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  1. Thyroid cancer - medullary carcinoma

    Science.gov (United States)

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary ... National Cancer Institute. PDQ thyroid cancer treatment. Bethesda, ... February 4, 2016. www.cancer.gov/cancertopics/pdq/treatment/ ...

  2. Thyroid carcinoma

    International Nuclear Information System (INIS)

    Lambertini, Roberto; Dalurzo, Liliana; Jaen, Ana del V.

    2008-01-01

    In this document the case of a 66-year old woman is presented, with record of multi nodular goiter of 5 year of evolution, which is derived to scan ultrasound office to make a puncture-aspiration with thin needle because of the growth of nodular thyroid injuries. The ultrasound scan examination made before the puncture determine multiple dominant nodules of hyperplasia aspect between 15 and 25 mm of diameter and a small nodule of 6 mm suspected proliferate process. Despite its size, it was decided to include small nodule in injuries to a biopsy. The cytological study reveals nodular hyperplasia with carcinoma in the small nodule of 6 mm. A thyroidectomy is practiced on the patient. The deferred histological study of the thyroid gland confirms the finding of multi-nodular goiter with a small focus of papillar carcinoma. The ganglions examined were negative in the deferred examination [es

  3. Protocol for thyroid remnant ablation after recombinant TSH in thyroid carcinoma Protocolo para ablación de remanentes tiroideos luego de TSH recombinante en el cáncer diferenciado de tiroides

    Directory of Open Access Journals (Sweden)

    Fabián Pitoia

    2009-02-01

    Full Text Available In some countries, in order to perform rhTSH-aided thyroid remnant ablation (TRA after surgery, it is generally necessary to confirm that thyroidectomy has been almost complete. Otherwise, the nuclear medicine specialist will not administer a high radioiodine dose because it might be hazardous due to the possibility of thyroid remnant actinic thyroiditis. Considering this, it would be necessary to use two rhTSH kits (one for diagnostic purposes and the other one to administer the 131I dose. In this study, we used an alternative protocol for TRA with the use of one kit of rhTSH in twenty patients diagnosed with low risk papillary thyroid carcinoma. All patients had negative titers of anti-thyroglobulin antibodies. Successful thyroid remnant ablation was confirmed with an undetectable rhTSH stimulated thyroglobulin level (En algunos países, para realizar la ablación de los remanentes tiroideos con radioyodo después de la cirugía, generalmente se requiere confirmar que la tiroidectomía fue casi completa, ya que de otra manera el especialista en medicina nuclear no administrará una dosis elevada de radioyodo, considerando que esto puede ser dañino para el paciente debido a la posibilidad de generar una tiroiditis actínica. De acuerdo con esto, sería necesario administrar 2 kits de rhTSH (uno para diagnóstico y otro para la dosis de radioyodo. En este estudio, empleamos un protocolo alternativo para la ablación luego de la administración de un único kit (2 ampollas de rhTSH en 20 pacientes con antecedentes de un carcinoma papilar de bajo riesgo. Todos los pacientes presentaban títulos negativos de anticuerpos anti-tiroglobulina. La ablación exitosa de remanente tiroideo se confirmó con un nivel no detectable de tiroglobulina (<1 ng/ml al estímulo por rhTSH en los 20 pacientes, entre 8 a 12 meses luego de la ablación. El uso de este protocolo que combina la posibilidad de realizar un centellograma diagnóstico y la ablación luego

  4. Thyroid carcinoma

    International Nuclear Information System (INIS)

    Friedman, M.; Skolnik, E.M.; Baim, H.M.; Becker, S.P.; Katz, A.H.; Mantravadi, R.V.

    1980-01-01

    Differentiated thyroid carcinoma was studied with regard to mode of presentation, initial findings, treatment and survival. The classic signs, symptoms, physical and scan findings were found to be present in approximately 70% of the patients. Prognosis was found to be dependent on age of presentation more than any other factor. Patients with prior exposure to radiation were found to have more extensive disease and require more extensive surgery but ultimately had the same prognosis for 15-year cure. Treatment for distant metastatic disease by surgery, radioactive iodine and external radiation all resulted in long-term survival in certain cases

  5. Thyroid cancer - papillary carcinoma

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000331.htm Thyroid cancer - papillary carcinoma To use the sharing features on ... does not increase the risk of developing thyroid cancer. Symptoms Thyroid cancer often begins as a small lump (nodule) ...

  6. MEDULLARY THYROID CARCINOMA

    Directory of Open Access Journals (Sweden)

    V. S. Medvedev

    2013-01-01

    Full Text Available Medullary thyroid carcinoma belongs to orphan diseases affecting a small part of the population. Multicenter trials are required to elaborate a diagnostic algorithm, to define treatment policy, and to predict an outcome.

  7. Papillary thyroid carcinoma

    DEFF Research Database (Denmark)

    Godballe, C; Asschenfeldt, P; Sørensen, J A

    1994-01-01

    The age influence on the prognosis of papillary thyroid carcinoma was analyzed in a group of 67 patients. A marked decline in cause-specific survival was found for patients older than 60 years of age at the time of diagnosis. In order to find a tumor-biological explanation of the prognostic...... invasion and distant metastases. The results indicate that 60 years of age the time of diagnosis may be the "prognostic break-point" for papillary thyroid carcinoma....

  8. Carcinoma of the thyroid

    International Nuclear Information System (INIS)

    Botta Zunino, L.

    1992-01-01

    Reference is made to the diagnostic evaluation of thyroid nodule, reaffirming the concepts of algorithm study, sensitivity and specificity of diagnostic procedures and cost-effectiveness. Stressing once again the place of cytology and the concept of selecting patients for surgery, surgical tactics in front of the thyroid nodule and the need for probate multidisciplinary study and treatment of this pathology. Briefly discusses the most controversial treatment of differentiated thyroid carcinomas, the sine qua non of the pathologist in the operating room in thyroid surgery and the value of the quantification of nuclear DNA in the diagnosis and prognosis of these tumors (Author) [es

  9. Emerging therapies for thyroid carcinoma.

    LENUS (Irish Health Repository)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Thyroid carcinoma and hot nodule

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Thyroglossal Duct Papillary Thyroid Carcinoma and Synchronous Lingual Thyroid Atypia

    Directory of Open Access Journals (Sweden)

    Timothy Yoo

    2016-01-01

    Full Text Available Thyroglossal duct and lingual thyroid ectopic lesions are exceedingly rare synchronous findings. Papillary thyroid carcinoma of these ectopic thyroid sites is well understood but still a rare finding. This case points to some management nuances in regard to ectopic thyroid screening with imaging and also shows the effectiveness of minimally invasive transoral robotic surgery for lingual thyroid.

  13. Clinical Observation on Thyroid Carcinoma

    International Nuclear Information System (INIS)

    Park, Seon Yang; Shin, Yong Tae; Cho, Bo Yun; Kim, Byung Kuk; Koh, Chang Soon; Lee, Mun Ho

    1978-01-01

    Clinical features of 147 patients with biopsy-proven thyroid carcinomas were investigated from January, 1972 to April, 1978 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid carcinomas according to their histopathological classification revealed 76.2% of papillary carcinoma, 19.0% of follicular carcinoma, and 3 cases of occult sclerozing carcinoma, 1 case of giant cell carcinoma and 1 case of metastatic melanoma. 2) The ratio of male to female patients was 1:8.3 and showed no difference between papillary and follicular carcinomas. 3) The age distribution showed the peak incidence in the fourth decade (29.3%) followed by the fifth and sixth decades. 4) The average duration of illness from the onset of symptoms was about 5 years while it was 4.4 years and 7.6 years in the papillary and follicular carcinomas respectively. 5) The diameter of the thyroid masses was smaller than 5 cm in 53.6% of the patients, from 5 cm to 10 cm in 40.0% and larger than 10 cm in 6.4%. 6) In 36.4% of the patients with thyroid carcinomas the thyroid masses were fixed to adjacent tissues. 7) Metastasis to the regional lymph nodes was noted in 40.0% of the total cases, and in 45.2% and 17.6% of the papillary and follicular carcinomas respectively, while the lung and bone metastases were found in 10.0% and 4.4% in each type respectively. 8) 88.9% of the patients showed cold areas in the thyroid scans using 131 I. 9) Typical psammoma bodies were observed in 21.3% of the cases in the microscopic examination of the pathological specimens. 10) The initial diagnosis of thyroid malignancy could be made before histological confirmation in 64.5% of the patients. 11) The clinical staging slightly modified from Schulz method revealed 43.6% of the patients in stage I, 26.4% in stage II, 20.9% in stage III and 9.1% in stage IV. 12) The association with Hashimoto's thyroiditis was noted in 4 cases, with nodular goiter in 3 cases, and with follicular adenoma

  14. Clinical Observation on Thyroid Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seon Yang; Shin, Yong Tae; Cho, Bo Yun; Kim, Byung Kuk; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1978-09-15

    Clinical features of 147 patients with biopsy-proven thyroid carcinomas were investigated from January, 1972 to April, 1978 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid carcinomas according to their histopathological classification revealed 76.2% of papillary carcinoma, 19.0% of follicular carcinoma, and 3 cases of occult sclerozing carcinoma, 1 case of giant cell carcinoma and 1 case of metastatic melanoma. 2) The ratio of male to female patients was 1:8.3 and showed no difference between papillary and follicular carcinomas. 3) The age distribution showed the peak incidence in the fourth decade (29.3%) followed by the fifth and sixth decades. 4) The average duration of illness from the onset of symptoms was about 5 years while it was 4.4 years and 7.6 years in the papillary and follicular carcinomas respectively. 5) The diameter of the thyroid masses was smaller than 5 cm in 53.6% of the patients, from 5 cm to 10 cm in 40.0% and larger than 10 cm in 6.4%. 6) In 36.4% of the patients with thyroid carcinomas the thyroid masses were fixed to adjacent tissues. 7) Metastasis to the regional lymph nodes was noted in 40.0% of the total cases, and in 45.2% and 17.6% of the papillary and follicular carcinomas respectively, while the lung and bone metastases were found in 10.0% and 4.4% in each type respectively. 8) 88.9% of the patients showed cold areas in the thyroid scans using {sup 131}I. 9) Typical psammoma bodies were observed in 21.3% of the cases in the microscopic examination of the pathological specimens. 10) The initial diagnosis of thyroid malignancy could be made before histological confirmation in 64.5% of the patients. 11) The clinical staging slightly modified from Schulz method revealed 43.6% of the patients in stage I, 26.4% in stage II, 20.9% in stage III and 9.1% in stage IV. 12) The association with Hashimoto's thyroiditis was noted in 4 cases, with nodular goiter in 3 cases, and with follicular

  15. Gene therapy of thyroid carcinoma

    International Nuclear Information System (INIS)

    Zheng Wei; Tan Jian

    2007-01-01

    Normally, differentiated thyroid carcinoma(DTC) is a disease of good prognosis, but about 30% of the tumors are dedifferentiate, which are inaccessible to standard therapeutic procedures such as 'operation, 131 I therapy and thyroid hormone'. Both internal and abroad experts are researching a new therapy of dedifferentiated thyroid carcinoma--gene therapy. Many of them utilize methods of it, but follow different strategies: (1) transduction of the thyroid sodium/iodide transporter gene to make tissues that do not accumulate iodide treatable by 131 I therapy; (2) strengthening of the anti-tumor immune response; (3) suicide gene therapy; (4) depression the generation of tumor cells; (5) gene therapy of anti- vascularization. (authors)

  16. Hashimotos Thyroiditis with Coexistent Papillary Carcinoma and ...

    African Journals Online (AJOL)

    Lymphocytic thyroiditis and hashimotofs thyroiditis (HT) are the two main forms of autoimmune thyroiditis among which the latter is most frequent. A vast majority of cases of papillary carcinoma and primary thyroid lymphoma (PTL) arise in the setting of HT. A case of 32.year.old female who presented with thyroid ...

