  17. 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.)

  18. Malignant nerve-sheath neoplasms in neurofibromatosis: distinction from benign tumors by using imaging techniques

    Malignant peripheral nerve-sheath neoplasms frequently complicate neurofibromatosis causing pain, enlarging masses, or neurologic deficits. However, similar findings sometimes also occur with benign nerve neoplasms. Our study was done retrospectively to determine if imaging techniques can differentiate malignant from benign nerve tumors in neurofibromatosis. Eight patients with symptomatic neoplasms (three benign, five malignant) were studied by CT in eight, MR in six, and 67Ga-citrate scintigraphy in seven. Uptake of 67Ga occurred in all five malignant lesions but not in two benign neoplasms studied. On CT or MR, all eight lesions, including three benign neoplasms, showed inhomogeneities. Of five lesions with irregular, infiltrative margins on CT or MR, four were malignant and one was benign. Of three lesions with smooth margins, one was malignant and two were benign. One malignant neoplasm caused irregular bone destruction. Accordingly, CT and MR could not generally distinguish malignant from benign lesions with certainty. However, both CT and MR provided structural delineation to help surgical planning for both types of lesion. 67Ga scintigraphy appears promising as a screening technique to identify lesions with malignant degeneration in patients with neurofibromatosis. Any area of abnormal radiogallium uptake suggests malignancy warranting further evaluation by CT or MR. Biopsy of any questionable lesion is essential

  19. 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.)

  20. Secondary Malignant Neoplasms Following Haematopoietic Stem Cell Transplantation in Childhood

    Simon Bomken

    2015-04-01

    Full Text Available Improving survival rates in children with malignancy have been achieved at the cost of a high frequency of late adverse effects of treatment, especially in intensively treated patients such as those undergoing haematopoietic stem cell transplantation (HSCT, many of whom suffer the high burden of chronic toxicity. Secondary malignant neoplasms (SMNs are one of the most devastating late effects, cause much morbidity and are the most frequent cause of late (yet still premature treatment-related mortality. They occur in up to 7% of HSCT recipients by 20 years post-HSCT, and with no evidence yet of a plateau in incidence with longer follow-up. This review describes the epidemiology, pathogenesis, clinical features and risk factors of the three main categories of post-HSCT SMNs. A wide range of solid SMNs has been described, usually occurring 10 years or more post-HSCT, related most often to previous or conditioning radiotherapy. Therapy-related acute myeloid leukaemia/myelodysplasia occurs earlier, typically three to seven years post-HSCT, mainly in recipients of autologous transplant and is related to previous alkylating agent or topoisomerase II inhibitor chemotherapy. Post-transplant lymphoproliferative disorders occur early (usually within two years post-HSCT, usually presenting as Epstein-Barr virus-related B cell non-Hodgkin lymphoma.

  1. 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.

  2. Molecular imaging with {sup 99m}Tc-MIBI and molecular testing for mutations in differentiating benign from malignant follicular neoplasm: a prospective comparison

    Giovanella, L.; Treglia, G.; Ceriani, L. [Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, Bellinzona (Switzerland); Campenni, A. [Policlinico Universitario, Istituto di Medicina Nucleare, Messina (Italy); Verburg, F.A. [RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany); Trimboli, P. [Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, Bellinzona (Switzerland); Ospedale Israelitico, Sezione di Endocrinologia e Diabetologia, Roma (Italy); Bongiovanni, M. [Centre Hopitalier Universitaire Vaudouise, Institut de Pathologie, Lausanne (Switzerland)

    2016-06-15

    To compare mutation analysis of cytology specimens and {sup 99m}Tc-MIBI thyroid scintigraphy for differentiating benign from malignant thyroid nodules in patients with a cytological reading of follicular neoplasm. Patients ≥18 years of age with a solitary hypofunctioning thyroid nodule (≥10 mm), normal thyrotropin and calcitonin levels, and a cytological diagnosis of follicular neoplasm were prospectively enrolled. Mutation analysis and {sup 99m}Tc-MIBI scintigraphy were performed and patients were subsequently operated on to confirm or exclude a malignant lesion. Mutations for KRAS, HRAS and NRAS and for BRAF and translocations of PAX8/PPARγ, RET/PTC1 and RET/PTC3 were investigated. Static thyroid scintigraphic images were acquired 10 and 60 min after intravenous injection of 200 MBq of {sup 99m}Tc-MIBI and visually assessed. Additionally, the MIBI washout index was calculated using a semiquantitative method. In our series, 26 % of nodules with a follicular pattern on cytology were malignant with a prevalence of follicular carcinomas. {sup 99m}Tc-MIBI scintigraphy was found to be significantly more accurate (positive likelihood ratio 4.56 for visual assessment and 12.35 for semiquantitative assessment) than mutation analysis (positive likelihood ratio 1.74). A negative {sup 99m}Tc-MIBI scan reliably excluded malignancy. In patients with a thyroid nodule cytologically diagnosed as a follicular proliferation, semiquantitative analysis of {sup 99m}Tc-MIBI scintigraphy should be the preferred method for differentiating benign from malignant nodules. It is superior to molecular testing for the presence of differentiated thyroid cancer-associated mutations in fine-needle aspiration cytology sample material. (orig.)

  3. 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.

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

    Tarık TİHAN; Hümayun GÜLTEKİN; Çomunoğlu, Nil

    2010-01-01

    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 t...

  5. Breast cancer as second malignant neoplasm after acute myeloid leukemia: A rare occurrence

    Govind Babu

    2016-01-01

    Full Text Available Cancer survivors after successful treatment of hematological and lymphoid malignancies are at an increased risk for second malignant neoplasms. As the overall survival has increased in these cancers, solid tumors are emerging as a serious long-term complication. In this article, we describe such a rare occurrence, in literature, of breast cancer after the treatment of acute myeloid leukemia.

  6. A CASE OF MALIGNANT RENAL NEOPLASM WITH RHABDOID FEATURES IN AN ADULT

    Kumamoto, Hiromi; Ozono, Seiichiro; Tsujimoto, Sigehiro; Yoshii, Masato; Kitauchi, Takanori; Hosokawa, Yukinari; Mibu, Hisakazu; Kagebayashi, Yoriaki; Hirao, Yoshihiko; Ichijima, Kunio

    2001-01-01

    We report a case of malignant neoplasm with rhabdoid features of the kidney in a 68 year old man. To our knowledge malignant rhabdoid tumor of the kidney (MRTK) has been limited to the pediatric age group. Malignant renal neoplasm similar to MRTK occurring in adults is very rare. However, there has been a recent review in which the authors found 23/480 cases of renal cell carcinoma (RCC) (4.7%) exhibiting rhabdoid features, all in adults. In the present case, examination of many sections of t...

  7. 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

  8. 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.

  9. Lifestyle Behaviors as Predictors of Malignant Neoplasm Development.

    Baum, L. S.; And Others

    The relationship between lifestyle behaviors and the onset of neoplasm development has been researched extensively. This study took a multivariate approach in attempting to identify lifestyle variables which could predict group membership among subjects diagnosed as having cancer and those subjects who have not been diagnosed as having cancer.…

  10. Malignant Nonfunctioning Neuroendocrine Neoplasm of the Pancreas in a 10-Year-Old Child

    Ahmed Marwan

    2009-04-01

    Full Text Available Malignant neoplasms of the pancreas are extremely rare in children and only represent a small percentage of pediatric cancer-related deaths. The paucity of cases reported in the literature, in addition to the lack of understanding of biologic behavior, has led to a lack of consensus concerning optimal management strategy. Presentation differs compared to adult counterparts and generally prognosis is improved even when lymph node metastases occur. Here we review the literature and report the case of a 10-year-old autistic female with a malignant nonfunctioning pancreatic endocrine neoplasm of the head of the pancreas successfully extirpated via pancreaticoduodenectomy.

  11. Expression of protein kinase A regulatory subunits in benign and malignant human thyroid tissues: A systematic review.

    Del Gobbo, Alessandro; Peverelli, Erika; Treppiedi, Donatella; Lania, Andrea; Mantovani, Giovanna; Ferrero, Stefano

    2016-08-01

    In this review, we discuss the molecular mechanisms and prognostic implications of the protein kinase A (PKA) signaling pathway in human tumors, with special emphasis on the malignant thyroid. The PKA signaling pathway is differentially activated by the expression of regulatory subunits 1 (R1) and 2 (R2), whose levels change during development, differentiation, and neoplastic transformation. Following the identification of gene mutations within the PKA regulatory subunit R1A (PRKAR1A) that cause Carney complex-associated neoplasms, several investigators have studied PRKAR1A expression in sporadic thyroid tumors. The PKA regulatory subunit R2B (PRKAR2B) is highly expressed in benign, as well as in malignant differentiated and undifferentiated lesions. PRKAR1A is highly expressed in follicular adenomas and malignant lesions with a statistically significant gradient between benign and malignant tumors; however, it is not expressed in hyperplastic nodules. Although the importance of PKA in human malignancy outcomes is not completely understood, PRKAR1A expression correlates with tumor dimension in malignant lesions. Additional studies are needed to determine whether a relationship exists between PKA subunit expression and clinical outcomes, particularly in undifferentiated tumors. In conclusion, the R1A subunit might be a good molecular candidate for the targeted treatment of malignant thyroid tumors. PMID:27321957

  12. Detection of telomerase activity in malignant neoplasms and nonmalignantepithelial tissues of human esophagus

    Shah Min Yang; Tian Jiao Wang; Bao Yu Li; Yuan Huan Wu

    2000-01-01

    AIM To study the expression of telomerase activity in malignant esophageal neoplasms and normal humanesophageal epithelia.METHODS Telomerase activity was assayed by the telomere repeat amplification protocol (TRAP)method. All the neoplasms and epithelia of esophagus were confirmed by routine pathological diagnosis.RESULTS Telomerase activity was assayed in 18 normal esophageal epithelial tissues and in 35 malignantneoplasms of esophagus, including 27 cases of esophageal carcinoma and 8 cases of cardiac carcinoma.Telomerase activity was detected in most of malignant neoplasms of esophagus (91.4%, 32/35) and in allthe normal esophageal epithelial tissues except one (18/19).CONCLUSION The results suggest that in addition to contributing to proliferation of immortal blast cellsand neoplastic cells, telomerase activity may also play a similar role in regeneration of normal epithelia ofhuman esophagus. The potential use of telomerase activity as a diagnostic marker in human esophagealneoplasm might not be suitable.

  13. A Computer System For Diagnostics Of Malignant Neoplasms Using Statistical Decision Rules

    Abramovich, M. S.; Kovalevsky, E. V.; Mashevsky, A. A.

    2004-01-01

    A structure and component parts of a computer system for diagnostics of malignant neoplasms on the base of biochemical blood testing indexes are considered. Parametric discriminant analysis and logistic regression method are used as decision rules. The computer system includes both the classic decision rules and robust decision rules that are stable under presence of anomalous observations.

  14. 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

  15. Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma: A name change to Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features would help prevent overtreatment.

    Thompson, Lester Dr

    2016-07-01

    Encapsulated follicular variant of papillary thyroid carcinoma is a common thyroid gland cancer, with a highly indolent behavior. Recently, reclassification as a non-malignant neoplasm has been proposed. There is no comprehensive, community hospital based longitudinal evaluation of encapsulated follicular variant of papillary thyroid carcinoma. Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma were identified in a review of all thyroid gland surgeries performed in 2002 within the Southern California Permanente Medical Group. All histology slides were reviewed and follow-up obtained. Seventy-five women and nineteen men, aged 20-80 years (mean 45.6 years), had a single (n=61), multiple (same lobe; n=20), or bilateral (n=13) tumor(s), ranging in size from 0.7 to 9.5 cm in diameter (mean 3.3 cm). Histologically, all cases demonstrated a well-formed tumor capsule, with capsular and/or lymphovascular invasion in 17 and no invasion in 77 cases. Lymph node metastases were not identified. The tumors had a follicular architecture, without necrosis or >3 mitoses/10 high-power fields (HPFs). Classical papillary thyroid carcinoma nuclear features were seen in at least three HPFs per 3 mm of tumor diameter, including enlarged, elongated, crowded, and overlapping nuclei, irregular nuclear contours, nuclear grooves, and nuclear chromatin clearing. Lobectomy alone (n=41), thyroidectomy alone (n=34), or completion thyroidectomy (n=19) was the initial treatment combined with post-op radioablative iodine in 25 patients. All patients were without evidence of disease after a median follow-up of 11.8 years. Encapsulated follicular variant of papillary thyroid carcinoma showed benign behavior, supporting conservative surgery alone and reclassification of these tumors to Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP). PMID:27102347

  16. Frequent hypermethylation of DBC1 in malignant lymphoproliferative neoplasms

    Grønbæk, Karin Elmegård; Ralfkiaer, U.; Dahl, C.;

    2008-01-01

    Allelic loss at chromosome 9q31-34 is a frequent event in many lymphoproliferative malignancies. Here, we examined DBC1 at 9q33.1 as a potential target in lymphomagenesis. DBC1 is a putative tumor suppressor that has been shown to be involved in the regulation of cell growth and programmed cell d...

  17. 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)

  18. 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

  19. Thyroid function following neck irraidation for malignant lymphoma

    Kim, Y.H.; Fayos, J.V.; Sisson, J.C.

    1980-01-01

    Thyroid function tests for T/sub 3/ resin (T/sub 3/-r), serum thyroxine (T/sub 4/), and serum thyroid stimulating hormone (TSH) were measured in 70 consecutive patients who had previously undergone lymphangiography and neck irradiation for malignant lymphoma. All were in remission and clinically euthyroid. The abnormalities found were: 23 (33%) patients hypothyroid by TSH, 14 (20%) with subnormal T/sub 4/, and 21 (30%) with subnormal T/sub 3/-r values. None of the patients were biochemically hyperthyroid. The prevalence and magnitude of abnormalities were highest during the third year after irradiation, thereafter decreasing with time.

  20. Bone sarcoma as a second malignant neoplasm in children: influence of radiation and genetic predisposition

    Osteosarcoma or chondrosarcoma developed as a second malignant neoplasm (SMN) in 40 of 188 individuals with SMN whose first neoplasm occurred in childhood. A genetic susceptibility to cancer was found in 23; the SMN developed in an irradiated field in 32; both factors were present in 16; neither in one. When a genetic predisposition was present, radiation shortened the interval to SMN. The intervals between tumors and the age at which the bone sarcomas developed in relation to genetic disease and therapy were analyzed by a two-mutation hypothesis

  1. 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

  2. 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.

  3. 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

  4. THE ANALYSIS OF STATISTICAL DATA ON MALIGNANT NEOPLASMS ASSOCIATED WITH HUMAN P APILLOMAVIRUS

    A. A. Kostin; V. V. Starinskiy; Y. V. Samsonov; A. T. Asratov

    2016-01-01

    In this study of statistical data for the first time in Russia the analysis of the morbidity and mortality of patients with malignant neoplasms that may be associated with human papilloma virus (HPV) is performed: cervical cancer (cervical cancer), cancer of the vulva and vagina, cancer of penis, cancer of the rectum, anal canal and rectosigmoid junction cancer, cancer of the pharynx and larynx.

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

    Brigitte Gómez J.; María Ramírez R.; Juan Maldonado E.

    2012-01-01

    ABSTRACTObjectives. To define the presence of lung metastasis in bitches with malignant mammary neoplasms. Material 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 suggest...

  6. THE ANALYSIS OF STATISTICAL DATA ON MALIGNANT NEOPLASMS ASSOCIATED WITH HUMAN P APILLOMAVIRUS

    A. A. Kostin

    2016-01-01

    Full Text Available In this study of statistical data for the first time in Russia the analysis of the morbidity and mortality of patients with malignant neoplasms that may be associated with human papilloma virus (HPV is performed: cervical cancer (cervical cancer, cancer of the vulva and vagina, cancer of penis, cancer of the rectum, anal canal and rectosigmoid junction cancer, cancer of the pharynx and larynx.

  7. Predictive factors associated with malignancy of intraductal papillary mucinous pancreatic neoplasms

    Jin; Hee; Lee; Kyu; Taek; Lee; Jongwook; Park; Sun; Youn; Bae; Kwang; Hyuck; Lee; Jong; Kyun; Lee; Kee-Taek; Jang; Jin; Seok; Heo; Seong; Ho; Choi; Dong; Wook; Choi; Jong; Chul; Rhee

    2010-01-01

    AIM:To identify preoperative predictive factors associated with malignancy of intraductal papillary mucinous neoplasms(IPMNs) of the pancreas.METHODS:Between April 1995 and April 2010,129 patients underwent surgical resection for IPMNs at our institute and had confirmed pathologic diagnoses.The medical records were retrospectively reviewed and immunohistochemical staining for mucin(MUC) in pancreatic tissues was performed.RESULTS:Univariate analysis showed that the following five variables were closely asso...

  8. Malignant Neoplasm Prevalence in the Aktobe Region of Kazakhstan.

    Bekmukhambetov, Yerbol; Mamyrbayev, Arstan; Jarkenov, Timur; Makenova, Aliya; Imangazina, Zina

    2015-01-01

    An oncopathological state assessment was conducted among adults, children and teenagers in Aktobe region for 2004-2013. Overall the burden of mortality was in the range of 94.8-100.2 per 100,000 population, without any obvious trend over time. Ranking by pathology, the highest incidences among women were registered for breast cancer (5.8-8.4), cervix uteri (2.9-4.6), ovary (2.4-3.6) and corpus uteri, stomach, esophagus, without any marked change over time except for a slight rise in cervical cancer rates. In males, the first place in rank was trachea, bronchus and lung, followed by stomach and esophagus, which are followed by bladder, lymphoid and hematopoietic tissues pathology. Agian no clear trends were apparent over time. In children, main localizations in cancer incidence blood (acute lymphocytic leukemia, lymphosarcoma, acute myeloid leukemia, Hodgkin's disease), brain and central nervous system, bones and articular cartilages, kidneys, and eye and it's appendages, in both sexes. Similarly, in young adults, the major percentage was in blood and lymphatic tissues (acute myeloid leukemia, acute lymphocytic leukemia, Hodgkin's disease) a significant percentage accruing to lymphosarcoma, lymphoma, other myeloid leukemia and hematological malignancies as well as tumors of brain and central nervous system, bones and articular cartilages. This initial survey provides the basis for more detailed investigation of cancer epidemiology in Aktobe, Kazakhstan. PMID:26745053

  9. A novel stem cell associated marker identified by monoclonal antibody HESC5:3 differentiates between neoplastic lesions in follicular thyroid neoplasms.

    Heikkilä, Annukka; Fermér, Christian; Hagström, Jaana; Louhimo, Johanna; Mäenpää, Hanna; Siironen, Päivi; Heiskanen, Ilkka; Nilsson, Olle; Arola, Johanna; Haglund, Caj

    2015-07-01

    Follicular thyroid lesions are the bane of cytopathology. Differentiation between adenoma and carcinoma is impossible, and often these neoplasms are indistinguishable even from uninodular goitre. In other cancers as well, a theory of stem cells as the origin of cancer has been discussed in thyroid carcinogenesis. We aimed to examine a novel stem cell associated marker identified by monoclonal antibody HESC5:3 in follicular lesions in an attempt to find a marker for differential diagnosis in thyroid cytopathology. HESC5:3 was raised against and is specific for undifferentiated human embryonic stem cells. The epitope of this novel antibody is to be defined. Immunohistochemical expression of HESC5:3 was examined in clinical material comprised of follicular neoplasms (83 adenomas, 43 carcinomas) and non-neoplastic lesions (41 goitrous, 22 hyperplastic, 23 normal tissue specimens). Staining differed significantly between neoplastic and non-neoplastic lesions. Nuclear staining was increased in non-neoplastic cells, whereas in neoplastic cells expression was mainly cytoplasmic. There was no difference between benign and malignant lesions, suggesting a role in early tumourigenesis. In conclusion, the HESC5:3 epitope may be of benefit as a neoplasia marker in distinguishing between uninodular goitre and neoplasia. Characterization of the epitope would increase the interest in this promising new stem cell associated marker. PMID:25960045

  10. Malignant transformation of ectopic thyroid tissue in the orbit: A rare case report

    Tuhin Bhattacharya

    2016-01-01

    Full Text Available Ectopic thyroid tissue refers to the presence of thyroid tissue in locations other than normal anterior neck region. It is the most frequent type of thyroid dysgenesis. Lingual thyroid is the most common type accounting for 90% of the cases. The presence of thyroid tissue in orbit is extremely rare along with malignant transformation and the presence of normal thyroid gland. We report a very rare case of follicular carcinoma arising in the ectopic thyroid tissue in the left orbit along with normal thyroid gland. To the best of our knowledge, it is the first ever reported case of this type.

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

    Tarık TİHAN

    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

  12. "MONOCLONAL ANTIBODY HBME-1 USEFULNESS IN DIFFERENTIATION OF BENIGN NEOPLASM AND DIFFERENTIATED THYROID CARCINOMA"

    M. Mokhtari

    2005-05-01

    Full Text Available HBME-l is an antimesothelial monoclonal antibody that recognizes an unknown antigen on microvilli of mesothelial cells. The antibody is only relatively specific for mesothelium and is used in the differential diagnosis of mesothelioma and adenocarcinoma within the context of an appropriate immuno-histochemical panel. HBME-l has also been reported to strongly and uniformly stain papillary and follicular carcinoma of the thyroid while benign disorders have been usually negative. We studied the immunoreactivity of HBME-l in 90 cases of benign and malignant thyroid lesions. We found strong positive staining in the majority of papillary carcinomas (28/31, in some of follicular carcinomas (4/6,and in a few follicular adenomas (2/17. Negative staining was found in oxyphilic cell adenoma (0/4, nodular goiter (0/13 and undifferentiated carcinoma. The results suggest that monoclonal antibody HBME-l is useful in differentiating papillary and follicular carcinoma of the thyroid from benign lesions, especially in more differentiated lesions. Strong and generalized immunoreactivity for HBME-l in a follicular lesion should raise the suspicion of malignancy, but negative staining specially in poorly differentiated lesion does not rule out malignancy.

  13. 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)

  14. 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

  15. NEOPLASMS

    1997-01-01

    970246 Detection of point mutations of p53 gene bynon-isotopic PCR-SSCP in paraffin-embedded malig-nant mesothelioma tissue. LUO Suqiong(罗素琼), etal. Pneumoconiosis Res Unit, Public Health Sch,West-China Med Univ, Chengdu, 610041. Chin J Ind

  16. Metastasis of leiomyosarcoma to the thyroid

    DENG Xiao-rong; WANG Gang; KUANG Chun-jing; PENG Gui-zu; CHEN Ren-sheng

    2005-01-01

    @@ Leiomyosarcoma metastatic to the thyroid is extremely rare. Despite the fact that the thyroid gland is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of only 3% for secondary malignancies of the organ. Nevertheless,thyroid metastases are not an exceptional finding at autopsy, they are encountered in 2% to 24% of the patients with malignant neoplasms.1 We report a man with right leg leiomyosarcoma metastatic to the thyroid gland.

  17. 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

  18. 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)

  19. 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)

  20. 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)

  1. A novel distinguishing system for the diagnosis of malignant pancreatic cystic neoplasm

    Purpose: To explore a simple and reliable non-invasive distinguishing system for the pre-operative evaluation of malignancy in pancreatic cystic neoplasm (PCN). Methods: This study first enrolled an observation cohort of 102 consecutive PCN patients. Demographic information, results of laboratory examinations, and computed tomography (CT) presentations were recorded and analyzed to achieve a distinguishing model/system for malignancy. A group of 21 patients was then included to validate the model/system prospectively. Results: Based on the 11 malignancy-related features identified by univariate analysis, a distinguishing model for malignancy in PCN was established by multivariate analysis: PCN malignant score = 2.967 × elevated fasting blood glucose (FBG) (≥6.16 mmol/L) ± 4.496 × asymmetrically thickened wall (or mural nodules ≥ 4 mm) ± 1.679 × septum thickening (≥2 mm) − 5.134. With the optimal cut-off value selected as −2.8 in reference to the Youden index, the proposed system for malignant PCN was established: septum thickening (>2 mm), asymmetrically thickened wall (or mural nodules > 4 mm), or elevated FBG (>6.16 mmol/L, accompanying commonly known malignant signs), the presence of at least one of these 3 features indicated malignancy in PCN. The accuracy, sensitivity and specificity of this system were 81.4%, 95.8% and 76.9%, respectively. MRI was performed on 32 patients, making correct prediction of malignancy explicitly in only 68.8% (22/32). The subsequent prospective validation study showed that the proposed distinguishing system had a predictive accuracy of 85.7% (18/21). Moreover, a higher model score, or aggregation of the features in the proposed system, indicated a higher grade of malignancy (carcinoma) in PCN. Conclusion: Elevated FBG (>6.16 mmol/L), asymmetrically thickened wall (or mural nodules > 4 mm) and septum thickening (>2 mm) are of great value in differentiating the malignancy in PCN. The developed distinguishing system is

  2. A novel distinguishing system for the diagnosis of malignant pancreatic cystic neoplasm

    Shen, Xiaoyong, E-mail: shanlixinc@163.com [Department of Radiology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Lu, Di, E-mail: lcyxld@126.com [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Xu, Xiao, E-mail: zdyyxx@163.com [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Wang, Jianguo, E-mail: 21118059@zju.edu.cn [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Wu, Jian, E-mail: drwujian@hotmail.com [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Yan, Sheng, E-mail: shengyan@zju.edu.cn [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Zheng, Shu-sen, E-mail: zyzss@zju.edu.cn [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China)

    2013-11-01

    Purpose: To explore a simple and reliable non-invasive distinguishing system for the pre-operative evaluation of malignancy in pancreatic cystic neoplasm (PCN). Methods: This study first enrolled an observation cohort of 102 consecutive PCN patients. Demographic information, results of laboratory examinations, and computed tomography (CT) presentations were recorded and analyzed to achieve a distinguishing model/system for malignancy. A group of 21 patients was then included to validate the model/system prospectively. Results: Based on the 11 malignancy-related features identified by univariate analysis, a distinguishing model for malignancy in PCN was established by multivariate analysis: PCN malignant score = 2.967 × elevated fasting blood glucose (FBG) (≥6.16 mmol/L) ± 4.496 × asymmetrically thickened wall (or mural nodules ≥ 4 mm) ± 1.679 × septum thickening (≥2 mm) − 5.134. With the optimal cut-off value selected as −2.8 in reference to the Youden index, the proposed system for malignant PCN was established: septum thickening (>2 mm), asymmetrically thickened wall (or mural nodules > 4 mm), or elevated FBG (>6.16 mmol/L, accompanying commonly known malignant signs), the presence of at least one of these 3 features indicated malignancy in PCN. The accuracy, sensitivity and specificity of this system were 81.4%, 95.8% and 76.9%, respectively. MRI was performed on 32 patients, making correct prediction of malignancy explicitly in only 68.8% (22/32). The subsequent prospective validation study showed that the proposed distinguishing system had a predictive accuracy of 85.7% (18/21). Moreover, a higher model score, or aggregation of the features in the proposed system, indicated a higher grade of malignancy (carcinoma) in PCN. Conclusion: Elevated FBG (>6.16 mmol/L), asymmetrically thickened wall (or mural nodules > 4 mm) and septum thickening (>2 mm) are of great value in differentiating the malignancy in PCN. The developed distinguishing system is

  3. Autoantibody profiling of benign and malignant thyroid tumors and design of a prototype diagnostic array

    K V Lanshchakov

    2012-06-01

    Full Text Available Currently the “gold standard” in diagnostics of thyroid tumors is a fine-needle aspiration cytology (FNAC. However, FNAC cannot discriminate between benign and malignant thyroid tumors in 15 to 30% of observations. In order to develop an additional tool for differential diagnostics of thyroid tumors we evaluated the diagnostic performance of 3-antigen serum autoantibody signature in groups of benign ( n = 22 and malignant ( n = 26 thyroid tumors using a dot-blot ELISA-based analysis The sensitivity and specificity of resultant array were estimated to be 55–60% and 95–100%, respectively ( p < 0.001 according to one-sided Fisher Exact Test. Thus, we created a prototype antigen array for differential diagnostics of thyroid tumors which can be regarded as a platform for design of more complicated panel, highly sensitive in thyroid cancer detection, which can significantly improve the accuracy of preoperative diagnosis of thyroid cancer.

  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. A sonographic scoring system to assess the risk of thyroid malignancy.

    Pathirana, A A; Bandara, K G M W; Faleel, M A; Kuruppumullage, S D; Solangarachchi, N; Rupasinghe, R D; Karunaratne, N P N; Ranasinghe, D D; Epa, W A; Thusyanthan, V

    2016-03-01

    Prediction of thyroid malignancy with fine needle aspiration cytology or individual ultrasound characteristics has several limitations. This study evaluates the usefulness of a combination of ultrasound characteristics in predicting malignancy in patients with thyroid nodules. We assessed 189 thyroid nodules using ultrasonography and histology. Each nodule was assigned a score based on ultrasonographic characteristics. This score was compared with histology to identify ability to predict malignancy. There were 28 malignant nodules. The scoring system was appropriate for clinical use, obtaining an area under ROC curve of 0.822 [p< 0.0001] 95% confidence. FNAC of nodules with a score of more than 4 can be recommended (100% sensitivity). Nodules with a score less than 8 can be offered total thyroidectomy when FNAC is inconclusive (97.5% sensitivity). A combination of ultrasonographic criteria increase the accuracy of predicting malignancy in thyroid nodules. PMID:27031977

  6. Concomitant chemo-radiotherapy and local dose of radiation as risk factors for second malignant neoplasms after cancer in childhood: a case control study

    Radiotherapy and chemotherapy are associated with an increased risk of a second malignant neoplasm. after a cancer during childhood. This study specified the dose effect relationship between the local dose of radiation received at the site of the second malignant neoplasm and the risk of a second malignant neoplasm.It also investigated the effect of chemo radiotherapy on the risk of second malignant neoplasm. An European cohort of 4581 patients, treated for a solid cancer during childhood have been included in the study. 153 cases with a second malignant neoplasm, and 442 controls were matched according to sex, age at first cancer, calendar year, type of first cancer and follow-up. The local dose of radiation was estimated at the site of the second malignant neoplasm, for each case and at the same site, for his matched control. In conclusion, radiation was the foremost treatment related risk factor for the occurrence of a second malignant neoplasm. Compared to sequential treatment, concomitant chemo radiotherapy may lead to a higher risk of a second malignant neoplasm. (N.C.)

  7. 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.)

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

    Brigitte Gómez 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 10.87±2.65 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.

  9. 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)

  10. Voluminous Incidental Oncocytic Neoplasm of the Adrenal Gland With Uncertain Malignant Potential.

    Chakroun, Marouene; Kerkeni, Waild; Zidi, Yosra; Ayed, Haroun; Bouzouita, Abderrazak; Ben Slama, Mohamed Riadh; Rammeh, Sihem; Derouiche, Amine; Chebil, Mohamed

    2016-09-01

    A 74-year-old man presented with right flank pain and a palpable mass in the left flank. Blood pressure was normal. Contrastenhanced computed tomography (CT) showed a 17 × 16 × 12 cm retroperitoneal mass over the left kidney, solid and heterogeneous. There were also 3 retro aortic lymph nodes and bilateral renal lithiasis. Twenty four-hour urinary metanephrines and normetanephrines were normal. The patient underwent a resection of the mass with left adrenalectomy by a lumbar incision. Histological findings revealed an adrenal oncocytic neoplasm (AON) with uncertain malignant potential. Six months after surgery, CT control showed neither local nor distant recurrence. PMID:27413692

  11. Role of radiotherapy and chemotherapy in the risk of second malignant neoplasms after cancer in childhood

    Of a cohort of 634 children treated from 1942 to 1969 at the Gustave Roussy Institute for a first cancer and alive 5 years after treatment, 32 later developed second malignant neoplasms (SMN). A case-control study was performed to determine the relationship between the dose of radiotherapy received on a given anatomical site for the treatment of a first cancer, and the risk of SMN development at the same anatomical site. Another aim of the study was to analyse the effects of the association of radiotherapy with chemotherapy on the risk of SMN. This study suggests that the oncogenic effect of radiations might be increased by chemotherapy, and that the combination of the two treatment modalities might be one of the major factors responsible for overall risk of SMN. (author)

  12. 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

  13. Avoiding reoperation for indeterminate thyroid nodules identified as malignant after surgery

    Block, M.A.; Dailey, G.E. 3d.; Muchmore, D. (Scripps Clinic Medical Group Inc, La Jolla, CA (USA))

    1991-05-01

    Thyroid nodules that are indeterminate as carcinoma by needle biopsy before surgery and by study of frozen sections at the time of surgery are occasionally identified to be malignant in later studies. If only a lobectomy has been performed, the advisability of reoperation to remove the remaining thyroid tissue to facilitate radioactive iodine therapy may cause concern. To obviate this difficulty as well as to reduce the occurrence of nodules later in a preserved contralateral thyroid lobe and to provide additional thyroid tissue for study, contralateral subtotal or near total lobectomy has been performed for indeterminate thyroid nodules. The small remnant of remaining thyroid tissue can later be ablated by radioactive iodine if desired. Of 37 patients with indeterminate thyroid nodules, none required reoperation, although the diagnosis of carcinoma was established after surgery for eight patients, three of whom were treated with radioactive iodine.

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

    Soelberg, Kerstin; Bonnema, Steen Joop; Brix, Thomas Heiberg;

    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...... uptake, 7 of whom (4.4%) had thyroid malignancy. In the eight studies reporting individual maximum standardized uptake values (SUV(max)), the mean SUV(max) was 4.8 (standard deviation [SD] 3.1) and 6.9 (SD 4.7) in benign and malignant lesions, respectively (p...

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

    2016-05-13

    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

  16. 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

  17. 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.

  18. Treatment for Malignant Struma Ovarii in the Eyes of Thyroid Surgeons

    Luo, Jiang-rong; Xie, Chun-bao; Li, Zhi-hui

    2014-01-01

    Abstract Malignant struma ovarii (MSO) is a rare malignant ovarian germ cell tumor that has been scarcely reported by thyroid surgeons focusing on treatment. There are no golden standards for its treatment. There has not been any Chinese case included in the English language literatures. This is the first study by collecting all Chinese cases with clinical information. We emphasize on using I131 therapy after operation. Presented is a case of struma ovarii with malignant histologic features w...

  19. 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)

  20. Risk of second malignant neoplasm following proton versus intensity-modulated photon radiotherapies for hepatocellular carcinoma

    Taddei, Phillip J.; Howell, Rebecca M.; Krishnan, Sunil; Scarboro, Sarah B.; Mirkovic, Dragan; Newhauser, Wayne D.

    2010-12-01

    Hepatocellular carcinoma (HCC), the sixth most common cancer in the world, is a global health concern. Radiotherapy for HCC is uncommon, largely because of the likelihood of radiation-induced liver disease, an acute side effect that is often fatal. Proton beam therapy (PBT) and intensity-modulated radiation therapy (IMRT) may offer HCC patients a better option for treating the diseased liver tissue while largely sparing the surrounding tissues, especially the non-tumor liver. However, even advanced radiotherapies carry a risk of late effects, including second malignant neoplasms (SMNs). It is unclear whether PBT or IMRT confers less risk of an SMN than the other. The purpose of this study was to compare the predicted risk of developing an SMN for a patient with HCC between PBT and IMRT. For both treatments, radiation doses in organs and tissues from primary radiation were determined using a treatment planning system; doses in organs and tissues from stray radiation from PBT were determined using Monte Carlo simulations and from IMRT using thermo-luminescent dosimeter measurements. Risk models of SMN incidence were taken from the literature. The predicted absolute lifetime attributable risks of SMN incidence were 11.4% after PBT and 19.2% after IMRT. The results of this study suggest that using proton beams instead of photon beams for radiotherapy may reduce the risk of SMN incidence for some HCC patients.

  1. Role of Duplex Power Doppler Ultrasound in Differentiation between Malignant and Benign Thyroid Nodules

    Algin, Oktay [Ataturk Training and Research Hospital Bilkent, Ankara (Turkmenistan); Algin, Efnan [Gazi University Medical Faculty, Ankara (Turkmenistan); Gokalp, Gokhan; Ocakog, Gokhan; Erdog an, Cuneyt; Saraydaroglu, Ozlem; Ercan Tuncel, Prof [Uludag University Medical Faculty, Bursa (Turkmenistan)

    2010-12-15

    To evaluate the usage of duplex power Doppler ultrasound (PDUS) for the differentiation of benign and malignant thyroid nodules. We prospectively examined 77 thyroid nodules in 60 patients undergoing ultrasound-guided fine needle aspiration biopsy (FNAB). Each nodule was described according to size, inner structure, borders, parenchymal echogenicity, peripheral halo formation, and the presence of calcification (Bmode ultrasound findings). Vascularity as determined by PDUS imaging was defined as non-vascular, peripheral, central, or of mixed type. For each nodule, the pulsatility index (PI) and resistive index (RI) values were obtained. Results of FNAB and surgical pathological examination (if available) were used as a proof of final diagnosis to categorize all nodules as benign or malignant. A receiver operating characteristic (ROC) curve analysis was performed to establish cut-off, sensitivity, and specificity values associated with RI-PI values. A significant relationship was observed between malignancy and irregular margins, microcalcifications, and hypoechogenicity on ultrasound examination (p < 0.05). The pattern of vascularity as determined by PDUS analysis was not a statistically significant criterion to suggest benign or malignant disease in this study (p > 0.05). The central, peripheral, and mean RI-PI values were higher in malignant nodules when compared to the other cytologies (p < 0.05). Vascularity is not a useful parameter for distinguishing malignant from benign thyroid nodules. However, RI and PI values are useful in distinguishing malignant from benign thyroid nodules

  2. Value of thyroid nodule ultrasonic strain elastography quantitative analysis in judging benignancy or malignancy of nodules

    Hai-Yun Zhao; Hai-Xia Liu; Wei Tong; Jin-Zhong Huang; Chun Xiang

    2016-01-01

    Objective:To analyze the value of thyroid nodule ultrasonic strain elastography quantitative analysis in judging benignancy or malignancy of nodules.Methods: Patients diagnosed with thyroid nodule and receiving ultrasonic strain elastography quantitative analysis in our hospital were selected for study and divided into benign group and malignant group according to fine needle biopsy or the pathological results after surgical resection; mean strain values of quantitative indicators, blue region area and disorder of ultrasonic strain elastography, expression levels of malignant biological molecules in nodule tissue as well as the contents of serum tumor markers were detected.Results:Mean strain value of malignant group was lower than that of benign group, blue region area and disorder were higher than those of benign group, and standard deviation, complexity, kurtosis, skewness, contrast, equality, consistency and correlation were without significant differences; mRNA contents ofFascin-1, S100A4, STAT3, TC-1, MUC1 andMUC15 in thyroid nodules as well as serum Midkine, Galectin-3, CEACAM1 and TFF3 contents of malignant group were significantly higher than those of benign group, negatively correlated with mean strain value and positively correlated with blue region area and disorder.Conclusions:Mean strain values of quantitative indicators, blue region area and disorder of thyroid nodule ultrasonic strain elastography can judge benign or malignant nodules and assess the malignant degree.

  3. 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.

  4. Malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously: A case report.

    Ozgun, Alpaslan; Tuncel, Tolga; Emirzeoglu, Levent; Celik, Serkan; Bilgi, Oguz; Haholu, Abdullah; Urhan, Muammer; Karagoz, Bulent

    2015-01-01

    Malignant melanoma can be successfully treated when it is identified in its early stages, but the disease is associated with a poor prognosis when it is detected in an advanced stage. Papillary thyroid carcinoma is a thyroid cancer that has a good prognosis. The present study reports a rare case of malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously. The present patient was a 37-year-old male, in whom examination of a skin biopsy that was obtained from a lesion in the right retroauricular region revealed the lesion to be consistent with malignant melanoma. The patient underwent radical neck dissection upon the detection of malignant melanoma metastasis to the sentinel lymph node. Metastases of papillary thyroid carcinoma were detected in four out of 38 lymph nodes. The patient was then diagnosed with papillary thyroid carcinoma and underwent total thyroidectomy. The patient was administered with high-dose followed by moderate-dose interferon-α therapy for the treatment of malignant melanoma. The patient also received concurrent radioactive iodine therapy for the treatment of papillary thyroid carcinoma, at the same time as the interferon therapy. The two primary tumors of the patient were treated successfully. During therapy, no serious side-effects were observed, with the exception of fever caused by high-dose interferon therapy. Malignant melanoma and papillary thyroid carcinoma may occur concurrently, although this is rarely observed. The present study reports a rare case that demonstrates that the two tumors can be successfully treated simultaneously. PMID:25436010

  5. Real-Time US Diagnosis for Perithyroidal Invasion of Thyroid Malignancy

    Heo, Young Jin; Kim, Dong Wook [Dept. of Radiology, Busan Paik Hospital, Inje University School of Medicine, Busan (Korea, Republic of)

    2011-07-15

    To assess the diagnostic accuracy of real-time ultrasound (US) for perithyroidal invasion of thyroid malignancy. From January 2009 to December 2009, real-time US was performed on malignant thyroid nodules (largest diameter {>=} 10 mm) located in the isthmus or attached to the adjacent tracheal wall, by a single radiologist who prospectively determined the presence or absence of perithyroidal invasion. Of the 60 malignant thyroid nodules examined, intraglandular location (n = 0), capsular attachment with clear perithyroidal fat (n = 15), perithyroidal fat infiltration without tracheal invasion (n = 43), and tracheal invasion (n = 2) were prospectively determined. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of real-time US diagnosis for perithyroidal invasion were 80%, 90%, 94.1%, 69.2% and 83.3%, respectively when the pathological result was used as reference standard. Real-time US accuracies for intraglandular location, capsular attachment with clear perithyroidal fat, perithyroidal fat infiltration without tracheal invasion, and tracheal invasion were 76.6%, 53.3%, 51.7%, and 85.0%, respectively. The results of the real-time US diagnoses indicate that this method may be useful for diagnosing perithyroidal invasion of thyroid malignancies. Hence, further research is needed to prove the use of diagnosing perithyroidal invasion of thyroid malignancies.

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

    Marco Russo

    2016-05-01

    Full Text Available 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.

  7. 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.

  8. 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

  9. Malignancy risk analysis in patients with inadequate fine needle aspiration cytology (FNAC of the thyroid.

    Talib Al Maqbali

    Full Text Available BACKGROUND: Thyroid fine needle aspiration cytology (FNAC is the standard diagnostic modality for thyroid nodules. However, it has limitations among which is the incidence of non-diagnostic results (Thy1. Management of cases with repeatedly non-diagnostic FNAC ranges from simple observation to surgical intervention. We aim to evaluate the incidence of malignancy in non-diagnostic FNAC, and the success rate of repeated FNAC. We also aim to evaluate risk factors for malignancy in patients with non-diagnostic FNAC. MATERIALS AND METHODS: Retrospective analyses of consecutive cases with thyroid non diagnostic FNAC results were included. RESULTS: Out of total 1657 thyroid FNAC done during the study period, there were 264 (15.9% non-diagnostic FNAC on the first attempt. On repeating those, the rate of a non-diagnostic result on second FNAC was 61.8% and on third FNAC was 47.2%. The overall malignancy rate in Thy1 FNAC was 4.5% (42% papillary, 42% follicular and 8% anaplastic, and the yield of malignancy decreased considerably with successive non-diagnostic FNAC. Ultrasound guidance by an experienced head neck radiologist produced the lowest non-diagnostic rate (38% on repetition compared to US guidance by a generalist radiologist (65% and by non US guidance (90%. CONCLUSIONS: There is a low risk of malignancy in patients with a non-diagnostic FNAC result, commensurate to the risk of any nodule. The yield of malignancy decreased considerably with successive non-diagnostic FNAC.

  10. 二维超声叠加彩色多普勒对甲状腺肿块诊断分析%Analysis of two dimensional ultrasonography combined with color doppler in the diagnosis of thyroid neoplasm

    高天玲

    2014-01-01

    目的:观察二维超声叠加彩色多普勒对甲状腺肿块中的临床价值。方法:2012年9月-2013年9月收治甲状腺肿块患者70例,均采用超声诊断,分析其临床资料。结果:所有甲状腺肿块患者中,14例甲状腺恶性肿块,其中10例乳头状癌,2例滤泡癌,1例髓样癌及1例未分化癌;56例甲状腺良性肿块,其中34例甲状腺腺瘤,17例结节性甲状腺肿及5例甲状腺囊腺瘤。结论:彩色多普勒在诊断甲状腺肿块中的临床效果显著,能够作出正确的诊断。%Objective:To explore the clinical value of two dimensional ultrasonography combined with color doppler in the diagnosis of thyroid neoplasm.Methods:70 cases with thyroid masses were selected from September 2012 to September 2013.They were diagnosed by ultrasound.We analyzed the clinical data.Results:In all thyroid tumor cases,14 cases were thyroid malignant tumor,including 10 cases of papillary thyroid carcinoma,2 cases of follicular carcinoma,1 case of medullary carcinoma,1 case of undifferentiated carcinoma;56 cases were benign thyroid tumor,including 34 cases of thyroid adenoma,17 cases of nodular goiter and 5 cases of thyroid adenoma.Conclusion:The clinical value of color doppler in the diagnosis of thyroid neoplasm is significant, We can make the right diagnosis.

  11. Prevalence of BRAF T1799A mutations in benign and malignant thyroid tumors and tumor-like thyroid lesions

    Full text: An increased incidence of thyroid cancer after the Chernobyl accident evoked a strong need in an early and accurate cancer diagnosis. Spectrum of thyroid diseases is wide, ranging from tumor-like lesions such as thyroiditis and various types of goiter, benign adenomas to malignant follicular, papillary, medullary and anaplastic (undifferentiated) cancer. Differential morphological diagnosis of these diseases is sometimes complicated. Therefore, much of attention has been recently paid to additional auxiliary diagnostic means, in particular to molecular and genetic assays. One of the most informative markers of papillary thyroid carcinoma (PTC) is a BRAF point mutation that has been shown to occur with a relatively high rate in PTCs but not in follicular cancer and benign lesions. The purpose of the current study was an investigation of hotspot BRAF T1799A mutation prevalence in a series of tumor-like thyroid lesions and thyroid tumors. For the study we collected thyroid tissue specimens from 44 patients living in the central region of the Russian Federation (8 males and 36 females; age range 23 to 69 years, 46 years old, mean) who were surgically treated in the Clinic of Medical Radiological Research Center of Russian Academy of Medical Sciences. Included in the study were 32 cases of malignant thyroid tumors (26 papillary, 4 follicular and 2 medullary carcinomas), 5 benign (follicular adenomas), and 7 tumor-like lesions (5 nodular goiters and 2 lymphocytic thyroiditis). Histological classification was made according to the criteria described by LiVolsi (1990) and Rosai and colleagues (1992). Remaining excess tissue specimens of thyroid benign and malignant lesions and surrounding normal thyroid not needed for histological examination were used for DNA extraction. Genomic DNA was analyzed for the BRAF mutations by mutant allele specific polymerase chain reaction. DNA from PTC tissue previously determined to harbor mutant BRAF was used as a positive

  12. Differentiation between Malignant and Benign Masses of Thyroid Gland Using Color Doppler Ultrasonogram

    Son, Chang Woo; Kim, Chang Woo; Sin, Se Kwon; Jang, Kyeung Jae [Dae Dong Hospital, Busan (Korea, Republic of); Kim, Yi Tae [Dong A Hospital, Busan (Korea, Republic of)

    1996-12-15

    To determine color Doppler ultrasound findings of malignant and benign thyroid nodules, and to identify differential points among them. 35 patients with palpable enlarged thyroid nodules were imaged by using with 7 MHz linear-array transducer. Color Doppler images were obtained in the transverse and longitudinal planes on the color setting for the thyroid gland. After setting receiver gain, velocity scale and filter were set to 6 cm / sec and 1, respectively. And we measured resistive index, pulsatility index, peak systolic velocity and end diastolic velocity from the fastest or next fast arterial signals in the thyroid nodules or in the margins of the thyroid nodules. Final diagnosis was confirmed by ultrasonography-guided or surgical biopsy. 25 cases of malignant nodule and 10 cases of benign nodule were confirmed histopathologically.On the color mapping, malignant nodules showed various internal flow signals from avascular to hyper vascular and no marginal flow signals in all cases, and benign nodules revealed 9 (36%) hypo vascular cases and 16 (64%)hyper vascular cases in the internal flow signals and increased marginal flow signals in all cases. On the spectral analysis, malignant nodules showed RI 0.7 (0.63{approx}0.83) in hyper vascular internal flow signals and RI 0.93(0.67{approx}1.00) in hypo vascular internal flow signals, and measured PI was 1.39 (1.03{approx}2.11), 2.71 (0.97{approx}4.81),respectively. and in benign nodules, measured RI was 0.65 (0.5{approx}0.88) and PI was 0.92 (0.59{approx}1.90). Color Doppler imaging can be helpful to differentiate benign and malignant thyroid masses by means of measuring marginal and internal flow signals of thyroid nodules

  13. Differentiation between Malignant and Benign Masses of Thyroid Gland Using Color Doppler Ultrasonogram

    To determine color Doppler ultrasound findings of malignant and benign thyroid nodules, and to identify differential points among them. 35 patients with palpable enlarged thyroid nodules were imaged by using with 7 MHz linear-array transducer. Color Doppler images were obtained in the transverse and longitudinal planes on the color setting for the thyroid gland. After setting receiver gain, velocity scale and filter were set to 6 cm / sec and 1, respectively. And we measured resistive index, pulsatility index, peak systolic velocity and end diastolic velocity from the fastest or next fast arterial signals in the thyroid nodules or in the margins of the thyroid nodules. Final diagnosis was confirmed by ultrasonography-guided or surgical biopsy. 25 cases of malignant nodule and 10 cases of benign nodule were confirmed histopathologically.On the color mapping, malignant nodules showed various internal flow signals from avascular to hyper vascular and no marginal flow signals in all cases, and benign nodules revealed 9 (36%) hypo vascular cases and 16 (64%)hyper vascular cases in the internal flow signals and increased marginal flow signals in all cases. On the spectral analysis, malignant nodules showed RI 0.7 (0.63∼0.83) in hyper vascular internal flow signals and RI 0.93(0.67∼1.00) in hypo vascular internal flow signals, and measured PI was 1.39 (1.03∼2.11), 2.71 (0.97∼4.81),respectively. and in benign nodules, measured RI was 0.65 (0.5∼0.88) and PI was 0.92 (0.59∼1.90). Color Doppler imaging can be helpful to differentiate benign and malignant thyroid masses by means of measuring marginal and internal flow signals of thyroid nodules

  14. Pattern of thyroid malignancy at a University Hospital in Western Saudi Arabia

    The aim is to study the incidence of thyroid cancer in surgically treated nodular thyroid disease, clinicopathological characteristics and treatment results. A retrospective review of 45 patients with thyroid malignancy at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia during a 3-years period between January 2000 through to December 2003 was carried out. Analysis of clinicopathologic characteristics, age correlation to different risk factors, outcome of surgery and radioiodine treatment. A total of 120 thyroidectomies were performed during the 3-years period, January 2000 through to December 2003 at King Abdul-Aziz University Hospital. Forty-five (37.5%) patients had histopathology confirmed diagnosis of thyroid cancer. Eighty-two point two percent cases of papillary carcinoma, 4.4% follicular type and 6.7% anaplastic and medullary carcinoma of thyroid. Mean age was 40.5 +/- 14.8 years. Male preponderance was seen in this study with males: females ratio is 1.1:1. Nodular goiter was the most frequent presentation, observed in 30 (66.7%) cases. Fine needle aspiration cytology was suggestive of malignancy in 76% of cases. Ninety-seven patients with papillary carcinoma received ablative dose of radioiodine with average dose of 100-200 mCi. One female patient with follicular carcinoma of thyroid with bone, lung, and brain metastases received 4 doses of radioiodine with total dose of 800 mCi. Mortality rate was (2.2%), one patient died of complication of invasive anaplastic carcinoma with invasion of the trachea. There is a lot of controversy regarding thyroid malignancy investigations and management. We recommend that thyroid cancer patients should be treated by a team of endocrinologist, pathologist, experience thyroid surgeon, nuclear medicine and external radiotherapy physician to achieve an optimum care and good prognosis. (author)

  15. Antiarrhythmic agents and the risk of malignant neoplasm of liver and intrahepatic bile ducts.

    Yun-Ping Lim

    Full Text Available The objective of this study was to determine the association between the use of antiarrhythmic agents and the risk of malignant neoplasm of liver and intrahepatic bile ducts (MNLIHD.We used the research database of the Taiwan National Health Insurance Program to conduct a population-based, case-control study. We identified 9944 patients with antiarrhythmic history who were first diagnosed as having MNLIHD between 2005 and 2010. We identified an additional 19,497 patients with antiarrhythmic history in the same period who did not develop MNLIHD and were frequency-matched using age, sex, and index year to form a control group. Five commercially available antiarrhythmic agents, amiodarone, mexiletine, propafenone, quinidine, and procainamide, were analyzed.The adjusted odds ratio (OR of MNLIHD was 1.60 (95% confidence interval [CI], 1.45-1.77 for amiodarone users versus nonamiodarone users. In subgroup analysis, amiodarone use was significantly associated with an increased risk of MNLIHD with an adjusted OR of 18.0 (95% CI, 15.7-20.5 for patients with comorbidities compared to an OR of 2.43 (95% CI, 1.92-3.06 for those without comorbidities. After adjustment for age, sex, statins, anti-diabetes medications, non-steroidal antiinflammatory drugs, propafenone use, quinidine use, and comorbidities, the ORs were 1.49, 1.66, and 1.79 for MNLIHD associated with annual mean defined daily doses of ≤ 30, 31-145, and >145, respectively.The results of the present study indicated that amiodarone might be associated with the development of MNLIHD in a dose-dependent manner, particularly among patients with comorbidities.

  16. 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)

  17. Management dilemma of thyroid nodules in patients with malignant struma ovarii

    Sternlieb, Sarah J.; Satija, Celine; Pointer, David T.; Crawford, Byron E.; Sullivan, Lacey

    2016-01-01

    Struma ovarii is a rare type of ovarian teratoma comprised of at least 50% thyroid tissue. While most are benign, 70% of malignant cases are diagnosed as papillary carcinoma. Management of patients with thyroid nodules following gynecologic surgery remains controversial and variable. Historically, the treatment of choice has been surgical removal to rule out ovarian carcinoma. Thyroid follow-up and further treatment options are guided by tumor characteristics. The patient in this case presented to the endocrine surgeon with multiple thyroid nodules, dysphagia and a history of struma ovarii that was surgically treated at an outside hospital. Fine needle aspiration demonstrated benign histology. However, due to compressive symptoms and uncertainty of other nodules, the patient underwent a total thyroidectomy. Due to limited published data and treatment guidelines regarding thyroid nodules in patients with a history of malignant struma ovarii, surgery was recommended to rule out papillary thyroid carcinoma and relieve the patient’s dysphagia. More research focused on treatment and outcomes of struma ovarii patients with thyroid nodules is essential to establish treatment guidelines for these patients. PMID:27563566

  18. Management dilemma of thyroid nodules in patients with malignant struma ovarii.

    Sternlieb, Sarah J; Satija, Celine; Pointer, David T; Crawford, Byron E; Sullivan, Lacey; Kandil, Emad

    2016-08-01

    Struma ovarii is a rare type of ovarian teratoma comprised of at least 50% thyroid tissue. While most are benign, 70% of malignant cases are diagnosed as papillary carcinoma. Management of patients with thyroid nodules following gynecologic surgery remains controversial and variable. Historically, the treatment of choice has been surgical removal to rule out ovarian carcinoma. Thyroid follow-up and further treatment options are guided by tumor characteristics. The patient in this case presented to the endocrine surgeon with multiple thyroid nodules, dysphagia and a history of struma ovarii that was surgically treated at an outside hospital. Fine needle aspiration demonstrated benign histology. However, due to compressive symptoms and uncertainty of other nodules, the patient underwent a total thyroidectomy. Due to limited published data and treatment guidelines regarding thyroid nodules in patients with a history of malignant struma ovarii, surgery was recommended to rule out papillary thyroid carcinoma and relieve the patient's dysphagia. More research focused on treatment and outcomes of struma ovarii patients with thyroid nodules is essential to establish treatment guidelines for these patients. PMID:27563566

  19. Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules

    Real-time ultrasound elastography (US-E) is a helpful tool in diagnosing thyroid nodules. This study aims to evaluate thyroid solid nodules, to establish the accuracy of US-E in providing information on the nature of these nodules, and to assess the clinical value of elasticity scores (ES) and strain ratio (SR) in differentiating thyroid solid nodules and to explore its distribution characteristics using pathological analysis as reference. Traditional ultrasonography and US-E were performed on 131 thyroid solid nodules (99 benign ones and 32 malignant ones) in 120 patients (78 females and 41 males). Three radiologists evaluated the nodules based on a four-degree elasticity scoring system. The nodules were classified according to the ES as soft (ES 1-2) or hard (ES 3-4). The SR was calculated online. The sensitivity and specificity of the ES for thyroid cancer diagnosis were 78% and 80%, respectively. SR values ≥ 2.9 used as a standard to distinguish benign from malignant nodules had a sensitivity of 87% and a specificity of 92%. The SR of the benign lesions was 1.64±1.37, which was significantly different from that of malignant lesions, which was 4.96±2.13 (P<0.01). Both the ES and SR were higher in malignant nodules than those in benign ones. Real-time US-E was a useful index in the differential diagnosis of thyroid solid nodules. It can provide quantitative information on thyroid nodule characterization and improve diagnostic confidence

  20. 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

  1. 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.)

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

    Marcos Emanuel de Alcântara Segura

    2005-10-01

    Full Text Available 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 staining against galectin-3. Normal thyroid adjacent to neoplastic tissue was also examined in 48 cases. All cases of papillary carcinoma were cytoplasmic stained, 18 cases of follicular carcinoma were cytoplasmic stained, and one case of follicular adenoma showed nuclear staining. No case of normal thyroid showed immunoreactivity. Sensitivity, specificity, positive predictive value and negative predictive value were respective 88%, 98%, 96%, and 94%. Galectin-3 expression is a valuable evidence of malignancy in cases where cytomorphological features are not conclusive. This immunomediated method could increase diagnosis accuracy for FNAB, thus making surgery indication more precise.A punção aspirativa por agulha fina de tireóide é o método pré-cirúrgico mais importante na definição da malignidade de uma lesão nodular. Entretanto esse procedimento apresenta limitações, como características morfológicas comuns entre neoplasias malignas e benignas. A expressão de uma lectina ligante de b-galactosídeos chamada galectina-3, aumentada em neoplasias malignas de tireóide, poderia ser utilizada como marcador de malignidade para neoplasias de tireóide. Cinqüenta e sete casos, entre eles 14 carcinomas papilares, 22 carcinomas foliculares e 21 adenomas foliculares, foram estudados quanto à expressão da galectina-3 por métodos imuno-histoquímicos. O tecido tireoidiano normal, adjacente ao tecido neoplásico, também foi avaliado em 48 casos. Todos

  3. 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

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

    Phillip J. Taddei

    2015-03-01

    Full Text Available 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.

  6. 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.

  7. 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

  8. 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...

  9. Neuroimaging findings of the post-treatment effects of radiation and chemotherapy of malignant primary glial neoplasms.

    Mamlouk, M D; Handwerker, J; Ospina, J; Hasso, A N

    2013-08-01

    Post-treatment radiation and chemotherapy of malignant primary glial neoplasms present a wide spectrum of tumor appearances and treatment-related entities. Radiologic findings of these post-treatment effects overlap, making it difficult to distinguish treatment response and failure. The purposes of this article are to illustrate and contrast the imaging appearances of recurrent tumor from necrosis and to discuss other radiologic effects of cancer treatments. It is critical for radiologists to recognize these treatment-related effects to help direct clinical management. PMID:24007728

  10. Synchronous papillary carcinoma thyroid with malignant struma ovarii: A management dilemma

    Struma ovarii (SO) is a rare form of ovarian tumor, which is defined by the presence of thyroid tissue comprising more than 50% of the overall tumor volume. The vast majority of the variants of SO are benign; however, malignant tumors have been reported in a small percentage of cases. An aggressive multimodality approach using ovarian cancer staging laparotomy, total thyroidectomy along with radioactive iodine-131 ablation, and thyroxin suppression therapy has been shown to safely treat malignant SO both its initial presentation as well as in the event of any subsequent recurrence with excellent efficacy and possibly better oncological outcomes. The rarity of the disease and the lack of evidence surrounding its management and prognosis continue to remain a challenge to the treating clinician. We present a unique case of malignant SO with an incidental synchronous association of follicular variant of papillary carcinoma of the cervical thyroid gland, this is possibly the second case reported in the English language literature

  11. 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.

  12. 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)

  13. 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

  14. 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

  15. Characteristic Dynamic Enhancement Pattern of Magnetic Resonance Imaging for Malignant Thyroid Tumor: A Preliminary Report

    Park, Young Nam; Hwang, Hee Young; Shim, Young Sup; Byun, Sung Su; Choi, Hye Young; Kim, Hyung Sik [Dept. of Radiology, Gil Hospital, Gachon University College of Medicine and Science, Incheon (Korea, Republic of)

    2011-11-15

    The purpose of this study is to determine the characteristic dynamic enhancement pattern of magnetic resonance (MR) imaging for malignant thyroid tumor. Eight patients who were pathology proven to have a malignant thyroid tumor, preoperatively. There are 5 papillary carcinomas, 1 medullary carcinoma, 1 follicular carcinoma, and 1 fine needle aspiration biopsy proven atypical cell. Based on preoperative MR imaging, we compared the dynamic MR enhancement pattern relating to the pathologic type. On contrast agent-enhanced dynamic T1-weighted image (T1WI), 5 papillary carcinoma and one medullary carcinoma showed delayed enhancement compared to normal parenchyma. In addition, one follicular carcinoma shows stronger enhancement than normal parenchyma, with one papillary carcinoma showing a persistent decrease in enhancement compared to normal parenchyma. Although this study is limited by a small patients population, the data suggests that delayed enhancement on enhanced dynamic T1WI is a possible characteristic MR finding of a malignant thyroid tumor. I think that the comparison of MR imaging between benign and malignant nodules is required for a correct characterization.

  16. Feasibility Study of Texture Analysis Using Ultrasound Shear Wave Elastography to Predict Malignancy in Thyroid Nodules.

    Bhatia, Kunwar Suryaveer Singh; Lam, Absalom Chung Lung; Pang, Sze Wing Angel; Wang, Defeng; Ahuja, Anil Tejbhan

    2016-07-01

    Textural analysis of ultrasound shear wave elastography (SWE) was evaluated to discriminate benign and malignant thyroid nodules. Sixteen papillary thyroid cancers and 89 benign hyperplastic nodules in 105 patients underwent SWE using four static pre-compression levels. Fifteen gray level co-occurrence matrix textural features and six absolute SWE indices were computed from SWE images. Diagnostic performances of each SWE index for malignancy were calculated and compared using the area under the receiver operating characteristic curve (AUC), and optimal models were generated at each pre-compression level. The optimal model comprised two SWE textural features at the highest pre-compression level, which attained AUC, sensitivity and specificity of 0.973, 97.5% and 90.0%, respectively. By comparison, absolute SWE indices attained AUC of 0.709 as well as 18.8% sensitivity and 95.8% specificity. These preliminary results suggest SWE textural analysis can distinguish benign and malignant thyroid nodules and SWE spatial heterogeneity is greater in malignant nodules. PMID:27126245

  17. 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

  18. Fine-Needle Aspiration Cytology of Parathyroid Carcinoma Mimic Hürthle Cell Thyroid Neoplasm

    Chutintorn Sriphrapradang

    2014-01-01

    Full Text Available Background. Fine-needle aspiration (FNA can cause misdiagnosis of cytomorphological findings between parathyroid and thyroid lesions. Case Presentation. A 31-year-old man presented with a palpable neck mass on the right thyroid lobe. FNA cytology was reported as intrathyroidal lymphoid hyperplasia. After 5 years, repeated FNA was done on the enlarged nodule with result of Hürthle cell lesion. Prior to right lobectomy, laboratories revealed elevated serum calcium and parathyroid hormone (PTH. Careful history taking revealed chronic knee pain and ossifying fibroma at the maxilla. Ultrasonography showed a 2.8 cm mass inferior to right thyroid lobe. Pathology from en bloc resection was parathyroid carcinoma and immunohistochemical study revealed positivity for PTH. Genetic analysis found somatic mutation of CDC73 gene in exon1 (c.70delG which caused premature stop codon in amino acid 26 (p.Glu24Lysfs2*. The final diagnosis was hyperparathyroidism-jaw tumor syndrome. Conclusions. FNA cytology of parathyroid can mimic thyroid lesion. It is important to consider and correlate the entire information from clinical history, laboratory, imaging, and FNA.

  19. 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

  20. Prevalence of neoplasms in definite and probable mitochondrial disorders.

    Finsterer, Josef; Frank, Marlies

    2016-07-01

    There are some indications that the prevalence of benign and malign neoplasms is increased in patients with a mitochondrial disorder (MID). This study aimed at calculating the prevalence of malign and benign neoplasms in MID patients compared to the general population. Among 103 adult patients with definite or probable MID 16 had a malignancy (15.5%) and 11 (10.7%) a benign neoplasm. Four patients had thyroid cancer, three patients had prostate cancer, two patients each colon cancer, or ovarian cancer, and one each lung cancer, basalioma, Paget carcinoma of the skin, Bowen disease, renal cancer, and urinary bladder cancer. One patient had two carcinomas. Five patients had lipomas, two thyroid adenoma, and one each meningeoma, ovarian adenoma, hemangioma of the liver, and pituitary adenoma. Compared to the general population, the prevalence of malignancies was 3-4 fold increased in definite and probable MIDs. Compared to a cohort of myotonic dystrophy type-1 patients, the prevalence was 1.4 fold increased. In conclusion, adult MID patients seem to carry an increased risk to develop malignancy or a benign neoplasm. Females with a MID seem to be predominantly at risk to develop a neoplasm. PMID:27181047

  1. Comparison of Na{sup +}/I{sup -} symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study

    Kang, Do Young; Jeong, Young Jin; Lee, Kyung Eun; Park, Heon Soo; Yoo, Young Hyun; Roh, Mee Sook [Donga University College of Medicine, Busan (Korea, Republic of)

    2006-02-15

    Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48{+-}13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease.

  2. 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)

  3. Endoscopic surgery and photodynamic therapy for behign and malignant neoplasms of colon

    А. А. Razzhivina

    2013-01-01

    Full Text Available The review of literature for current methods of endoscopic treatment for colon epithelial neoplasms is represented. Such types of endoscopic interventions as loop electroresection, submucosal dissection, coagulation and destruction of tumors and combination of several options depending on efficiency of previous therapy is analyzed. Limitations of every method, its special aspects and possible complications are described. Special focus is on specifics of neoplasms for which selected methods may be the most effective. Thus, hot biopsy and destruction using high-energy laser is efficient for small flat neoplasms, endoscopic electroexcision – far small pedunculated lesions, and fragmentation is adequate for exophytic tumors more than 2.0 cm. Long-term results of endoscopic treatment, recurrence rates after different options are represented. The literature for photodynamic therapy consists mostly articles about development (on pre-clenecal stage of new photosensitizers which are effective for colon cancer, new methods of treatment including combination with hyperthermia in low-dose light irradiation etc. The literature data shows the prospectivity of subsequent developments in this field. 