  17. Chemotherapy in thyroid carcinoma

    International Nuclear Information System (INIS)

    Samuel, A.M.; Shah, D.H.

    1999-01-01

    Chemotherapy alone, either as a single drug or a combination of drugs with or without external radiation (ER) is useful for treatment of locally advanced disease and non iodine concentrating metastasis in differentiated thyroid cancers (DTC). The reported response is not encouraging, but the absence of better alternatives leave no choice for the treatment of such cases. However, for treatment of anaplastic thyroid cancers (ANC), chemotherapy (CT) in combination with ER results in local control. In medullary thyroid cancers (MTC), the results obtained with multimodal treatment are encouraging

  18. Oncoytic carcinoma of the thyroid

    International Nuclear Information System (INIS)

    Schaeffer, R.; Reiners, C.; Reimann, J.; Boerner, W.

    1983-01-01

    The WHO classification of thyroid tumours does not list the oncocytic carcinomas (Huerthle cell carcinoma) as a separate tumour entity. Whereas the diagnosis of oncocytomas is relatively easy because of their characteristic cytological appearance the typing as follicular or papillary carcinoma is often problematical for pathologists; more detailed directions for the typing of Huerthle cell carcinomas in the WHO classification would be useful. It is of clinical importance that most oncocytic carcinomas are obviously able to produce thyroglobulin but unable to take up radioiodine. No significant differences are seen in sex incidence and prognosis between oncocytic and non-oncocytic differentiated thyroid carcinomas. Some histomorphological findings such as aggressively infiltrating behaviour, invasion of blood-/lymphatic vessels, lack of papillary structures, and high mitotic activity seem to be signs of bad prognoses. For therapy of oncocytic carcinomas total thyroidectomy is recommended without subsequent radioiodine treatment but with external irradiation in the few cases of more aggressive tumours. Thyroglobulin measurement using radioimmunoassay is recommended for follow-up. (orig.) [de

  19. Medullary carcinoma of the thyroid

    International Nuclear Information System (INIS)

    Samuel, A.M.; Pradhan, S.A.; D'Cruz, A.; Shah, D.H.

    1999-01-01

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

  20. [Insular carcinoma of the thyroid].

    Science.gov (United States)

    Sanz, J; Cerpa, F; Domínguez, M; Franco, C; Jadresic, A; Pérez, G; Phillippi, V

    1999-03-01

    We report 5 cases of insular carcinoma of the thyroid. Most patients were females (80%) with an age range of 28 to 75 years. Treatment consisted of total or near total thyroidectomy plus modified cervical lymph node dissection in cases with lymph node metastasis. This was followed by radioiodine therapy and external radiation therapy in patients with residual disease. None of the patients had distant metastasis. However, three patients with involvement of the perithyroid soft tissue died within 4 years of the diagnosis. The other two patients are alive without evidence of disease. This type of thyroid carcinoma has an aggresive clinical course with frequent extension to the adjacent soft tissue associated to poor outcomes.

  1. Treatment of thyroid follicular carcinoma.

    Science.gov (United States)

    Ríos, Antonio; Rodríguez, José M; Parrilla, Pascual

    2015-12-01

    Differentiated thyroid carcinoma includes 2 different tumor types, papillary (PC) and follicular carcinoma (FC), and although similar, their prognosis is different. FC is uncommon, and this has led to it often being analyzed together with PC, and therefore the true reality of this tumor is difficult to know. As a result, the diagnostic and therapeutic management and the prognostic factors in differentiated carcinoma are more predictive of PC than FC. In this review we analyze the current state of many of the therapeutic aspects of this pathology. The best surgical technique and the usefulness of associated lymphadenectomy is also analyzed. Regarding post-surgical ablation with 131I, the indications, doses and usefulness are discussed. For the remaining therapies we analyze the few indications for radiotherapy and chemotherapy, and of new drugs such as tyrosine kinase inhibitors. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Diagnosis of bone metastasis from thyroid carcinoma

    DEFF Research Database (Denmark)

    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...

  3. Synchronous thyroid carcinoma and squamous cell carcinoma. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Seo [Chonnam National Univ. School of Dentistry, Kwangju (Korea, Republic of)

    2006-12-15

    Thyroid carcinoma occurring as a second primary associated with head and neck squamous cell carcinoma (SCC) is unusual. This report presents a synchronous thyroid carcinoma and squamous cell carcinoma in the anterior palate region of a 41-year-old man. The clinical, radiologic, and histologic features are described. At 10-month follow-up after operation, no evidence of recurrence ana metastasis was present.

  4. Differentiated thyroid carcinoma : nuclear medicine studies

    NARCIS (Netherlands)

    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

  5. Treatment of well-differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Block, M.A.

    1981-01-01

    Improved selection of thyroid nodules for surgery and greater individualization of surgery for well-differentiated thyroid carcinoma are emphasized. Thyroid nodules are common but infrequently are manifestations of carcinoma. Needle biopsy permits better selection of patients with thyroid nodules for surgery by identifying those which are malignant or are likely to become malignant. Experience in performing diagnostic needle biopsies and in cytologic and histologic interpretation is essential. The majority of well-differentiated thyroid carcinomas are well-localized papillary carcinomas controlled by surgery, usually a lobectomy or partial thyroidectomy. Well-differentiated thyroid carcinomas include papillary and follicular types and their subsets. The extent of surgery should be individualized based on gross extent of disease, histologic variety, and age of the patient. The prognosis is reduced for patients more than 40 years of age. With appropriate early surgical treatment, the outlook is excellent. Metastatic disease can frequently also be controlled by large doses of thyroid hormone and the use of radioactive iodine

  6. Hashimoto's thyroiditis - an independent risk factor for papillary carcinoma.

    Science.gov (United States)

    Uhliarova, Barbora; Hajtman, Andrej

    2017-09-14

    The link between Hashimoto's thyroiditis and thyroid carcinoma has long been a topic of controversy. The aim of our study was to determine the prevalence of thyroid carcinoma and Hashimoto's thyroiditis coexistence in histopathologic material of thyroidectomized patients. In a retrospective study, the clinicohistopathologic data of 2117 patients (1738 females/379 males), who underwent total or partial thyroidectomy for thyroid gland disorder at a single institution from the 1st of January 2005 to the 31st of December 2014 were analyzed. Thyroid carcinoma was detected in 318 cases (15%) and microcarcinoma (thyroid cancer ≤10mm in diameter) was found in permanent sections in 169 cases (8%). Hashimoto's thyroiditis was detected in 318 (15%) patients. Hashimoto's thyroiditis was significantly more often associated with thyroid carcinoma and microcarcinoma compare to benign condition (p=0.048, p=0.00014, respectively). Coexistence of Hashimoto's thyroiditis and thyroid carcinoma/thyroid microcarcinoma did not affect tumor size (p=0.251, p=0.098, respectively), or tumor multifocality (p=0.831, p=0.957, respectively). Bilateral thyroid microcarcinoma was significantly more often detected when Hashimoto's thyroiditis was also diagnosed (p=0.041), but presence of Hashimoto's thyroiditis did not affect bilateral occurrence of thyroid carcinoma (p=0.731). Hashimoto's thyroiditis is associated with significantly increased risk of developing thyroid carcinoma, especially thyroid microcarcinoma. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  7. Differentiated thyroid carcinoma and intestinal polyposis syndromes.

    Science.gov (United States)

    Triggiani, Vincenzo; Angelo Giagulli, Vito; Tafaro, Angela; Resta, Francesco; Sabba, Carlo; Licchelli, Brunella; Guastamacchia, Edoardo

    2012-12-01

    Familial Adenomatous Polyposis, Cowden's Syndrome, and Peutz-Jeghers Syndrome are well known as Intestinal Polyposis Syndromes, inherited conditions characterized by the development of polyps of the gastro-intestinal tract in association with extra-intestinal manifestations, in particular malignant tumors at different sites. Thyroid carcinoma is sometimes a part of the clinical picture of these syndromes. The aim of this paper is to review the literature dealing with the association between differentiated thyroid carcinomas and Intestinal Polyposis Syndromes in order to point out peculiar aspects, providing suggestions for the screening and the management of thyroid tumors in these patients.

  8. Thyroid hormone therapy following the thyroidectomy for thyroid carcinoma

    International Nuclear Information System (INIS)

    Horster, F.A.

    1986-01-01

    Medication with thyroid hormones following total thyroidectomy for thyroid carcinoma is based on the following principles: 1. The patient is informed about the lifelong necessity of taking a thyroid hormones daily before breakfast. This hormone must be given orally and its bioligical effect is identical with that of the tyhroid hormone secreted by the healthy thyroid gland. 2. The daily dosage of thyroid hormones may be assessed on the basis of the following parameters: a) the patient's clinical euthyroidism, b) suppression of thyrotropic activity, c) unrestricted tolerance of the preparation. 3. The in vitro parameters associated with optimal medication should be within the following ranges: Thyroxine value (TT4 or FT4): above the normal range, triiodothyronine value (TT3 or FT3): within the upper normal range and thyrotropin value (TSH 'ultrasensitive' or TRH-test): suppressed. (orig.) [de

  9. Cathepsin B trafficking in thyroid carcinoma cells

    Directory of Open Access Journals (Sweden)

    Tedelind Sofia

    2011-08-01

    Full Text Available Abstract Background The cysteine peptidase cathepsin B is important in thyroid physiology by being involved in prohormone processing initiated in the follicle lumen and completed in endo-lysosomal compartments. However, cathepsin B has also been localized to the extrafollicular space in thyroid cancer tissue, and is therefore suggested to promote invasiveness and metastasis in thyroid carcinomas through e.g. extracellular matrix degradation. Methods Transport of cathepsin B in normal thyroid epithelial and carcinoma cells was investigated through immunolocalization of endogenous cathepsin B in combination with probing protease activity. Transport analyses of cathepsin B-eGFP and its active-site mutant counterpart cathepsin B-C29A-eGFP were used to test whether intrinsic sequences of a protease influence its trafficking. Results Our approach employing activity based probes, which distinguish between active and inactive cysteine proteases, demonstrated that both eGFP-tagged normal and active-site mutated cathepsin B chimeras reached the endo-lysosomal compartments of thyroid epithelial cells, thereby ruling out alterations of sorting signals by mutagenesis of the active-site cysteine. Analysis of chimeric protein trafficking further showed that GFP-tagged cathepsin B was transported to the expected compartments, i.e. endoplasmic reticulum, Golgi apparatus and endo-lysosomes of normal and thyroid carcinoma cell lines. However, the active-site mutated cathepsin B chimera was mostly retained in the endoplasmic reticulum and Golgi of KTC-1 and HTh7 cells. Hence the latter, as the least polarized of the three carcinoma cell lines analyzed, exhibited severe transport defects in that it retained chimeras in pre-endolysosomal compartments. Furthermore, secretion of endogenous cathepsin B and of other cysteine peptidases, which occurs at the apical pole of normal thyroid epithelial cells, was most prominent and occurred in a non-directed fashion in thyroid