  4. Diagnostic potential of ancillary molecular testing in differentiation of benign and malignant thyroid nodules.

    Bhatia, Parisha; Deniwar, Ahmed; Friedlander, Paul; Aslam, Rizwan; Kandil, Emad

    2015-03-01

    Fine needle aspiration (FNA) cytology, being the mainstay to diagnose thyroid nodules, does not provide definitive results in a subset of patients. The use of molecular markers testing has been described as a useful aid in differentiation of thyroid nodules that present with an indeterminate cytodiagnosis. Molecular tests, such as the Afirma gene classifier, mutational assay and immunohistochemical markers have been increasingly used to further increase the accuracy and defer unnecessary surgeries for benign thyroid nodules. However, in light of the current literature, their emerging roles in clinical practice are limited due to financial and technical limitations. Nevertheless, their synergistic implementation can predict the risk of malignancy and yield an accurate diagnosis. This review discusses the clinical utility of various molecular tests done on FNA indeterminate nodules to avoid diagnostic thyroidectomies and warrant the need of future multi-Institutional studies. PMID:25750270

  5. 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.

  6. 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.

  7. 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. PMID:27110424

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

    Mehmet Uludag

    2016-01-01

    Full Text Available 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.

  9. 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.)

  10. Information theoretical methods to deconvolute genetic regulatory networks applied to thyroid neoplasms

    Hernández-Lemus, Enrique; Velázquez-Fernández, David; Estrada-Gil, Jesús K.; Silva-Zolezzi, Irma; Herrera-Hernández, Miguel F.; Jiménez-Sánchez, Gerardo

    2009-12-01

    Most common pathologies in humans are not caused by the mutation of a single gene, rather they are complex diseases that arise due to the dynamic interaction of many genes and environmental factors. This plethora of interacting genes generates a complexity landscape that masks the real effects associated with the disease. To construct dynamic maps of gene interactions (also called genetic regulatory networks) we need to understand the interplay between thousands of genes. Several issues arise in the analysis of experimental data related to gene function: on the one hand, the nature of measurement processes generates highly noisy signals; on the other hand, there are far more variables involved (number of genes and interactions among them) than experimental samples. Another source of complexity is the highly nonlinear character of the underlying biochemical dynamics. To overcome some of these limitations, we generated an optimized method based on the implementation of a Maximum Entropy Formalism (MaxEnt) to deconvolute a genetic regulatory network based on the most probable meta-distribution of gene-gene interactions. We tested the methodology using experimental data for Papillary Thyroid Cancer (PTC) and Thyroid Goiter tissue samples. The optimal MaxEnt regulatory network was obtained from a pool of 25,593,993 different probability distributions. The group of observed interactions was validated by several (mostly in silico) means and sources. For the associated Papillary Thyroid Cancer Gene Regulatory Network (PTC-GRN) the majority of the nodes (genes) have very few links (interactions) whereas a small number of nodes are highly connected. PTC-GRN is also characterized by high clustering coefficients and network heterogeneity. These properties have been recognized as characteristic of topological robustness, and they have been largely described in relation to biological networks. A number of biological validity outcomes are discussed with regard to both the

  11. 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

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

    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. 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. 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. 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

  13. Antioxidant defence-related genetic variants are not associated with higher risk of secondary thyroid cancer after treatment of malignancy in childhood or adolescence

    Vodusek Ana Lina

    2016-03-01

    Full Text Available Thyroid cancer is one of the most common secondary cancers after treatment of malignancy in childhood or adolescence. Thyroid gland is very sensitive to the carcinogenic effect of ionizing radiation, especially in children. Imbalance between pro- and anti-oxidant factors may play a role in thyroid carcinogenesis. Our study aimed to assess the relationship between genetic variability of antioxidant defence-related genes and the risk of secondary thyroid cancer after treatment of malignancy in childhood or adolescence.

  14. Malignancy Risk Assessment in Patients with Thyroid Nodules Using Classification and Regression Trees

    Shokouh Taghipour Zahir

    2013-01-01

    Full Text Available Purpose. We sought to investigate the utility of classification and regression trees (CART classifier to differentiate benign from malignant nodules in patients referred for thyroid surgery. Methods. Clinical and demographic data of 271 patients referred to the Sadoughi Hospital during 2006–2011 were collected. In a two-step approach, a CART classifier was employed to differentiate patients with a high versus low risk of thyroid malignancy. The first step served as the screening procedure and was tailored to produce as few false negatives as possible. The second step identified those with the lowest risk of malignancy, chosen from a high risk population. Sensitivity, specificity, positive and negative predictive values (PPV and NPV of the optimal tree were calculated. Results. In the first step, age, sex, and nodule size contributed to the optimal tree. Ultrasonographic features were employed in the second step with hypoechogenicity and/or microcalcifications yielding the highest discriminatory ability. The combined tree produced a sensitivity and specificity of 80.0% (95% CI: 29.9–98.9 and 94.1% (95% CI: 78.9–99.0, respectively. NPV and PPV were 66.7% (41.1–85.6 and 97.0% (82.5–99.8, respectively. Conclusion. CART classifier reliably identifies patients with a low risk of malignancy who can avoid unnecessary surgery.

  15. Clinical evaluation of 24 cases of primary thyroid malignant lymphoma

    We analyzed open biopsy in diagnosing primary thyroid lymphoma (PTL) and tumor management with compression symptoms and therapy. We retrospectively studied 24 subjects diagnosed with PTL from December 1997 to June 2010.Open biopsy was done in 23 of 24 subjects. Incisional biopsy was done in 14, 13 of whom yielded sufficient materials in the first biopsy. Excisional biopsy was done in the remaining 9, 2 of whom developed permanent recurrent laryngeal nerve palsy after biopsy. The five with airway obstruction underwent incisional biopsy followed by immediate steroid administration of dexamethasone or methylprednisolone. All had histopathologically confirmed diagnosis and airway symptoms were resolved within a few days. Multidisciplinary therapy including chemotherapy, radiotherapy, and surgery was applied in 20 of 24 subjects. Single therapy was done in 4-chemotherapy in 2 and radiotherapy and surgery in 1 each. Overall results were satisfactory, with a 92% 10-year disease-free survival rate and an 86% 10-year overall survival rate based on the Kaplan-Meier method with 46-month median follow up. When diagnosing PTL, especially large tumors spreading into extrathyroid tissue, incisional biopsy is more advantageous in histopathological diagnosis than excisional biopsy due to the lower risk of surgical complications. In a case involving a small intrathyroidal nodule, excisional biopsy is safer and more diagnostically accurate. In an airway obstruction emergency, once a definitive diagnosis is made, steroid administration plus endotracheal intubation, if necessary, for airway management is optimal management. Subjects with stage IE mucosa-associated lymphoid tissue (MALT) lymphomas can be treated with radiotherapy or surgery alone. Those with diffuse large B-cell lymphoma (DLBCL) or greater than stage IE MALT lymphoma, however, should be treated with multidisciplinary therapy because they have a potentially poor outcome. (author)

  16. Clinical Significance of Cannabinoid Receptors CB1 and CB2 Expression in Human Malignant and Benign Thyroid Lesions

    Eleftheria Lakiotaki

    2015-01-01

    Full Text Available The endocannabinoid system is comprised of cannabinoid receptors (CB1 and CB2, their endogenous ligands (endocannabinoids, and proteins responsible for their metabolism participate in many different functions indispensable to homeostatic regulation in several tissues, exerting also antitumorigenic effects. The present study aimed to evaluate the clinical significance of CB1 and CB2 expression in human benign and malignant thyroid lesions. CB1 and CB2 proteins’ expression was assessed immunohistochemically on paraffin-embedded thyroid tissues obtained from 87 patients with benign (n=43 and malignant (n=44 lesions and was statistically analyzed with clinicopathological parameters, follicular cells’ proliferative capacity, and risk of recurrence rate estimated according to the American Thyroid Association (ATA staging system. Enhanced CB1 and CB2 expression was significantly more frequently observed in malignant compared to benign thyroid lesions (p=0.0010 and p=0.0005, resp.. Enhanced CB1 and CB2 expression was also significantly more frequently observed in papillary carcinomas compared to hyperplastic nodules (p=0.0097 and p=0.0110, resp.. In malignant thyroid lesions, elevated CB2 expression was significantly associated with the presence of lymph node metastases (p=0.0301. Enhanced CB2 expression was also more frequently observed in malignant thyroid cases with presence of capsular (p=0.1165, lymphatic (p=0.1989, and vascular invasion (p=0.0555, as well as in those with increased risk of recurrence rate (p=0.1165, at a nonsignificant level though, whereas CB1 expression was not associated with any of the clinicopathological parameters examined. Our data suggest that CB receptors may be involved in malignant thyroid transformation and especially CB2 receptor could serve as useful biomarker and potential therapeutic target in thyroid neoplasia.

  17. 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

    2016-03-01

    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

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

    Sevgi Gözdaşoğlu

    2016-03-01

    Full Text Available 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.

  19. Comparison of diagnostic value of conventional ultrasonography and shear wave elastography in the prediction of thyroid lesions malignancy.

    Ewelina Szczepanek-Parulska

    Full Text Available INTRODUCTION: Thyroid nodular disease (TND is a very common disorder. However, since the rate of malignancy is reported to be 3-10%, only a minority of patients require aggressive surgical treatment. As a result, there is a need for diagnostic tools which would allow for a reliable differentiation between benign and malignant nodules. Although a number of conventional ultrasonographic (US features are proved to be markers of malignancy, Shear Wave Elastography (SWE is considered to be an improvement of conventional US. The aim of this study was to compare conventional US markers and SWE diagnostic values in the differentiation of benign and malignant thyroid nodules. MATERIALS AND METHODS: All patients referred for thyroidectomy, irrespective of the indications, underwent a US thyroid examination prospectively. Patients with TND were included into the study. Results of the US and SWE examinations were compared with post-surgical histopathology. RESULTS: One hundred and twenty two patients with 393 thyroid nodules were included into the study. Twenty two patients were diagnosed with cancer. SWE turned out to be a predictor of malignancy superior to any other conventional US markers (OR=54.5 using qualitative scales and 40.8 using quantitative data on maximal stiffness with a threshold of 50 kPa. CONCLUSIONS: Although most conventional US markers of malignancy prove to be significant, none of them are characterized by both high sensitivity and specificity. SWE seems to be an important step forward, allowing for a more reliable distinction of benign and malignant thyroid nodules. Our study, assessing SWE properties on the highest number of thyroid lesions at the time of publication, confirms the high diagnostic value of this technique. It also indicates that a quantitative evaluation of thyroid lesions is not superior to simpler qualitative methods.

  20. 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.

  1. 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.

  2. 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.

  3. False-negative Results with the Bethesda System of Reporting Thyroid Cytopathology: Predictors of Malignancy in Thyroid Nodules Classified as Benign by Cytopathologic Evaluation

    Richmond, Bryan K.; JUDHAN, RUDY; Chong, Benny; Ubert, Adam; AbuRahma, Zachary; Mangano, William; Thompson, Stephanie

    2014-01-01

    The benign category of the Bethesda System for reporting thyroid cytopathology (BSRTC) predicts an incidence of malignancy from zero to three per cent. However, recent series report higher rates of malignancy ranging from eight to 14 per cent. Surgery is often performed for reasons other than their fine needle aspiration biopsy (FNAB) such as symptoms, nodule enlargement, or worrisome imaging. We hypothesized that an analysis of patients who underwent thyroidectomy despite a benign FNAB would...

  4. Overexpression of the anti-apoptotic protein AVEN contributes to increased malignancy in hematopoietic neoplasms.

    Eißmann, M; Melzer, I M; Fernández, S B M; Michel, G; Hrabě de Angelis, M; Hoefler, G; Finkenwirth, P; Jauch, A; Schoell, B; Grez, M; Schmidt, M; Bartholomae, C C; Newrzela, S; Haetscher, N; Rieger, M A; Zachskorn, C; Mittelbronn, M; Zörnig, M

    2013-05-16

    AVEN has been identified as an inhibitor of apoptosis, which binds to the adaptor protein, APAF-1, and thereby prevents apoptosome formation and mitochondrial apoptosis. Recent data have demonstrated high expression levels of AVEN messenger RNA in acute leukemias as well as a positive correlation between AVEN mRNA overexpression and poor prognosis in childhood acute lymphoblastic leukemia. On the basis of these data, we investigated the potential involvement of AVEN in tumorigenesis. First, we confirmed the overexpression of AVEN in T-cell acute lymphoblastic leukemia/lymphoma (T-ALL) patient samples. We then established a transgenic mouse model with T-cell-specific overexpression of AVEN, with which we demonstrated the oncogenic cooperation of AVEN with heterozygous loss of p53. Finally, we used a subcutaneous xenograft mouse model to show that AVEN knockdown in the T-ALL cell lines, MOLT-4 and CCRF-CEM, and in the acute myeloblastic leukemia cell line, Kasumi-1, leads to a halt in tumor growth owing to the increased apoptosis and decreased proliferation of tumor cells. Collectively, our data demonstrate that the anti-apoptotic molecule, AVEN, functions as an oncoprotein in hematopoietic neoplasms. PMID:22751129

  5. 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)

  6. 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 Radiation Effects Research Foundation's Life-Span Study E-85 sample, and 106 autopsied cases with benign ovarian neoplasms were ascertained among all 3046 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 histologic type. The age-adjusted ovarian cancer incidence rates showed a statistically significant increase with increased exposure dose, both in the entire exposed group (P less than .01) and in the microscopically reviewed subset (P less than .01). This dose response was only significant (P less than .01) in the latter half of the study period, 1965-80. The radiation effect was higher in the younger age group at the time of the bomb (ATB) for the specific attained age or was adjusted for attained age. In general, relative risk (greater than or equal to 100 rad vs. 0 rad) did not differ by attained age, except for the youngest age group, less than 20 years old ATB, where the relative risk tended to decrease with increased attained age, although cases were few in number and follow-up study was necessary. Estimated minimum latent period for radiation-induced ovarian cancer seemed to be 15-20 years. The proportion of autopsied cases with benign ovarian tumor increased with increasing exposure dose, both in the entire series of cases (P less than .05) and in the microscopically reviewed subset. Statistical significance, however, was not achieved in the latter group. The distribution of histologic types of both cancer and benign tumor of the ovary did not vary significantly with radiation dose

  7. 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.

  8. 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.)

  9. 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.

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

    Cella, L.; M. Conson; Pressello, M C; S. Molinelli; Schneider, U.; Donato, V; Orecchia, R.; M. Salvatore; R. Pacelli

    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...

  11. Estimate of the uncertainties in the relative risk of secondary malignant neoplasms following proton therapy and intensity-modulated photon therapy

    Fontenot, Jonas D; Bloch, Charles; Followill, David; Titt, Uwe; Newhauser, Wayne D

    2010-01-01

    Theoretical calculations have shown that proton therapy can reduce the incidence of radiation-induced secondary malignant neoplasms (SMN) compared with photon therapy for patients with prostate cancer. However, the uncertainties associated with calculations of SMN risk had not been assessed. The objective of this study was to quantify the uncertainties in projected risks of secondary cancer following contemporary proton and photon radiotherapies for prostate cancer. We performed a rigorous pr...

  12. The clinical significance and management of incidental focal FDG uptake in the thyroid gland on positron emission tomography/computed tomography (PET/CT) in patients with non-thyroidal malignancy

    Background Incidental focal fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG) uptake in the thyroid is not uncommon. A significant proportion is due to intercurrent thyroid cancer on further evaluation. Purpose To investigate and discuss the clinical significance and management of incidental focal FDG uptake in the thyroid gland on positron emission tomography/computed tomography (PET/CT) in patients with non-thyroidal malignancy. Material and Methods We investigated 188/7896 (2.4%) patients who had incidental focal thyroid uptake on FDG PET/CT in an oncology population over a 45-month period. Diagnosis was confirmed in 63 patients of whom 59 patients had histopathological verification. Results Thirty-two percent of confirmed cases were malignant comprising intercurrent thyroid cancer in three-quarters of these patients. Maximum standardized uptake values of the thyroid lesions and SUV ratios compared with background thyroid and mediastinal uptake were not predictive of a benign or malignant etiology. In patients with incidental thyroid cancers, more than half had non-papillary and intermediate to high-risk pathology. Conclusion Focal FDG uptake in the thyroid gland on PET/CT showed a malignancy risk of 32%. The intensity of uptake does not predict histology and underpins the importance of further investigations to exclude intercurrent thyroid cancer in suitable patients

  13. Differentiation between malignant and benign thyroid tumors by X-ray fluorescent analysis-comparison of cases from Russia and Albany, New York

    Intra thyroid iodine level in different types of thyroid neoplasms in Russia (126 cases) and USA (37 cases) were investigated by X-ray fluorescent analysis in vitro. A decrease in intra thyroid iodine concentration is associated with the stepwise loss of differentiation in thyroid tumors. In colloid goiter tissue from Russia, the intra thyroid iodine level is increased. The intra thyroid iodine level was markedly increased in micro follicular adenomas and colloid goiters from American patients which may reflect a higher iodine supply in the USA. X-ray fluorescent analysis together with careful clinical appraisal can be used for management of thyroid patients with suspicious nodules which should be treated by surgery

  14. 131I treatment response in thyroid neoplasms and evaluation of radiation dose complications. A review of ten years of experience

    Full text: Thyroid cancer (TC) is the most common endocrine malignancy, but its management is still a controversial issue that included an interdisciplinary approach who compounds surgery, radioiodine (RAI) therapy and sometimes external radiation therapy. The aim of our work is to evaluate the role of the RAI treatment in well differenciated thyroid carcinoma and its implication in terms of survival and complications. Methods and Material: we collected data from medical records of 215 patients with confirmed TC, registered from 1990-2004 at the Nuclear Medicine Unit, Hospital Temuco, Chile, who received 50 to 150 mCi RAI therapy four to six weeks after lobectomy, partial or total thyroidectomy. Clinical and laboratory examinations were analyzed including blood count, thorax X Ray, whole body I-131 scans, and serum thyroglobulin. Results: the median age at the diagnosis was 51 years, there were 89% females. All patients were treated surgically and recived postoperative RAI treatment. Total thyroidectomy, subtotal thyroidectomy and nodule excision was done in 69%, 31% and 37% of patients respectively. The histopathologic results included papillary (62%), follicular (24%) and papillary-follicular carcinoma (14%). Regional lymph nodes were positive in 36% and distant metastases were detected in 20 %, located in the lungs in all of those patients. Additional RAI doses between 100-200 mCi were administrated in 35% patients after to wait a period longer than 1 year. The overall survival rate at 14 years was 93 %, and recurrent disease was detected in 15%. at 5 years and 20% at 14 years from the diagnosis. There were no major complications and minimal alterations in the blood count was observed. We conclude that total or near total thyroidectomy followed by RAI treatment appears to benefit for better survival and lower recurrence disease. Favorable prognostic management included radioiodine therapy at the primary treatment using high actvities (more than 100 mCi) after

  15. 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)

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

    Souza, Marcelo Cruzick de; Momesso, Denise P.; Vieira Neto, Leonardo; Vaisman, Mario, E-mail: dmomesso@terra.com.br [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, (Brazil). Servico de Endocrinologia; Vaisman, Fernanda; Corbo, Rossana [Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ (Brazil). Servico de Endocrinologia; Martins, Rosangela Aparecida Gomes [Hospital Universitario Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ (Brazil). Divisao de Pesquisa

    2016-02-15

    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)

  17. Analysis on Causes of Death of the Inpatients with Malignant Neoplasm in Foshan City from 2003 to 2014%佛山市2003年-2014年恶性肿瘤住院死因分析

    欧阳菊香; 刘冬生; 曾勇; 吕彩红; 梁东; 王尔笑; 利强; 黄才东; 曾章康

    2016-01-01

    目的:了解2003年-2014年佛山市恶性肿瘤住院死亡的特征和变化趋势,以便更好地开展肿瘤防治工作。方法选取2003年-2014年佛山市区级以上医院恶性肿瘤患者的病案首页资料,进行回顾性分析。结果恶性肿瘤死亡呈上升趋势,每十万常住人口在区以上医院死亡人数从2003年的7.9上升到2014年的9.9(P<0.001),但是病死率有下降趋势(P<0.001)。前五位死因分别为:肺癌、肝癌、结肠癌、白血病和胃癌,合计占61.2%。男性前五位死因为:肺癌、肝癌、结肠癌、鼻咽癌和白血病,合计占67.2%,女性前五位死因分别为:肺癌、乳腺癌、结肠癌、肝癌和白血病,合计占57.1%。结肠癌、乳腺癌和胰腺癌的顺位上升(P<0.05)。结论佛山市肿瘤死因有向发达国家模式转变的趋势,防治工作重点主要是肺癌、肝癌、结肠癌、白血病和胃癌等肿瘤,同时应注意乳腺癌和胰腺癌死亡顺位的上升。%Objective To analysis on the characteristics and variation trend of causes of death of inpatients with malignant neoplasm in Foshan City from 2003 to 2014 in order to provide reference basis for the prevention and treatment of tumor.Methods The front page data of medical records of the malignant neoplasm patients received in the hospitals above municipal and district level in Foshan City in 2003-2014 were retrospectively analyzed. Results Malignant neoplasm mortality showed an increasing trend and the death number in the hospitals above district level in per hundred thousand permanent population increased from 7.9 in 2003 to 9.9 in 2014(P<0.001), but the case fatality rate showed an down trending(P<0.001). The top five causes of death of malignant neoplasms were respectively malignant neoplasm of lung, malignant neoplasm of liver, malignant neoplasm of colon, leukaemia, and malignant neoplasm of stomach, jointly accounting for 61.2%. The top five tumors of male

  18. Aberrant Activation of Notch Signaling Inhibits PROX1 Activity to Enhance the Malignant Behavior of Thyroid Cancer Cells.

    Choi, Dongwon; Ramu, Swapnika; Park, Eunkyung; Jung, Eunson; Yang, Sara; Jung, Wonhyeuk; Choi, Inho; Lee, Sunju; Kim, Kyu Eui; Seong, Young Jin; Hong, Mingu; Daghlian, George; Kim, Daniel; Shin, Eugene; Seo, Jung In; Khatchadourian, Vicken; Zou, Mengchen; Li, Wei; De Filippo, Roger; Kokorowski, Paul; Chang, Andy; Kim, Steve; Bertoni, Ana; Furlanetto, Tania Weber; Shin, Sung; Li, Meng; Chen, Yibu; Wong, Alex; Koh, Chester; Geliebter, Jan; Hong, Young-Kwon

    2016-02-01

    Papillary thyroid cancer (PTC) is one of the most common endocrine malignancies associated with significant morbidity and mortality. Although multiple studies have contributed to a better understanding of the genetic alterations underlying this frequently arising disease, the downstream molecular effectors that impact PTC pathogenesis remain to be further defined. Here, we report that the regulator of cell fate specification, PROX1, becomes inactivated in PTC through mRNA downregulation and cytoplasmic mislocalization. Expression studies in clinical specimens revealed that aberrantly activated NOTCH signaling promoted PROX1 downregulation and that cytoplasmic mislocalization significantly altered PROX1 protein stability. Importantly, restoration of PROX1 activity in thyroid carcinoma cells revealed that PROX1 not only enhanced Wnt/β-catenin signaling but also regulated several genes known to be associated with PTC, including thyroid cancer protein (TC)-1, SERPINA1, and FABP4. Furthermore, PROX1 reexpression suppressed the malignant phenotypes of thyroid carcinoma cells, such as proliferation, motility, adhesion, invasion, anchorage-independent growth, and polyploidy. Moreover, animal xenograft studies demonstrated that restoration of PROX1 severely impeded tumor formation and suppressed the invasiveness and the nuclear/cytoplasmic ratio of PTC cells. Taken together, our findings demonstrate that NOTCH-induced PROX1 inactivation significantly promotes the malignant behavior of thyroid carcinoma and suggest that PROX1 reactivation may represent a potential therapeutic strategy to attenuate disease progression. PMID:26609053

  19. Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma

    The question of thyroid neoplasia following high-dose radiation treatment to the neck and mediastinum for malignant neoplasms such as Hodgkin's lymphoma in children and young adults has been raised recently. Five patients, 19 to 39 years old, were operated on for thyroid neoplasms that developed following cervical and mediastinal radiation therapy for Hodgkin's lymphoma. Three patients had papillary carcinomas and two had follicular adenomas. The latency period between radiation exposure and the diagnosis of thyroid neoplasm ranged from eight to 16 years. This limited series provided strong support for the recommendation that children and young adults who are to receive high-dose radiation therapy to the head, neck, and mediastinum should receive suppressive doses of thyroxine prior to radiation therapy in order to suppress thyrotropin (thyroid-stimulating hormone) and then be maintained on a regimen of suppression permanently

  20. 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.

  1. Nuclear medicine in the assessment of differentiated thyroid cancer

    Rutherford, G.-C. [Nuclear Medicine Department, Nottingham City Hospital, Nottingham (United Kingdom)], E-mail: gaylerutherford@doctors.org.uk; Franc, B. [Department of Radiology, Nuclear Medicine Section, University of California, San Francisco, CA (United States); O' Connor, A. [Nuclear Medicine Department, Nottingham City Hospital, Nottingham (United Kingdom)

    2008-04-15

    Despite modern multi-modality treatment, 10-30% of patients treated for differentiated thyroid cancer (DTC) ultimately develop local recurrence or metastatic disease. These malignancies are frequently slow-growing and secondary surgical resection is often undertaken along with radioactive iodine treatment. Correlation of radiological imaging with nuclear medicine studies is essential for individualized treatment planning, and to optimize this management. Radiologists should be familiar with the interpretation of various nuclear medicine studies used to image differentiated thyroid neoplasms.

  2. Nuclear medicine in the assessment of differentiated thyroid cancer

    Despite modern multi-modality treatment, 10-30% of patients treated for differentiated thyroid cancer (DTC) ultimately develop local recurrence or metastatic disease. These malignancies are frequently slow-growing and secondary surgical resection is often undertaken along with radioactive iodine treatment. Correlation of radiological imaging with nuclear medicine studies is essential for individualized treatment planning, and to optimize this management. Radiologists should be familiar with the interpretation of various nuclear medicine studies used to image differentiated thyroid neoplasms

  3. 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

  4. Functional polymorphisms in antioxidant genes in Hurthle cell thyroid neoplasm - an association of GPX1 polymorphism and recurrent Hurthle cell thyroid carcinoma

    Krhin Blaz

    2016-09-01

    Full Text Available Hurthle cells of the thyroid gland are very rich in mitochondria and oxidative enzymes. As a high level oxidative metabolism may lead to higher level of oxidative stress and can be associated with an increased risk for cancer, we investigated whether common functional polymorphisms in antioxidant genes (SOD2, CAT, GPX, GSTP1, GSTM1 and GSTT1 are associated with the development or clinical course of Hurthle cell thyroid carcinoma (HCTC.

  5. 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;

    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...... = .07) were related to increased risk of SMN. Thiopurine methyltransferase (TPMT) methylates 6MP and its metabolites, and thus reduces cellular levels of cytotoxic 6-thioguanine nucleotides. Of 524 patients who had erythrocyte TPMT activity measured, the median TPMT activity in 9 patients developing an...

  6. 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)

  7. 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

  8. 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)

  9. Ex vivo imaging of human thyroid pathology using integrated optical coherence tomography and optical coherence microscopy

    Zhou, Chao; Wang, Yihong; Aguirre, Aaron D.; Tsai, Tsung-Han; Cohen, David W.; Connolly, James L.; Fujimoto, James G.

    2010-01-01

    We evaluate the feasibility of optical coherence tomography (OCT) and optical coherence microscopy (OCM) for imaging of benign and malignant thyroid lesions ex vivo using intrinsic optical contrast. 34 thyroid gland specimens are imaged from 17 patients, covering a spectrum of pathology ranging from normal thyroid to benign disease/neoplasms (multinodular colloid goiter, Hashimoto's thyroiditis, and follicular adenoma) and malignant thyroid tumors (papillary carcinoma and medullary carcinoma). Imaging is performed using an integrated OCT and OCM system, with tumor cells, can be identified from OCT and OCM images and are clearly differentiable from normal or benign thyroid tissues. With further development of needle-based imaging probes, OCT and OCM could be promising techniques to use for the screening of thyroid nodules and to improve the diagnostic specificity of fine needle aspiration evaluation.

  10. 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.

  11. 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.)

  12. Nulliparity enhances the risk of second primary malignancy of the breast in a cohort of women treated for thyroid cancer

    Milazzo Francesca

    2011-08-01

    Full Text Available Abstract Background Many studies have reported an increased risk of developing a second primary malignancy (SPM of the breast in women treated for thyroid cancer. In this study, we investigated several potential risk factors for this association. The aim of this retrospective cohort study was to identify a subgroup of women surgically treated for papillary thyroid cancer that may benefit from more careful breast cancer screening. Methods A total of 101 women surgically treated for papillary thyroid cancer from 1996 to 2009 with subsequent follow-up were interviewed by phone regarding personal risk factors and lifestyle habits. Only 75 questionnaires could be evaluated due to a 25.7% rate of patients not retrieved or refusing the interview. Data analysis was performed using a multivariate logistic model. Results The standardised incidence ratio (SIR for breast cancer was 3.58 (95% IC 1.14 - 8.37. Our data suggest a protective effect of multiparity on the development of a SPM of the breast (O.R. 0.15; 95% IC 0.25 - 0.86. Significant associations were not found with other known risk factors including Body Mass Index (BMI, age at first tumour, concurrent metabolic diseases, smoking, physical activity and familiarity. Conclusions This study confirms that a higher incidence of SPM of the breast is observed in women treated for papillary thyroid cancer. Additionally, this risk is increased by nulliparity, thus a strict breast screening program for nulliparous women treated for thyroid cancer may be advisable.

  13. Infrared absorption spectra of human malignant tumor tissues

    Skornyakov, I. V.; Tolstorozhev, G. B.; Butra, V. A.

    2008-05-01

    We used infrared spectroscopy methods to study the molecular structure of tissues from human organs removed during surgery. The IR spectra of the surgical material from breast, thyroid, and lung are compared with data from histological examination. We show that in malignant neoplasms, a change occurs in the hydrogen bonds of protein macromolecules found in the tissue of the studied organs. We identify the spectral signs of malignant pathology.

  14. Unusual bone metastasis from follicular carcinoma thyroid: presenting as a primary bone malignancy

    Saurabh Varshney

    2014-12-01

    Full Text Available Osseous metastasis in patients of thyroid carcinoma is not very common, and appendicular skeleton is very rare. Bone metastasis represents a complication, especially of follicular thyroid carcinoma and severely reduces the quality of life causing pain, and fractures. Diagnosis is typically done by correlating clinical suspicion with imaging. Occult clinical presentations usually delay the detection and management of patients with bone metastasis from thyroid carcinoma. There is limited information about the clinical presentations and prognosis of patients with follicular thyroid carcinoma with bone metastasis. We hereby present a case report of right arm swelling diagnosed as metastatic carcinoma having metastasis from thyroid primary.

  15. Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma

    McHenry, C.; Jarosz, H.; Calandra, D.; McCall, A.; Lawrence, A.M.; Paloyan, E.

    1987-06-01

    The question of thyroid neoplasia following high-dose radiation treatment to the neck and mediastinum for malignant neoplasms such as Hodgkin's lymphoma in children and young adults has been raised recently. Five patients, 19 to 39 years old, were operated on for thyroid neoplasms that developed following cervical and mediastinal radiation therapy for Hodgkin's lymphoma. Three patients had papillary carcinomas and two had follicular adenomas. The latency period between radiation exposure and the diagnosis of thyroid neoplasm ranged from eight to 16 years. This limited series provided strong support for the recommendation that children and young adults who are to receive high-dose radiation therapy to the head, neck, and mediastinum should receive suppressive doses of thyroxine prior to radiation therapy in order to suppress thyrotropin (thyroid-stimulating hormone) and then be maintained on a regimen of suppression permanently.

  16. Endocrine neoplasms in familial syndromes of hyperparathyroidism.

    Li, Yulong; Simonds, William F

    2015-06-01

    Familial syndromes of hyperparathyroidism, including multiple endocrine neoplasia type 1 (MEN1), multiple endocrine neoplasia type 2A (MEN2A), and the hyperparathyroidism-jaw tumor (HPT-JT), comprise 2-5% of primary hyperparathyroidism cases. Familial syndromes of hyperparathyroidism are also associated with a range of endocrine and nonendocrine tumors, including potential malignancies. Complications of the associated neoplasms are the major causes of morbidities and mortalities in these familial syndromes, e.g., parathyroid carcinoma in HPT-JT syndrome; thymic, bronchial, and enteropancreatic neuroendocrine tumors in MEN1; and medullary thyroid cancer and pheochromocytoma in MEN2A. Because of the different underlying mechanisms of neoplasia, these familial tumors may have different characteristics compared with their sporadic counterparts. Large-scale clinical trials are frequently lacking due to the rarity of these diseases. With technological advances and the development of new medications, the natural history, diagnosis, and management of these syndromes are also evolving. In this article, we summarize the recent knowledge on endocrine neoplasms in three familial hyperparathyroidism syndromes, with an emphasis on disease characteristics, molecular pathogenesis, recent developments in biochemical and radiological evaluation, and expert opinions on surgical and medical therapies. Because these familial hyperparathyroidism syndromes are associated with a wide variety of tumors in different organs, this review is focused on those endocrine neoplasms with malignant potential. PMID:27207564

  17. 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

  18. VON RECKLINGHAUSEN’S 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 Recklinghausen’s 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.