  10. Synchronous Parathyroid and Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Shi-Dou Lin

    2005-02-01

    Full Text Available Concomitant thyroid disease is not unusual among patients with primary hyperparathyroidism. However, the simultaneous occurrence of parathyroid and thyroid carcinoma is extremely rare. We report a 38-year-old man with primary hyperparathyroidism who presented with osteitis fibrosa cystica complicated with pathologic femoral neck fracture. Preoperative investigation for exclusion of multiple endocrine neoplasia did not find evidence of medullary thyroid carcinoma or pheochromocytoma, but imaging studies revealed the presence of nodules in the right lobe and a parathyroid lesion over the left inferior pole of the thyroid gland. Total thyroidectomy, left parathyroidectomy, and bipolar hemiarthroplasty of the left hip were then performed simultaneously. The resected specimens were pathologically identified as papillary thyroid carcinoma and parathyroid carcinoma, respectively. After the operation, 131I ablation therapy was administered at a dose of 120 mCi. Additional doses of 30 mCi were given yearly as serum thyroglobulin level became elevated. Serum calcium level remained normal during yearly follow-up. Although parathyroid carcinoma is an uncommon cause of parathyroid hormone-dependent hypercalcemia, it should nonetheless be given due consideration because its surgical approach differs from that of parathyroid adenoma. As the coexistence of parathyroid and non-medullary thyroid carcinoma has previously been reported, the possibility of both malignancies must also be considered in the setting of primary hyperparathyroidism with thyroid nodules. If confirmed with preoperative parathyroid scintigraphic and other laboratory studies, an optimal outcome may be achieved with complete resection of both tumors at the time of initial operation, followed by adjunctive therapy.

  11. Papillary thyroid carcinoma formation in a thyroglossal cyst: a case ...

    African Journals Online (AJOL)

    Thyroglossal cyst rarely presents with carcinoma formation in the remnants of the thyroid gland. We report a 40 year old male with papillary thyroid carcinoma formation in a thyroglossal cyst. The patient underwent surgical intervention for the cyst. His pathology was positive for thyroid carcinoma and he underwent complete ...

  12. Metastatic follicular carcinoma of thyroid in maxilla

    OpenAIRE

    Kumar, Caliaperoumal Santhosh; Shanmugam, Devakumari; Venkatapathy, Ramesh; Munshi, Meer Ahmed Ibrahim

    2013-01-01

    Metastasis to the oral region is very rare and accounts for less than 1% of oral malignant tumors. Breast, lung, kidney, adrenal, gastro intestinal tract and prostates are most common primary tumors from which metastasis to oral region occur frequently. Metastasis from thyroid gland is extremely rare to oral region. We present an unusual case of metastatic follicular carcinoma of thyroid in maxilla. The significance of this report is that the secondary lesion was the only symptom of the prima...

  13. Serum thyroglobulin: tumor marker in thyroid carcinoma

    International Nuclear Information System (INIS)

    Ajay Kumar; Shah, D.H.

    1999-01-01

    Measurement of s-Tg is of limited value in the diagnosis of primary thyroid tumor but is very useful in post-operative management of differentiated thyroid carcinoma. The sensitivity and the specificity of Tg determination is comparable to that obtained with whole body scan WBS, however, both are complimentary. In our experience, the accuracy of s-Tg determination whether on or off thyroxin medication does not differ significantly

  14. Ultrasonographic imaging of papillary thyroid carcinoma variants

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jung Hee [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    Ultrasonography (US) is routinely used to evaluate thyroid nodules. The US features of papillary thyroid carcinoma (PTC), the most common thyroid malignancy, include hypoechogenicity, spiculated/microlobulated margins, microcalcifications, and a nonparallel orientation. However, many PTC variants have been identified, some of which differ from the classic type of PTC in terms of biological behavior and clinical outcomes. This review describes the US features and clinical implications of the variants of PTC. With the introduction of active surveillance replacing immediate biopsy or surgical treatment of indolent, small PTCs, an understanding of the US characteristics of PTC variants will facilitate the individualized management of patients with PTC.

  15. Malar Bone Metastasis Revealing a Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Ihsen Slim

    2012-01-01

    Full Text Available Papillary thyroid carcinoma is the most common form of differentiated thyroid carcinoma. It is generally confined to the neck with or without spread to regional lymph nodes. Metastatic thyroid carcinomas are uncommon and mainly include lung and bone. Metastases involving oral and maxillofacial region are extremely rare. We described a case of malar metastasis revealing a follicular variant of papillary thyroid carcinoma, presenting with pain and swelling of the left cheek in a 67-years-old female patient with an unspecified histological left lobo-isthmectomy medical history. To our knowledge, this is the first recorded instance of a malar metastasis from a follicular variant of papillary thyroid carcinoma.

  16. Papillary thyroid carcinoma presenting as an asymptomatic pelvic bone metastases

    Directory of Open Access Journals (Sweden)

    Siddiq S

    2010-05-01

    Full Text Available Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites.We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma.Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.

  17. Cervical lymphadenopathy: metastasis of papillary carcinoma or ectopic thyroid tissue?

    Science.gov (United States)

    Simion, Nicolae Irinel; Muntean, Valentin

    2012-01-01

    Papillary thyroid carcinoma frequently metastasises to the regional neck lymph nodes. However, cervical lymph node metastases as sole manifestation of occult papillary thyroid carcinoma are observed rarely. The authors report the case of a 52-year-old man presenting for slowly enlarging neck region and shortness of breath, with an insidious history for 15 years. Thyroid imaging showed a goitre predominantly of the right lobe, but histopathological finding revealed a multi-centric thyroid papillary carcinoma with lymph node metastasis. PMID:22605833

  18. Metabolic Reprogramming in Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Raquel Guimaraes Coelho

    2018-03-01

    Full Text Available Among all the adaptations of cancer cells, their ability to change metabolism from the oxidative to the glycolytic phenotype is a hallmark called the Warburg effect. Studies on tumor metabolism show that improved glycolysis and glutaminolysis are necessary to maintain rapid cell proliferation, tumor progression, and resistance to cell death. Thyroid neoplasms are common endocrine tumors that are more prevalent in women and elderly individuals. The incidence of thyroid cancer has increased in the Past decades, and recent findings describing the metabolic profiles of thyroid tumors have emerged. Currently, several drugs are in development or clinical trials that target the altered metabolic pathways of tumors are undergoing. We present a review of the metabolic reprogramming in cancerous thyroid tissues with a focus on the factors that promote enhanced glycolysis and the possible identification of promising metabolic targets in thyroid cancer.

  19. Metabolic Reprogramming in Thyroid Carcinoma

    Science.gov (United States)

    Coelho, Raquel Guimaraes; Fortunato, Rodrigo S.; Carvalho, Denise P.

    2018-01-01

    Among all the adaptations of cancer cells, their ability to change metabolism from the oxidative to the glycolytic phenotype is a hallmark called the Warburg effect. Studies on tumor metabolism show that improved glycolysis and glutaminolysis are necessary to maintain rapid cell proliferation, tumor progression, and resistance to cell death. Thyroid neoplasms are common endocrine tumors that are more prevalent in women and elderly individuals. The incidence of thyroid cancer has increased in the Past decades, and recent findings describing the metabolic profiles of thyroid tumors have emerged. Currently, several drugs are in development or clinical trials that target the altered metabolic pathways of tumors are undergoing. We present a review of the metabolic reprogramming in cancerous thyroid tissues with a focus on the factors that promote enhanced glycolysis and the possible identification of promising metabolic targets in thyroid cancer. PMID:29629339

  20. Induction of thyroid carcinoma by ionizing radiation

    International Nuclear Information System (INIS)

    Roedler, H.D.

    1987-01-01

    The risk of thyroid carcinoma induction, due to external or internal exposure of the thyroid, is described and quantified. A modified absolute risk model is used. The assessment is based on a risk coefficient of 2.5 induced cases per million persons per cGy per year of risk, derived from US-investigations in persons who had received external radiation therapy during childhood for treatment of benign diseases. This value is considered to be suitable for a dose range of 0.06-15 Gy. Modifying factors are given for age at exposure, gender and relative effectiveness of various radiation sources. The minimum induction period is taken to be 5 years; the remaining life expectancy minus minimum induction period is considered as the number of years at risk. For external exposure of the general public, a calculated incidence for lethal thyroid carcinoma of 7.5 cases per million persons per cGy thyroid dose for the total life time may be derived from the average life expectancy, the age distribution of the population and a mortality of radiation induced thyroid carcinoma of 10%. This figure is in good agreement with earlier estimates. (orig./ECB) [de

  1. Synchronous parathyroid adenoma and papillary thyroid carcinoma ...

    African Journals Online (AJOL)

    Simultaneous existence of parathyroid adenoma and thyroid nonmedullary carcinoma is rarely observed. A 52‑year‑old female was diagnosed approximately 4 years ago with primary hyperparathyroidism (PHPT) on the basis of hypercalcemia and elevated serum parathyroid hormone (PTH) level. Clinically, PHPT ...

  2. Synchronous Parathyroid Adenoma and Papillary Thyroid Carcinoma

    African Journals Online (AJOL)

    Simultaneous existence of parathyroid adenoma and thyroid nonmedullary carcinoma is rarely observed. A 52‑year‑old female was diagnosed approximately. 4 years ago with primary hyperparathyroidism (PHPT) on the basis of hypercalcemia and elevated serum parathyroid hormone (PTH) level. Clinically,.

  3. A case of metastatic renal cell carcinoma to thyroid gland.

    Science.gov (United States)

    Lee, Jae-Geun; Yang, Youngro; Kim, Kwang Sik; Hyun, Chang Lim; Lee, Ji Shin; Koh, Gwanpyo; Lee, Daeho

    2011-08-01

    Metastasis to the thyroid gland from distant cancer is rare, and, in some cases, is a diagnostic challenge. Here, we report a case of metastatic renal cell carcinoma of the thyroid gland. A 77-year-old man presented with a neck mass detected about 1 month previously. He had undergone a right nephrectomy owing to renal cell carcinoma 14 years previously. Fine needle aspiration cytology showed a few atypical follicular cells with nuclear atypia. Under a tentative diagnosis of papillary thyroid carcinoma, a total thyroidectomy was performed. The histologic and immunohistochemical studies of the surgical specimens indicated that the thyroid masses were metastatic renal cell carcinoma to the thyroid.