  19. Anaplastic thyroid cancer

    ... or MRI of the neck may show a tumor growing from the thyroid gland. A thyroid biopsy makes the diagnosis. An examination ... the thyroid Images ... Saunders; 2016:chap 226. Lai SY, Mandel SJ, Weber RS. Management of thyroid neoplasms. In: Flint PW, Haughey BH, Lund LJ, et ...

  20. 白血病迭合实体瘤105例临床分析并文献复习%Clinical analysis of 105 cases of solid malignant neoplasm superimposed with leukemia

    赵海军

    2014-01-01

    Objective To explore the clinical features and diseases types of solid malignant neoplasm superimposed with leukemia;to investigate the changes of diseases types among patients of solid malignant neoplasm superimposed with leukemia with time. Methods A to-tal of 105 cases were collected from articles published in biomedical journals in our country, and among them 3 cases were in our hospital. The clinical features, treatment history and types of neoplasm were studied. Results Among the 105 cases, 78 cases were firstly diagnosed as solid malignant neoplasm, 22 cases as leukemia and 5 as both. The most common solid malignant neoplasm was lymphoma, intestinal tumors, breast cancer;however, types of the most common leukemia were AML,CML,CLL. Conclusion The appearance of second neoplasm is asso-ciated with therapy of firstly diagnosed neoplasm. Researching risk factors of second neoplasm and improving treatment options of malignant neoplasm are the emphasis of cancer treatment research.%目的:探讨白血病迭合实体瘤的临床特点,分析白血病迭合第二肿瘤的疾病类型,引起第二肿瘤疾病随时间推移的变化,为降低二重肿瘤的发生提供依据。方法电子检索自2000年1月至2013年4月发表在国内生物医学期刊上关于白血病迭合实体瘤的病例以及结合我院确认病例,分析其临床特点、迭合肿瘤类型。结果105例中,以实体瘤首发者78例,以白血病首发者22例,同时发病者5例:淋巴瘤、肠道肿瘤、乳腺癌仍然是引起继发肿瘤最常见的实体肿瘤,而以白血病为首发表现者,其疾病类型仍以AML、CML、CLL为主。结论二重肿瘤的发生与首发肿瘤的类型及治疗相关,研究迭合肿瘤发生风险,改进肿瘤治疗方案,是肿瘤治疗的研究方向。

  1. Metachronous Colon Metastasis to the Thyroid: A Case Report and Literature Review

    Dvir Froylich

    2013-01-01

    Full Text Available The thyroid gland is a known site for metastatic tumors from various primary sites. Thyroid metastases are not an exceptional finding at autopsy, and they are encountered in 2% to 9% of the patients with malignant neoplasm. The most frequent tumors to metastasize are breast, lung, melanoma, and kidney carcinomas. Despite the fact that it is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of 3% of secondary malignances of this organ. Metastatic colon carcinoma to the thyroid gland has been reported, and it is not as rare as one might think. We present a very unique case of colon carcinoma metastasis to the right thyroid lobe and lung five years after colon resection, with reoccurrence two years later in the contralateral thyroid lobe. The literature regarding colon cancer metastasizing to the thyroid gland was reviewed with an attempt to disclose features of this presentation regarding patient’s prognosis.

  2. 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.

  3. Incidence of malignant hemopathies and thyroid carcinomas in infants less than 15 years old around the nuclear site of Marcoule

    The objective was to determine, for the last ten years (1985-1995), the incidence of malignant blood diseases and thyroid carcinomas for children less than fifteen years old in a periphery of 35 km around the nuclear site of Marcoule. The conclusions are that it does not seem to exist a sur-incidence of these pathologies around Marcoule. But a surveillance register is placed for these carcinomas for the coming years, because of the choices made by the site of Marcoule and the expected developments. (N.C.)

  4. Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases; Stellenwert des Serum-Thyreoglobulinspiegels bei der Diagnostik benigner und maligner Schilddruesenerkrankungen

    Rink, T.; Schroth, H.J. [Abt. fuer Nuklearmedizin, Staedtisches Klinikum, Hanau (Germany); Dembowski, W.; Klinger, K. [Medizinische Klinik, St. Vinzenz Krankenhaus, Hanau (Germany)

    2000-08-01

    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 thyroidvolume, 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

  5. 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

  6. Are Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm Applicable to Other Malignancies—Assessment of Nodal Distribution in Gynecological Malignancies

    Purpose: Intensity modulated radiation therapy is used to reduce dose to adjacent critical structures while maintaining adequate target coverage, but it requires precise target localization. We report the 3-dimensional distribution of para-aortic (PA) lymph nodes (LN) in pelvic malignancies. We propose a guideline to accurately define the PA LN by anatomic landmarks and compare our data with published guidelines for pancreatic cancer. Methods and Materials: A retrospective analysis was performed on 46 patients with pelvic malignancies and positive PA LNs. Positive LNs were defined based on size and morphology or fluorodeoxyglucose avidity. All PA LNs were characterized into 3 groups based on location: left PA (between aorta and left psoas muscle), aortocaval (between aorta and inferior vena cava), and right paracaval (between inferior vena cava and right psoas muscle). Patients with retrocrural LNs were also analyzed. Results: One hundred thirty-three positive PA LNs were evaluated. The majority of the PA LNs were in the left PA (59%) and aortocaval (35) regions, and only 8% were in the right paracaval region. All patients with positive right paracaval LNs also had involved left PA LNs, with only 1 exception. The highest PA LN involvement was at the level of the renal vessels and was seen in 28% of patients. Of these patients with disease extending to renal vessels, 38% had retrocrural LN involvement. Conclusions: The nodal contouring for the PA region should not be defined by a fixed circumferential margin around the vessels. The left PA and aortocaval spaces should be covered adequately because these are common locations of PA LNs. For microscopic disease superiorly, contouring should extend up to renal vessels rather than a fixed bony landmark. For patients who have nodal involvement at renal vessels, one can consider including retrocrural LNs. Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm are not applicable to

  7. Mixed thyroid malignant tumors%不同病理类型并存的甲状腺恶性肿瘤临床分析

    黄亮; 于洋; 张艳; 高明

    2009-01-01

    Objective To study the diagnosis, treatment and prognosis of mixed thyroid malignant tumors. Methods Clinical data of 7 cases with merged different histological types of thyroid malignant tumor treated from January 1977 to December 2006 were retrospectively analyzed. Results Merged different histologic types of thyroid malignant tumor accounted for 0. 14% of all thyroid malignant tumors treated during this period. Preoperative imaging and laboratory data had no specific value in the diagnosis of this merged different histologic types of thyroid malignant tumors. Radical resection in combination of hormonal therapy and 131I radiotherapy achieved a satisfactory result, though thyroid malignant tumor combined with thyroid cancer usually predict a poor prognosis. Conclusions Merged different histologic types of thyroid malignant tumor is a rare clinical entity, with the pathogenesis being obscure and no consensus of opinion on its nomenclature. The prognosis depends on the highest ~ade among an individual group of malignant tumors.%目的 探讨不同病理类型并存的甲状腺恶性肿瘤的临床诊断、治疗方法和预后.方法 对1977年1月-2006年12月收治的7例不同病理类型并存的甲状腺恶性肿瘤病例进行回顾性分析.结果 不同病理类型并存的甲状腺恶性肿瘤占本院同期甲状腺恶性肿瘤的0.14%,影像学及实验室检查均无特异性诊断价值,不同病理类型并存的甲状腺癌采用甲状腺癌根治手术配合内分泌治疗及[3]I治疗可取得满意疗效,甲状腺癌合并甲状腺其他恶性肿瘤预后差. 结论不同病理类型并存的甲状腺恶性肿瘤属于罕见疾病,发病机制尚不明确,命名也不统一,目前尚无特异性诊断方法,其预后取决于恶性程度最高的病理类型.

  8. 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)

  9. 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

  10. 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)

  11. 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.

  12. 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

  13. 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

  14. Infrared spectra of thyroid tumor tissues

    Tolstorozhev, G. B.; Skornyakov, I. V.; Butra, V. A.

    2010-07-01

    We used infrared spectroscopy methods to study thyroid tumor tissues removed during surgery. The IR spectra of the surgical material are compared with data from histological examination. We show that in malignant neoplasms, the spectra of proteins in the region of C=O vibrations are different from the spectra of these substances in benign tumors and in tissues outside the pathological focus at a distance >1 cm from the margin of the tumor. The differences in the spectra are due to changes in the supermolecular structure of the proteins, resulting from rearrangement of the system of hydrogen bonds. We identify the spectral signs of malignant pathologies.

  15. Fine Needle Aspiration Cytology of Pediatric Thyroid Nodules

    Ayper KAÇAR

    2010-05-01

    Full Text Available Objective: The objectives were to evaluate fine needle aspiration cytology results of 39 pediatric patients, and the pathologies that cause childhood thyroid nodules, and to review the literature on the subject.Material and Method: Thyroid fine needle aspiration cytology results of 39 pediatric patients were retrospectively reviewed. Associated diseases, thyroid functions, anti-thyroid antibody levels, ultrasonographic findings and number of nodules were also evaluated.Results: The vast majority of patients with thyroid nodules were cytopathologically diagnosed as benign (97.3%. Of these patients, 64.8% (24 patients were diagnosed as nodular goiter and 35.2% (13 patients as lymphocytic thyroiditis. Thyroid malignancy was found in two patients; one was diagnosed as follicular neoplasm/ minimal invasive follicular carcinoma on surgical evaluation while the other was a secondary tumor (Burkitt's lymphoma. The majority of our subjects were females (66.6%: the female/male ratio was 2:1 for nodular goiter and 3.3:1 for thyroiditis. Surgical resection was performed in 5 patients (4 cases of nodular goiter, 1 suspicious for malignancy and cytological diagnoses were confirmed by histology.Conclusion: Our study confirmed the utility of fine needle aspiration cytology in childhood thyroid disorders along with a possible higher incidence of nodular thyroiditis in childhood. Nodular autoimmune thyroiditis, focal thyroiditis and thyroid cancer in children are discussed and attention is drawn to some special subtypes of thyroid cancer and some benign lesions that can cause difficulty in interpreting fine needle aspiration cytology and frozen sections at this age.

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

    R. Nissi

    2013-01-01

    Full Text Available 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.

  17. 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

  18. CT-guided percutaneous ethanol injection with disposable curved needle for treatment of malignant liver neoplasms and their metastases in retroperitoneal lymph nodes

    Chang-Jing Zuo; Pei-Jun Wang; Cheng-Wei Shao; Min-Jie Wang; Jian-Ming Tian; Yi Xiao; Fang-Yuan Ren; Xi-Yan Hao; Min Yuan

    2004-01-01

    AIM: To explore the feasibility of computed tomography (CT)-guided percutaneous ethanol injection (PEI) using a disposable curved needle for treatment of malignant liver neoplasms and their metastases in retroperitoneal lymph nodes.METHODS: CT-guided PEI was conducted using a disposable curved needle in 26 malignant liver tumors smaller than 5 cm in diameter and 5 lymph node metastases of liver cancer in the retroperitoneal space. The disposable curved needle was composed of a straight trocar (21G) and stylet, a disposable curved tip (25 G) and a fine stylet. For the tumors found in deep sites and difficult to reach, or for hepatic masses inaccessible to the injection using a straight needle because of portal vein and bile ducts, the straight trocar was used at first to reach the side of the tumor. Then, the disposable curved needle was used via the trocar. When the needle reached the tumor center, appropriate amount of ethanol was injected. For relatively large malignant liver tumors,multi-point injection was carried out for a better distribution of the ethanol injected throughout the masses. The curved needle was also used for treatment of the metastasis in retroperitoneal lymph nodes blocked by blood vessels and inaccessible by the straight needle.RESULTS: All of the 26 liver tumors received 2 or more times of successful PEI, through which ethanol was distributed throughout the whole tumor mass. Effect of the treatment was monitored by contrast-enhanced multi-phase CT and magnetic resonance imaging (MRI) examinations three months later. Of the 18 lesions whose diameters were smaller than 3 cm, the necrotic change across the whole mass and that in most areas were observed in 15 and 3 tumors,respectively. Among the 8 tumors sizing up to 3 cm, 5 were completely necrotic and 3 largely necrotic. Levels of tumor seromarkers were significantly reduced in some of the cases.In 5 patients with metastases of liver cancer in retroperitoneal lymph nodes who received 1 to 3

  19. 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.

  20. 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

  1. 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.

  2. 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)

  3. Estimate of the uncertainties in the relative risk of secondary malignant neoplasms following proton therapy and intensity-modulated photon therapy

    Fontenot, Jonas D.; Bloch, Charles; Followill, David; Titt, Uwe; Newhauser, Wayne D.

    2010-12-01

    Theoretical calculations have shown that proton therapy can reduce the incidence of radiation-induced secondary malignant neoplasms (SMN) compared with photon therapy for patients with prostate cancer. However, the uncertainties associated with calculations of SMN risk had not been assessed. The objective of this study was to quantify the uncertainties in projected risks of secondary cancer following contemporary proton and photon radiotherapies for prostate cancer. We performed a rigorous propagation of errors and several sensitivity tests to estimate the uncertainty in the ratio of relative risk (RRR) due to the largest contributors to the uncertainty: the radiation weighting factor for neutrons, the dose-response model for radiation carcinogenesis and interpatient variations in absorbed dose. The interval of values for the radiation weighting factor for neutrons and the dose-response model were derived from the literature, while interpatient variations in absorbed dose were taken from actual patient data. The influence of each parameter on a baseline RRR value was quantified. Our analysis revealed that the calculated RRR was insensitive to the largest contributors to the uncertainty. Uncertainties in the radiation weighting factor for neutrons, the shape of the dose-risk model and interpatient variations in therapeutic and stray doses introduced a total uncertainty of 33% to the baseline RRR calculation.

  4. Clinical value of virtual bronchoscopy in early diagnosis of central malignant lung neoplasm in high risk patients

    shape of the carinae (Kappa values ranging between 0,310 and 0,520). As to the evaluation of the secretion deposits, for example, the two diagnostic tests showed very poor agreement (negative Kappa value) concluding, this preliminary evaluation indicates that virtual bronchoscopy combined with the evaluation of MS-CT axial scans may be a promising and non-invasive diagnostic method for evaluation of patients at high risk of developing central lung neoplasm and can add important information about an intraluminal tumor and its relation to surrounding structures. Further studies should be undertaken to evaluate the potentials of this promising method as a tool to evaluate endoluminal growth in tumorous lung lesions. Even though it showed just fair agreement with flexible fiberoptic bronchoscopy, the evaluation of changes in the form of the carinae, in the shape of the ostia and the accurate analysis of modifications in the mucosal architecture as early signs of tumor growth, showed to be three valid separate diagnostic criteria for airway assessment by means of virtual bronchoscopy. From a technical point of view, multislice-CT allowed the optimization of examination parameters such as acquisition time and primary collimation resulting not only in a reduction of respiratory and pulsation artefacts but also in a dramatic improvement of the z-axis and hence a much better resolution of the 3-dimensional reconstructions. As a consequence, MS-CT virtual bronchoscopy provides enhanced detail fidelity and represents a valid diagnostic tool for the evaluation of the whole tracheo-bronchial tree up to its third generation bronchi. (author)

  5. Malignant Transformation of a Mature Cystic Ovarian Teratoma into Thyroid Carcinoma, Mucinous Adenocarcinoma, and Strumal Carcinoid: A Case Report and Literature Review

    Hilary D. Hinshaw

    2012-01-01

    Full Text Available Malignant transformation of a mature cystic teratoma (MCT is an infrequent, often asymptomatic event. We report the first example of a struma ovarii with a focus of follicular variant of papillary thyroid carcinoma (a, mucinous adenocarcinoma (b, and strumal carcinoid tumor (c—all three arising in one mature cystic teratoma of the ovary. From our reviews, we found limited data to guide management when these malignant foci occur within an MCT. Consideration should be given to thyroidectomy followed by total-body scanning and serum studies for foci of thyroid carcinoma and adjuvant therapy with thyroidectomy and radioablation if residual disease is identified (a. Additionally, extrapolating from data for mucinous adenocarcinomas, consideration could be given to adjuvant chemotherapy after appropriate staging (b. Strumal carcinoid tumors should be treated as tumors of low malignant potential. Observation is appropriate if after complete staging, no invasive implants are noted (c.

  6. 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

  7. Diagnosis and treatment of chronic lymphocytic thyroiditis coexistent with thyroid malignancy%慢性淋巴细胞性甲状腺炎合并甲状腺恶性肿瘤的临床诊治观察

    曹晓征

    2014-01-01

    ObjectiveTo explore the principles of diagnosis and treatment of chronic lymphocytic thyroiditis (CLT) coexistent with thyroid malignancy.MethodsThe clinical data of 38 patients with CLT, including clinic opathologic features, treatment, and prognosis were retrospectively analyzed.Results Chronic lymphocytic thyroiditis with papillary carcinoma 29 cases, the merger medullary carcinoma 3 cases, combined lymphoma 6 cases. 35 cases received follow-up, the treatment effect of 86.84% patients was good.ConclusionChronic lymphocytic thyroiditis thyroid malignant tumor in the combining more papillary carcinoma (29/38). Preoperative thyroid function, serum thyroid antibody detection, B ultrasonic and intraoperative and postoperative biopsy can improve the diagnosis and treatment, and help to choose the right operation method.%目的:对慢性淋巴细胞性甲状腺炎(CLT)合并甲状腺恶性肿瘤的临床诊治方法进行探讨。方法回顾性分析38例CLT合并甲状腺恶性肿瘤患者的诊断及治疗过程。结果CLT合并乳头状癌29例,CLT合并髓样癌3例,CLT合并淋巴瘤6例。其中35例获得随访,86.84%的患者治疗效果良好。结论 CLT合并甲状腺恶性肿瘤中以合并乳头状癌居多(29/38)。术前甲状腺功能、血清甲状腺抗体检测、B超及术中和术后切片检查可以提高诊断率和治疗率,并有助于选择正确的手术方式。

  8. 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

  9. Risk of a Second Malignant Neoplasm After Cancer in Childhood Treated With Radiotherapy: Correlation With the Integral Dose Restricted to the Irradiated Fields

    Purpose: After successful treatment of cancers in childhood, the occurrence of second malignant neoplasm (SMN) came to the fore. Few studies have considered the relationship between the radiation dose received and the risk of developing an SMN. To take into account the heterogeneity of the dose distribution so as to evaluate the overall risk of an SMN after a childhood cancer, we therefore focused on the integral dose restricted to the irradiated fields. Methods and Materials: The study was performed in a cohort of 4,401 patients who were 3-year survivors of all types of childhood cancer treated between 1947 and 1986 in France and Great Britain. For each patient, the integral dose was estimated for the volume inside the beam edges. Results: We found a significant dose-response relationship between the overall risk of an SMN and the estimated integral dose. The excess relative risk for each incremental unit of the integral dose was only 0.008 in a linear model and 0.017 when a negative exponential term was considered, when adjusted for chemotherapy. The risk of SMN occurrence was 2.6 times higher in the case of irradiation. However among patients who had received radiotherapy, only those who had received the highest integral dose actually had a higher risk. Conclusions: The integral dose in our study cannot be considered as a good predictor of later risks. However other studies with the same study design are obviously needed to evaluate the use of the integral dose as a tool for decision making concerning different radiotherapy techniques

  10. 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.

  11. Comparative evaluation of angiography and computed tomography in 34 cases with malignant neoplasm of the liver, bile duct, gallbladder and pancreas

    In 34 cases with malignant neoplasm of the liver, bile duct, gallbladder and pancreas, angiographic and CT finding were studied. 1) As CT findings, the margin of many hepatomas and almost all liver metastasis were able to be found except for some hepatomas. In many hepatomas, it was also found that there were lower parts in low density area. These lesions are seemed due to necrosis or hemorrhage. Metastatic carcinomas which had angiographic finding of much diffuse hypervasculature were seen as uniform low density area. On the other hand, those which had peripheral hypervasculature and of which the angiographic findings were some ring-like tumor stains were shown as the more obvious low density areas. These lesions became smaller by contrast enhancement, because the peripheral part of the lesion was changed to isodensity as normal liver. This phenomenon was not seen in the large a vasculer liver metastasis. 2) The dilatation of the partial intrahepatic bile duct was found in many intrahepatic cholangiomas (hiler type), but rare in hepatoma and liver metastasis. At the same time, CT showed low density areas which had ill-defined margin and did not coincide with tumor location. The low density area may suggest inflammatory change but it was not certified why these area did not coincide with tumor location. 3) In most extrahepatic bile duct carcinoma, the encasement of portal vein was shown on angiography. CT showed bile duct dilatation in all patient. These two findings might be rarely found in gallbladder carcinoma because of its location. 4) Unresectable pancreas carcinomas were easily diagnosed by CT and angiography, but it is impossible to find early pancreas carcinoma by conventional second generation CT examination. (author)

  12. Time trend in incidence of malignant neoplasms of the central nervous system in relation to mobile phone use among young people in Japan.

    Sato, Yasuto; Kiyohara, Kosuke; Kojimahara, Noriko; Yamaguchi, Naohito

    2016-07-01

    The aim of this study was to examine whether incidence of malignant neoplasms of the central nervous system from 1993 to 2010 has increased among young people in Japan, and whether the increase could be explained by increase in mobile phone use. Joinpoint regression analysis of incidence data was performed. Subsequently, the expected incidence rate was calculated assuming that the relative risk was 1.4 for those who used mobile phones more than 1640 h cumulatively. Annual percent change was 3.9% (95% confidence interval [CI], 1.6-6.3) for men in their 20s from 1993 to 2010, 12.3% (95% CI, 3.3-22.1) for women in their 20s from 2002 to 2010, 2.7% (95% CI, 1.3-4.1) for men in their 30s from 1993 to 2010, and 3.0% (95% CI, 1.4-4.7) for women in their 30s from 1993 to 2010. Change in incidence rates from 1993 to 2010 was 0.92 per 100,000 people for men in their 20s, 0.83 for women in their 20s, 0.89 for men in their 30s, and 0.74 for women in their 30s. Change in expected incidence rates from 1993 to 2010 was 0.08 per 100,000 people for men in their 20s, 0.03 for women in their 20s, 0.15 for men in their 30s, and 0.05 for women in their 30s. Patterns in sex-, age-, and period-specific incidence increases are inconsistent with sex-, age-, and period-specific prevalence trends, suggesting the overall incidence increase cannot be explained by heavy mobile phone use. Bioelectromagnetics. 37:282-289, 2016. © 2016 Wiley Periodicals, Inc. PMID:27197787

  13. 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

  14. Malignant melanoma of nose

    Kundu, I. N.; Haldar, B.; Saha, A. K.

    2001-01-01

    Malignant melanoma (MM) is one of the uncommon malignancies of the nose. We present an unusually big proliferative like MM in the vestibule of the nose. Malignancy of nose constitutes less than 1% of all malignancies (3% of head & neck tumour). MM however contributes only 2% of all malignant neoplasms of the nose (Moore & Martin. 1955).

  15. Cytodiagnosis of thyroid lesions-usefulness and pitfalls: A study of 288 cases

    Guhamallick M

    2008-01-01

    Full Text Available Background: Fine needle aspiration cytology (FNAC of the thyroid gland has been widely and successfully utilized for diagnosis. Aim: Our aim was to demonstrate the effectiveness of this cheap and simple procedure for the diagnosis of different thyroid lesions, particularly, differentiation of malignant and nonmalignant lesions. In addition, we sought to highlight probable causes of error and possible remedies in the cases showing lack of correlation between cytological and histological diagnoses. Materials and Methods: A total of 288 cases of thyroid swellings were aspirated in our two-year study period. Cases were divided into four groups, namely, aspiration inadequate where diagnosis was not offered; a nonneoplastic group which included different goiters and thyroiditis; an indeterminate group which included cases showing features of follicular or Hurthle cell neoplasms, and a malignant group that included nonfollicular malignant tumors of the thyroid. Cases showing cytohistologic disparity were reevaluated. Results: Almost 14% of the cases could not be reported because of inadequate aspiration, however, an overall cytohistological correlation was achieved in 82.66% of all cases. Sensitivity and specificity for the diagnosis of malignancy were 92.7 and 98.2%, respectively. There were four false negative malignant cases with one false positive case and 13 cases failed to show any cytohistological correlation. Conclusions: FNAC is the single most important test for preoperative assessment of thyroid pathology if attention is paid to the clinical features and collection of samples from proper sites.

  16. 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)

  17. 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.)

  18. Utility of malignancy markers in fine-needle aspiration cytology of thyroid nodules: comparison of Hector Battifora mesothelial antigen-1, thyroid peroxidase and dipeptidyl aminopeptidase IV

    De Micco, C; Savchenko, V.; Giorgi, R; Sebag, F; Henry, J-F

    2008-01-01

    The purpose of this study was to compare the diagnostic interest of Hector Battifora mesothelial antigen-1 (HBME-1), thyroid peroxidase (TPO), and dipeptidyl aminopeptidase IV (DPP4) in thyroid fine-needle aspirates obtained from 200 resected thyroid lesions (55 colloid nodules, 54 follicular adenomas, 59 papillary cancers, and 32 follicular carcinomas). Hector Battifora mesothelial antigen-1 or TPO expression (% positive cells) and DPP4 staining score (12-point scale) were evaluated. Receive...

  19. 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?

    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

  20. 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

  1. The differential diagnosis value of contrast-enhanced ultrasound(CEUS) between benign and malignant renal neoplasm%超声造影在肾脏良恶性肿物诊断中的应用价值

    王小立; 苏中振; 黄泽萍

    2012-01-01

    Objective To investigate the differential diagnosis value of contrast-enhanced ultrasound(CEUS) between benign and malignant renal neoplasm. Methods The contrast-enhanced CT,CEUS and conventional US features of 31 cases of renal neoplasm were analyzed retrospectively.Results The CEUS modes of malignant renal neoplasm included "quick in and out" (52.4%) and "quick in and slow out”(47.6%).Most of the malignant tumors demonstrated good enhancement (71.4%) and non-uniform enhancement with defective filling (85.7%).In benign group,the CEUS modes included "quick in and slow out”(70%), "slow in and out"(20%) and "quick in and out" (10%).Most of them showed fair-poor enhancement (70%) and homogeneous enhancement (60%).There were significant difference between the malignant and benign renal neoplasm in CEUS mode,degree of enhancement and homogeneity of enhancement.There is no significant difference of diagnostic accuracy of contrast-enhanced CT and CEUS (84.6% vs 77.4%).Conclusion CEUS could provide more information to improve the diagnostic accuracy for renal neoplasm,and had important value in differential diagnosis between benign and malignant neoplasm.%目的 探讨超声造影对肾脏良恶性肿物鉴别的诊断价值.方法 对31例肾脏肿物患者术前常规二维、彩色多普勒、超声造影及增强CT的资料进行回顾性分析.结果 肾恶性肿瘤造影模式为快进快退52.4%(11/21)及快进慢退47.6% (10/21);高增强为主71.4%(15/21),等-低增强28.6% (6/21);大部分为不均匀增强85.7% (18/21).肾良性肿物造影模式包括快进慢退70% (7/10),慢进慢退20% (2/10),快进快退1例10%(1/10);多为均匀增强60% (6/10);低-等增强70%(7/10).两组间增强模式、增强水平及增强形态均存在显著差别.超声造影准确率:77.4% (24/31),增强CT准确率:84.6%(22/26),两者无显著差别.结论 超声造影可提供更多的信息,对提高诊断准确性以及良

  2. Ex vivo imaging of human thyroid pathology using integrated optical coherence tomography and optical coherence microscopy

    Zhou, Chao; Wang, Yihong; Aguirre, Aaron D.; Tsai, Tsung-Han; Cohen, David W.; Connolly, James L.; Fujimoto, James G.

    2010-01-01

    We evaluate the feasibility of optical coherence tomography (OCT) and optical coherence microscopy (OCM) for imaging of benign and malignant thyroid lesions ex vivo using intrinsic optical contrast. 34 thyroid gland specimens are imaged from 17 patients, covering a spectrum of pathology ranging from normal thyroid to benign disease/neoplasms (multinodular colloid goiter, Hashimoto's thyroiditis, and follicular adenoma) and malignant thyroid tumors (papillary carcinoma and medullary carcinoma). Imaging is performed using an integrated OCT and OCM system, with <4 μm axial resolution (OCT and OCM), and 14 μm (OCT) and <2 μm (OCM) transverse resolution. The system allows seamless switching between low and high magnifications in a way similar to traditional microscopy. Good correspondence is observed between optical images and histological sections. Characteristic features that suggest malignant lesions, such as complex papillary architecture, microfollicules, psammomatous calcifications, or replacement of normal follicular architecture with sheets/nests of tumor cells, can be identified from OCT and OCM images and are clearly differentiable from normal or benign thyroid tissues. With further development of needle-based imaging probes, OCT and OCM could be promising techniques to use for the screening of thyroid nodules and to improve the diagnostic specificity of fine needle aspiration evaluation.

  3. 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)

  4. 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

  5. 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

  6. Percutaneous alcohol injection (PAI) of thyroid nodule

    Nah, Hae Kyeong; Kim, Yoon Sook; Lee, Shin Hyung; Yoon, Chong Hyun; Kim, Chong Soon [National Medical Center, Seoul (Korea, Republic of); Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    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.

  7. Longitudinal trends in use of targeted therapies for treatment of malignant neoplasms of the eye: a population-based study in Taiwan

    Hsu, Jason C.; Gonzalez-Gonzalez, Luis A; Lu, Vicky H; Christine Y Lu

    2016-01-01

    Objectives: This study examined the recent trend in use and costs of antineoplastic agents for treatment of eye malignancies in Taiwan from 2009 to 2012. We also forecasted use and costs of targeted therapies up to and including year 2016 based on the current patterns. Design: Retrospective observational study focusing on the usage of targeted therapies for treatment of eye malignancy. Setting: The monthly claims data for eye malignancy-related antineoplastic agents were retrieved from Taiwan...

  8. Unusual Presentation of Cystic Papillary Thyroid Carcinoma

    Patil, Vijayraj S.; 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...

  9. Thyroid disease in the pediatric patient: emphasizing imaging with sonography

    Thyroid disease does occur in the pediatric patient, and imaging plays an important role in its evaluation. A review is presented of normal development of the thyroid gland, the technique and indications for thyroid sonography, and key imaging features of congenital thyroid disorders (ectopic or absent thyroid, infantile goiter, thyroglossal duct remnants), benign thyroid masses (follicular adenoma, degenerative nodules, colloid and thyroid cysts), malignant masses (follicular, papillary and medullary carcinoma) and diffuse thyroid disease (acute bacterial thyroiditis, Hashimoto's thyroiditis, Grave's disease). (orig.)

  10. [The implementation of computer model in research of dynamics of proliferation of cells of thyroid gland follicle].

    Abduvaliev, A A; Gil'dieva, M S; Khidirov, B N; Saĭdalieva, M; Khasanov, A A; Musaeva, Sh N; Saatov, T S

    2012-04-01

    The article deals with the results of computational experiments in research of dynamics of proliferation of cells of thyroid gland follicle in normal condition and in the case of malignant neoplasm. The model studies demonstrated that the chronic increase of parameter of proliferation of cells of thyroid gland follicle results in abnormal behavior of numbers of cell cenosis of thyroid gland follicle. The stationary state interrupts, the auto-oscillations occur with transition to irregular oscillations with unpredictable cell proliferation and further to the "black hole" effect. It is demonstrated that the present medical biologic experimental data and theory propositions concerning the structural functional organization of thyroid gland on cell level permit to develop mathematical models for quantitative analysis of numbers of cell cenosis of thyroid gland follicle in normal conditions. The technique of modeling of regulative mechanisms of living systems and equations of cell cenosis regulations was used PMID:22768711

  11. Pediatric Thyroid Cancer

    ... to other parts of the body, making the disease more difficult to control. Medullary : This rare form of thyroid cancer develops in ... about 5-10 percent of all thyroid malignancies. Medullary thyroid carcinoma (MTC) ... Symptoms: Symptoms of this disease vary. Your child may have a lump in ...

  12. 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.

  13. Less common neoplasms of the pancreas

    Abby L Mulkeen; Peter S Yoo; Charles Cha

    2006-01-01

    Recently, there has been an increased recognition of neoplasms of the pancreas other than ductal adenocarcinoma. Although not as well studied or characterized as pancreatic adenocarcinoma there are many distinct lesions which exhibit diverse biological behaviors and varying degrees of malignancy. These lesions include: endocrine neoplasms, cystic tumors, solid pseudopapillary tumors, acinar cell carcinoma, squamous cell carcinoma, primary lymphoma of the pancreas, and metastatic lesions to the pancreas. These less common neoplasms are being diagnosed more frequently as the number and sensitivity of diagnostic imaging studies increase. This review article discusses the clinical course,diagnosis, and treatment of these less common, but quite relevant, neoplasms of the pancreas.

  14. Postirradiation carcinoma of the thyroid gland

    In the early 1920's many infants and children received x-ray therapy for such conditions as enlarged thymus, hypertrophy of the tonsils and adenoids, cervical adenitis, sinusitis, and so forth. Unfortunately, the thyroid gland frequently received direct or scattered irradiation during these treatments. As the irradiated population has grown older it has become apparent that these people have an increased incidence of thyroid cancer. Recent publicity on this problem in the newspaper, radio, and television has alarmed individuals or their parents who in turn have consulted their physicians for advice. All individuals with a history of head and neck irradiation should be considered as having an increased risk of developing thyroid cancer. These patients should be examined every two years indefinitely. Fortunately, only a small percentage of irradiated individuals develop thyroid tumors. Most of the tumors found have been benign. Those which are malignant have been well differentiated, papillary, or follicular neoplasms which grow slowly, metastasize relatively late, and are curable by surgical removal before metastasis has occurred. If on palpation of the thyroid gland one or more firm, discrete nodules are palpated, these should be removed regardless of other findings. A scan may be useful in assessing the functional status of the nodule and may give some indication as to whether the nodule is malignant or benign. If the scan shows a cold area which corresponds with a palpable mass, the patient should be considered for prompt surgical exploration. If the scan shows a hot nodule, it is usually not malignant, but should be closely observed for change

  15. 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.