  4. Medullary carcinoma of the thyroid - an unusual case of hyalinizing ...

    African Journals Online (AJOL)

    Medullary thyroid carcinoma is a neoplasm occurring in sporadic and familial patterns. A rare variant of medullary thyroid carcinoma shows microscopic features similar to hyalinizing trabecular adenoma of thyroid. Detection of this variant requires a high index of suspicion and immunohistochemical confirmation by ...

  5. Painless thyroiditis associated to thyroid carcinoma: role of initial ultrasonography evaluation.

    Science.gov (United States)

    Valentini, Raisa Bressan; Macedo, Bruno Mussoi de; Izquierdo, Rogério Friedrich; Meyer, Erika Laurini Souza

    2016-04-01

    Even though it is a rare event, most associations of thyroid carcinoma with subacute thyroiditis described in the literature are related to its granulomatous form (Quervain's thyroiditis). We present a patient with subacute lymphocytic thyroiditis (painless thyroiditis) and papillary thyroid cancer that was first suspected in an initial ultrasound evaluation. A 30-year old female patient who was referred to the emergency room due to hyperthyroidism symptoms was diagnosed with painless thyroiditis established by physical examination and laboratory findings. With the presence of a palpable painless thyroid nodule an ultrasound was prescribed and the images revealed a suspicious thyroid nodule, microcalcification focus in the heterogeneous thyroid parenquima and cervical lymphadenopathy. Fine needle aspiration biopsy was taken from this nodule; cytology was assessed for compatibility with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a multicentric papillary carcinoma and lymphocytic infiltration. Subacute thyroiditis, regardless of type, may produce transitory ultrasound changes that obscure the coexistence of papillary carcinoma. Due to this, initial thyroid ultrasound evaluation should be delayed until clinical recovery. We recommended a thyroid ultrasound exam for initial evaluation of painless thyroiditis, particularly in patients with palpable thyroid nodule. Further cytological examination is recommended in cases presenting with suspect thyroid nodule and/or non-nodular hypoechoic (> 1 cm) or heterogeneous areas with microcalcification focus.

  6. Metastatic renal cell carcinoma to the thyroid gland.

    Science.gov (United States)

    Duggal, Neal Murari; Horattas, Mark C

    2008-11-01

    To examine the presentation, diagnosis, and appropriate management of renal clear cell carcinoma metastasis to the thyroid gland. We describe a clinical case of solitary thyroid metastasis from renal clear cell carcinoma and present a comprehensive review of the related English-language literature. Common patterns of presentation and generalized overall management recommendations are evaluated and summarized. Eight years after nephrectomy for renal carcinoma at age 61 years, a man presented with a thyroid mass. Cytology and histopathologic surgical findings were consistent with a solitary metastasis most compatible with metastatic clear cell carcinoma from his previous renal carcinoma. After left thyroid lobectomy and isthmusectomy, the patient remains disease-free 5 years later. Although uncommon, nearly 150 cases of clinically recognized metastatic renal cell carcinoma to the thyroid have been reported in the English-language literature. Metastatic disease from the kidney to the thyroid gland can occur more than 20 years after nephrectomy with the average time interval being 7.5 years. Obtaining a full clinical history in any patient who presents with a thyroid nodule is essential to allow consideration of possible metastatic disease from previous primary tumor. Metastatic disease to the thyroid gland can be correctly diagnosed preoperatively. If metastatic renal cancer is limited to the thyroid gland only, prompt, appropriate surgical intervention can be curative. Metastatic renal carcinoma to the thyroid should be considered in any patient presenting with a thyroid mass and a medical history of renal cell carcinoma.

  7. Metastatic follicular carcinoma of thyroid in maxilla

    Directory of Open Access Journals (Sweden)

    Caliaperoumal Santhosh Kumar

    2013-01-01

    Full Text Available Metastasis to the oral region is very rare and accounts for less than 1% of oral malignant tumors. Breast, lung, kidney, adrenal, gastro intestinal tract and prostates are most common primary tumors from which metastasis to oral region occur frequently. Metastasis from thyroid gland is extremely rare to oral region. We present an unusual case of metastatic follicular carcinoma of thyroid in maxilla. The significance of this report is that the secondary lesion was the only symptom of the primary tumor and helped us in diagnosis and treatment of disease.

  8. Metastatic follicular carcinoma of thyroid in maxilla.

    Science.gov (United States)

    Kumar, Caliaperoumal Santhosh; Shanmugam, Devakumari; Venkatapathy, Ramesh; Munshi, Meer Ahmed Ibrahim

    2013-11-01

    Metastasis to the oral region is very rare and accounts for less than 1% of oral malignant tumors. Breast, lung, kidney, adrenal, gastro intestinal tract and prostates are most common primary tumors from which metastasis to oral region occur frequently. Metastasis from thyroid gland is extremely rare to oral region. We present an unusual case of metastatic follicular carcinoma of thyroid in maxilla. The significance of this report is that the secondary lesion was the only symptom of the primary tumor and helped us in diagnosis and treatment of disease.

  9. Papillary thyroid carcinoma: does the association with Hashimoto's thyroiditis affect the clinicopathological characteristics of the disease?

    Directory of Open Access Journals (Sweden)

    Fábio Muradás Girardi

    2015-06-01

    Full Text Available INTRODUCTION: Papillary carcinoma is the most common malignant thyroid neoplasm. The effect of the concurrent presence of Hashimoto's thyroiditis and papillary thyroid carcinoma remains controversial. OBJECTIVE: To evaluate the association between Hashimoto's thyroiditis and clinicopathological parameters in thyroid papillary carcinoma cases, based on an historical institutional cohort analysis. METHODS: Cross-sectional study obtained from a historical cohort, including all cases submitted to thyroidectomy for papillary thyroid carcinoma in a single institution during an 11-year period study. RESULTS: A total of 417 patients with papillary thyroid carcinoma were enrolled; 148 (35.4% also had Hashimoto's thyroiditis. A female predominance among cases associated to Hashimoto's thyroiditis was observed. The thyroid tumor, in cases associated with Hashimoto's thyroiditis, had a smaller mean diameter, lower frequency of extra-thyroid extension, and earlier clinicopathological staging. CONCLUSIONS: A high proportion of papillary thyroid carcinoma cases are associated with Hashimoto's thyroiditis. There are associations among these cases with several histopathological factors already recognized for their prognostic value, which by themselves could impact outcomes.

  10. Medullary Thyroid Carcinoma Program | Center for Cancer Research

    Science.gov (United States)

    Medullary Thyroid Carcinoma Program Multiple endocrine neoplasia (MEN) types 2A and 2B are rare genetic diseases, which lead to the development of medullary thyroid cancer, usually in childhood. Surgery is the only standard treatment.

  11. Molecular photoacoustic imaging of follicular thyroid carcinoma

    DEFF Research Database (Denmark)

    Levi, Jelena; Kothapalli, Sri-Rajashekar; Bohndiek, Sarah

    2013-01-01

    Purpose To evaluate the potential of targeted photoacoustic imaging as a non-invasive method for detection of follicular thyroid carcinoma. Experimental Design We determined the presence and activity of two members of matrix metalloproteinase family (MMP), MMP-2 and MMP-9, suggested as biomarkers...... in living mice optically, observing the increase in Alexa750 fluorescence, and photoacoustically, using a dual wavelength imaging method. Results Active forms of both MMP2 and MMP-9 enzymes were found in FTC133 tumor homogenates, with MMP-9 detected in greater amounts. The molecular imaging agent...... for malignant thyroid lesions, in FTC133 thyroid tumors subcutaneously implanted in nude mice. The imaging agent used to visualize tumors was MMP activatable photoacoustic probe, Alexa750-CXeeeeXPLGLAGrrrrrXK-BHQ3. Cleavage of the MMP activatable agent was imaged after intratumoral and intravenous injections...

  12. Renal Cell Carcinoma Metastatic to Thyroid Gland, Presenting Like Anaplastic Carcinoma of Thyroid

    Directory of Open Access Journals (Sweden)

    Khalid Riaz

    2013-01-01

    Full Text Available Background. Renal cell carcinoma (RCC has unpredictable and diverse behavior. The classic triad of hematuria, loin pain, and abdominal mass is uncommon. At time of diagnosis, 25%–30% of patients are found to have metastases. Bones, lungs, liver, and brain are the frequent sites of metastases. RCC with metastasis to the head and neck region and thyroid gland is the rarest manifestation and anaplastic carcinoma behaving metastatic thyroid mass is an extremely rare presentation of RCC. Case Presentation. A 56-year-old Saudi man with past history of right radical nephrectomy 5 years back presented with 3 months history of rapid increasing neck mass with dysphagia, presenting like anaplastic thyroid carcinoma. Tru-cut biopsy turned out to be metastatic renal cell carcinoma. Patient was treated with radiation therapy 30 Gy in 10 fractions to mass. Patient died 4 months after the discovery of anaplastic thyroid looking metastasis. Conclusion. Rapidly progressing thyroid metastases secondary to RCC are rare and found often unresectable which are not amenable to surgery. Palliative radiotherapy can be considered for such patients.

  13. Integrated Genomic Characterization of Papillary Thyroid Carcinoma

    Science.gov (United States)