  16. 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 ...

  17. Metastasis of Colorectal Adenocarcinoma to the Thyroid: A Case Report and Review of the Literature

    C. Goatman

    2012-01-01

    Full Text Available Purpose. We present a rare case of colorectal metastasis to the thyroid five years following primary colonic resection. This case highlights the need to be cognisant of unusual sites of metastasis from colorectal neoplasms. Case Report. An 82-year-old male patient had a panproctocolectomy for synchronous colorectal tumours. Five years later he was found to have lung and thyroid metastases found incidentally on imaging for an acute presentation with small bowel obstruction. Conclusion. Metastases to the thyroid should be considered in the differential diagnosis of the thyroid lesion with any history of malignancy, particularly with increasing patient age and when renal cell carcinoma or lung, colon, or breast primaries are involved.

  18. 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.)

  19. BRAF and Epithelial-Mesenchymal Transition: Lessons From Papillary Thyroid Carcinoma and Primary Cutaneous Melanoma.

    Mitchell, Brendon; Dhingra, Jagdish K; Mahalingam, Meera

    2016-07-01

    The increased prevalence of BRAF mutations in thyroid carcinoma and primary cutaneous melanoma (PCM) hint that dysregulation of BRAF might contribute to the noted association between PCM and thyroid carcinoma. A recent study evaluating the rate of BRAFV600E mutations among patients who had been diagnosed with primary papillary thyroid carcinoma (PTC) and PCM showed that patients with either PCM or PTC were at an increased risk of developing the other as a second primary malignant neoplasm. Furthermore, the authors noted that samples from patients suffering from both malignancies exhibited a higher rate of incidence of the BRAFV600E mutation, compared with patients not suffering from both malignancies. These studies support the hypothesis that the pathogenesis of these 2 malignancies might share a conserved molecular pattern associated with dysregulation of the BRAF protein. One mechanism through which BRAF might contribute to PCM and thyroid carcinoma progression is through induction of epithelial-mesenchymal transition (EMT). Specifically, the Snail/E-cadherin axis has been demonstrated as a pathway dysregulated by BRAF, leading to EMT in both malignancies. Our analysis focuses on the results of these recent investigations, and through a review of select molecules relevant to EMT, looks to provide a context by which to better understand the relevance and role of stromal-parenchymal signaling and the BRAF mutation in the pathogenesis of PTC and PCM. PMID:27145091

  20. Risk of Malignant Neoplasm in Patients with Incident Rheumatoid Arthritis 1980–2007 in relation to a Comparator Cohort: A Population-Based Study

    Wright, Kerry

    2016-01-01

    Objective. To determine whether the incidence of malignancy is increased in patients with rheumatoid arthritis (RA) compared to a matched comparison cohort and to identify risk for any individual malignancy in RA. Methods. A cohort of 813 Olmsted County, Minnesota, residents who first fulfilled 1987 ACR criteria for RA in 1980–2007 was previously identified by medical record review. Medical records of 813 RA cases and a comparison cohort of age and sex matched Olmsted County residents without RA were evaluated retrospectively for cancer occurrence. Patients in both cohorts were followed until death, migration from Olmsted County, or 12/31/2014. Results. The RA and non-RA cohorts (mean age at incidence/index date: 55.9 [SD: 15.7] years; 68.4% females in both cohorts) were followed on average of 14.1 (SD: 7.7) and 14.9 (SD: 8.1) years, respectively. Prior to RA incidence/index date, 52 RA patients and 66 non-RA subjects had malignancies excluding NMSC (p = 0.21). During follow-up, significantly more malignancies occurred in patients with RA (n = 143) than in comparator subjects (n = 118; hazard ratio: 1.32; p = 0.027). Inclusion of NMSC obviated this difference. Conclusion. After excluding NMSC, there was a small to moderately increased risk of malignancies in patients with RA. Cancer surveillance is imperative in all patients with RA.

  1. 7.NEOPLASMS

    1993-01-01

    930635 Intensive combination chemotherapy with au-tologous bone marrow transplantation in advanced sol-id tumor:A report of 9 cases.SHEN Baijunet al.Shandong Med Univ,Jinan,250000.Chin J ClinOncol 1993;20(8):587—590.Nine patients with advanced malignancies(3 malig-nant lymphomas,3 osteosarcoma,1 each of Wilm’s tu-mor,brain tumor and bone metastasis)were treated

  2. 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.

  3. Thyroid stem cells: lessons from normal development and thyroid cancer

    Thomas, Dolly; Friedman, Susan; Lin, Reigh-Yi

    2008-01-01

    Ongoing advances in stem cell research have opened new avenues for therapy for many human disorders. Until recently, however, thyroid stem cells have been relatively understudied. Here, we review what is known about thyroid stem cells and explore their utility as models of normal and malignant biological development. We also discuss the cellular origin of thyroid cancer stem cells and explore the clinical implications of cancer stem cells in the thyroid gland. Since thyroid cancer is the most...

  4. 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

  5. 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.

  6. 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.)

  7. 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

  8. [The role of fine-needle aspiration in the diagnosis of thyroid nodules].

    Marrazzo, Antonio; Casà, Luigi; David, Massimo; Lo Gerfo, Domenico; Noto, Antonio; Taormina, Piera

    2005-01-01

    The aim of this study was to prospectively evaluate the sensitivity, specificity and accuracy of fine-needle aspiration of thyroid nodules. From January 1978 to December 2003, 497 patients underwent fine-needle aspiration of thyroid nodules and then thyroidectomy. Fine-needle aspiration was performed with a fine 23-25 gauge and the aspirate was fixed and dyed with May-Grounwald-Giemsa method. The results of cytology were divided into four groups: positive for malignancy (77 patients), negative for malignancy (370 patients), suspect for malignancy (34 patients) and not diagnostic (16 patients). Suspect specimens also included follicular neoplasm and Hürthle cell neoplasm. Fine-needle aspiration results were compared with histopathologic analysis after thyroidectomy. There were 2 false-positive (0.5%) and 5 false-negative patients (1%). Sensitivity, specificity and accuracy were respectively 94.7%, 99% and 98.4%. This study confirms that fine-needle aspiration of thyroid nodules can be performed easily with high sensitivity, specificity and accuracy. PMID:15832740

  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

    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 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. 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.

  10. 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

  11. MR imaging of ovarian neoplasms

    MR imaging of 105 patients with surgically proved ovarian neoplasms was performed on a 0.6-T superconducting magnet using two-dimensional spin-echo technique. Findings were correlated with CT and US scans. In both benign (n = 27) and malignant (n = 78) cases, the primary site was identified, but only some benign cysts, dermoid cysts, and endometriomas had characteristic appearances. The sensitivity and specificity of MR imaging in staging ovarian carcinomas will be compared to those of CT. MR imaging and CT were nonspecific in distinguishing benign from malignant disease and equivalent in defining the intrapelvic extent; however, CT was better for detection of abdominal implants, adenopathy, and ascites

  12. 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

  13. Automated screening of pigmentary skin neoplasms

    Kudrin, Konstantin G.; Matorin, Oleg V.; Reshetov, Igor V.

    2015-01-01

    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.

  14. 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

  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. Risk factors of thyroid cancer in Babol, Northern Iran

    Moazezi, Zoleika; Mahmoudi, Mahmoud; Yahyahpour, Yousef; Alaleh, AliReza

    2011-01-01

    Background : Thyroid cancer is the most common endocrine malignancy. Several risk factors were found to play a role in thyroid cancer. The purpose of the study was to determine the risk factors for thyroid cancer, in Babol, north of Iran.

  17. Renal cell carcinoma metastasis to thyroid tumor: a case report and review of the literature

    Medas, Fabio; Calò, Pietro Giorgio; Lai, Maria Letizia; Tuveri, Massimiliano; Pisano, Giuseppe; Nicolosi, Angelo

    2013-01-01

    Introduction Metastatic neoplasms to the thyroid gland are rare in clinical practice. Clear cell renal carcinoma is the most frequent site of origin of thyroid metastases and represents 12 to 34% of all secondary thyroid tumors. Tumor-to-tumor metastases, in which a thyroid neoplasm is the recipient of a metastasis, are exceedingly rare. We report a case of clear cell renal carcinoma metastatic to a follicular adenoma. This is the tenth case of renal cell carcinoma metastasis to thyroid tumor...

  18. Clinical and Epidemiological Clinical and Epidemiological Characteristics of Colloid Goiter Patients Undergoing Reoperation for Recurrent Thyroid Disease

    Gladys Iglesias Díaz

    2015-11-01

    Full Text Available Background: thyroid disease is one of the most prevalent medical conditions and thyroid cancer is the most common endocrine neoplasm. Thyroid reoperations are more common than it might seem.Objective: to establish the clinical and epidemiological characteristics of patients operated on for colloid goiter undergoing reoperation for recurrent thyroid disease.Methods: a case-series study was conducted at the León Cuervo Rubio Clinical-Surgical Hospital in Pinar del Rio. The sample included all patients (n = 29 who underwent thyroid operation and were reoperated on for recurrent thyroid disease in 2010, 2011 and 2012. The information was obtained from medical records and the register of histopathological diagnoses.Results: most patients (27.6% were in the 40-49 age group and females (79.3% were most affected. Recurrence was observed 5 to 9 years after surgery. Mixed nodules (55.2% followed by cysts (17.2% were the most frequent ultrasound diagnoses. Recurrent thyroid disease was malignant in 9% of patients.Conclusions: patients reoperated on for thyroid disease were mostly females in the fourth and fifth decade of life. The disease recurred in a period of 10 years after the first surgery in a greater number of cases. Follicular-patterned lesions, colloid goiter and cancer were the most common histologic diagnosis.

  19. Distribution of the Ca (Oxford) antigen in lung neoplasms and non-neoplastic lung tissues.

    Paradinas, F. J.; Boxer, G.; Bagshawe, K D

    1984-01-01

    The Ca (Oxford) antigen was originally isolated from a malignant neoplasm and with few exceptions was reported to discriminate between malignant and non-malignant neoplasms or normal tissues. Using the Ca 1 antibody we have studied the Ca distribution in 54 lung neoplasms and adjacent non-neoplastic lung tissue. Staining of tumours was very focal and the proportion of positive cells varied from about 50% for adenocarcinomas to less than 1% for oat cell carcinomas, which were often negative. F...

  20. Diagnosis of bone metastasis from thyroid carcinoma

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

    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...

  1. 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

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

    Mytsyk, Yulian; Borys, Yuriy; Komnatska, Iryna; Dutka, Ihor; Shatynska-Mytsyk, Iryna

    2014-01-01

    Summary Background 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. Material/Methods 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. Results 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. Conclusions 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

  3. 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

  4. Thyroid scan

    ... PET scan Skin nodules Thyroid cancer Thyroid cancer - medullary carcinoma Thyroid cancer - papillary carcinoma Toxic nodular goiter ... Topics Hyperthyroidism Hypothyroidism Nuclear Scans Thyroid Cancer Thyroid Diseases Thyroid Tests Browse the Encyclopedia A.D.A. ...

  5. Color-coded duplex sonography in the study of thyroid pathologic conditions

    The authors examined 110 patients with suspected pathologic conditions of the thyroid by means of color-coded duplex US. In addition to the information yielded by conventional US, this technique allows organ vascularization to be demonstrated. Five normal patients were considered as a control group: no tissue vascularization was demonstrated in these cases. In 8 patients presenting with carcinoma or recurrences, vascularization was markedly increased both peripheral and central to the nodule. A few doubts are still to be solved as to the diagnostic value of color-coded duplex US in the evaluation of non-carcinomas nodular pathologic conditions. As a matter of fact, non-functioning avascular adenomas can be demonstrated only in a very low percentage of cases (66%). Color-coded duplex US proved extremely sensitive and specific in depicting malignant neoplasms. Moreover, the use of fine.needle biopsy could be optimized and subsequently reduced. Color-coded duplex US proved to be markedly superior to othe rmethods and techniques in the study of thyroid diseases, especially thyroiditis and multiple pathologic conditions. The simultaneous presence of hypocapture at scintigraphy and peripheral and central vascularization in a single nodule or within multinodular struma at color-Doppler was highly suggestive of malignant thyroid neoplasm. Color-coded duplex US is a low-cost technique, which can be performed on an outpatient basis. Moreover, it is not invasive, nor does it damage the thyroid. That is why its use is almost mandatory in the study of pathologic conditions of the thyroid

  6. Mammary neoplasms of the bitch.

    Cotchin, E

    1958-01-01

    In this paper, the interrelationships of the neoplasms of the canine mammary gland are investigated. These neoplasms are a group of tumors of a great variety of histological structure and sometimes of uncertain histogenesis. Particular attention is given to the histogenesis of the mucoid, cartilaginous, and bony elements. From 1950-56, a macroscopic and histological examination of mammary neoplasms from 424 bitches (2-17 years of age) was made. The tumors from 381 bitches were removed surgically while the others came from 43 bitches who were examined postmortem. Of the 160 tumors whose location was recorded, 105 occurred in the 2 hinder glands, 19 in the middle glands, and 46 in one or another of the 2 anterior glands. 186 of the 424 bitches bore malignant mammary tumors (87 carcinomas, 73 sarcomas, 27 complex malignant tumors) and 249 had benign tumors (19 simple and 230 complex). 40 of the benign complex tumors contained bone, an additional 63 contained cartilage but no bone, and 67 showed mucoid tissue but no cartilage or bone. It is suggested that there is a predominant proliferation of myoepithelial cells which tend to become embedded in a mucoid or chondroid matrix. The bone in the tumors appears to be formed by endochondral ossification of preformed cartilage, or by intramembranous ossification in the connective tissue of the tumor. Metastases were present in 41 of the 424 bitches. PMID:12311486

  7. Thyroid Metastasis from Breast Carcinoma Accompanied by Papillary Thyroid Carcinoma

    Song-I Yang

    2014-07-01

    Full Text Available Metastasis to the thyroid gland is very rare. Recently, we experienced a case of thyroid metastasis from breast cancer accompanying a papillary thyroid. A 51-year-old female patient presented with a palpated lymph node on her left lateral neck. The patient had undergone a left modified radical mastectomy followed by chemotherapy and hormonal therapy 12 years prior. Ultrasonography of the neck revealed a malignant looking nodule at the left thyroid lobe, measuring 0.9 × 0.9 cm, and several cystic nodules at the right thyroid lobe. Ultrasonography of the neck additionally revealed a malignant looking lymph node at the right level VI. Fine-needle aspiration of the left thyroid lobe resulted in a diagnosis of papillary thyroid carcinoma and that of the right level VI in Hurthle cell lesion. The patient had a total thyroidectomy with selective dissection of the left neck node. Pathologic assessment of the specimen revealed metastatic carcinoma from the breast carcinoma and papillary thyroid carcinoma. Although the thyroid gland is highly vascularized, metastasis of malignant tumors to the thyroid is relatively rare and detection of metastasis shows a low frequency. So a careful evaluation of thyroid tumor should be considered in a patient with a history of other malignancy.

  8. Thyroid carcinoma and hot nodule

    Fukata, Shuji; Tamai, Hajime; Matsubayashi, Sunao; Nagai, Keisuke; Hirota, Yoshihiko; Matsuzuka, Fumio; Katayama, Shoichi; Kuma, Kanji; Nagataki, Shigenobu

    1987-09-01

    A 70-year-old woman presented with a nodule in the thyroid gland. /sup 131/I scintigraphy of the gland showed a hot nodule. Histology of the resected thyroid revealed a papillary adenocarcinoma. Although a thyroid carcinoma with a hot nodule seen on the radioiodine isotope scan is a very rare occurrence, it is clinically very important because it may indicate a thyroid malignancy.

  9. 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

  10. 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.

  11. Atypical Fibroxanthoma: An Unusual Skin Neoplasm in Xeroderma Pigmentosum

    Ranjana Bandyopadhyay; Dipanwita Nag; Sanjay Bandyopadhyay; Swapan Kumar Sinha

    2012-01-01

    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-y...

  12. Conventional radiological strategy of common gastrointestinal neoplasms

    Yi-Zhuo; Li; Pei-Hong; Wu

    2015-01-01

    This article summarizes the clinical characteristics and imaging features of common gastrointestinal(GI) neoplasms in terms of conventional radiological imaging methods. Barium studies are readily available for displaying primary malignancies and are minimallyor not at all invasive. A neoplasm may be manifested as various imaging findings, including mucosal disruption, soft mass, ulcer, submucosal invasion and lumen stenosis on barium studies. Benign tumors typically appear as smoothly marginated intramural masses. Malignant neoplasms most often appear as irregular infiltrative lesions on barium examination. Tumor extension to adjacent GI segments may be indistinct on barium images. Cross-sectional images such as computed tomography and magnetic resonance imaging may provide more accurate details of the adjacent organ invasion, omental or peritoneal spread.

  13. [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

  14. 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.

  15. 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

  16. 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)

  17. 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

  18. Application of narrow band imaging in head and neck malignant neoplasm%窄带成像技术在头颈部恶性肿瘤中的应用

    韩双; 于丹(综述); 文连姬(审校)

    2015-01-01

    头颈部恶性肿瘤晚期大多伴有转移和邻近器官的浸润,进而会大大增加肿瘤患者死亡率,影响患者生存质量,因此肿瘤早期发现、诊断和干预是临床工作中亟待解决的问题。内镜检测技术一直是头颈恶性肿瘤的有效检查手段,然而传统的白光成像技术在早期检测黏膜下病变时具有局限性。窄带成像技术(NBI)是一种新型、无创的电子内镜显像技术,它可以清晰地显示早期癌变部位黏膜及黏膜下血管的形态和分布,即上皮内乳头样毛细血管袢(IPCL)。该文针对 NBI 在头颈恶性肿瘤中的临床应用做一综述,期望能对临床工作有更好的应用价值和指导意义。%The malignant neoplasm in head and neck region increased the mortality as for cervical lymph nodes metastasisand local invasion into the adjacent organs which influence the patient’s quality of life.It is essential to detect and diagnosemalignant tumors as early as possible.Endoscopy is useful for the diagnosis and treatment of cancers derivedfrom the head and neck region.However,a laryngoscope with conventional white light (CWL)has technical limitationsin detecting small or superficial lesions on the mucosa.Narrow band imaging(NBI),especially combined withmagnifying endoscopy (ME),is a new non-invasive endoscopic imaging technique,which can clearly show the morphologiccharacteristics and sites of mucosal and submucosal vessels,known as intraepithelial papillary capillary loop(IPCL)).This article is a review of NBI’s clinical application for head and neck malignant tumor.

  19. Mucins in the diagnosis and differential diagnosis of pancreatic cystic neoplasms: report of 40 cases

    JI Yuan; TAN Yun-shan; XU Jian-fang; QI Wei-dong; LI Xiao-ping; SU-JIE Ake-su; ZHU Xiong-zeng

    2006-01-01

    @@ Cystic neoplasms of the pancreas account for 10% to 15% of all cystic pancreatic lesions.The majority (85% to 90%) of cystic lesions of the pancreas are pseudocysts. Although cystic neoplasms of the pancreas are rare, they range from benign to malignant neoplasms. The clinical challenge is the differential diagnosis and management of the cystic neoplasms, which represent 10% to 25% of primary pancreatic neoplasms. Pancreatic neoplasms and tumour like lesions with cystic features have been recently reviewed. The incidence of pancreatic cystic neoplasms reported is variable. Because there is no large, systematic study on tne cases from China comparing the incidence and biology of cystic neoplasms of pancreas to that of Western series, we reviewed all the cases of cystic neoplasms from Zhongshan Hospital over 6 years. Most of the neoplasms in our series were classified according to the recent World Health Organization (WHO)classification.1,2

  20. Palliative radiation in primary squamous cell carcinoma of thyroid: A rare case report

    Sushmita Ghoshal

    2013-01-01

    Full Text Available Primary squamous cell carcinoma of the thyroid is an extremely rare neoplasm with aggressive behavior. Until date, only around 60 cases have been reported in the literature. Primary treatment of the patient is radical surgery. With optimum treatment survival is not more than 6 months in this aggressive malignancy. However in our patient surgery it was not possible because of unresectability of the mass due to encroachment of major vessels. Hence, we have delivered radiotherapy alone, with which effective palliation could be achieved and patient is leading a good quality-of-life for last 1 year.

  1. Thyroid nodule

    ... 2016:chap 14. Read More Chronic thyroiditis (Hashimoto disease) Laryngeal nerve damage Multiple endocrine neoplasia (MEN) II Thyroid cancer Thyroid cancer - medullary carcinoma Thyroid gland removal Patient Instructions Thyroid gland ...

  2. Thyroid disease in the pediatric patient: emphasizing imaging with sonography

    Babcock, Diane S. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2006-04-15

    Thyroid disease does occur in the pediatric patient, and imaging plays an important role in its evaluation. A review is presented of normal development of the thyroid gland, the technique and indications for thyroid sonography, and key imaging features of congenital thyroid disorders (ectopic or absent thyroid, infantile goiter, thyroglossal duct remnants), benign thyroid masses (follicular adenoma, degenerative nodules, colloid and thyroid cysts), malignant masses (follicular, papillary and medullary carcinoma) and diffuse thyroid disease (acute bacterial thyroiditis, Hashimoto's thyroiditis, Grave's disease). (orig.)

  3. 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

  4. The Effect of Implementing Gene Expression Classifier on Outcomes of Thyroid Nodules with Indeterminate Cytology.

    Abeykoon, Jithma Prasad; Mueller, Luke; Dong, Frank; Chintakuntlawar, Ashish V; Paludo, Jonas; Mortada, Rami

    2016-08-01

    Thyroid nodules are classified into six cytological categories under the Bethesda classification system. Two of these categories, atypical of undetermined significance (AUS) and suspicious for a follicular neoplasm (SFN), are further labeled as "indeterminate" diagnosis. Starting in June, 2012, Kansas University-Wichita Endocrine clinic implemented Afirma® Gene Expression Classifier (AGEC) to evaluate the need for surgical resection of thyroid nodules in patients with an indeterminate diagnosis. Electronic medical records of patients who underwent thyroid nodule fine-needle aspiration from 2004-2014 were reviewed. The aim of this study was to find whether implementing AGEC was associated with decreased surgical recommendation rate, decreased cost, and increased incidence of thyroid malignancy diagnosed by surgery in patients with indeterminate diagnosis. A total of 299 consecutive patients' charts were screened. Sixty-one (20 %) patients had an indeterminate diagnosis. Out of these, 27 (44 %) patients underwent evaluation before and 34 (56 %) patients underwent evaluation after AGEC implementation, respectively. Surgical recommendation for patients with indeterminate finding decreased from 81.5 to 50 % (p = 0.01) after AGEC implementation. Surgical pathology was read as malignant in 20 and 85.7 % (p < 0.01) of patients before and after AGEC implementation, respectively. Primary cost-benefit estimate showed implementing AGEC has saved $1048/patient in medical evaluation and initial management of patients with indeterminate diagnosis. AGEC implementation has decreased the number of surgical recommendations, has lowered financial burden, and has increased incidence of thyroid malignancy diagnosed by surgical pathology in patients with indeterminate diagnosis of thyroid nodules. PMID:27102883

  5. Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm

    Teresa Pusiol

    2011-01-01

    Full Text Available 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.

  6. 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.

  7. 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)

  8. 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

  9. Case presentation – thyroid lymphoma

    Belkisa Izić

    2011-11-01

    Full Text Available Malignant tumors of the thyroid gland account for about 1% of thenewly diagnosed malignant tumors each year, and their incidence inwomen is twice the incidence in men. According to the WHO classification (2004 thyroid tumors are divided into: carcinoma of the thyroid, adenoma and similar tumors, and other thyroid tumors which include: teratomas, angiosarcomas, paragangliomas and others, as well as primary lymphomas and plasmacytomas. Primary thyroid lymphomasare defined as lymphomas which originate in the thyroid gland. This study presents the case of a 68-year-old patient with a thyroid lymphoma, which caused compression of the airways. In the patientpresented there was reduced activity of the thyroid gland. The dominant symptoms were: breathing difficulties, hoarse voice and the enlargement of the thyroid. An ultrasound examination was performedbefore surgery on the neck, which showed a multinodular thyroid,with compromised and compressed trachea to the right and rear. Anemergency surgical procedure was performed to reduce the tumor.Pathohistological diagnosis confirmed diffuse large B cell lymphoma.The aim of the study was to present a patient with a thyroid lymphoma, who had previously not had any immunological changes to the gland,that is, she had not had any chronic lymphocyte thyroiditis, but due to the compressive syndrome it was necessary to perform an emergencysurgical procedure to reduce the tumor.

  10. Pin1:a catalyst of the tumorigenesis of malignant neoplasms%肽脯氨酰基顺反异构酶Pin1:恶性肿瘤形成的催化剂

    曹明晓; 姜立新

    2016-01-01

    Pin1 belongs to peptidyl-prolyl cis-trans isomerase (PPlases) family, which can specif⁃ically catalyze the phosphorylated Ser/Thr-Pro motif to change its cis-trans isomerism, thereby modulat⁃ing the conformation and function of substrtates. Previous studies have verified that Pin1 is overexpressed in 38 of 60 tumors, and it participates in many cellular signal pathways and promotes tumorigenesis as a catalyst and an amplifier. Here we make a review about the structure and function of Pin1, and the in⁃volvement and development in malignant neoplasms.%Pin1蛋白属于肽脯氨酰基顺反异构酶(peptidyl-prolyl cis-trans isomerase,PPlases)家族,可以特异性催化磷酸化的丝/苏-脯氨酸基序(pSer/Thr-Pro)发生化顺反异构,从而调节底物的构象与功能。已经有研究证实,在60种肿瘤组织中有38种Pin1高表达,且Pin1参与到细胞的多种信号通路中,并作为催化剂和放大器,在同一时间或不同过程分别对大量原癌基因及抑癌基因担任着“开-关”功能,从而促进肿瘤的发生和发展。Pin1独特的底物特异性及功能使得Pin1成为目前治疗恶性肿瘤非常有潜力的靶点。笔者就Pin1的结构与功能,以及如何参与恶性肿瘤的形成与进展做一综述。

  11. The etiology of thyroid tumours

    The etiology of thyroid tumors is a complex subject, complicated by the fact that these tumors are not one entity, but separate neoplasms with different histology, evolution and prognosis. The recognized etiological factors of thyroid cancer include the iodine content of the diet, the inheritance, racial predispositions, the presence of an autoimmune thyroiditis and mostly, the exposure of the thyroid gland to external radiation following radiotherapy. The role played by these factors varies from one type of tumor to another. Thyroid radiation probably represents the most important factor in the development of a papillary carcinoma, with other factors (iodine-rich diet, inheritance, racial predispositions) having a minor role. The follicular carcinoma is more common in regions with low-iodine diet, therefore suggesting that TSH stimulation could be an etiological factor of these tumors. Thyroid radiation may also be carcinogenic for follicular carcinoma although less than for papillary carcinoma. Anaplastic carcinoma appears to originate from a papillary carcinoma already in the thyroid gland. In medullary carcinoma, inheritance plays a major role (autosomal dominant) and lymphomas occur in thyroids already affected by autoimmune thyroiditis. Recent experimental studies have suggested other possible cellular factors as responsible for the development of thyroid tumors. They include an alteration of the responsivity of TSH cellular receptors and the monoclonal mutation of C-cells. These new factors could provide a new insight on the etiology of thyroid tumors

  12. 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.

  13. 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.

  14. Thyroid dysfunction: an autoimmune aspect.

    Khan, Farah Aziz; Al-Jameil, Noura; Khan, Mohammad Fareed; Al-Rashid, May; Tabassum, Hajera

    2015-01-01

    Auto immune thyroid disease (AITD) is the common organ specific autoimmune disorder, Hashimoto thyroiditis (HT) and Grave's disease (GD) are its well-known sequelae. It occurs due to loss of tolerance to autoantigens thyroid peroxidase (TPO), thyroglobulin (Tg), thyroid stimulating hormone receptor (TSH-R) which leads to the infiltration of the gland. T cells in chronic autoimmune thyroiditis (cAIT) induce apoptosis in thyroid follicular cells and cause destruction of the gland. Presences of TPO antibodies are common in HT and GD, while Tg has been reported as an independent predictor of thyroid malignancy. Cytokines are small proteins play an important role in autoimmunity, by stimulating B and T cells. Various cytokines IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, IL-14, TNF-α and IFN-γ are found in thyroid follicular cells which enhance inflammatory response with nitric oxide (NO) and prostaglandins. PMID:26221205

  15. Leptomeningeal metastases from anaplastic thyroid carcinoma

    Anaplastic thyroid carcinoma is an extremely aggressive neoplasm that accounts for 1-3% of all thyroid cancers. ' Most patients have metastatic disease at presentation and die in a short period of time, often with uncontrolled local disease. We report a case of anaplastic thyroid cancer characterised by good response to initial treatment both locally and in distant metastases, and the subsequent development of refractory metastatic disease in an unusual site, the leptomeninges

  16. Fever of unknown origin as the first manifestation of malignant neoplasm:analysis of 31 cases%不明原因发热为首发表现的恶性肿瘤31例

    石秋萍; 徐定华; 陶礼荣; 王超; 任爱民; 王红; 张淑文

    2014-01-01

    Objective To explore fever of unknown origin (FUO) as the first manifestation of the characteristics of patients with malignant etiology and diagnosis difficult .Methods Retrospectively analyzed 31 patients with FUO who were hospitalized from January 2003 to August 2013.20 males and 11 females, age (55.5 ±16.0) years old.Results Among the 31 patients, the lymphatic /hematopoietic tissue tumors in 26 cases (83.9%), solid tumors of 5 cases (16.1%).These patients usually had high fever , accompanied by symptoms of chills , chills, fatigue, night sweats and weight loss based ; pa-tients'fever, hospitalization, diagnosed with longer time.Patients eventually diagnosed with a preliminary diagnosis does not meet in 18 cases (58.1%).Conclusion Lymphatic /hematopoietic tissue tumor was the most main cause in malignant neo -plasm patients first presenting with FUO, and lymphoma was the main cause of lymphatic /hematopoietic tissue tumor.Malig-nant neoplasm patients of long term fever were easily misdiagnosed ;should be alert to the possibility of tumor diseases in FUO etiology diagnosis.%目的:探讨以不明原因发热(FUO)为首发表现的恶性肿瘤患者的病因构成特点和诊断难点。方法回顾性分析2003年1-2013年8月住院且符合 FUO 诊断标准的恶性肿瘤患者31例。男20例,女11例,平均年龄(55.5±16.0)岁。结果31例患者中,淋巴/造血组织肿瘤26例(83.9%,其中淋巴瘤16例),实体瘤5例(16.1%)。发热程度通常为高热,伴随症状以畏寒、寒战、乏力盗汗、体质量减轻为主;患者具有热程、住院时间、确诊时间长等特点,患者最终确诊与初步诊断不符合18例(58.1%)。结论以 FUO 为首发表现的恶性肿瘤患者中,淋巴/造血组织肿瘤是最主要的病因,其中淋巴瘤最为常见。长期发热的恶性肿瘤患者容易误诊,在 FUO 病因诊断中,应警惕恶性肿瘤性疾病的可能。

  17. Thyroid Growth and Cancer.

    Williams, Dillwyn

    2015-09-01

    It is proposed that most papillary thyroid cancers originate in infancy and childhood, based on the early rise in sporadic thyroid carcinoma incidence, the pattern of radiation-induced risk (highest in those exposed as infants), and the high prevalence of sporadic papillary thyroid cancers in children and adolescents (ultrasound screening after the Fukushima accident). The early origin can be linked to the growth pattern of follicular cells, with a high mitotic rate in infancy falling to very low replacement levels in adult life. The cell of origin of thyroid cancers, the differentiated follicular cell, has a limited growth potential. Unlike cancers originating in stem cells, loss of the usually tight link between differentiation and replicative senescence is required for immortalisation. It is suggested that this loss distinguishes larger clinically significant papillary thyroid cancers from micro-papillary thyroid cancers of little clinical significance. Papillary carcinogenesis can then be divided into 3 stages: (1) initiation, the first mutation in the carcinogenic cascade, for radiation-induced papillary thyroid cancers usually a RET rearrangement, (2) progression, acquisition of the additional mutations needed for low-grade malignancy, and (3) escape, further mutations giving immortality and a higher net growth rate. Most papillary thyroid cancers will not have achieved full immortality by adulthood, and remain as so-called micro-carcinomas with a very low growth rate. The use of the term 'cancer' to describe micro-papillary thyroid cancers in older patients encourages overtreatment and alarms patients. Invasive papillary thyroid tumours show a spectrum of malignancy, which at its lowest poses no threat to life. The treatment protocols and nomenclature for small papillary carcinomas need to be reconsidered in the light of the new evidence available, the continuing discovery of smaller lesions, and the model of thyroid carcinogenesis proposed. PMID:26558233

  18. Cutaneous metastasis of medullary carcinoma thyroid masquerading as subcutaneous nodules anterior chest and mandibular region.