    Agrawal, Nishant; Akbani, Rehan; Aksoy, B. Arman; Ally, Adrian; Arachchi, Harindra; Asa, Sylvia L.; Auman, J. Todd; Balasundaram, Miruna; Balu, Saianand; Baylin, Stephen B.; Behera, Madhusmita; Bernard, Brady; Beroukhim, Rameen; Bishop, Justin A.; Black, Aaron D.; Bodenheimer, Tom; Boice, Lori; Bootwalla, Moiz S.; Bowen, Jay; Bowlby, Reanne; Bristow, Christopher A.; Brookens, Robin; Brooks, Denise; Bryant, Robert; Buda, Elizabeth; Butterfield, Yaron S.N.; Carling, Tobias; Carlsen, Rebecca; Carter, Scott L.; Carty, Sally E.; Chan, Timothy A.; Chen, Amy Y.; Cherniack, Andrew D.; Cheung, Dorothy; Chin, Lynda; Cho, Juok; Chu, Andy; Chuah, Eric; Cibulskis, Kristian; Ciriello, Giovanni; Clarke, Amanda; Clayman, Gary L.; Cope, Leslie; Copland, John; Covington, Kyle; Danilova, Ludmila; Davidsen, Tanja; Demchok, John A.; DiCara, Daniel; Dhalla, Noreen; Dhir, Rajiv; Dookran, Sheliann S.; Dresdner, Gideon; Eldridge, Jonathan; Eley, Greg; El-Naggar, Adel K.; Eng, Stephanie; Fagin, James A.; Fennell, Timothy; Ferris, Robert L.; Fisher, Sheila; Frazer, Scott; Frick, Jessica; Gabriel, Stacey B.; Ganly, Ian; Gao, Jianjiong; Garraway, Levi A.; Gastier-Foster, Julie M.; Getz, Gad; Gehlenborg, Nils; Ghossein, Ronald; Gibbs, Richard A.; Giordano, Thomas J.; Gomez-Hernandez, Karen; Grimsby, Jonna; Gross, Benjamin; Guin, Ranabir; Hadjipanayis, Angela; Harper, Hollie A.; Hayes, D. Neil; Heiman, David I.; Herman, James G.; Hoadley, Katherine A.; Hofree, Matan; Holt, Robert A.; Hoyle, Alan P.; Huang, Franklin W.; Huang, Mei; Hutter, Carolyn M.; Ideker, Trey; Iype, Lisa; Jacobsen, Anders; Jefferys, Stuart R.; Jones, Corbin D.; Jones, Steven J.M.; Kasaian, Katayoon; Kebebew, Electron; Khuri, Fadlo R.; Kim, Jaegil; Kramer, Roger; Kreisberg, Richard; Kucherlapati, Raju; Kwiatkowski, David J.; Ladanyi, Marc; Lai, Phillip H.; Laird, Peter W.; Lander, Eric; Lawrence, Michael S.; Lee, Darlene; Lee, Eunjung; Lee, Semin; Lee, William; Leraas, Kristen M.; Lichtenberg, Tara M.; Lichtenstein, Lee; Lin, Pei; Ling, Shiyun; Liu, Jinze; Liu, Wenbin; Liu, Yingchun; LiVolsi, Virginia A.; Lu, Yiling; Ma, Yussanne; Mahadeshwar, Harshad S.; Marra, Marco A.; Mayo, Michael; McFadden, David G.; Meng, Shaowu; Meyerson, Matthew; Mieczkowski, Piotr A.; Miller, Michael; Mills, Gordon; Moore, Richard A.; Mose, Lisle E.; Mungall, Andrew J.; Murray, Bradley A.; Nikiforov, Yuri E.; Noble, Michael S.; Ojesina, Akinyemi I.; Owonikoko, Taofeek K.; Ozenberger, Bradley A.; Pantazi, Angeliki; Parfenov, Michael; Park, Peter J.; Parker, Joel S.; Paull, Evan O.; Pedamallu, Chandra Sekhar; Perou, Charles M.; Prins, Jan F.; Protopopov, Alexei; Ramalingam, Suresh S.; Ramirez, Nilsa C.; Ramirez, Ricardo; Raphael, Benjamin J.; Rathmell, W. Kimryn; Ren, Xiaojia; Reynolds, Sheila M.; Rheinbay, Esther; Ringel, Matthew D.; Rivera, Michael; Roach, Jeffrey; Robertson, A. Gordon; Rosenberg, Mara W.; Rosenthall, Matthew; Sadeghi, Sara; Saksena, Gordon; Sander, Chris; Santoso, Netty; Schein, Jacqueline E.; Schultz, Nikolaus; Schumacher, Steven E.; Seethala, Raja R.; Seidman, Jonathan; Senbabaoglu, Yasin; Seth, Sahil; Sharpe, Samantha; Mills Shaw, Kenna R.; Shen, John P.; Shen, Ronglai; Sherman, Steven; Sheth, Margi; Shi, Yan; Shmulevich, Ilya; Sica, Gabriel L.; Simons, Janae V.; Sipahimalani, Payal; Smallridge, Robert C.; Sofia, Heidi J.; Soloway, Matthew G.; Song, Xingzhi; Sougnez, Carrie; Stewart, Chip; Stojanov, Petar; Stuart, Joshua M.; Tabak, Barbara; Tam, Angela; Tan, Donghui; Tang, Jiabin; Tarnuzzer, Roy; Taylor, Barry S.; Thiessen, Nina; Thorne, Leigh; Thorsson, Vésteinn; Tuttle, R. Michael; Umbricht, Christopher B.; Van Den Berg, David J.; Vandin, Fabio; Veluvolu, Umadevi; Verhaak, Roel G.W.; Vinco, Michelle; Voet, Doug; Walter, Vonn; Wang, Zhining; Waring, Scot; Weinberger, Paul M.; Weinstein, John N.; Weisenberger, Daniel J.; Wheeler, David; Wilkerson, Matthew D.; Wilson, Jocelyn; Williams, Michelle; Winer, Daniel A.; Wise, Lisa; Wu, Junyuan; Xi, Liu; Xu, Andrew W.; Yang, Liming; Yang, Lixing; Zack, Travis I.; Zeiger, Martha A.; Zeng, Dong; Zenklusen, Jean Claude; Zhao, Ni; Zhang, Hailei; Zhang, Jianhua; Zhang, Jiashan (Julia); Zhang, Wei; Zmuda, Erik; Zou., Lihua

    2014-01-01

    Summary Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. Here, we describe the genomic landscape of 496 PTCs. We observed a low frequency of somatic alterations (relative to other carcinomas) and extended the set of known PTC driver alterations to include EIF1AX, PPM1D and CHEK2 and diverse gene fusions. These discoveries reduced the fraction of PTC cases with unknown oncogenic driver from 25% to 3.5%. Combined analyses of genomic variants, gene expression, and methylation demonstrated that different driver groups lead to different pathologies with distinct signaling and differentiation characteristics. Similarly, we identified distinct molecular subgroups of BRAF-mutant tumors and multidimensional analyses highlighted a potential involvement of oncomiRs in less-differentiated subgroups. Our results propose a reclassification of thyroid cancers into molecular subtypes that better reflect their underlying signaling and differentiation properties, which has the potential to improve their pathological classification and better inform the management of the disease. PMID:25417114

  14. Thyroid carcinoma. A descriptive retrospective study

    International Nuclear Information System (INIS)

    Gonzalez, Carolina C.; Yaniskowski, Maria L.; Wyse, Eduardo P.; Giovannini, Andrea A.; Lopez, Monica B.; Wior, Myrian E.

    2006-01-01

    The thyroid carcinoma (TC) is not very frequent among all cancer. Its course is slow and is high potentially curable. Our aim was to analyse the characteristics in patients with TC. A retrospective analysis on 171 patients, with an average age of 41.1. (± 14.6), who asked for TC to our service between the years 2000-2004, was performed. From case histories it was evaluated: anamnesis, diagnostic image, histopathology and evolution. Tumours were grouped for size and TNM (tumor-nodule-metastasis) in stage (S). A simulated serum thyroglobulin level >2 ng/ml and positive image with 131 I or another nuclear marker were considered as positive for residual TC. In the totality of the analyzed patients 88% were female, 62% below 45 years old, and in 77% the thyroid function was normal. The fine needle aspiration (FNA) was diagnostic in 78%. Papillary thyroid carcinoma (PTC) in 96%. The 63% was SI; 14% SII; 19% SIII and 4% SIV. During follow-up, we observed that 90% of patients with Tg between 2 and 10 had evidence of residual TC, and 100% with Tg > 10 ng/ml, whereas 18% of those whose simulated Tg [es

  15. Correlation between serum lead and thyroid diseases: papillary thyroid carcinoma, nodular goiter, and thyroid adenoma.

    Science.gov (United States)

    Li, Hui; Li, Xiang; Liu, Jie; Jin, Langping; Yang, Fan; Wang, Junbo; Wang, Ouchen; Gao, Ying

    2017-10-01

    Studies have showed that lead was associated with human health. However, the effects of lead on thyroid functions are inconsistent, and studies based on Chinese population are fragmentary. To evaluate the correlation between lead and thyroid functions of Chinese with different thyroid diseases, we conducted a hospital-based study. Ninety-six papillary thyroid carcinoma (PTC), 10 nodular goiter (NG), and 7 thyroid adenoma (TA) patients were recruited from the First Affiliated Hospital of Wenzhou Medical University, China. Serum triiodothyronine (T3), free triiodothyronine (FT3), free thyroxin (FT4), and thyroid stimulating hormone (TSH) were evaluated with chemiluminescent microparticle immunoassay. Serum lead was assessed with ICP-MASS. Partial correlation was used to explore the correlations of serum lead and thyroid diseases. Compared to PTC, the level of lead was significantly higher in TA, and lower in NG (p lead was negatively correlated with TSH (r s  =  - 0.27, p lead at quartile4 (r s  = 0.61, p lead and FT3 or FT4 in any group. The results suggested that lead might have different etiological roles in these three thyroid diseases.

  16. Follicular Thyroid Carcinoma Presenting as Massive Skull Metastasis

    African Journals Online (AJOL)

    of follicular thyroid carcinoma metastasizing to the skull, metastases occurred long after the diagnosis and institution of treatment for primary cancer. Very few cases have been reported with occult follicular thyroid carcinoma presenting as skull metastasis. A 48-year-old female patient presented with massive swelling in the ...

  17. OCTREOTIDE FOR MEDULLARY-THYROID CARCINOMA ASSOCIATED DIARRHEA

    NARCIS (Netherlands)

    SMID, WM; DULLAART, RPF

    Medullary thyroid carcinoma associated diarrhoea can be disabling. A 75-yr-old man with metastatic medullary thyroid carcinoma and refractory diarrhoea is described. Subcutaneous administration of the somatostatin analogue, octreotide, 100-mu-g thrice daily, resulted in a sustained improvement in

  18. Papillary Carcinoma Arising from the Pyramidal Lobe of the Thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Gi; Lee, Sarah; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    The authors present a rare case of papillary carcinoma arising from the pyramidal lobe of the thyroid in a 54-year-old woman, who presented with a right submental palpable mass. An ultrasound evaluation depicted a 3 cm mixed echoic mass from the thyroid cartilage level without a focal lesion in the thyroid gland. Surgical specimens obtained during bilateral thyroidectomy confirmed papillary carcinoma of the pyramidal lobe. To the authors' knowledge, this is the first case report to describe papillary carcinoma arising from the pyramidal lobe of the thyroid gland

  19. Ultrasonic imaging of metastatic carcinoma in thyroid gland

    International Nuclear Information System (INIS)

    Bai Ling; Yang Tao; Tang Ying; Mao Jingning; Chen Wei; Wang Wei

    2008-01-01

    Objectives: To explore the ultrasonic findings of metastatic thyroid carcinoma and to evaluate the diagnostic value of the ultrasonic imaging for patients with metastatic thyroid neoplasm. Methods: The ultrasonic imaging characteristics of ten patients who were diagnosed with metastatic thyroid carcinoma were retrospectively analyzed. In all the cases, fine-needle aspiration cytology (FNAC) of the thyroid was performed during the clinical diagnosis. Results: The ultrasonic images of the ten patients fell into four types: multiple nodules in the thyroid, single nodule in the thyroid, diffuse calcification and heterogeneous echo. Seven cases showed speckled calcific foci. Abnormal blood flow signal was found in 9 cases. Conclusion: The ultrasonic findings of metastatic carcinoma in the thyroid gland are various and non-specific. Color Doppler ultrasound may provide ample evidence. The diagnosis depends on FNAC. (authors)

  20. A Case of Metastatic Renal Cell Carcinoma to Thyroid Gland

    OpenAIRE

    Lee, Jae-Geun; Yang, Youngro; Kim, Kwang Sik; Hyun, Chang Lim; Lee, Ji Shin; Koh, Gwanpyo; Lee, Daeho

    2011-01-01

    Metastasis to the thyroid gland from distant cancer is rare, and, in some cases, is a diagnostic challenge. Here, we report a case of metastatic renal cell carcinoma of the thyroid gland. A 77-year-old man presented with a neck mass detected about 1 month previously. He had undergone a right nephrectomy owing to renal cell carcinoma 14 years previously. Fine needle aspiration cytology showed a few atypical follicular cells with nuclear atypia. Under a tentative diagnosis of papillary thyroid ...

  1. Medullary carcinoma arising in a thyroid with Hashimoto's disease.

    Science.gov (United States)

    Weiss, L M; Weinberg, D S; Warhol, M J

    1983-10-01

    A 51-year-old woman presented with a large goiter and on pathologic examination was found to have both Hashimoto's thyroiditis and medullary carcinoma of the thyroid. To our knowledge, this is the first well-documented case of the coexistence of these two entities in the same patient in the English literature. The association of Hashimoto's disease and carcinoma of the thyroid is reviewed and its relevance discussed.

  2. Radioactive iodine treatment of differentiated thyroid carcinoma in teenager

    International Nuclear Information System (INIS)

    Chen Yonghui

    2008-01-01

    Incidence rate of differentiated thyroid carcinoma in teenager is not high. It has some different characteristics compared to adult differentiated thyroid carcinoma. Such as larger tumor at diagnosis; greater prevalence of neck lymph node and distant metastases at diagnosis; more sodium-iodide symporter expression; high recurrence rate but higher overall survival rate. 131 I administration to remove residual thyroid tissue and treat metastases is still one of the important approaches after surgery. (authors)

  3. Clinicopathologic Features of Familial Nonmedullary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Yu-Fang Fan

    2015-01-01

    Full Text Available Background: Familial nonmedullary thyroid carcinoma (FNMTC is a variant of nonmedullary thyroid carcinoma(NMTC with particular clinicopathologic features. In recent years, a number of studies have shown that FNMTC is more invasive than sporadic NMTC(SNMTC. The purpose of this study was to explore the differences in clinicopathologic features of FNMTC between different types of families and to determine in which of these families more invasive FNMTC occurred. Methods: We retrospectively reviewed all patients with thyroid carcinoma admitted to Peking Union Medical College Hospital from January 2009 to July 2013 in the database. Of all 2000 cases, 55 met the inclusive criteria for FNMTC and were studied. There are two different grouping methods. The first is that all samples were allocated to families with three or more first-degree relatives affected (FNMTC-3 group and families with only two affected first-degree relatives (FNMTC-2 group. The second is that all patients were divided into families with three or more affected first-degree relatives over two generations (FNMTC-3-2 group and the other families. We compared the clinicopathologic features such as sex, age, tumor size, multifocality, location, complications by thyroiditis, complications by benign thyroid nodules, surgical procedure, capsule invasion, histological type, lymph node metastases, tumor node metastasis stage, and BRAF mutation between FNMTC-2 group and FNMTC-3 group. We also made the same comparison between FNMTC-3-2 group and other families. Results: No pronounced differences in clinicopathological features were present between FNMTC-2 group and FNMTC-3 group. The proportion of FNMTC-3-2 group aged <45 years was significantly higher than that in the other families (58.8% vs. 26.3%, P = 0.021. A similar difference was found in the proportion of lymph node metastasis (64.7% vs. 34.2%, P = 0.035. Conclusions: FNMTC-3-2 is more invasive than the other families. Early screening

  4. Overview of Hurthle cell carcinoma of thyroid

    Directory of Open Access Journals (Sweden)

    Martin A Korzeniowski

    2017-07-01

    Full Text Available The clinical behaviour of Hurthle cell carcinoma (HCC of the thyroid is variable and there are many controversies in the literature. Here, we summarize an up-to-date review of the literature on genetics, diagnosis (ultrasound scan, fine needle aspiration, frozen section, etc., and management. At presentation, treatment decision should be made by a multidisciplinary board. Recurrent HCCs are seldom curable despite salvage treatments, which include radioactive iodine ablation, radiofrequency ablation, ethanol ablation, external radiotherapy, and systemic therapy. Further research is needed to develop more efficacious systemic treatments. Currently, lenvatinib, sunitinib, and sorafenib are available. The completed and ongoing clinical trials for HCC are summarized

  5. Scintigraphy in thyroid carcinoma; Szintigraphie beim Schilddruesenkarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Pink, R.; Bockisch, A. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Essen (Germany); Pink, V. [Gemeinschaftspraxis Radiologie/Nuklearmedizin, Essen (Germany)

    2004-06-01

    Primary thyroid exploration is to find the rare malignant nodule (in Germany 1/1000 in all nodular thyroids), which is capable to decrease significantly life quality and survival rate. Cervical sonography as basic examination determines the following steps with scintigraphy in nodules > 10 mm, aspiration fine needle biopsy in ''cold'' nodules and thyroidectomy in case of finding malignant cells. After surgical resection of organoid thyroid tumors and ablation of residual tissue by radioiodine follow-up is possible by sonography and serum thyreoglobulin. In case of relapse high dose radioiodine offers highly effective curative therapy of tumor and/or metastases, when the malignant tissue is avid for radioiodine. Compared to {sup 131}I-scintigraphy is PET-CT with {sup 124}I clearly superior because of better spatial resolution, precise localisation even of small metastases und new technical approaches for individual dosimetry. In case of increasing serum thyroglobuline levels and radioiodine negative metastases as well as in case of increasing serum calcitonin levels after medullary carcinoma, {sup 18}F-FDG-PET or -PET-CT is well suited as an alternate diagnostic approach. Radiolabelled somatostatin analogues may serve as diagnostic as well as therapeutic agents. (orig.)

  6. A study of tumor makers for thyroid carcinoma

    International Nuclear Information System (INIS)

    Kim, Ok Kyung

    1986-01-01

    Thyroid-associated antigens, such as calcitonin, thyroglobulin and carcinoembryonic antigen(CEA), can be demonstrated by immuno-histochemical detection. The main purpose of this study is to investigate the diagnosis, especially in regard to proving or excluding the thyroid origin of metastasis. A total of 47 cases of the thyroid specimen including 5 colonic and 5 ovarian cancer were studied by immunoperoxidase stain for the distribution and intensity of the calcitonin, thyroglobulin, and CEA. The following results are obtained. 1. The calcitonin reveals diffuse intracellular positivity of only medullary carcinoma, all others are negative. 2. The thyroglobulin show 100% positivity to thyroid adenoma, follicular carcinoma and papillary carcinoma although their intensity and distribution differed in each tumor. 3. The CEA reveals strong positivity of colonic carcinoma and ovarian carcinoma, intracytoplasmic and luminal, as well as moderate positive reaction of follicular carcinoma and papillary carcinoma of throid. In summary, the calcitonin is best tumor marker for medullary carcinoma, where as the thyroglobulin is best for follicullar and paillary carcinoma. The CEA shows variable stain property, but it has a good correlation to diagnosis of colonic carcinoma and ovarian carcinoma. (Author)

  7. Prognostic factors of follicular thyroid carcinoma.

    Science.gov (United States)

    Ríos, Antonio; Rodríguez, José M; Ferri, Belén; Martínez-Barba, Enrique; Torregrosa, Núria M; Parrilla, Pascual

    2015-01-01

    Most prognostic studies in differentiated carcinoma have included a high number of papillary carcinomas and few follicular carcinomas, and not all of their conclusions therefore apply to the latter. To analyze the prognostic factors of follicular thyroid carcinoma. Patients with histological diagnosis of follicular carcinoma who had undergone potentially curative surgery, had no disseminated disease at diagnosis, and had been followed up for at least 5 years. Tumor recurrence was defined as: 1) tumor lesions with cytological analysis suggesting malignancy and/or 2) patients with total thyroidectomy with thyroglobulin levels >2 ng/mL. Clinical, therapeutic, and histological parameters were analyzed to assess prognostic factors. Recurrence was found in 25 (38%) of the 66 study patients during a follow-up period of 99 ± 38 months. Most patients with recurrence (n=20) had increased Tg levels without anatomical location, and were initially treated with radioactive I131. In the remaining 5 cases, surgical excision of the lesion was performed, and three patients required surgery during the follow-up period. Two patients died due to the disease (3%), and two other patients (3%) currently have distant metastases. Mean disease-free interval was 154 ± 14 months, and rates of disease-free patients at 5, 10, 15, and 20 years were 71, 58, 58, and 58% respectively. Clinical factors influencing recurrence included 1) age (p=0.0035); 2) sex (p=0.0114); and 3) cervical pain (p=0.0026). Histological/surgical factors associated with recurrence included 1) infiltration into neighboring structures (p=0.0000); 2) type of carcinoma (p=0.0000); 3) size (p=0.0162); 4) vascular invasion (p=0.0085); and 5) adenopathies (p=0.046). In the multivariate study, cervical pain (p=0.018) and extrathyroid invasion (p=0.045) continued to be significant factors. In follicular carcinoma, rates of disease-free patients are 71% at 5 years and 58% at 10 years, and the main predictive factors are presence

  8. Thyroid Duplication and Papillary Carcinoma in an Ectopic Thyroid. A Case Presentation

    Directory of Open Access Journals (Sweden)

    José Alberto Puerto Lorenzo

    2012-05-01

    Full Text Available We present the case of a patient with a palpable tumor located in midline of the anterior neck above the hyoid bone, initially diagnosed as a thyroglossal duct cyst. Preliminary study of the lesion was conducted, both clinically and radiologically and cytologically. The tumor was removed through surgery by conventional technique. The paraffin biopsy defined the existence of thyroid papillary carcinoma. Despite this condition, the patient had thyroid gland in normal location. It is considered to be a curious case, combining the concepts of thyroid duplication and ectopic thyroid, with the presence, in this last one, of papillary carcinoma.

  9. THE ASSOCIATION OF WELL-DIFFERENTIATED THYROID-CARCINOMA WITH INSULAR OR ANAPLASTIC THYROID-CARCINOMA - EVIDENCE FOR DEDIFFERENTIATION IN TUMOR PROGRESSION

    NARCIS (Netherlands)

    van der Laan, Bernard F.A.M.; FREEMAN, JL; TSANG, RW; ASA, SL

    1993-01-01

    The sequence of tumorigenesis in the thyroid is unclear. It has been proposed that anaplastic carcinomas of the thyroid develop by dedifferentiation in pre-existing differentiated carcinomas. We reviewed all anaplastic and insular (poorly differentiated) thyroid carcinomas in a consultation practice

  10. Metastatic follicular thyroid carcinoma to the mandible

    Directory of Open Access Journals (Sweden)

    Ajay Prakash Pasupula

    2012-01-01

    Full Text Available Metastatic tumors are of great significance since few cases may represent the only symptom of an undiscovered underlying malignancy. Metastatic tumors rarely metastasize to the oral region despite the fact that many common primary neoplasms frequently metastasize to bone. The true incidence of metastatic tumors in the bones of the jaw is unknown, as jaws are not always included in radiographic skeletal surveys for metastasis. Sometimes oral metastasis may be the first evidence of metastasis from its primary site. A case of metastatic follicular thyroid carcinoma to the mandible is presented here, along with the discussion of clinical and histological features. The present case not only emphasizes the importance of considering metastasis in the differential diagnosis of a radiolucent lesion in the mandible, but also emphasizes in the improvement of the overall survival rate and treatment results by an early detection of metastatic disease.