    Mannan, Rahul; Kaur, Jasmine; Kaur, Jasleen; Piplani, Sanjay; Kaur, Harjot; Kaur, Harleen

    2014-01-01

    Cutaneous metastasis of underlying primary malignancies can present to dermatologist with chief complaints of cutaneous lesions. The underlying malignancy is generally diagnosed much later after a complete assessment of the concerned case. Medullary carcinoma thyroid (MCT) is a relatively uncommon primary neoplasia of the thyroid. Very few cases presenting as cutaneous metastases of MCT have been reported in the literature. Most of the cases which have been reported are of the papillary and the follicular types. We here report a case of a patient who presented in the dermatology clinic with the primary complaint of multiple subcutaneous nodules in anterior chest wall and left side of body of mandible. By systematic application of clinical and diagnostic skills these nodules were diagnosed as cutaneous metastasis of MCT bringing to the forefront a history of previously operated thyroid neoplasm. So clinically, the investigation of a flesh coloured subcutaneous nodule, presenting with a short duration, particularly in scalp, jaw, or anterior chest wall should include possibility of metastastic deposits. A dermatologist should keep a possibility of an internal organ malignancy in patients while investigating a case of flesh coloured subcutaneous nodules, presenting with short duration. A systematic application of clinical and diagnostic skills will eventually lead to such a diagnosis even when not suspected clinically at its primary presentation. A prompt and an emphatic diagnosis and treatment will have its bearing on the eventual outcome in all these patients. PMID:25478248

  19. Cutaneous Metastasis of Medullary Carcinoma Thyroid Masquerading as Subcutaneous Nodules Anterior Chest and Mandibular Region

    Rahul Mannan

    2014-01-01

    Full Text Available Cutaneous metastasis of underlying primary malignancies can present to dermatologist with chief complaints of cutaneous lesions. The underlying malignancy is generally diagnosed much later after a complete assessment of the concerned case. Medullary carcinoma thyroid (MCT is a relatively uncommon primary neoplasia of the thyroid. Very few cases presenting as cutaneous metastases of MCT have been reported in the literature. Most of the cases which have been reported are of the papillary and the follicular types. We here report a case of a patient who presented in the dermatology clinic with the primary complaint of multiple subcutaneous nodules in anterior chest wall and left side of body of mandible. By systematic application of clinical and diagnostic skills these nodules were diagnosed as cutaneous metastasis of MCT bringing to the forefront a history of previously operated thyroid neoplasm. So clinically, the investigation of a flesh coloured subcutaneous nodule, presenting with a short duration, particularly in scalp, jaw, or anterior chest wall should include possibility of metastastic deposits. A dermatologist should keep a possibility of an internal organ malignancy in patients while investigating a case of flesh coloured subcutaneous nodules, presenting with short duration. A systematic application of clinical and diagnostic skills will eventually lead to such a diagnosis even when not suspected clinically at its primary presentation. A prompt and an emphatic diagnosis and treatment will have its bearing on the eventual outcome in all these patients.

  20. Usefulness of fine-needle aspiration in the diagnosis of thyroid lesions: an institutional experience of 340 patients

    Pinki Pandey

    2013-12-01

    Full Text Available Objective: To evaluate the results of fine needle aspiration cytology (FNAC in the diagnosis, its correlation with histology, to highlight its limitations and diagnostic pitfalls as well as the impact of FNAC on the decreased rate of surgery in clinically suspect thyroid lesions.Study design: FNAC was performed on 340 patients with thyroid enlargement over a period of six years. The cytological results were correlated with clinical features, thyroid function tests and histopathological examination.Results: Among non- neoplastic group, the most frequently encountered lesion was colloid goiter in 231 (67.94% cases followed by thyroiditis in 68 (20% cases, five (1.47% adenomatous goiter and four (1.17% thyroglossal cysts. Among the neoplasticgroup, twelve (3.52% cases were reported as follicular neoplasm, seven (2.05% cases as Hürthle cell neoplasm and four (1.17% as malignant tumors. The cytological and histological concordance was determined. A false positive cytologic diagnosis of neoplasms was made in five cases. Presence of Hürthle cell metaplasia, hyperplastic nodules and papillary hyperplasia were responsible for the false positive diagnoses. For the entire series, the false negative rate was 8.57% and the false positive rate was 7.14%. FNA revealed a sensitivity of 62.5%, a specificity of 90.74%, a positive predictive value of 66.66% and a negative predictive value of 89.09%.Conclusion: FNAC is thus an accurate, cost- effective, minimally invasive and reliable diagnostic tool for assessment of patients with thyroid lesions and their management.

  1. Role of MTHFR C677T and MTR A2756G polymorphisms in thyroid and breast cancer development.

    Zara-Lopes, T; Gimenez-Martins, A P A; Nascimento-Filho, C H V; Castanhole-Nunes, M M U; Galbiatti-Dias, A L S; Padovani-Júnior, J A; Maniglia, J V; Francisco, J L E; Pavarino, E C; Goloni-Bertollo, E M

    2016-01-01

    Folate metabolism is essential for DNA synthesis and repair. Alterations in genes that participate in folate metabolism can be associated with several types of malignant neoplasms, including thyroid and breast cancer. In the present case-control study, we examined the association between methylenetetrahydrofolate reductase (MTHFR C677T, rs1801133) and methionine synthase (MTR A2756G, rs1805087) polymorphisms and risk for thyroid and breast cancer. Polymerase chain reaction-restriction fragment length technique was used to determine the specific genotypes in the genes of interest. Statistical analysis was performed by multiple logistic regression test. We found an association between MTHFR C677T polymorphism and risks to both thyroid (OR = 2.50; 95%CI = 1.15-5.46; P = 0.02) and breast cancer (OR = 2.53; 95%CI = 1.08-5.93; P = 0.03). Tobacco consumption and high body mass index were also associated with thyroid cancer. In addition, increased age (≥50 years) and alcohol consumption were found to be associated with breast cancer. Our results indicated that MTHFR C677T is significantly associated with thyroid and breast cancer risks. Thus, these factors may be used as potential prognostic markers for thyroid and breast cancers. PMID:27173331

  2. 彩色多普勒超声鉴别诊断甲状腺良恶性肿块%Clinical Significance of Color Doppler Ultrasound in Differential Diagnosis to Benign and Malignant Thyroid Tumors

    石卫东; 孙辉; 李杰; 宋君; 马小梅

    2001-01-01

    [目的 ]探讨彩色多普勒超声在甲状腺肿块中的诊断与鉴别诊断价值。 [方法 ]对 120例甲状腺肿患者观察二维及彩色多普勒血流 (CDFI)的特点。 [结果 ]结节性甲状腺肿 67例,超声诊断符合率 94.0%,甲状腺炎 25例,超声诊断符合率 92.0%,甲状腺良性肿瘤 18例,超声诊断符合率 100%,甲状腺恶性肿瘤 10例,超声诊断符合率 80.0%。 [结论 ]甲状腺良性肿块之间及良、恶性肿块在超声声像图及血流上有鉴别意义。%[Purpose] To study the value of color doppler ultrasound in diagnosis and differentiation to thyroid tumors .[Methods ] One Hundred and twenty patients with thyroid tumors were examined, and the character of two_dimensional ultrasound and color doppler flow image were observed.[Results] The accuracy of ultrasonic diagnosis was found in 67 cases with nodular goiter (94.0% ), 25 cases with thyroiditis (92.0% ),18 cases with begin thyroid (100% ),and 10 cases with malignant thyroid tumors ( 80% ) . [Conclusion] Color doppler ultrasound plays significant role in differential diagnosis for thyorid tumors.

  3. 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 ...

  4. SNP Array in Hematopoietic Neoplasms: A Review

    Song, Jinming; Shao, Haipeng

    2015-01-01

    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.

  5. The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer

    Hossam Eldin Mohamed

    2016-01-01

    Conclusion: ECLN are associated with an increased likelihood of thyroid malignancy in the patients undergoing evaluation of a suspicious nodule. The risk of malignancy in thyroid nodules increases with the presence of suspicious ultrasonographic features on cervical lymph nodes.

  6. 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 Laboratório de Patologia Veterinária, 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.

  7. 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.

  8. 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

  9. Cholecystokinin-B/Gastrin receptor-targeting peptides for staging and therapy of medullary thyroid cancer and other cholecystokinin-B receptor-expressing malignancies.

    Behr, Thomas M; Béhé, Martin P

    2002-04-01

    The high sensitivity of the pentagastrin stimulation test in detecting primary or metastatic medullary thyroid cancer (MTC) suggests a widespread expression of the corresponding receptor type on human MTC. Indeed, autoradiographic studies demonstrated cholecystokinin (CCK)-B/gastrin receptors not only in more than 90% of MTCs, but also in a high percentage of small-cell lung cancers, stromal ovarian tumors, and potentially a variety of other tumors, including gastrointestinal adenocarcinomas, neuroendocrine tumors, and malignant glioma. The aim of our work was to develop and systematically optimize suitable radioligands for targeting CCK-B receptors in vivo and to investigate their role in the staging and therapy of MTC and other CCK-B receptor expressing malignancies. For this purpose, a variety of CCK/gastrin-related peptides, all having in common the C-terminal CCK-receptor binding tetrapeptide sequence-Trp-Met-Asp-PheNH(2) or derivatives thereof, were investigated. They were members of the gastrin or cholecystokinin families or possessed characteristics of both, which differ by the intramolecular position of a tyrosyl moiety. Their stability and affinity were studied and optimized in vitro and in vivo; their biodistribution and therapeutic efficacy were tested in preclinical models. Best tumor uptake and tumor to nontumor ratios were obtained with members of the gastrin family, because of their superior selectivity and affinity for the CCK-B receptor subtype. Radiometal-labeled derivates of minigastrin showed excellent targeting of CCK-B receptor expressing tissues in animals and healthy human volunteers. Preclinical therapy experiments in MTC-bearing animals showed significant antitumor efficacy. In a subsequent clinical study, 45 MTC patients with metastatic MTC were investigated; 23 had known and 22 had occult disease. CCK-B receptor scintigraphy was performed with (111)In-diethylenetriamine pentaacetic acid-d-Glu(1)-minigastrin. The normal organ uptake was

  10. Epigenetic modifications in human thyroid cancer

    Faam, Bita; Ghaffari, Mohammad Ali; Ghadiri, Ata; Azizi, Fereidoun

    2014-01-01

    Thyroid carcinoma is the most common endocrine malignancy of the endocrine organs, and its incidence rate has steadily increased over the last decade. Over 95% of thyroid carcinoma is derived from follicular cells that have a spectrum of differentiation to the most invasive malignancy. The molecular pathogenesis of thyroid cancer remains to be clarified, although activating the RET, RAS and BRAF oncogenes have been well characterized. Increasing evidence from previous studies demonstrates tha...

  11. Plurihormonal Cosecretion by a Case of Adrenocortical Oncocytic Neoplasm.

    Corrales, J J; Robles-Lázaro, C; Sánchez-Marcos, A I; González-Sánchez, M C; Antúnez-Plaza, P; Miralles, J M

    2016-01-01

    Adrenocortical oncocytic neoplasms (oncocytomas) are extremely rare; only approximately 159 cases have been described so far. The majority are nonfunctional and benign. We describe an unusual case of a functional oncocytoma secreting an excess of glucocorticoids (cortisol) and androgens (androstenedione and DHEAS), a pattern of plurihormonal cosecretion previously not reported in men, presenting with endocrine manifestations of Cushing's syndrome. The neoplasm was considered to be of uncertain malignant potential (borderline) according to the Lin-Weiss-Bisceglia criteria. PMID:27413559

  12. Molecular biology of Philadelphia-negative myeloproliferative neoplasms

    Paulo Vidal Campregher; Fábio Pires de Souza Santos; Guilherme Fleury Perini; Nelson Hamerschlak

    2012-01-01

    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 ...

  13. 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

  14. PRIMARY FIBROSARCOMA OF THE THYROID GLAND: CASE REPORT.

    Dabelić, Nina; Mateša, Neven; Jukić, Tomislav; Soldić, Željko; Kust, Davor; Prgomet, Angela; Bolanca, Ante; Kusić, Zvonko

    2016-03-01

    Due to progressive dyspnea, a male patient aged 59 underwent medical examination in 2003 in a local hospital. Neck ultrasound and fine-needle aspiration biopsy (FNAB) of a suspect lesion in the thyroid gland revealed the presence of a malignant neoplasm, i.e. mesenchymal tumor. Immunocytochemistry for epithelial membrane antigen, chromogranin A and leukocyte common antigen (CD45) was negative, while vimentin and S-100 were positive. The patient was referred to a university hospital center, where further oncologic work-up was done. Neck ultrasound revealed a tumor in the left lobe of the thyroid, with extension to the aortic arch. After repeated FNAB, cytologic diagnosis of primary thyroid fibrosarcoma was established. Due to the locally advanced and consequently inoperable disease, primary radiotherapy to the neck region (64 Gy in 32 fractions) was applied, followed by 6 cycles of chemotherapy with doxorubicin. After completion of therapy, computed tomography scan demonstrated significant regression of primary disease, but it was still not amenable to surgical treatment. Thus, the decision of the oncology board was active surveillance of the patient. During 9-year follow up, no signs of progression or activity of the disease were found. PMID:27333734

  15. Malignant neoplasms of the uterus following radiation therapy for cervical carcinoma:a clinical study of 47 cases%子宫颈癌放疗后子宫体恶性肿瘤47例临床分析

    Shaokang Ma; Lingying Wu

    2009-01-01

    Objective: To study the characteristics and clinical features of uterine neoplasms developed after radiation ther-apy for cervical carcinoma. Methods: Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively reviewed. Results: The median age at uterine neoplasms diagnosis was 62 years (range: 38-77 years), and the median latency period from initial therapy to development of uterine neoplasms was 14 years (range: 5-35 years). Thirty of 47 cases were endometrial carcinoma, of which 3 were uterine papillary serous carcinoma (UPSC). Seventeen of 47 patients were uterine sarcoma, all of those were carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows: stage Ib, 1 case; stage Ic, 2 cases; stage Ⅱ, 6; stage Ilia, 4; stage Ⅲb, 2; stage Ⅲc, 11; stage Ⅳ, 4 cases; grade 1, two cases; grade 2, nine; grade 3 (include 3 UPSC patients), seventeen; unknown grade, two; endometried, 27; UPSC, 3 cases; 7 of 30 cases of endometrial carcinoma had recurrences (23.3%), at median time to recurrence was 24 months, and their median survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine sarcoma, the median survival was 10 months, 6 patients oc-curred recurrence (35.9%), at a median time to recurrence was 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively. Conclusion: The main uterine neoplasms development after radiation therapy for cervical carcinoma is endomethal carcinomas, of which there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor.

  16. Cystic neoplasms of the pancreas

    Cystic neoplasms of pancreas are rare lesions. Following the Compagno-Oertel classification, we differenciate serous microcystic adenomas (SMA) from mucinous macrocystic adenomas/adenocarcinomas (MMA). The former are benign tumors with slow growth, composed by innumerable small and tiny cystic with centra calcifications, resulting in a ''honeycomb'' pattern. They have a mixed US structure while CT densitometric values reflect a mixture of connective tissue and proteinaceous fluid. Postcontrast enhancement is frequently seen. MMA are potential (adenoma) or frankly (adenocarcinoma) malignant tumors. They appears as moltilocular cystic masses containing septa and/or papillary bulgings, with thickened walls. Both US and CT demonstrate their predominantly cystic character, and the eventual presence of excrescences. WE report a series of 23 cases (6 SMA, 17 MMA) of cystic neoplasms of the pancreas studied during the past five years. A correct diagnosis of SMA was possible in all 6 cases, while MMA was correctly diagnosed in 17 out of 18 cases. There were no false negatives, and 1 falsa positive. All differential diagnoses are also discussed

  17. 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.

  18. Pediatric choroid plexus neoplasms

    Purpose: Choroid plexus tumors (CPT) are rare childhood neoplasms. The relatively small number of reported cases and the controversies surrounding the clinical and pathological classification of these tumors have made it difficult to define a standard of care for these patients. Our intention is to contribute to the body of knowledge of these tumors and further define the role of adjuvant therapy. Methods and Materials: We performed a retrospective review of 14 children with choroid plexus neoplasms referred to St. Jude Children's Research Hospital between October 1985 and December 1987. Ten patients had choroid plexus carcinoma (CPC) based on pathologic criteria and evidence of brain invasion at surgery or leptomeningeal disease (M+); 4 patients had choroid plexus papilloma (CPP). Patients with CPP were initially treated with surgery alone whereas patients with CPC were generally treated with postoperative therapy that included chemotherapy (CT) and/or craniospinal irradiation (CSI) with a focal boost to the primary site. For most patients CT consisted of combinations of cyclophosphamide, etoposide, vincristine, and a platinum agent. The median CSI dose was 35.2 Gy (range 24-46.2 Gy). The median primary site dose was 55.2 Gy (range 49.6-64 Gy). Results: Seven of the 10 CPC cases presented with leptomeningeal dissemination; two of these patients have succumbed to disease. Of the 3 patients with M0 status, all are alive with no evidence of disease (NED). The medial time to relapse from the time of surgery was 5.3 mo (range 3-25 mo). Seven CPC patients were treated with gross total resection (GTR). Three of these patients (2 M0, 1 M+) received CT without CSI and are currently NED (27, 69, and 60 mo respectively). One M+ patient progressed on CT and has stable disease after CSI (6 mo), one (M0) received CT and CSI and is NED (120 mo), one (M+) is currently on CT with objective response (3 mo) and one (M+) died of progressive disease (24.5 mo) despite CT and CSI. Three

  19. {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.)

  20. Incidence of malignant hemopathies and thyroid carcinomas in infants less than 15 years old around the nuclear site of Marcoule; Incidence des hemopathies malignes et des cancers thyroidiens chez les enfants de moins de 15 ans autour du site nucleaire de Marcoule

    Bouges, S.; Daures, J.P. [Montpellier Institut Universitaire de Recherche Clinique, 34 - Montpellier (France); Arthus, J.C. [Centre Hospitallier Universitaire de Nimes, 30 - Nimes (France); Vidonne Sartre, O. [Medecin Inspecteur Chef, 83 - Gard (France)

    1997-03-01

    The objective was to determine, for the last ten years (1985-1995), the incidence of malignant blood diseases and thyroid carcinomas for children less than fifteen years old in a periphery of 35 km around the nuclear site of Marcoule. The conclusions are that it does not seem to exist a sur-incidence of these pathologies around Marcoule. But a surveillance register is placed for these carcinomas for the coming years, because of the choices made by the site of Marcoule and the expected developments. (N.C.).

  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. Synchronous primary malignancy of head and neck- a case report

    Maheswari Ramasamy

    2015-07-01

    Full Text Available The incidence of multiple primary malignant neoplasms increases with age, reflecting an increase in overall cancer risk in older patients. Cases of two or more concurrent primary cancers are still rare, although its incidence is increasing. Here, we report the case of a 41-years female who was referred to our institution with synchronous papillary carcinoma of thyroid and Adenoid cystic carcinoma of submandibular gland. The case is being presented to emphasize that the clinicians should keep in mind that the appearance of another tumour in a patient suffering from cancer could be either a synchronous or a metachronous or a metastatic lesion. [Int J Res Med Sci 2015; 3(7.000: 1792-1794

  4. Chronic myeloproliferative neoplasms and subsequent cancer risk: a Danish population-based cohort study

    Frederiksen, Henrik Kronholm; Farkas, Dóra Körmendiné; Christiansen, Christian Fynbo;

    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...... 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...... conclude that patients with chronic myeloproliferative neoplasms are at increased risk of developing a new malignant disease. © 2011 by The American Society of Hematology....

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

    Sevgi Gözdaşoğlu; İsmail Haluk Gökçora; Ömer Uluoğlu

    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 o...

  6. Thyroid Nodule Imaging, Status and Limitations

    Durre Sabih; Kashif Rahim

    2015-01-01

    Thyroid nodules are common, occurring in almost two-thirds of some populations; among these only about 7% are malignant. The most important question with any new discovered thyroid nodule is, “is this malignant?” The main arbiter of malignancy or benignity remains fine needle aspiration and the mainstay of treatment surgery. But given the resources involved, doing an FNAC or surgery in every discovered nodule would be prohibitive to impossible. The clinician must decide which nodule to invest...

  7. 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

  8. 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)

  9. Malignant tumors of the small intestine

    The clinical symptoms, kind and localization of the neoplasm are studied in 17 patients with malignant tumors of the small intestine. The treatment, evolution and survival rate are discussed. (M.A.C.)

  10. Malignant thymona with symptoms of myasthenia gravis

    The rare case of malignant tumor of thymus - Thymoma malignum was described. The initial diagnosis was difficult, because of the irregular symptoms of myasthenia gravis. The diagnostic difficulties, treatment and clinical features of this neoplasm were also discussed. (author)

  11. 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, ...

  12. Thyroid Antibodies

    ... be 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; ...

  13. Thyroid ultrasound

    ... that may or may not be cancerous (a tumor ). Sometimes the thyroid is enlarged without any nodules. ... to: Cysts Enlargement of the thyroid gland ( goiter ) Thyroid nodules Your doctor can use these ...

  14. Thyroid Surgery

    ... The American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma (2015) Radiation Safety in the Treatment of Patients with Thyroid Diseases by Radioiodine 131 I: Practice Recommendations of the ...

  15. Application value of contrast-enhanced ultrasound combined with time-intensity curve to identify benign and malignant orbital neoplasms%超声造影时间-强度曲线在眼眶良恶性肿瘤鉴别诊断中的应用价值

    柏刚; 陈文卫; 孙彬; 陈辽; 康莹; 陈继

    2013-01-01

    目的 探讨超声造影在眼眶肿瘤良恶性病变鉴别诊断中的应用价值.方法 对47例眼眶肿瘤患者47个病灶(良性组35例,恶性组12例)进行术前常规超声和超声造影检查,观察肿瘤超声造影的特征,应用SonoLiver分析软件进行后处理得到肿瘤造影时间-强度曲线(TIC),获取造影剂达到时间(AT)、上升时间(RT)、达峰时间(TTP)、平均渡越时间(mTT)、曲线下面积(AUC)、峰值强度(IMAX)、造影灌注指数(PI)进行定量分析.结果 良恶性肿瘤的血流灌注特点不同.时间-强度曲线参数中上升支斜率、半降斜率的绝对值、IMAX、PI、mTT、半洗出时间、RT良恶性间差异有统计学意义(P<0.05),AT、AUC、TTP差异无统计学意义(P>0.05).结论 超声造影在眼眶良恶性肿瘤的鉴别诊断中有一定的临床应用价值.%Objective To explore the value of ultrasound-enhanced ultrasound (CEUS) in the differential diagnosis of orbital neoplasms by observing the perfusion characteristics of orbital benign and malignant neoplasms for the application of ultrasound contrast microbubbles.Methods Preoperative ultrasound imaging of 47 patients with orbital neoplasms(benign group 35 cases,malignant group 12 cases)were observed for the tumor characteristics of CEUS.The parameters of tumor imaging obtained time intensity curve (TIC) were obtained by quantitative analysis of SonoLiver analysis software,which were contrast agent arrive time (AT),rise time (RT),time to peak (TTP),mean transit time (mTT),area under the curve (AUC),maximum intensity(IMAX) and perfusion index (PI).Results Different characteristics of perfusion were shown between benign and malignant groups.Time parameters of TIC:rising slope,semidescending slope,IMAX,PI,mTT,semi-washed out time and RT were significantly different between the two groups (P < 0.05) while there was no significant difference of parameters as AT,TTP,AUC.Conclusions There is certain clinical value of the CEUS

  16. The Effects of ASC of Mitochondrial Apoptosis Pathway Regulated by Retinoic Acid on the Growth of Follicular Thyroid Neoplasm%维甲酸调控线粒体途径对甲状腺滤泡状癌ASC的影响

    薛晓婕

    2011-01-01

    Objective To investigate the role of ASC ( apoptosis-associated specklike protein containing a CARD, ASC ) in FIE-133 cell line of follicular thyroid neoplasm induced by retinoic acid , and the correlation of mitochondrial mechanism. Methods Methyl thiazolyl tetrazolium ( MTT ) method was used to measure the growth of FIE-133 cells treated with retinoic acid at different time points ( 12 ,24,36 ,48h ). The mitochondrial structure was observed by electron microscopic technique ( EM ). ASC were detected by Western-blotting before and after treatment with retinoic acid. Results Acid inhibited FIE-133 cells in time-dependent manners after treatment with retinoic acid. The intensity of mitochondria were occurred through scanning and transmission electron microscope. The expression of ASC was up-regulated in FIE-133 cells treated with retinoic acid. Conclusion Retinoic acid had inhibitory effect for growth of FIE-133 cells line of follicular thyroid neoplasm. Mitochondrial apoptosis pathway might be regulated with ASC and recover cells apoptosis.%目的:研究维甲酸(retinoic acid,RA)对甲状腺滤泡状癌细胞FIE-133ASC调控的影响,并探讨线粒体作用机制与凋亡相关斑点样蛋白(apoptosis-associated specklike protein containing a CARD,ASC)的关系.方法:应用噻唑蓝(MTT)比色法检测RA在不同时间(12、24、36、48h)下对甲状腺滤泡状癌细胞FIE-133存活率的影响,透射电镜观察细胞线粒体超微形态结构的改变,蛋白印迹法检测经RA作用前后ASC蛋白的表达.结果:RA对FIE-133细胞生长的抑制有时间依赖性,电镜下甲状腺滤泡状癌细胞线粒体结果发生剧烈改变,ASC表达明显增加.结论:RA对甲状腺滤泡状癌细胞FIE-133的生长具有抑制作用,这一抑制作用是由于线粒体凋亡通路调节ASC表达的影响使细胞凋亡功能得以恢复.

  17. 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

  18. 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...

  19. The value of thyroid imaging reporting and data system classification in combination with multivariate statistical analysis in the diagnosis of benign and malignant thyroid nodules%甲状腺超声影像报告和数据系统分类联合多变量统计分析在甲状腺良恶性结节鉴别诊断中的应用价值

    张坦; 张晟; 忻晓洁; 穆佳丽; 赵静

    2015-01-01

    目的:探讨甲状腺超声影像和数据报告系统(TI-RADS)分级结合多变量统计分析在诊断甲状腺良恶结节中的应用价值。方法回顾性分析经病理证实的247例单发甲状腺结节患者的临床资料,对患者进行 TI-RADS 分级,并运用多变量统计分析方法对病例进行分析,筛选重要声像特征。结果甲状腺良性结节组和甲状腺恶性结节组比较,肿块的大小、肿块的性质、形态、边界、回声、钙化、钙化类型、纵横比,CDFI 均具有统计学差别。多变量统计结果显示甲状腺良性结节组和甲状腺恶性结节能够很好的被分离,而甲状腺恶性结节的不同分类也能很好的被区分。此外,肿物的形态、边界和钙化的异常可能预示着甲状腺结节的恶性结果,而肿物的纵横比和高是鉴别恶性结节级别的重要特征。结论TI-RADS 分级联合多变量统计分析将更有利于对甲状腺良恶性结节的诊断。%Objective To explore the application of thyroid imaging reporting and data system (TI-RADS)classifi-cation in combination with multivariate statistical analysis in the diagnosis of benign and malignant thyroid nodules. Methods Two hundred and forty seven histologically proved thyroid nodules in 247 patients were analyzed according to the TI-RADS classification.Multivariate statistical analysis was used to assess the classification of TI-RADS and find out the important parameters identified the benign and malignant thyroid nodules.Results There were statistical differ-ence in the size and property of the goiter,border,shape,solid echo,calcifications,calcifications pattern,a short-to-long axis ratio and CDFI between benign and malignant thyroid nodules.The results of multivariate statistical analysis showed that there were clearly classified between benign and malignant thyroid nodules and shape,border and calcifica-tions were important feature identified the benign and malignant

  20. MR imaging of pancreatic and peripancreatic neoplasms

    The MR imaging appearances of pancreatic and peripancreatic neoplasms were studied. Thirty-five primary tumors of the pancreas, including 18 ductal adenocarcinomas, 16 islet cell tumors, and one papillary epithelial carcinoma, were studied, as were five cases of malignant peripancreatic lymphadenopathy. MR imaging studies were performed using T1 and T2-weighted spin-echo pulse sequences. Inversion-recovery technique was also utilized in approximately one third of cases. The different MR imaging patterns of the primary pancreatic neoplasms are described and compared with findings in patients with peripancreatic lymphadenopathy. In addition, the use of MR imaging in staging pancreatic tumors, in detecting local and distant metastases, and in detecting vascular involvement is discussed. Comparison is made with correlative CT examinations

  1. Surgical Management of Minor Salivary Gland Neoplasms of the Palate

    Moore, Brian A.; Burkey, Brian B.; Netterville, James L.; Butcher, R. Brent; Amedee, Ronald G.

    2008-01-01

    Objective: Minor salivary gland tumors are uncommon, accounting for up to 15% of salivary gland neoplasms. We describe our experience with both benign and malignant tumors of the palatal minor salivary glands, focusing on the extent of resection and options for defect reconstruction.

  2. Mucin profile of the pancreatic mucinous cystic neoplasms

    JI Yuan; XU Jian-fang; KUANG Tian-tao; ZHOU Yan-nan; LU Shao-hua; TAN Yun-shan

    2006-01-01

    @@ Mucinous cystic neoplasms (MCNs) of the pancreas are a distinct entity, account for 1% of pancreatic exocrine tumors. MCNs can be classified histologically as adenomas, borderline tumors, or carcinomas. Because several evidences showing that mucinous cystadenomas are poten- tially malignant and may transform into cystadeno- carcinomas, particularly if treated by drainage, these tumors should be identified accurately.1

  3. “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.

  4. Chronic Myeloproliferative Neoplasms Treatment

    ... Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer Recurrent Cancer Research NCI’s Role in ... on the hands and feet. Muscle pain. Itching. Diarrhea . Stages of Chronic Myeloproliferative Neoplasms Key Points There is no standard staging system ...

  5. 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

  6. 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.

  7. Phase II Study of Intraventricular Methotrexate in Children With Recurrent or Progressive Malignant Brain Tumors

    2016-06-30

    Recurrent Childhood Medulloblastoma; Recurrent Childhood Ependymoma; Childhood Atypical Teratoid/Rhabdoid Tumor; Embryonal Tumor With Abundant Neuropil and True Rosettes; Metastatic Malignant Neoplasm to the Leptomeninges

  8. PATTERN OF OVARIAN NEOPLASM IN RURAL POPULATION: A FIVE YEAR STUDY FROM TERTIARY CARE HOSPITAL

    Umesh

    2014-02-01

    Full Text Available OBJECTIVE : The aim of the study was to know the morphological pattern of benign and malignant ovarian neoplasms and their distribution in different age groups in rural population of India. MATERIAL AND METHODS : A retrospective study of all cases of ovarian neoplasms diagnosed at department of pathology, Maharaja Medical College, Agroha during period of five year (Aug, 07 — Oct.12 was done. The tumors were classified according to WHO classification after thorough examination of slides and their distribution in different age groups was also noted. RESULTS : There were total fifty three cases of ovarian tumors noted during this period. Benign tumors comprised 81.13% and malignant tumors were 18.86%. Surface epithelial tumor emerged as the commonest variety accounting for 60.37%, followed by germ cell tumor (32.07% and sex cord stromal tumors were least common comprising 7.54 % of all ovarian neoplasm. No metastatic tumor or tumors with borderline malignancy were seen. Serous cystadenoma was the commonest tumor (43.39% followed by mature cystic teratoma (30.23%.Among the malignant tumor, malignant germ cell tumor were the commonest type (40%, followed by 30 %of each surface epithelial tumor and sex cord stromal tumor. CONCLUSION : Benign ovarian tumors are seen more common than malignant tumor. Malignant epithelial tumors are seen after the age of 30 years and malignant germ cell tumor are seen below the age of 30 years. Bilaterality is more commonly seen in malignant o varian neoplasm

  9. Thyroid functional status in aged patients with malignant tumors and relationship with chemo-therapy%老年恶性肿瘤患者甲状腺功能状态及化学药物疗法对其的影响

    邹春华; 黄涛金; 谢勇久; 林争; 王绎; 明华

    2014-01-01

    目的:探讨老年恶性肿瘤患者的甲状腺功能状态及化学药物疗法(简称化疗)对其甲状腺功能的影响。方法选取2010-01至2014-02确诊的老年恶性肿瘤患者398例,并选择400例体检老年人群作为健康对照组,进行甲状腺激素(thyroid hormone,TH)和促甲状腺激素(thyroid stimulating hormone,TSH)水平测定。将激素水平正常,KPS (Karnofsky)评分>60的老年恶性肿瘤患者分为:肿瘤治疗组132例,肿瘤对照组129例。两组年龄、KPS评分无统计学差异。肿瘤治疗组患者进行相应化疗,观察治疗前及治疗后6个月的TH和TSH水平,肿瘤对照组仅给予对症治疗,同期比较两组TH和TSH水平,分析化疗对老年恶性肿瘤患者甲状腺功能的影响。结果398例老年恶性肿瘤患者的TH、TSH与健康对照组相比差异无统计学意义(P>0.05)。肿瘤治疗组患者的TH、TSH与肿瘤对照组相比,TSH的差异存统计学意义(P<0.05)。肿瘤治疗组中甲状腺功能减退(甲减)的比例为7.58%,亚临床型甲减的比例为23.48%。肿瘤对照组中甲减的比例为5.65%,亚临床甲减的比例为5.65%。两组比较,亚临床型甲减的发生率存在统计学差异( P<0.05)。结论老年恶性肿瘤患者的甲状腺功能异常发生率与健康群体比较无统计学差异,化疗对老年恶性肿瘤患者的甲状腺功能有一定的影响。%Objective To study thyroid functional status of the aged patients with malignant tumors and the relationship be-tween thyroid function with chemotherapy.Methods 398 aged patients with malignant tumors were recruited as the pathological group.At the same time, 400 aged healthg subjects served as the control group.The thyroid hormones (thyroid hormone, TH), and thyrotropin ( thyroid stimulating hormone, TSH) levels were measured.The thyroid function in the groups was analyzed and compared. When KPS

  10. ANTI-THYROID PEROXIDASE ANTIBODY LEVEL IN THYROID NODULES: WITH SPECIAL REFERENCE TO THYROID NEOPLASIA

    Bera Swati

    2013-06-01

    Full Text Available Anti-TPO antibody level was evaluated in 86 patients, along with 25 healthy controls to detect its change in various forms of thyroid nodules particularly in thyroid malignancy when compared with healthy controls. The study revealed that Anti-TPO antibody level was increased in Benign & toxic form of Multi nodular goiter and papillary carcinoma but there is no elevation of Anti- TPO antibody level in follicular adenoma or follicular carcinoma.