  11. External Beam Radiation in Differentiated Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Salem Billan

    2016-01-01

    Full Text Available The treatment of differentiated thyroid carcinoma (DTC is surgery followed in some cases by adjuvant treatment, mostly with radioactive iodine (RAI. External beam radiotherapy (EBRT is less common and not a well-established treatment modality in DTC. The risk of recurrence depends on three major prognostic factors: extra-thyroid extension, patient’s age, and tumor with reduced iodine uptake. Increased risk for recurrence is a major factor in the decision whether to treat the patient with EBRT. Data about the use of EBRT in DTC are limited to small retrospective studies. Most series have demonstrated an increase in loco-regional control. The risk/benefit from giving EBRT requires careful patient selection. Different scoring systems have been proposed by different investigators and centers. The authors encourage clinicians treating DTC to become familiarized with those scoring systems and to use them in the management of different cases. The irradiated volume should include areas of risk for microscopic disease. Determining those areas in each case can be difficult and requires detailed knowledge of the surgery and pathological results, and also understanding of the disease-spreading pattern. Treatment with EBRT in DTC can be beneficial, and data support the use of EBRT in high-risk patients. Randomized controlled trials are needed for better confirmation of the role of EBRT.

  12. Papillary Thyroid Carcinoma in Denmark, 1996-2008

    DEFF Research Database (Denmark)

    Londero, Stefano Christian; Krogdahl, Annelise; Bastholt, Lars

    2015-01-01

    Background: Regional as well as national series show an increasing incidence of thyroid cancer largely small size papillary thyroid carcinoma (PTC). Prognostic scoring systems have been developed, but these do not take into account the rapidly changing case mix, and adjustments may be required...

  13. Metastatic papillary carcinoma of the thyroid in a patient previously ...

    African Journals Online (AJOL)

    She had an 123I diagnostic whole body scan that showed 123I avid areas in the thyroid bed as well as left cervical lymph nodes, which later turned out to be metastatic papillary carcinoma of the thyroid on histology. She was treated with therapeutic doses of 131I. Follow-up radioactive iodine scans and serum thyroglobulin ...

  14. Prognostic factors in papillary and follicular thyroid carcinomas

    DEFF Research Database (Denmark)

    Godballe, C; Asschenfeldt, P; Jørgensen, K E

    1998-01-01

    To identify clinical and histologic prognostic factors and to investigate whether immunohistochemical detection of p53 expression might contain prognostic information, a retrospective study of patient and tumor characteristics was performed in 225 cases of papillary and follicular thyroid...... prognostic indicator, which might be of value in the treatment planning in patients with papillary or follicular thyroid carcinomas....

  15. COEXISTENCE OF CARCINOMAS OF THYROID WITH MULTINODULAR GOITRES OF THYROID – A TWO-YEAR STUDY

    Directory of Open Access Journals (Sweden)

    Kiran Kumar Epari

    2016-08-01

    Full Text Available BACKGROUND Multinodular goitre or nodular hyperplasia or adenomatoid goitre is the most common thyroid disease, which occurs due to deficient iodine intake. Initial hyperthyroid states, followed by follicular atrophy and secondary changes like haemorrhage, calcification and cystic degeneration occurs in most of the cases. Longstanding cases of nodular goitre can be associated with carcinomas, usually follicular carcinomas, and rarely papillary carcinomas.[1] This study was done to know the incidence of coexisting malignancies, follicular and papillary carcinomas of thyroid, in longstanding nodular goitres of thyroid. METHODS All the cases of nodular goitres examined in the last two years were studied, including the thyroidectomy specimens and FNAC slides whichever was done. Extensive grossing of the thyroidectomy specimens was done to detect the possibility of malignancy in longstanding cases of nodular goitre of thyroid. Review of FNAC slides was done in cases where cytodiagnosis of coexisting malignancy was missed and detected in histopathological examination. RESULTS In the present study, conducted over a two-year period, out of 50 cases of thyroidectomy specimens of multinodular goitres studied, six cases were diagnosed to be having coexisting malignancy of thyroid, of which four were follicular carcinomas of thyroid and two were papillary carcinomas of thyroid. FNAC diagnosis of coexisting malignancy was initially missed in FNAC in two cases, i.e. one case each of follicular carcinoma and papillary carcinoma. These FNAC slides were reviewed and the foci of malignancies detected. CONCLUSION There is a possibility of malignancy of thyroid coexisting with longstanding multinodular goitre of thyroid, which should be kept in mind, while performing the needle biopsy and thorough examination of FNAC slides is needed to avoid missing the possible detection of the coexisting malignant lesion. Thyroidectomy specimens should be extensively grossed to

  16. Diffuse sclerosing variant of thyroid papillary carcinoma: Diagnostic challenges occur with Hashimoto's thyroiditis

    Directory of Open Access Journals (Sweden)

    Chien-Chin Chen

    2013-06-01

    Full Text Available Diffuse sclerosing papillary thyroid carcinoma (DSPTC is a relatively rare variant of papillary thyroid carcinoma with distinct histological features, radiological characteristics, and biological aggressiveness. Compared with conventional papillary thyroid carcinoma, DSPTC is characterized by scattered microscopic tumor islands, diffuse fibrosis, calcification, and abundant lymphocytic aggregation. A preoperative diagnosis is challenging in the absence of nodules and scanty fine needle aspiration cytology samples. We describe a unique DSPTC patient, an 18-year-old woman who presented with a neck mass that grew slowly for 2 years. The palpable neck mass was nontender, well defined, firm, and unmovable. Laboratory studies showed normal thyroid function and positive autoimmune markers: antithyroglobulin antibody = 1:1600 and antimicrosomal antibody = 1:1600. A neck ultrasound showed diffusely prominent microcalcifications with one small vague nodule. Hashimoto's thyroiditis with an accompanying malignancy was suspected. Based on the result of intraoperative pathology reports, the patient was given a total thyroidectomy. Lymph node dissection and histological analysis revealed bilateral DSPTC in addition to lymphocytic thyroiditis in nonmalignant areas of the thyroid. Clinical and histological diagnostic challenges usually occur when DSPTC presents with a diffuse thyroid enlargement, dispersed microscopic tumor islands (frequently without mass formation, extensive fibrosis, and abundant lymphocytic infiltration mimicking thyroiditis.

  17. Acute airway failure secondary to thyroid metastasis from renal carcinoma

    Directory of Open Access Journals (Sweden)

    Lastilla Gaetano

    2008-02-01

    Full Text Available 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 radical nephrectomy for renal cell carcinoma was performed 8 years previously. An emergency endotracheal intubation was followed by total thyroidectomy. Histological examination confirmed the diagnosis of thyroid metastasis from renal cell carcinoma. Conclusion A literature review regarding emergency treatment for acute respiratory compromise resulting from secondary thyroid tumours was undertaken. Only two cases of metastatic colon cancer and one case of metastatic meningioma requiring emergency thyroidectomy for acute respiratory failure are reported in the literature. This appears to be the first case of emergency surgery performed for acute respiratory compromise due to thyroid metastasis from renal cell carcinoma.

  18. Simultaneous Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid

    Directory of Open Access Journals (Sweden)

    Gustavo Cancela e Penna

    2017-01-01

    Full Text Available Thyroglossal duct cyst (TDC is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.

  19. Effect of the micronutrient iodine in thyroid carcinoma angiogenesis.

    Science.gov (United States)

    Daniell, Kayla; Nucera, Carmelo

    2016-12-20

    Iodide is a micronutrient essential for thyroid hormone production. The uptake and metabolism of iodide by thyrocytes is crucial to proper thyroid function. Iodide ions are drawn into the thyroid follicular cell via the sodium-iodide symporter (NIS) in the cell membrane and become integrated into tyrosyl residues to ultimately form thyroid hormones. We sought to learn how an abnormal concentration of iodide within thyrocyte can have significant effects on the thyroid, specifically the surrounding vascular network. Insufficient levels of iodide can lead to increased expression or activity of several pathways, including vascular endothelial growth factor (VEGF). The VEGF protein fuel vessel growth (angiogenesis) and therefore enhances the nutrients available to surrounding cells. Alternatively, normal/surplus iodide levels can have inhibitory effects on angiogenesis. Varying levels of iodide in the thyroid can influence thyroid carcinoma cell proliferation and angiogenesis via regulation of the hypoxia inducible factor-1 (HIF-1) and VEGF-dependent pathway. We have reviewed a number of studies to investigate how the effect of iodide on angiogenic and oxidative stress regulation can affect the viability of thyroid carcinoma cells. The various studies outlined give key insights to the role of iodide in thyroid follicles function and vascular growth, generally highlighting that insufficient levels of iodide stimulate pathways resulting in vascular growth, and viceversa normal/surplus iodide levels inhibit such pathways. Intriguingly, TSH and iodine levels differentially regulate the expression levels of angiogenic factors. All cells, including carcinoma cells, increase uptake of blood nutrients, meaning the vascular profile is influential to tumor growth and progression. Importantly, variation in the iodine concentrations also influence BRAF V600E -mediated oncogenic activity and might deregulate tumor proliferation. Although the mechanisms are not well eluted, iodine

  20. Thyroid Metastases from Renal Cell Carcinoma: Review of the Literature

    Directory of Open Access Journals (Sweden)

    Alessandro Sindoni

    2010-01-01

    Full Text Available The thyroid gland is a rare site of clinically detectable tumor metastasis and kidneys are frequently the site of the parent malignancy. In the present review on thyroid metastases from renal cell carcinoma, cases were searched on PubMed by entering the strings: “renal carcinoma [or“hypernephroma”] AND thyroid metastasis/metastases”. Thus, we retrieved a total of 111 cases that were published between 1964 and 2007, a total that became 113 by adding two patients observed by us. The female to male ratio was 1.35:1. The primary renal cancer was almost always unilateral (90% (with no significant side preference and only rarely bilateral (9% in men, 4% in women, whereas bilaterality of thyroid metastases was relatively more frequent (28%. Thyroid metastasis from renal cancer was commonly single with a unique node that appears solid and hypoechoic at ultrasonography, approximately 9 years after nephrectomy. Concordance of lateralization was insignificantly greater for the right kidney/right thyroid lobe pattern (54% than for the left kidney/left thyroid lobe pattern (40%, regardless of gender. Finally, survival was longer for women. Thyroid metastases, even if rare in the clinical practice, must be considered in the differential diagnosis of a thyroid nodule, particularly in patients who have a history of malignancies.