  11. 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)

  12. Misdiagnosed ectopic thyroid carcinoma:report of two cases

    凌玲; 周水洪; 汪审清; 王丽君

    2004-01-01

    Ectopic thyroid tissue is a congenital disease caused by abnormal migration of thyroid in the embryonic stage. Malignant ectopic thyroid tissue is often misdiagnosed as a cyst of the thyroglossal duct. We treated 2 patients with papillary carcinoma in the anterior midline of the neck from May 1985 to Detober 2002.

  13. 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 ...

  14. 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...

  15. 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

  16. [Molecular pathology of plasma cell neoplasms].

    Fend, F

    2010-10-01

    Plasma cell myeloma (PCM) and related immunosecretory disorders are a group of B-cell proliferations with a wide clinical and prognostic spectrum, characterized by the production of monoclonal immunoglobulin by immortalized plasma cells. Recent years have seen an explosion in knowledge on the genetic basis and biology of these diseases, followed by improved clinical risk stratification and the introduction of novel therapeutic concepts, such as treatment with proteasome inhibitors or immunomodulatory substances. PCM is a common malignancy, accounting for approximately 10% of all hematological neoplasms. There is good evidence to support a multistep transformation process in plasma cell neoplasms, which corresponds to clinically discernible disease stages. Monoclonal gammopathy of unknown significance is a common asymptomatic precursor lesion for PCM which carries an approximately 1% annual risk for progression. Terminal disease stages are characterized by increasing genetic complexity and independence from bone marrow stromal cells and show a rapidly increasing tumour load with severe clinical symptoms. Modern diagnostics of plasma cell neoplasms require inclusion of clinical, morphological, immunophenotypical and cytogenetic features to allow for individual risk assessment and therapy planning. PMID:20852863

  17. 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.

  18. The Study on the Thyroid Disease

    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, T3, 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.

  19. Imaging strategy in differentiated thyroid cancer

    Phan, Thi Thanh Ha

    2007-01-01

    This thesis focuses on clinical dilemmas, which the clinician faces in the management of patients with differentiated thyroid cancer (DTC) with a specific emphasis on the role of current and new diagnostic imaging. Thyroid cancer is a rare disease, but it is the most common endocrine malignancy of a

  20. 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.

  1. 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.

  2. 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.)

  3. 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

  4. Imaging diagnosis of thyroid gland congenital anomalies

    The clinical and radiological findings in 25 patients presenting diverse thyroid gland anomalies are described, as follows: thyroid aplasia - 2, thyroid hemiagenesis - 9, lingual thyroid gland - 3, median cervical cysts - 8, lateral cervical aberrant tissue - 2, distant aberrant thyroid tissue - 1 case. In all patients the following methods are applied: echography, computer tomography and radionuclide examination with 99mTc. Conclusions are made that: 1) To make definite diagnosis of thyroid ectopia the complex application of imaging methods is mandatory. 2) Ultrasound examination is sufficient to establish agenesis, hypo- or hemiaplasia of the thyroidea without need to resort to other imaging modalities. 3) Ectopic thyroid tissue eventually discovered should be carefully monitored by echography and cytologically because of susceptibility of malignant degeneration

  5. 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

  6. Thyroid Cancer

    Your thyroid is a butterfly-shaped gland in your neck, just above your collarbone. It makes hormones that help ... There are several types of cancer of the thyroid gland. You are at greater risk if you ...

  7. Postpartum Thyroiditis

    ... disorders cannot be distinguished from one another on pathology specimens. As in Hashimoto’s thyroiditis, postpartum thyroiditis is ... associated with symptoms including anxiety, insomnia, palpitations (fast heart rate), fatigue, weight loss, and irritability. Since these ...

  8. Thyroid storm

    ... this page: //medlineplus.gov/ency/article/000400.htm Thyroid storm To use the sharing features on this page, please enable JavaScript. Thyroid storm is a life-threatening condition that develops ...

  9. 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 ...

  10. Thyroid disease

    Presenting a multidisciplinary approach to the diagnosis and treatment of thyroid disease, this volume provides a comprehensive picture of current thyroid medicine and surgery. The book integrates the perspectives of the many disciplines that deal with the clinical manifestations of thyroid disorders. Adding to the clinical usefulness of the book is the state-of-the-art coverage of many recent developments in thyroidology, including the use of highly sensitive two-site TSH immunoradionetric measurements to diagnose thyroid activity; thyroglobulin assays in thyroid cancer and other diseases; new diagnostic applications of MRI and CT; treatment with radionuclides and chemotherapy; new developments in thyroid immunology, pathology, and management of hyperthyroidism; suppressive treatment with thyroid hormone; and management of Graves' ophthalmopathy. The book also covers all aspects of thyroid surgery, including surgical treatment of hyperthyroidism; papillary, follicular, and other carcinomas; thyroidectomy; and prevention and management of complications

  11. Thyroid Disease

    ... 2030: The Unexpected Burden of Thyroid, Liver, and Pancreas Cancers in the United States . Cancer Research; 74(11): ... 2030: The Unexpected Burden of Thyroid, Liver, and Pancreas Cancers in the United States . Cancer Research; 74(11): ...

  12. Radiofrequency ablation for postsurgical thyroid removal of differentiated thyroid carcinoma.

    Xu, Dong; Wang, Lipin; Long, Bin; Ye, Xuemei; Ge, Minghua; Wang, Kejing; Guo, Liang; Li, Linfa

    2016-01-01

    Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy. Surgical removal with radioactive iodine therapy is recommended for recurrent thyroid carcinoma, and the postsurgical thyroid removal is critical. This study evaluated the clinical values of radiofrequency ablation (RFA) in the postsurgical thyroid removal for DTC. 35 DTC patients who had been treated by subtotal thyroidectomy received RFA for postsurgical thyroid removal. Before and two weeks after RFA, the thyroid was examined by ultrasonography and (99m)TcO4 (-) thyroid imaging, and the serum levels of free triiodothyronine (FT3), free thyroxin (FT4), thyroid stimulating hormone (TSH) and thyroglobulin (Tg) were detected. The efficacy and complications of RFA were evaluated. Results showed that, the postsurgical thyroid removal by RFA was successfully performed in 35 patients, with no significant complication. After RFA, the average largest diameter and volume were significantly decreased in 35 patients (P > 0.05), and no obvious contrast media was observed in ablation area in the majority of patients. After RFA, the serum FT3, FT4 and Tg levels were markedly decreased (P < 0.05), and TSH level was significantly increased (P < 0.05). After RFA, radioiodine concentration in the ablation area was significantly reduced in the majority of patients. The reduction rate of thyroid update was 0.69±0.20%. DTC staging and interval between surgery and RFA had negative correlation (Pearson coefficient = -0.543; P = 0.001), with no obvious correlation among others influential factors. RFA is an effective and safe method for postsurgical thyroid removal of DTC. PMID:27186311

  13. Evaluation of immunohistochemical expression of P-glycoprotein in neoplasms of the mammary gland in bitches.

    Badowska-Kozakiewicz, A M; Malicka, E

    2010-01-01

    The aim of the study was to investigate the P-glycoprotein expression in correlation with other neoplasm traits such as: histological type, the differentiation grade, proliferative activity, expression of the cyclooxygenase-2. Material for the investigation comprised 50 tumours of the mammary gland collected from bitches during surgical procedures performed in Warsaw Veterinary Clinics and Small Animal Clinic of the Department of Clinical Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences - SGGW. All together 8 adenomas, 22 complex carcinomas, 15 simple carcinomas and 5 solid carcinomas. In case of cancers, the degree of histological malignancy was established: 1st degree of histological malignancy--18 neoplasms, 2nd degree of histological malignancy--14 neoplasms and 3rd degree of histological malignancy--10 neoplasms. Evaluations were conducted with histopathological and immunohistochemical methods using suitable antibodies. Proliferative activity was highly dependent on type of the neoplasm and the degree of histological malignancy. The highest value of the mitotic index was characteristic for solid and simple cancers and neoplasms with the highest degree of histological malignancy. Results of expression of the nuclear antigen Ki-67 were similar. Expression of P-glycoprotein was revealed in all types of neoplasms. The expression of P-glycoprotein was identified in cytoplasm and cell membranes of neoplastic cells. Positive expression of P-gp was observed in 76% of cancers. Complex carcinomas were the biggest group among the cancer types which demonstrated positive reaction of P-gp. High expression of P-gp was also established in cancers with the highest degree of malignancy. In bitches aged 9 through 12 years, the cancers featuring a positive reaction of P-gp constituted the most numerous group (63.2%); on the other hand, this cancer type barely appeared in the oldest bitches (10.5%). PMID:20731191

  14. 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.

  15. 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.

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

    Baek, Jung Hwan; Lee, Jeong Hyun; Valcavi, Roberto; Pacella, Claudio M.; Rhim, Hyunchul; Na, Dong Gyu

    2011-01-01

    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.

  17. Decrease in thyroid adenoma associated (THADA expression is a marker of dedifferentiation of thyroid tissue

    Kloth Lars

    2011-11-01

    Full Text Available Abstract Background Thyroid adenoma associated (THADA has been identified as the target gene affected by chromosome 2p21 translocations in thyroid adenomas, but the role of THADA in the thyroid is still elusive. The aim of this study was to quantify THADA gene expression in normal tissues and in thyroid hyper- and neoplasias, using real-time PCR. Methods For the analysis THADA and 18S rRNA gene expression assays were performed on 34 normal tissue samples, including thyroid, salivary gland, heart, endometrium, myometrium, lung, blood, and adipose tissue as well as on 85 thyroid hyper- and neoplasias, including three adenomas with a 2p21 translocation. In addition, NIS (sodium-iodide symporter gene expression was measured on 34 of the pathological thyroid samples. Results Results illustrated that THADA expression in normal thyroid tissue was significantly higher (p p p THADA mRNA expression was found to be inversely correlated with HMGA2 mRNA. HMGA2 expression was recently identified as a marker revealing malignant transformation of thyroid follicular tumors. A correlation between THADA and NIS has also been found in thyroid normal tissue and malignant tumors. Conclusions The results suggest THADA being a marker of dedifferentiation of thyroid tissue.

  18. Is there loss or qualitative changes in the expression of thyroid peroxidase protein in thyroid epithelial cancer?

    Czarnocka, B; Pastuszko, D; Janota-Bzowski, M; Weetman, A P; Watson, P F; Kemp, E.H.; McIntosh, R S; Asghar, M S; Jarzab, B.; Gubala, E; Wloch, J.; Lange, D.

    2001-01-01

    There is disagreement concerning the expression of thyroid peroxidase (TPO) in thyroid cancer, some studies finding qualitative as well as quantitative differences compared to normal tissue. To investigate TPO protein expression and its antigenic properties, TPO was captured from a solubilizate of thyroid microsomes by a panel of murine anti-TPO monoclonal antibodies and detected with a panel of anti-human TPO IgGκ Fab. TPO protein expression in 30 samples of malignant thyroid tissue was comp...

  19. 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

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

    Behiye Pınar Çilesiz Göksedef

    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. Anti-thyroid peroxidase antibodies: Its effect on thyroid gland and breast tissue

    Sabitha Kandi

    2012-01-01

    Full Text Available Thyroid peroxidase (TPO is a key enzyme in the synthesis of thyroid hormone. TPO is involved in thyroid hormone synthesis (organification and coupling reactions. TPO is a major antigen corresponding to thyroid-microsomal autoantibodies. Anti-TPO auto antibodies are very important to diagnose autoimmune thyroid diseases and also in estimating its clinical course. Autoimmune thyroid disease is detected mostly by measuring circulating antibodies to thyroglobulin which is uncommon measurement of antibodies to TPO that gives reliable information about autoimmune thyroid disease. Eighty percent of Grave′s disease patients have high levels of antiTPO antibodies. About 4% of subclinical hypothyroid patients with positive TPO antibodies develop clinical hypothyroidism. There is always a controversy on the relationship between breast cancer and thyroid disorders. As these tissues, i.e., breast and thyroid, originate embryologically from the same type of cells, hypothyroid/hyperthyroid females are more prone to develop benign or malignant breast tumors. The studies on breast cancer patients indicate increased thyroid disorders in breast cancer patients, most commonly Hashimoto′s thyroiditis accounts to increased thyroid disorders in these patients. This is independent of hormonal receptor status of the patient. These findings suggest the usefulness of screening for thyroid disease in any patient with breast cancer.

  2. [Thyroid cancer].

    Nagayama, Yuji

    2012-03-01

    The thyroid glands are a vulnerable organ to ionizing radiation. Indeed the epidemiological studies have revealed an increase in the incidences of thyroid cancer among atomic bomb survivors in Hiroshima and Nagasaki and radiation casualties in Chernobyl. The carcinogenic risk for the thyroids is dependent on radiation dose, and higher in younger people. Recent advances in molecular biology contribute to clarify the mechanisms for thyroid carcinogenesis at genetic and molecular levels. Here radiation-induced thyroid carcinogenesis is reviewed from epidemiological data to basic research. PMID:22514922

  3. 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 BRAF(V600E) 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 BRAF(V600E) 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 BRAF(V600E) mutation. Furthermore, depletion of CAS by RNAi in the BRAF(V600E)-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 BRAF(V600E)-positive tumors. PMID:26892809

  4. Pediatric Thyroid Disease: When is Surgery Necessary, and Who Should be Operating on Our Children?

    Breuer, Christopher; Tuggle, Charles; Solomon, Daniel; Sosa, Julie Ann

    2013-01-01

    Surgical diseases of the thyroid in the pediatric population represent a diverse set of both benign and malignant conditions. Overall, incidence is rare. Benign conditions include Graves’ disease, toxic adenomas, congenital hyperthyroidism, and goiter. Differentiated thyroid cancer (DTC) and medullary thyroid carcinoma (MTC), with its related familial cancer syndromes, are the most common malignancies. Near-total or total thyroidectomy is the appropriate surgery for thyroid cancer, with/out c...

  5. Application of rapid immunohistochemical staining technique in intraoperative frozen section diagnosis of thyroid neoplasm%快速免疫组织化学技术在甲状腺肿瘤术中冷冻诊断中的应用

    刘西林; 杨平玲; 张永生; 韩洁; 朱晓玲; 高萍

    2011-01-01

    目的 探讨快速免疫组织化学(IHC)新方法在甲状腺肿瘤术中冷冻诊断中的应用价值.方法 采用MaxVision快速IHC一步法检测CK19、HBME-1 、Gla-3在甲状腺乳头状癌(PTC)及甲状腺良性病变组织冷冻切片中的表达,以冰剩组织MaxVision常规IHC作对照.结果 MaxVision快速IHC一步法在20 min内完成,三种标记阳性定位与常规IHC基本对应一致,表达部位CK19位于细胞质和细胞膜,Gla-3 、HBME-1以滤泡腔缘或(和)乳头表面为主,表达强度强于常规IHC.冷冻切片快速IHC CK19、HBME-1、Gla-3阳性表达率:良性病变(结节性甲状腺肿、慢性淋巴细胞性甲状腺炎、腺瘤)为0、10.7%(3/28)、0,PTC为94.9%(37/39)、92.3%(36/39)、92.3 %(36/39),三种标记在甲状腺良性病变与PTC间表达差异均有统计学意义(x2值分别为59.326、55.861、44.605,均P<0.05);同一病例两种以上标记阳性在良性病变为0,PTC为100%,差异有统计学意义(x2=67.000,P< 0.05).结论 MaxVision快速IHC一步法可以应用于术中冷冻诊断,联合检测CK19、HBME-1 、Gla-3对PTC术中冷冻诊断具有较高辅助诊断价值.%Objective To investigate the application of rapid immunohistochemical staining technique in intraoperative frozen section diagnosis of thyroid neoplasm. Methods MaxVision one-step rapid immunohistochemical staining technique was used to detect the expression of CK19,HBME-1,and Gal-3 in frozen section of papillary thyroid carcinoma (PTC) and thyroid benign lesions.MaxVision conventional immunohistochemistry of frozen remaining tissue was served as control.Results MaxVision one-step rapid immunohistochemical staining technique could be completed in 20 minutes.The positive localizations of three markers detected by rapid immunohistochemistry were similar to conventional immunohistochemistry, in general.The expression of CK19 was located in cytoplasm and cellular membrane.Gal-3 and HBME-1 were mainly detected in follicular

  6. CK19、Galectin-3在甲状腺良恶性肿瘤中的表达及其临床意义%The Expression of CK19,Galectin-3 in Benign and Malignant Thyroid Tumor and Its Clinical Significance

    杜岗; 马艳波

    2014-01-01

    目的:检测细胞角蛋白-19(CK19)、半乳糖凝集素-3(Galectin-3)在甲状腺良恶性肿瘤中的表达情况,探讨其在鉴别诊断甲状腺良恶性肿瘤中的临床意义。方法:收集2012年1月-2013年12月在山西医科大学第一附属医院行手术切除并且经病理证实的80例甲状腺肿瘤组织标本,包括40例甲状腺癌手术标本、40例甲状腺瘤手术标本,采用免疫组化技术检测CK19、Galectin-3在甲状腺良恶性肿瘤中的表达情况,实验结果根据阳性细胞的百分率和染色强度进行评价,两组间样本率的比较用独立样本字2检验(检验水准α=0.0167),应用灵敏度、特异度及诊断符合率评价CK19、Galectin-3在鉴别诊断甲状腺良恶性肿瘤中的价值。结果:CK19在甲状腺癌和甲状腺瘤中的阳性率分别为100%(40/40)、37.50%(15/40),差异具有统计学意义(P<0.001),CK19在鉴别诊断甲状腺良恶性肿瘤中的评价结果显示:灵敏度为100%、特异度为62.50%、诊断符合率为81.25%;Galectin-3在甲状腺癌和甲状腺瘤中的阳性率分别为80.00%(32/40)、25.00%(10/40),差异具有统计学意义(P<0.001),Galectin-3在鉴别诊断甲状腺良恶性肿瘤中的评价结果显示:灵敏度为80.00%、特异度为75.00%、诊断符合率为77.50%。结论:CK19、Galectin-3在甲状腺癌中的阳性表达明显增强,可作为鉴别诊断甲状腺良恶性肿瘤的重要辅助指标,联合检测可提高甲状腺癌的诊断率。%Objective:To detect the expression of CK19,Galectin-3 in benign and malignant thyroid tumor,and to investigate the clinical significance in the differential diagnosis of benign and malignant thyroid tumor.Method:80 cases of thyroid tumor tissue specimens between January 2012 to December 2013 were collected from the first affiliated hospital of Shanxi Medical University.All specimens had been proved by pathology,including 40 cases of

  7. 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

  8. Cutaneous epithelioid angiosarcoma: a neoplasm with potential pitfalls in diagnosis.

    Mobini, Narciss

    2009-03-01

    Angiosarcoma (AS) is a rare neoplasm. Cutaneous AS is the most common form of AS. The epithelioid variant of the disease, however, is a rare entity. This subset can histologically mimic non-vascular neoplasms and impose serious challenges in reaching the correct diagnosis. We present five patients with cutaneous epithelioid angiosarcoma (EAS); in none, the clinical diagnosis included a vascular lesion. Three patients had history of breast conservation surgery with/without radiation therapy. Other patients had no previous radiation, and there was no lymphedema in any of the cases. The histopathological examination of the biopsy specimens by hematoxylin and eosin method was not suggestive of a malignant vascular neoplasm initially and the differential diagnoses included carcinoma, malignant melanoma and atypical lymphoid infiltrate. Only after performing immunohistochemical studies that included vascular markers, a definitive diagnosis was possible. Some cases showed unusual histopathological features. Cutaneous EAS is a rare variant of cutaneous AS that can mimic a variety of more common, non-vascular neoplasms, creating a major pitfall in the diagnosis. A careful and thorough histopathological examination and a high index of suspicion, along with appropriate immunohistochemical evaluation, can help reach a correct diagnosis and provide optimal patient care. PMID:19220634

  9. Cystic neoplasms of the pancreas: A diagnostic challenge

    Grant F Hutchins; Peter V Draganov

    2009-01-01

    Cystic neoplasms of the pancreas are increasingly recognized due to the expanding use and improved sensitivity of cross-sectional abdominal imaging. Major advances in the last decade have led to an improved understanding of the various types of cystic lesions and their biologic behavior. Despite significant improvements in imaging technology and the advent of endoscopic-ultrasound (EUS)-guided fineneedle aspiration, the diagnosis and management of pancreatic cystic lesions remains a significant clinical challenge. The first diagnostic step is to differentiate between pancreatic pseudocyst and cystic neoplasm.If a pseudocyst has been effectively excluded, the cornerstone issue is then to determine the malignant potential of the pancreatic cystic neoplasm. In the majority of cases, the correct diagnosis and successful management is based not on a single test but on incorporating data from various sources including patient history, radiologic studies, endoscopic evaluation, and cyst fluid analysis. This review will focus on describing the various types of cystic neoplasms of the pancreas, their malignant potential, and will provide the clinician with a comprehensive diagnostic approach.

  10. Hyalinizing trabecular tumor and papillary carcinoma of the thyroid

    ZHU Hong; QI Ji-ping; WANG Ying-wei; SONG Yue-jia; ZHANG Zhi-yi

    2010-01-01

    Background Hyalinizing trabecular tumor (HTT) is a rare thyroid neoplasm, which shares some histologic features with thyroid papillary carcinoma (TPC). Clinically, it is frequently misdiagnosed as papillary carcinoma, even for some experienced pathologists. The aim of this study was to investigate whether HTT is variant of TPC or HTT is an independent entity of thyroid neoplasm.Methods The expression of CK19, galectin-3, HBME-1 and MIB-1 was detected by immunohistochemical staining in 12 cases of hyalinizing trabecular tumor and 20 cases of thyroid papillary carcinoma.Results Two of the 12 HTT samples were positive or focally positive for CK19. Four of the 12 samples of HTT presented positive to galectin-3; 3 were stained strongly and the other one was focally positive. None of the 12 samples of HTT was positive for HBME-1. Five in 12 HTT samples were stained in nucleus for MIB-1. Almost all the 20 cases of thyroid papillary carcinoma were intensely stained for CK19, galectin-3 and HBME-1. Fifteen in 20 cases of thyroid papillary carcinoma showed nuclear staining for MIB-1.Conclusions HTT is an independent thyroid neoplasm, not a variant of TPC. This study could help in the differential diagnosis of HTT from TPC. CK19, galectin-3 and HBME-1 are adequate to identify HTT and TPC, but MIB-1 does not play an important role in discrimination between HTT and TPC.

  11. An unusual case of Hashimoto′s thyroiditis with four lobed thyroid gland

    Rayees Ahmad Dar

    2012-01-01

    Full Text Available Hashimoto′s thyroiditis (HT, an autoimmune disorder, is the most prevalent cause of subclinical or overt hypothyroidism in areas with sufficient iodine intake. The gland is often diffusely enlarged, and the parenchyma is coarsened, hypoechoic, and often hypervascular on ultrasonograpy. Histopathologic appearance of HT includes lymphocyte aggregates with germinal centers, small thyroid follicles, presence of Hurthle cells, and variable fibrosis. We present a case of a 40-year-old female with suspected follicular neoplasm on fine-needle aspiration cytology of neck swelling. Intraoperatively, thyroid gland was found having four lobes separated from each other. Total thyroidectomy was done and histopathology from all four lobes revealed HT. At present, there is no literature to support the fact that such distorted thyroid anatomy may be due to the underlying disease. If we consider it as thyroid gland anomaly, no such anomaly has been mentioned in the literature till date.

  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. 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 ...

  14. 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 ...

  15. What Causes Thyroid Cancer?

    ... TOPICS Document Topics GO » SEE A LIST » Thyroid cancer risk factors What causes thyroid cancer? Can thyroid cancer be prevented? Previous Topic Thyroid cancer risk factors Next Topic Can thyroid cancer be prevented? What ...

  16. Thyroid gland removal

    ... small thyroid growth ( nodule or cyst) A thyroid gland that is so overactive it is dangerous ( thyrotoxicosis ) Cancer of the thyroid Noncancerous (benign) tumors of the thyroid that are causing symptoms Thyroid ...

  17. 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.

  18. Thyroid Nodule Imaging. Status and Limitations.

    Durre Sabih

    2015-01-01

    Full Text Available Thyroid nodules are common, occurring in almost two-thirds of some populations; among these only about 7% are malignant. The most important question with any new discovered thyroid nodule is, “is this malignant?” The main arbiter of malignancy or benignity remains fine needle aspiration and the mainstay of treatment surgery. But given the resources involved, doing an FNAC or surgery in every discovered nodule would be prohibitive to impossible. The clinician must decide which nodule to investigate and which to watch in the hope that this will never turn out to be malignant. FNACs are used basically to decide which nodule to operate upon (or more importantly which to not operate upon and clinical and imaging features are used to decide which nodule to investigate by FNAC and which to leave alone. This paper describes the various imaging options for looking at thyroid nodules and briefly discusses the advantages and disadvantages with each.

  19. 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)

  20. 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.)

  1. Malignant ovarian tumours in childhood in Britain, 1962-78.

    La Vecchia, C; Morris, H. B.; Draper, G J

    1983-01-01

    The files of the Childhood Cancer Research Group and of the Oxford Survey of Childhood Cancers were scrutinized for all the ovarian neoplasms registered in England, Scotland and Wales in children under age 15 years throughout the period 1962-78. Among 172 cases confirmed as malignant ovarian tumours, 145 (84%) were tumours of germ cell origin (54 dysgerminomas, 36 malignant teratomas, 26 endodermal sinus tumours, 4 embryonal carcinomas, 2 pure choriocarcinomas, 20 mixed germ cell neoplasms, 3...

  2. Hyperfunctioning Solid/Trabecular Follicular Carcinoma of the Thyroid Gland

    Luca Giovanella

    2010-01-01

    Full Text Available A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the 99mTc-pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.

  3. 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.

  4. Nuclear medicine diagnostics of malignant tumors

    The monography deals with the localization diagnosis in nuclear medicine. After general remarks on technical and physical fundamentals and on methods and devices for scintigraphic localization of malignant tumors, specific scintiscanning of malignancies of thyroid, bones, liver, lungs, pancreas, adrenal glands, brain lymph nodes and eyes is discussed in detail. Numerous relevant references are added to each chapter

  5. CC-486 (Oral Azacitidine) Bioequivalence Study in Patients With Solid Tumor or Hematologic Malignancies

    2016-06-01

    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

  6. 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.

  7. 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.)

  8. 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.

  9. An unusual presentation of pancreatic pseudocyst mimicking cystic neoplasm of the pancreas: a case report

    Gintowt, Aleksandra; Hac, Stanislaw; Dobrowolski, Sebastian; Śledziński, Zbigniew

    2009-01-01

    In spite of their rarity, cystic neoplasms of the pancreas are characterized by existing or potential malignancy that cannot be ignored during decisive process with regard to the choice of treatment. Diagnostic difficulties in the differentiation of pancreatic pseudocyst and cystic pancreatic neoplasm can lead to misdiagnosis and inappropriate treatment, since clinical symptoms, preoperative imaging tests and even endoscopic retrograde cholangiopancreatography are often not sufficient to esta...

  10. PATTERN OF OVARIAN NEOPLASM IN RURAL POPULATION: A FIVE YEAR STUDY FROM TERTIARY CARE HOSPITAL

    Umesh

    2014-01-01

    OBJECTIVE : The aim of the study was to know the morphological pattern of benign and malignant ovarian neoplasms and their distribution in different age groups in rural population of India. MATERIAL AND METHODS : A retrospective study of all cases of ovarian neoplasms diagnosed at department of pathology, Maharaja Medical College, Agroha during period of five year (Aug, 07 — Oct.12) was done. The tumors were classified according to WHO classification after thorou...

  11. Thyroid cancer

    This paper reviews the relationship between A-bomb radiation and thyroid cancer in the literature. The previous studies have showed a similar outcome; that is, the incidence of thyroid cancer is higher with increasing radiation doses. Risk for thyroid cancer is significantly high in women. Latent cancer found at autopsy is also found to be significantly increased with increasing radiation doses, especially for women. (N.K.)

  12. Thyroid nodule

    Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice ...

  13. MR imaging of subarachnoid spread of neoplasms

    One hundred nineteen MR examinations of 40 patients with cytologically proved subarachnoid dissemination of neoplasms were retrospectively reviewed. In the brain, 12 of 54 unenhanced (22.2%) and seven of 20 gadolinium-enhanced studies (35%) were positive for leptomeningeal metastases. Four of 29 (13.8%) unenhanced (13.8%) and six of 16 enhanced spine studies (37.5%) were positive. Patients with non-central nervous system primary tumors were most likely to show MR findings of leptomeningeal dissemination (31.4%). Hematologic malignancies were least likely (5.6%). The overall sensitivity of unenhanced (19.3%) and enhanced (36.1%) MR examinations in patients with cerebrospinal fluid positive for neoplastic seeding is low

  14. MALIGNANT MELANOMA OF THE ORAL CAVITY

    Vishnu Prasad

    2016-02-01

    Full Text Available Oral malignant melanoma is a rare aggressive neoplasm commonly affects males and is more frequently seen at the level of the hard palate and gingiva. In many cases, melanoma has evolved from the pre-existing pigmented lesions. These neoplasms are biologically aggressive, but they often go unnoticed since they usually present merely as a hyperpigmented patch on the gingival surface. Performing biopsies of doubtful pigmented lesions helps in early treatment and better prognosis. The surgical excision combined with the chemotherapy is the treatment of choice. Here, we report a rare case of an elderly male patient with oral malignant melanoma with metastasis to vertebral column.

  15. 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.)

  16. Anaplastic thyroid cancer Irish epidemiology and novel chemotherapeutic strategies

    O'Neill, James Paul

    2009-01-01

    This body of work was conducted over a four year period. Within this timeframe we have conducted a National Epidemiology project, established a National Head and Neck Cancer database and completed Oncology laboratory investigations. Anaplastic thyroid cancer (ATC) is the most aggressive endocrine disease in nature. Within the thyroid gland a heterogeneous group of neoplasms may develop. These can range from well differentiated tumours with an excellent prognosis, to ATC tumours which prese...

  17. 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.)

  18. EVALUATION OF THYROID NODULES: AN ULTRASONOGRAPHIC STUDY

    Vijai

    2013-10-01

    Full Text Available ABSTRACT : Thyroid nodules are common in adults, with a reported prevalence of up to 50%. (1 – 5. Furthermore, 9% to 15% of nodules identified during clinical examinations are diagnosed as malignant (6 – 8. It is gen erally accepted that sonography and sonographically guided fine - needle aspiration cytologic examination are the modalities of choice for differentiating benign and malignant thyroid nodules (1 , 9 . Thyroid ultrasonography (USG is the major diagnostic moda lity for evaluating thyroid nodules. Using USG, a thyroid nodule appears as a nodular lesion within the thyroid gland that is distinguishable from the adjacent parenchyma. Several USG features, such as marked hypoechogenicity, irregular margin, micro calci fications, and a taller - than - wide shape have been introduced as potential predictors for the presence of thyroid malignancies. AIMS & OBJECTIVE : The aim of this study was to assess the accuracy of USG diagnosis for thyroid nodules. MATERIALS & METHODS: Th e present study was conducted in the Department of Radiodiagnosis, TMMC & RC, TMU, Moradabad. Patients under the study were referred from department of Surgery, Paediatrics, Medicine, ENT, Gynaecology and Obstetrics. Patients for the study were evaluated b y Clinical & Radiological examination. The total number of patients were 120. RESULT: On clinical examination, multiple nodules were found only in 17% of cases, whereas on USG, multiple nodules were found in 58%. 50% of clinically solitary nodules were d emonstrated to be multiple on USG. CONCLUSION: In conclusion, similar to the recent literature reviewed so far, for a large majority of patients, diagnosis changed after ultrasonography, so the results necessitate the use of ultrasonography, which is a non invasive method, as a complementary method to physical examination in the diagnosis of thyroid diseases, especially thyroid nodules.

  19. Myeloproliferative Neoplasms (MPNs) Patient Registry

    2016-04-28

    Primary Myelofibrosis; Polycythemia Vera; Essential Thrombocythemia; Mastocytosis; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative; Leukemia, Myelomonocytic, Juvenile; Chronic Eosinophilic Leukemia-not Otherwise Specified; Myelodysplastic-Myeloproliferative Diseases; Neoplasms; Leukemia, Myelomonocytic, Chronic

  20. Immunohistochemical expression of protein p53 in neoplasms of the mammary gland in bitches.

    Rodo, A; Malicka, E

    2008-01-01

    The aim of the study was to investigate the presence of protein p53 in correlation with other tumor traits: histological type, tumor grade and proliferative activity. Material for the investigation comprised mammary gland tumours collected from dogs, the patients of veterinary clinics, during surgical procedures, and archival samples. Alltogether 21 adenomas, 31 complex carcinomas, 35 simple carcinomas and 12 solid carcinomas were qualified for further investigation. No protein p53 expression was found in adenomas. Cancers show positive reaction in 32.5%. The highest percent of p53 positive neoplasms was observed in solid carcinomas and neoplasms with the highest degree of histological malignancy. The smallest number showing this expression was observed in adenomas and the highest was characteristic for solid carcinomas. Considering the tumour grading, it was found that an increase in neoplasm malignancy was positively correlated with the number of the cells showing the expression of protein p53. The differences were statistically significant. Statistically significant positive correlations were observed between the proliferative activity and protein p53 expression. Higher accumulation of protein p53 in more malignant neoplasms suggests that mutations of protein p53 can be responsible for higher proliferation in neoplasms with advanced progression of malignancy. PMID:18683536

  1. Neurological Findings in Myeloproliferative Neoplasms

    Semra Paydas

    2013-01-01

    Myeloproliferative neoplasms (MPN) arise from genetic deficiencies at the level of pluripotent stem cells. Each of these neoplasms is a clonal stem cell disorder with specific phenotypic, genetic and clinical properties. Age is one of the most important factors in the development of symptoms and complications associated with MPNs.High white blood cell counts in chronic myelocytic leukemia also known as leukocytosis may lead to central nervous system findings. Tumors developing outside the bon...

  2. Thyroid diseases

    This chapter reviews the correlation between thyroid disease, other than cancer, and radiation in the literature. Radiation-induced thyroid disturbance is discussed in the context of external and internal irradiation. External irradiation of 10 to 40 Gy may lower thyroid function several months or years later. Oral administration of I-131 is widely given to patients with Basedow's disease; it may also lower thyroid function with increasing radiation doses. When giving 70 Gy or more of I-131, hypothyroidism has been reported to occur in 20-30% and at least 10%. Thyroiditis induced with internal I-131 irradiation has also been reported, but no data is available concerning external irradiation-induced thyroiditis. The incidence of nodular goiter was found to be several ten times higher with external irradiation than internal irradiation. Thyroid disturbance is correlated with A-bomb survivors. A-bomb radiation can be divided into early radiation within one minute after A-bombing and the subsequent residual radiation. Nodular goiter was significantly more frequent in the exposed group than the non-exposed group; it increased with increasing radiation doses and younger age (20 years or less) at the time of exposure. The incidence of decrease in thyroid function was higher with increasing radiation doses. However, in the case of Nagasaki, the incidence of hypothyroidism was significantly higher in the low-dose exposed group, especially A-bomb survivors aged 10-39 at the time of exposure and women. (N.K.)

  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. Primary Synovial Sarcoma of the Thyroid Gland

    Jang, Ki-Seok; Min, Kyueng-Whan; Jang, Si-Hyong; Paik, Seung Sam; Tae, Kyung; Jang, Se Jin; Park, Moon Hyang

    2007-01-01

    Synovial sarcoma is a rare but distinct soft tissue neoplasm, most commonly occurring in para-articular regions of the extremities of young adults and also occurring in the head and neck region. To the best of our knowledge, only one case of primary synovial sarcoma of the thyroid has been previously reported. Here, we report a 15-yr-old man who had a chief complaint of a palpable neck mass. The neck computed tomography revealed a relatively well-demarcated solid mass in the left thyroid glan...

  5. Evaluation of the value of ROC curve in the differential diagnosis of benign and malignant thyroid nodules by ultrasonic elasticity imaging and blood flow classification%ROC曲线评估超声弹性成像联合血流分级鉴别甲状腺结节性质的价值

    林剑英; 陈茹; 刘观成; 罗春月

    2016-01-01

    目的:利用高频超声作为检测手段,探讨超声弹性成像联合血流分级在甲状腺结节良恶性鉴别诊断中的价值。方法:回顾性分析68个甲状腺结节的血流分级及弹性成像特点,和术后病理结果对照,通过受试者工作特征( ROC)曲线下面积的比较,对二者单独及联合应用鉴别甲状腺结节的效果分别进行评估。结果:血流分级诊断甲状腺恶性结节的灵敏性、特异性、和准确性分别为75.0%、80.0%、77.9%,超声弹性成像诊断甲状腺恶性结节的灵敏性、特异性和准确性分别为78.6%、90.0%、85.3%,二者联合诊断甲状腺恶性结节的灵敏性、特异性、准确性为92.9%、92.5%、92.6%。ROC曲线下面积二者联合应用(0.936)大于单独使用血流分级(0.831)(Z=2.59,P﹤0.01)或单独使用超声弹性成像(0.859)(Z=2.22,P﹤0.05)。结论:超声弹性成像联合血流分级可以有效提高甲状腺恶性结节的诊断符合率。%Objective To explore the value of ultrasonic elastography combined with grades of blood in differential diagnosis between benign and malignant thyroid nodules by the detection of high frequency ultrasound. Method Retrospecting the 68 thy-roid nodules'grades of blood and elastograph,and compared with the postoperative pathological results. The areas under the re-ceiver operating characteristic( ROC)curves were compared to estimate the diagnostic effects in differentiating thyroid nodules by grades of blood,Elastograph and their combination respectively. Results The sensitivity,specificity and accuracy of grades of blood in the diagnosis of malignant thyroid nodules were 75. 0% ,80. 0% and 77. 9%,respectively,the sensitivity,specificity and accuracy of ultrasonic elastography in diagnosis of malignant thyroid nodules were 78. 6%,90. 0% and 85. 3%,respective-ly,and the sensitivity,specificity and accuracy of joint detection of grades of

  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

  7. 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

  8. [Benign thyroid nodules: diagnostic and therapeutic approach].

    Durante, Cosimo; Cava, Francesco; Paciaroni, Alessandra; Filetti, Sebastiano

    2008-05-01

    In the last years an increase in thyroid nodules detection has been reported from several epidemiological studies. This trend is largely due to the routine use of diagnostic sonography procedures in clinical practice. Thyroid nodules, both palpable or not palpable, rarely turn out to be malignant. Fine-needle aspiration cytology (FNAc) plays a central role in establishing the nature of the nodule. Excluded the presence of malignant lesions, which are generally treated with surgery, physicians are faced with a variety of therapeutic options, and choosing the optimal approach can be a difficult task. These include a periodic follow-up alone without treatment, the iodine supplementation, the thyroid-hormone suppressive therapy, the radioiodine administration, the percutaneous ethanol injections, and the new technique of laser photocoagulation. In all cases, decisions on the management of benign thyroid nodules should always be based on clinical target and a careful analysis of benefits and risks to the patient. PMID:18581970

  9. Clinical value of 99TCm-MIBI SPECT/CT imaging in the identification of benign and malignant thyroid nodules%99TCm-MIBI SPECT/CT亲肿瘤融合显像对甲状腺结节良恶性鉴别的临床价值

    杨文定; 覃卫华

    2012-01-01

    目的 评价SPECT/CT亲肿瘤融合显像对甲状腺结节良恶性鉴别的临床价值.方法 106例甲状腺结节患者静注99TCm-MIBI后行早期(30 min)及延迟(120 min)平面显像,在30 min时进行SPECT/CT融合显像.显像结果与手术病理结果相对照.结果 106例患者中良性病变82例(77.36%),恶性病变24例(22.64%),SPECT/CT融合显像的敏感度为70.83%;特异性为80.49%;诊断准确度为78.30%.结论 SPECT/CT亲肿瘤融合显像对甲状腺结节的良恶性鉴别有重要价值.%Objective To evaluate the clinical value of SPECT/CT imaging to identify benign and malignant thyroid nodules. Methods One hundred and six patients with thyroid nodule received early (30 min) and delayed (120 min) planar imaging as well as SPECT/CT fusion imaging (30 min) after intravenous 99TCm-MIBI. The imaging results were compared the surgical and pathological results. Results Eighty-two patients were found to be benign lesions (77.3%) and 24 were malignant lesions (22.6%). The sensitivity, specificity and the accuracy of SPECT/CT fusion imaging were 70.8%, 80.4%, 78.3%, respectively. Conclusion SPECT/CT fusion imaging has great significance in the identification of benign and malignant thyroid nodule.

  10. Analysis of thyroid malignant pathological findings identified during three rounds of screening (1997-2008) of a Belarusian cohort of children and adolescents exposed to radioiodines after the Chernobyl accident

    Zablotska, Lydia; Nadyrov, Eldar; Rozhko, Alexander; Gong, Zhihong; Polyanskaya, Olga; McConnell, Robert; O'Kane, Patrick; Brenner, Alina; Little, Mark P.; Ostroumova, Evgenia; Bouville, Andre; Drozdovitch, Vladimir; Minenko, Viktor; Demidchik, Yuri; Nerovnya, Alexander; Yauseyenka, Vassilina; Savasteeva, Irina; Nikonovich, Sergey; Mabuchi, Kiyohiko; Hatch, Maureen

    2015-01-01

    Background Recent studies of children and adolescents exposed to radioactive iodine-131 (I-131) after the 1986 Chernobyl nuclear accident in Ukraine showed significant dose-related increase in the risk of thyroid cancer, but the association of radiation doses with tumor histological and morphological features is not clear. Methods A cohort of 11,664 individuals in Belarus ≤18 years at the time of the accident underwent three cycles of thyroid screening in 1997-2008. I-131 thyroid doses were estimated from individual thyroid activity measurements taken within two months after the accident and dosimetric data from questionnaires. Demographic, clinical and pathological characteristics of thyroid cancer cases were analyzed using one-way analysis of variance, chi-square or Fisher's exact tests, and logistic regression. Results As a result of screening, 158 thyroid cancers were identified. The majority of cases had T1a and T1b tumors (93.7%), with many regional N1 (60.6%) but few distant M1 (<1%) metastases. Higher I-131 doses were associated with higher frequency of solid or diffuse sclerosing variants of thyroid cancer (P<0.01) and histological features of cancer aggressiveness, such as lymphatic vessel invasion, intrathyroidal infiltration, and multifocality (all P<0.03). Latency was not correlated with radiation dose. Fifty-two cases of self-reported thyroid cancers diagnosed prior to 1997 were younger at the time of the accident and had a higher percentage of solid variant cancers compared to screening-detected cases (all P<0.0001). Conclusions I-131 thyroid radiation doses were associated with significantly higher frequency of solid or diffuse sclerosing variants of thyroid cancer and various features of tumor aggressiveness. PMID:25351557

  11. 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...

  12. Malignant melanoma of breast: a case report

    A. Bhagyalakshmi

    2014-04-01

    Full Text Available Malignant melanoma rarely affects the breast. Malignant melanoma of breast is divided into two categories: primary and metastatic lesions. Primary melanoma involves the skin and less commonly the glandular parenchyma of the breast. Differentiating them is very important in deciding on treatment strategies. This case report aims to increase awareness of unusual neoplasms of the breast which requires a different surgical and adjuvant therapeutic approach. [Int J Res Med Sci 2014; 2(2.000: 755-758

  13. 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.

  14. TFF3 and C1orf24 Assist in the Identification of Benign and Malignant Thyroid Follicular Tumor%TFF3和C1orf24协助鉴别甲状腺滤泡型肿瘤良恶性

    张福彬; 王坚

    2014-01-01

    Objective Using RT-PCR technique in the nucleic acid level to detected the gene expression of TFF3, C1orf24 in thyroid tumor tissues,that was extracted from patients by fine-needle aspiration biopsy.To assess whether it can be used clinical y in the identification of benign and malignant thyroid fol icular type tumor. Methods 279 cases of fine-needle aspiration tissue samples were col ected from patients with thyroid nodules between April 2013 and April 2011 in Jinling hospital.Then using RT-PCR technique in nucleic acid level to detected TFF3, C1orf24 gene expression level in each tissue sample.Contrast the cytology and postoperative pathology examination results,To learn the gene expression level of TFF3 and C1orf24 whether there are dif erences between thyroid fol icular tumor and malignant thyroid fol icular tumor. Results The gene expression level of TFF3 was higher in Fol icular thyroid carcinoma group compared to Thyroid fol icular adenoma group ( <0.05). Conclusion Two kinds of molecular biomarkers can help clinical identification of thyroid fol icular type of benign and malignant tumors.%目的:运用RT-PCR技术在核酸水平上检测甲状腺细针穿刺提取的甲状腺肿瘤组织中的TFF3、C1orf24基因的表达,评估其是否可用于临床上甲状腺滤泡型肿瘤良恶性的鉴别。方法选取我院2013年4月~2011年4月的细针穿刺甲状腺结节组织标本279例。然后运用RT-PCR技术在核酸水平上分别检测各样本组织中目的TFF3、C1orf24的表达水平。对照细胞学和术后病理学检查结果,了解TFF3、C1orf24在良性甲状腺滤泡型肿瘤和恶性甲状腺滤泡型肿瘤中是否存在差异。结果 TFF3在滤泡状癌中的表达高于滤泡状腺瘤(P<0.05)。 C1orf24在滤泡状癌中的表达高于滤泡状腺瘤(P<0.05)。结论两种分子标记物能较好的帮助临床鉴别甲状腺滤泡型肿瘤的良恶性。

  15. 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.

  16. 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 ...

  17. Stages of Thyroid Cancer

    ... enlarged thyroid). Having a family history of thyroid disease or thyroid cancer. Having certain genetic conditions such as familial medullary thyroid cancer (FMTC), multiple endocrine neoplasia type 2A ...

  18. Thyroid Hormone Treatment

    ... Giving Workplace Giving Other Ways to Donate Thyroid Hormone Treatment Thyroid hormone is used in two situations: ... prevent recurrence or progression of their cancer. THYROID HORMONE REPLACEMENT THERAPY Many people have a thyroid gland ...

  19. 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

  20. Thyroid nodule guidelines: agreement, disagreement and need for future research

    Paschke, Ralf; Hegedüs, Laszlo; Alexander, Erik;

    2011-01-01

    , clinically very relevant areas of uncertainty need to be addressed by further research. This situation applies, for instance, to better definition of ultrasound malignancy criteria and the evaluation of emerging new diagnostic and therapeutic techniques, including molecular markers. For clinicians who advise......This article reviews agreement, disagreement and need for future research of the thyroid nodule guidelines published by the British Thyroid Association, National Cancer Institute, American Thyroid Association and the joint, transatlantic effort of three large societies, the American Society of...

  1. 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.

  2. 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...

  3. Thyroid disorders in mild iodine deficiency

    Laurberg, P; Nøhr, S B; Pedersen, K M;

    2000-01-01

    elderly subjects, especially women, with risk of cardiac arrhythmias, osteoporosis, and muscle wasting. The hyperthyroidism is caused by autonomous nodular growth and function of the thyroid gland and it is accompanied by a high frequency of goiter. Pregnant women and small children are not immediately...... endangered but the consequences of severe iodine deficiency for brain development are grave and a considerable safety margin is advisable. Moreover, a shift toward less malignant types of thyroid cancer and a lower radiation dose to the thyroid in case of nuclear fallout support that mild-to-moderate iodine...

  4. 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)

  5. Primary thyroid angiosarcoma: an unusual localization

    Petronella Pasquale

    2012-05-01

    Full Text Available Abstract The finding of thyroid nodules is a very common occurrence in routine clinical practice. Approximately 5% to 7% of the entire population have thyroid nodules. Vascular lesions are one of the most controversial issues in thyroid pathology. These include benign lesions such as hemangiomas and, rarely, malignant tumors such as angiosarcomas or undifferentiated angiosarcomatoid carcinomas. In particular, angiosarcoma of the thyroid gland is a rare, highly aggressive malignant vascular tumor and in Italy the greatest geographical incidence of this lesion is witnessed near the Alps. Here, a case of thyroid angiosarcoma in a 71-year-old man with a history of goiter for about 20 years is described. The unusual localization of this lesion, the difficulties in reaching a definitive diagnosis for this particular histological type of primary tumor and a history of long-standing multinodular goiter in thyroid of an older man from outside the Alpine region prompted us to report this case of thyroid angiosarcoma mainly to discuss surgical, histopathological and immunohistochemical features.

  6. Risk factors in larynx and oropharyngeal malignant neoplasms

    Gabriela Corina Kodjabashija

    2014-08-01

    Full Text Available Alcohol consumption and cigarette smoking are most strongly and best-recognized risk factors of oral cavity cancer (OCC and laryngeal cancer (LC. Alcohol multiplicative interaction includes acetaldehyde effects, reactive oxygen compound, epithelial cells irritation, increasing cross links penetration in mucosal cells. Some of the adverse effects of cigarette smoke and induction of oxidative stress by inhalation of free radicals of O2 and N2 are gunanine derivatives like polycyclic aromatic hydrocarbons (PAHs and N-nitrosamines. There is substantial evidence that N-nitrosamines have an important role in DNA alkylation as a result of reactions with N, O and P atoms. The mutagenic properties of polycyclic aromatic hydrocarbons (PAHs and N-Nitrosamines are known as important factors in pulmonary carcinogenesis. Alcohol consumption and cigarette smoking metabolism derivatives mutually play a roll in carcinogenesis. Alcohol's role as solvent for polycyclic aromatic hydrocarbons (PAHs and N-nitrosamines stimulates carcinogenics absorption and transport to tissues. Alcohol has a role in the selective inhibition of nitrostamines metabolism in liver and cigarette smoking increased risk of extra hepatic tissues exposure of nitrostamines. These mechanisms are not mutually exclusive, but may play an important role as risk factor in extra hepatic carcinogenesis.

  7. Malignant neoplasms after radiation therapy for peptic ulcer.

    Carr, Zhanat A; Kleinerman, Ruth A; Stovall, Marilyn; Weinstock, Robert M; Griem, Melvin L; Land, Charles E

    2002-06-01

    Most information on radiation-related cancer risk comes from the Life Span Study (LSS) of the Japanese atomic bomb survivors. Stomach cancer mortality rates are much higher in Japan than in the U.S., making the applicability of LSS findings to the U.S. population uncertain. A unique cohort of U.S. patients who were irradiated for peptic ulcer to control gastric secretion provides a different perspective on risk. Cancer mortality data were analyzed and relative risks estimated for 3719 subjects treated by radiotherapy (mean stomach dose 14.8 Gy) and/or by surgery and medication during the period 1936-1965 and followed through 1997 (average 25 years). Compared to the U.S. rates, stomach cancer mortality was significantly increased for irradiated and nonirradiated patients (observed/expected = 3.20 and 1.52, respectively). We observed strong evidence of exposure-related excess mortality from cancer of the stomach (RR 2.6, 95% CI 1.3, 5.1), pancreas (RR 2.7, 95% CI 1.5, 5.1), and lung (RR 1.5, 95% CI 1.1, 2.1), with commensurate radiation dose responses in analyses that included nonexposed patients. However, the dose responses for these cancers were not significant when restricted to exposed patients. Our excess relative risk per gray estimate of 0.20 at doses

  8. 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)

  9. 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.

  10. Selective laser hyperthermia of malignant neoplasms: experimental and clinical research

    Gelfond, Mark L.; Mizgirev, I. V.; Barchuk, A. S.; Hudoley, V. V.; Vasilyev, D. V.; Balluzek, F. V.; Venkov, A. A.; Chaly, Viktor P.; Ter-Martirosyan, Alexander L.

    1999-12-01

    Experimental study of various modes of the semiconductor laser irradiation upon Ehrlich carcinoma in mice was carried out. Optimal patterns for distance laser scanning irradiation resulting in practically complete healing of experimental animals, were found. Selective damage of tumor tissue subjected to laser irradiation at 800 nm was evidenced in the absence of a photosensitizing agent. The results of a clinical trial completely corresponded to the experimental data. The treatment proved to be efficient in all 28 patients.

  11. 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.

  12. 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

  13. Image Reporting and Characterization System for Ultrasound Features of Thyroid Nodules: Multicentric Korean Retrospective Study

    Kwak, Jin Young; Jung, Inkyung; Baek, Jung Hwan; Baek, Seon Mi; Choi, Nami; Choi, Yoon Jung; Jung, So Lyung; Kim, Eun-Kyung; Kim, Jeong-Ah; Kim, Ji-Hoon; Kim, Kyu Sun; Lee, Jeong Hyun; Lee, Joon Hyung; Moon, Hee Jung; Moon, Won-Jin

    2012-01-01

    Objective The objective of this retrospective study was to develop and validate a simple diagnostic prediction model by using ultrasound (US) features of thyroid nodules obtained from multicenter retrospective data. Materials and Methods Patient data were collected from 20 different institutions and the data included 2000 thyroid nodules from 1796 patients. For developing a diagnostic prediction model to estimate the malignant risk of thyroid nodules using suspicious malignant US features, we...

  14. Thyroid Metastasis in Pyramidal Lobe from Renal Cell Carcinoma: A Case Report

    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.

  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. The diagnostic evaluation of fine needle aspiration cytology of thyroid and its clinical application

    Jiayu Zhang; Jian Wang

    2012-01-01

    Objective: The aim of the study was to investigate the diagnostic value of fine needle aspiration cytology (FNAC) and its clinical application. Methods: From April 2009 to February 2011, thyroid FNAC were performed in a total of 186 patients with thyroid nodule or mass in our hospital and 78 of those 186 patients subsequently underwent thyroidectomy. The FNAC findings were compared with the results of the corresponding histological diagnosis. Results: The results of thyroid FNAC for 186 patients showed that, (1) 166 cases of benign lesions, the detection rate was 89.24% (166/186), including 96 cases of nodular colloid goiter (51.61 %), 28 cases of simple colloid goiter (15.05%), 38 cases of Hashimoto's thyroiditis (HT) (20.43%) and 4 cases of thyroid adenoma (2.15%); (2) 4 cases of suspicious malignant lesion, the detection rate was 2.15% (4/186); (3) 16 cases of malignant tumor, the detection rate was 8.60% (16/186). Seventy eight patients including malignant (16), suspicious malignant (4), HT (20) and nodular colloid goiters (38) cases diagnosed by FNAC were performed operation with thyroidectomy and the postoperative histopathologic results showed that there were 2 cases HT combined thyroid papillary carcinoma in HT 20 cases by FNAC, 15 cases of thyroid papillary carcinoma and 1 case of follicular carcinoma in 16 cases of malignant tumor by FNAC and 4 case of thyroid papillary carcinoma in 4 cases of suspicious malignant by FNAC. Conclusion: Thyroid FNAC is a valuable and reliable method for the diagnosis of the thyroid nodules or mass or even most diffuse thyroid diseases. Diagnosis of HT and thyroid papillary carcinoma can be made by thyroid FNAC. There was larger hint value for nodular colloid goiter and simple colloid goiter according to thyroid FNAC.

  17. 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

  18. Synchronous occurrence of gastrointestinal stromal tumors and other primary gastrointestinal neoplasms

    Marek Wronski; Bogna Ziarkiewicz-Wroblewska; Barbara Gornicka; Wlodzimierz Cebulski; Maciej Slodkowski; Aleksander Wasiutynski; Ireneusz W Krasnodebski

    2006-01-01

    AIM: To review clinical and pathologic features of Gastrointestinal stromal tumors (GISTs) occurring synchronously with other primary gastrointestinal neoplasms.METHODS: 28 patients with primary GIST were treated at our institution between 1989 and 2005. Clinical and pathologic records were reviewed.RESULTS: The gastrointestinal stromal tumor occurred simultaneously with other primary GI malignancies in 14% of all patients with GIST. The synchronous stromal tumors were located in the stomach and were incidentally found during the operation. The coexistent neoplasms were colon adenocarcinoma, gastric cancer (2 cases) and gastric lymphoma.CONCLUSION: The synchronous occurrence of GISTs and other gastrointestinal malignancies is more common than it has been considered. The development of gastrointestinal stromal tumors and other neoplasms may involvethe same carcinogenic agents.

  19. 甲状腺结节细针穿刺细胞学检查评估%Fine-needle aspiration cytology of thyroid nodules:a clinical evaluation

    张永侠; 张彬; 张智慧; 郭会芹; 王勇; 徐震纲; 唐平章

    2011-01-01

    Objective To investigate the clinical application of fine needle aspiration ( FNA )cytology of thyroid nodules.Methods A retrospective review was performed of 474 consecutive cases of FNA cytology of thyroid nodules from October 2005 to January 2011.Two hundred and eighteen patients underwent ultrasound-guided FNA,and 256 patients experienced palpation-guided FNA.Cytologic diagnoses were classified as unsatisfactory,benign,atypical cellular lesion,follicular neoplasm,suspicious for malignancy,and positive for malignancy.The discrepancies between initial cytologic diagnoses and histologic diagnoses were evaluated in 157 surgical specimens.Results According to the cytological categories,the rates for histologically confirmed malignancy in the 157 patients were as follows:2/7 of unsatisfactory results,16.7% (9/54) of benign lesion,3/9 of atypical cellular lesion,1/3 of follicular neoplasm,83.3%(35/42) of suspicious for malignancies,and 97.6% (41/42) of positive for malignancies.The sensitivity,specificity and positive predictive value of thyroid FNA for the diagnosis of malignancy were 85.4%,86.9%and 90.5%,respectively.Conclusions FNA can provide an accurate diagnosis of thyroid malignancy preoperatively.The 6 diagnostic categories were beneficial for either clinical follow-up or surgical management of the patients with thyroid nodules.%目的 探讨甲状腺细针穿刺细胞学(fine-needle aspiration,FNA)检查的临床价值.方法 回顾性分析中国医学科学院肿瘤医院2005年10月至2011年1月行甲状腺细针穿刺的474例连续病例资料.B超引导下穿刺218例(46.0%),触诊穿刺256例(54.0%).细胞学诊断结果分为六级:无法诊断、良性、不典型细胞、滤泡样肿瘤、可疑恶性及恶性.将其中157例手术患者术前细胞学诊断结果与术后组织病理学诊断结果进行比较.结果 157例手术治疗患者中91例为恶性,术前FNA诊断为无法诊断2/7、良性16.7% (9/54)

  20. [Utility of bone marrow biopsy in the diagnosis of myeloproliferative neoplasm].

    Tovar-Bobadilla, José Leonard; Ortiz-Hidalgo, Carlos

    2016-01-01

    A diagnostic approach of myeloproliferative neoplasms, according to the 2008 WHO classification system for hematological malignancies, has to consider clinical, molecular, and cytogenetic information as well as bone marrow histology. A diagnosis of chronic myeloid leukemia requires the presence of BCR-ABL-1, and the Philadelphia chromosome-negative (Ph-1-negative) myeloproliferative neoplasms constitute three main subtypes, including primary myelofibrosis, polycythemia rubra vera, and essential thrombocythemia. These three Ph-1-negative myeloproliferative neoplasms share many pathogenic characteristic such as JAK2 mutations; however, they differ in prognosis, progression to myelofibrosis, and risk of leukemic transformation. There are currently various major points of interest in bone marrow examination in myeloproliferative neoplasms. One is the morphology of megakaryocytes, which are the hallmark of Ph-1-negative myeloproliferative neoplasms and play a crucial role in separating the different subtypes of myeloproliferative neoplasms. Another is reticulin fibrosis or collagen fibrosis, which may only be detected on a bone marrow biopsy specimen by reticulin and trichrome stains, respectively, and immunohistochemistry and certain molecular techniques may be applied in bone marrow biopsies as supporting evidence of certain features of myeloproliferative neoplasms. PMID:27335198

  1. [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

  2. 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

  3. 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

  4. Molecular diagnostics of myeloproliferative neoplasms

    Langabeer, S. E.; Andrikovics, H.; Asp, J.;

    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...

  5. 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.

  6. Gastrointestinal Surgery of Neuroendocrine Neoplasms

    Hansen, Carsten Palnæs; Olsen, Ingrid Marie 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...

  7. Thyroid-Like Follicular Carcinoma of the Kidney in a Patient with Skull and Meningeal Metastasis: A Unique Case Report and Review of the Literature.

    Dong, Liang; Huang, Jiayu; Huang, Luke; Shi, Oumin; Liu, Qiang; Chen, Haige; Xue, Wei; Huang, Yiran

    2016-04-01

    Thyroid-like follicular carcinoma of the kidney (TLFCK) is an extremely rare subtype of renal cell carcinoma with close resemblance to the well-differentiated thyroid follicular neoplasms. TLFCK has not been included in the 2004 World Health Organization (WHO) classification due to the limited data available. Only 27 cases have been reported in the literature to date. Herein, we report a unique case of TLFCK that presented as a striking skull and meningeal metastasis 5 years after the initial diagnosis; this is the first case of TLFCK with such a novel metastasis pattern. A 68-year-old woman was found to have a right renal lesion using computed tomography (CT) during her regular clinical follow-up visit for bladder cancer, but she exhibited no obvious clinical symptoms. The CT scan showed a 4.4-cm diameter, slightly lobulated soft tissue mass in the right lower kidney, the pathological findings of which showed a TLFCK. Five years later, the patient had progressed to skull and meningeal metastasis. Both the renal tumor and the metastasis lesion were composed almost entirely of follicles with a dense, colloid-like material that resembled thyroid follicular carcinoma. However, no lesion was found in the thyroid gland. The neoplastic epithelial cells were strongly immunoreactive for cytokeratin 7 (and vimentin but negative for thyroid transcription factor-1 and thyroglobulin. This is the first reported case of TLFCK to consist of widespread metastases to the skull and meninges and provides evidence that this rare variant of renal cell carcinoma has uncertain malignant potential and can be more clinically aggressive than previously believed. PMID:27082575

  8. 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)

  9. Biology and Molecular Markers of Malignant Gonadal Germ Cell Tumors

    Salonen, Jonna

    2009-01-01

    Germ cell tumors occur both in the gonads of both sexes and in extra-gonadal sites during adoles-cence and early adulthood. Malignant ovarian germ cell tumors are rare neoplasms accounting for less than 5% of all cases of ovarian malignancy. In contrast, testicular cancer is the most common malignancy among young males. Most of patients survive the disease. Prognostic factors of gonadal germ cell tumors include histology, clinical stage, size of the primary tumor and residua, and levels of tu...

  10. Thermoradiotherapy in treatment of vulva neoplasm

    The possibilities of increasing of radiotherapy efficiency using local SHF-hyperthermia in treating primary and relapsed neoplasms as well as metastases in patients with vulva neoplasms are clarified. It is shown that immediate and early results of thermoradiotherapy of vulva neoplasms and metastases are favourable. Further investigations in this field are necessary. 4 refs

  11. 9 CFR 311.11 - Neoplasms.

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Neoplasms. 311.11 Section 311.11... CERTIFICATION DISPOSAL OF DISEASED OR OTHERWISE ADULTERATED CARCASSES AND PARTS § 311.11 Neoplasms. (a) An individual organ or other part of a carcass affected with a neoplasm shall be condemned. If there is...

  12. Plasma levels of osteocalcin and retinol binding protein-4 in patients with medullary thyroid carcinoma

    Jabar Lotfi; Mohammad Taghikhani; Marjan Zarif Yeganeh; Sara Sheikholeslami; Mehdi Hedayati

    2014-01-01

    Background: Thyroid carcinoma is the most frequent malignant tumor of the endocrine system in human body and accounts for nearly 1% of all cancers. Medullary thyroid carcinoma is the third frequent of thyroid cancer and accounts about 5-8% of thyroid cancer. Osteocalcin, known as a Bone Gamma-carboxyglutamic Acid-containing Protein (BGLAP), is the most non collagenous protein. Retinol binding proteins are the family of proteins that have diverse actions but mainly transport retinol in human b...

  13. 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.

  14. 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.

  15. Cellular schwannoma: a benign neoplasm sometimes overdiagnosed as sarcoma

    Alberghini, M. [Dept. of Surgical Pathology, Rizzoli Institute, Bologna (Italy); Anatomia Patologica, Istituto Rizzoli, Bologna (Italy); Zanella, L.; Bacchini, P.; Bertoni, F. [Dept. of Surgical Pathology, Rizzoli Institute, Bologna (Italy)

    2001-06-01

    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.)

  16. 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.)

  17. Relationship between prognostic score and thyrotropin receptor (TSH-R) in papillary thyroid carcinoma: immunohistochemical detection of TSH-R.

    Tanaka, K.; 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...

  18. Primary Ureteral Thyroid Transcription Factor 1-Positive Small Cell Neuroendocrine Carcinoma: Case Report and Review of the Literature.

    Acosta, Andrés Martin; Hamedani, Farid Saei; Meeks, Joshua James; Wu, Shoujin

    2015-09-01

    Upper urinary tract neoplasms comprise only 5% of urinary malignancies overall, the overwhelming majority showing an urothelial histology. Nonurothelial lesions represent 1.9% of upper tract neoplasms, and small cell carcinomas (SmCCs) only account for a minute fraction of them, with few cases reported in the literature to date. In the genitourinary tract, these lesions are most frequently found in the urinary bladder, where they tend to show a mixed histology with a characteristic small cell neuroendocrine component that is positive for chromogranin A, synaptophysin, and CD56 immunostains. Urinary SmCCs are almost invariably aggressive, with a propensity to infiltrate surrounding tissues and vascular structures. Unfortunately, clinical stage at presentation is often advanced, with early dissemination to lymph nodes or distant organs in a significant proportion of patients. For the most part, prognosis is dismal and can be predicted by the pathologic stage at diagnosis. Recently, new chemotherapeutic regimens have shown some potential benefit for the treatment of urinary SmCC, albeit not achieving curative results. Here we present the case of a 71-year-old male patient with a history of treated bladder urothelial carcinoma that presented with subacute flank pain and was diagnosed with a primary pure SmCC of the ureter. Besides the usual neuroendocrine immunomarkers, this tumor showed intense positivity for TTF-1 (thyroid transcription factor-1), a phenomenon that has been described for extrapulmonary SmCC of other locations. PMID:26162396

  19. Thyroid Nodules and Thyroid Cancer: Surgical Aspects

    Clark, Orlo H.

    1980-01-01

    Patients with thyroid nodules must be treated selectively because these nodules develop far more frequently than does thyroid cancer. A thorough clinical history, family history and history of radiation, as well as an accurate physical examination, are very important in determining whether surgical treatment is indicated. Thyroid function tests, a radioactive isotope scan, a thyroid echogram and fine-needle biopsy are also useful.

  20. 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