  1. Thyroid metastases from renal cell carcinoma: review of the literature.

    Science.gov (United States)

    Sindoni, Alessandro; Rizzo, Massimo; Tuccari, Giovanni; Ieni, Antonio; Barresi, Valeria; Calbo, Letterio; Cucinotta, Eugenio; Trimarchi, Francesco; Benvenga, Salvatore

    2010-04-01

    The thyroid gland is a rare site of clinically detectable tumor metastasis and kidneys are frequently the site of the parent malignancy. In the present review on thyroid metastases from renal cell carcinoma, cases were searched on PubMed by entering the strings: "renal carcinoma [or "hypernephroma"] AND thyroid metastasis/metastases". Thus, we retrieved a total of 111 cases that were published between 1964 and 2007, a total that became 113 by adding two patients observed by us. The female to male ratio was 1.35:1. The primary renal cancer was almost always unilateral (90%) (with no significant side preference) and only rarely bilateral (9% in men, 4% in women), whereas bilaterality of thyroid metastases was relatively more frequent (28%). Thyroid metastasis from renal cancer was commonly single with a unique node that appears solid and hypoechoic at ultrasonography, approximately 9 years after nephrectomy. Concordance of lateralization was insignificantly greater for the right kidney/right thyroid lobe pattern (54%) than for the left kidney/left thyroid lobe pattern (40%), regardless of gender. Finally, survival was longer for women. Thyroid metastases, even if rare in the clinical practice, must be considered in the differential diagnosis of a thyroid nodule, particularly in patients who have a history of malignancies.

  2. Management of the Patient with Aggressive and Resistant Papillary Thyroid Carcinoma

    OpenAIRE

    Miftari, Rame; Top?iu, Valdete; Nura, Adem; Haxhibeqiri, Valdete

    2016-01-01

    Purpose: Papillary carcinoma is the most frequent type of thyroid cancer and was considered the most benign of all thyroid carcinomas, with a low risk of distant metastases. However, there are some variants of papillary thyroid carcinoma that have affinity to spread in many organs, such as: lymph nodes, lungs and bones. Aim: The aim of this study was presentation of a case with papillary carcinoma of the thyroid gland, very persistent and resistant in treatment with I 131. Material and result...

  3. The investigation of foxe1 variations in papillary thyroid carcinoma

    Science.gov (United States)

    Somuncu, Erkan; Karatas, Adem; Ferahman, Sina; Saygili, Neslihan; Yilmaz, Eren; Ozturk, Oguz; Kapan, Metin

    2015-01-01

    Background: Recent reports indicated that incidence of thyroid carcinoma is increasing throughout the worldwide. The aim of our study was to determine a possible relationship between Forkhead box E1 (FOXE1) gene variants and histopathological features of papillary thyroid carcinoma. Methods: FOXE1 gene variations; rs894673, rs1867277 and rs3758249 were analyzed in 57 Papillary thyroid carcinoma patients and 51 age matched healthy control subjects. Restriction fragment length polymorphism (RFLP) technique was used to specifically detect the variations. Results: There was a significant difference in the distribution of rs894673 genotypes in Papillary thyroid carcinoma cases (P=0.01). AA genotype presence of rs1867277 was more significantly associated with several histopathological parameters such as focal and diffuse capsular invasion, lymphatic invasion, P3 with P4 tumor grade and surgical margins. AA genotype presence in rs1867277 variation was significantly associated with the classical variant which is subtype of papillary thyroid carcinoma. Furthermore, the presence of the allel A was found to be related with lymph node invasion risk by 2.46 fold, capsular invasion risk by 2.97 fold, and pT3 with pT4 pathological stage risk by 4.13 fold and the presence of allele A in rs1867277 was significantly associated with classic variants. The presence of allele A in rs1867277 was more significantly associated with several histopathological parameters in classic variant in papillary thyroid carcinoma cases such as, the presence of the A allele was found relationship with lymph node invasion risk by 2.0 fold, capsular invasion risk by 2.39 fold , and pT3 with pT4 pathological stage risk by 3.57 fold. In addition, AATT, AAAA and GATT haplotypes (rs1867277 and rs894673) were evaluated for association with papillary thyroid carcinoma cases. Our results indicate that the significant difference according to two-allele haplotype distribution between papillary thyroid carcinoma

  4. Metastatic Renal Cell Carcinoma to the Thyroid 23 Years After Nephrectomy

    Directory of Open Access Journals (Sweden)

    Carrie Valdez

    2014-07-01

    Full Text Available Thyroid carcinoma is an uncommon form of human cancer, with an outstanding overall cure rate. This excellent prognosis is based on the fact that well over 99% of thyroid cancers are primary tumors. Metastatic cancer to the thyroid remains very rare. We report a case of clear cell renal carcinoma metastatic to the thyroid gland 23 years after nephrectomy.

  5. Metastatic Renal Cell Carcinoma to the Thyroid 23 Years After Nephrectomy ?

    OpenAIRE

    Valdez, Carrie; Rezaei, M. Katayoon; Hendricks, Fredrick; Knoll, Stanley M.

    2014-01-01

    Thyroid carcinoma is an uncommon form of human cancer, with an outstanding overall cure rate. This excellent prognosis is based on the fact that well over 99% of thyroid cancers are primary tumors. Metastatic cancer to the thyroid remains very rare. We report a case of clear cell renal carcinoma metastatic to the thyroid gland 23 years after nephrectomy.

  6. Chronic lymphocytic thyroiditis is associated with invasive characteristics of differentiated thyroid carcinoma in children and adolescents.

    Science.gov (United States)

    Iliadou, Paschalia K; Effraimidis, Grigoris; Konstantinos, Michalakis; Grigorios, Panagiotou; Mitsakis, Periklis; Patakiouta, Frideriki; Pazaitou-Panayiotou, Kalliopi

    2015-12-01

    The association between chronic lymphocytic thyroiditis (CLT) and thyroid cancer is an interesting topic. The aim of the present study was to evaluate if demographic and histological characteristics as well as the long-term outcome of thyroid cancer was different in children and adolescents with and without CLT. The medical records of children and adolescents (≤21 years old) were reviewed. The following data were recorded: gender, year and age at diagnosis, family history of thyroid cancer, history of external radiation therapy, histological type (papillary and variants, follicular and variants), tumour size, multifocality, infiltration of thyroid parenchyma or surrounding soft tissues, vascular invasion, presence of lymph node and distant metastases. Information about the presence of TgAb and TPOAb was also collected. One hundred eight children and adolescents (median age 19.0, interquartile range 4.0 years) were diagnosed with differentiated thyroid carcinoma (DTC); 31 patients (28.7%) presented histological characteristics compatible with CLT. Infiltration of thyroid parenchyma was more frequent in patients with CLT compared to patients without (74.2% vs 48.1% respectively, P=0.024). Familial papillary thyroid carcinoma (PTC) was more frequent in patients with CLT compared to those without CLT (20.7% vs 2.8% respectively, P=0.009). There was no better outcome with respect to the presence of CLT or not. Children and adolescents with CLT present more frequently familial PTC as well as thyroid cancer with invasive characteristics. © 2015 European Society of Endocrinology.

  7. Hyponatremia after Thyroid Hormone Withdrawal in a Patient with Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Hyo Jin Jo

    2014-03-01

    Full Text Available Hyponatremia is an electrolyte abnormality commonly found in clinical practice. It is important to diagnose the underlying etiology of the hyponatremia and correct it appropriately because severe hyponatremia can cause serious complications and substantially increase the risk of mortality. Although hypothyroidism is known to be a cause of hyponatremia, it is rare that hyponatremia occurs in relation to hypothyroidism induced by thyroid hormone withdrawal in patients with differentiated thyroid cancer. We report a case of a 76-year-old woman with papillary thyroid carcinoma presenting with severe hyponatremia related to hypothyroidism induced by thyroid hormone withdrawal for radio-active iodine whole-body scanning, who was treated by thyroid hormone replacement and hydration. Considering that the incidence of differentiated thyroid cancer is rapidly increasing, physicians should be aware that, although uncommon, hyponatremia can occur in patients undergoing radioiodine therapy or diagnostic testing.

  8. Acute exacerbation of Hashimoto thyroiditis mimicking anaplastic carcinoma of the thyroid: A complicated case.

    Science.gov (United States)

    Kanaya, Hiroaki; Konno, Wataru; Fukami, Satoru; Hirabayashi, Hideki; Haruna, Shin-ichi

    2014-12-01

    The fibrous variant of Hashimoto thyroiditis is uncommon, accounting for approximately 10% of all cases of Hashimoto thyroiditis. We report a case of this variant that behaved like a malignant neoplasm. The patient was a 69-year-old man who presented with a right-sided anterior neck mass that had been rapidly growing for 2 weeks. Fine-needle aspiration cytology revealed clusters of large multinucleated cells suggestive of an anaplastic carcinoma. A week after presentation, we ruled out that possibility when the mass had shrunk slightly. Instead, we diagnosed the patient with an acute exacerbation of Hashimoto thyroiditis on the basis of laboratory findings. We performed a right thyroid lobectomy, including removal of the isthmus, to clarify the pathology and alleviate pressure symptoms. The final diagnosis was the fibrous variant of Hashimoto thyroiditis, with no evidence of malignant changes. Physicians should keep in mind that on rare occasions, Hashimoto thyroiditis mimics a malignant neoplasm.

  9. Treatment of thyroid carcinoma as a problem of internal medicine

    International Nuclear Information System (INIS)

    Roos, J.

    1975-01-01

    The usefulness of gallium-67 as a radiopharmaceutical for the detection of carcinoma of the thyroid gland is investigated. Gallium-67 does not accumulate in a benign goitre. In combination with iodide and pertechnetate scintigraphy of the thyroid, the application of gallium-67 is important for the detection of malignancy in large goitres. To increase the efficiency of iodine-131 therapy, a low-iodine diet and intensive diuresis during four days preceding administration of radioactive iodide is recommended

  10. Thyroid-associated orbitopathy in patients with thyroid carcinoma: A case report of 5 cases.

    Science.gov (United States)

    Yu, Peng; Liu, Siyue; Zhou, Xinrong; Huang, Teng; Li, Yaling; Wang, Hong; Yuan, Gang

    2017-11-01

    Thyroid-associated orbitopathy (TAO) is most often seen in patients with autoimmune thyroid disease. Data about TAO occurred in patients with thyroid carcinoma are rare. We give a report of 5 patients to present the clinical characteristics, treatment, and prognosis of this type of case. Five thyroid carcinoma patients presented with orbitopathy. Among them, two patients (patient 1 and 4) were hyperthyroid and TSH receptor antibody (TRAb) positive, two patients (patient 3 and 5) were euthyroid and displayed slightly elevated TRAb titres, one patient (patient 2) was euthyroid and TRAb negative. They were diagnosed as thyroid carcinoma and TAO. Patient 1 underwent total thyroidectomy, intravenous glucocorticoids (GCs) therapy, orbital decompression surgery and oral GCs therapy. Patient 2 and 3 only received total thyroidectomy. Patient 4 received sub-total thyroidectomy and oral GCs therapy. patient 5 didn't received thyroidectomy and underwent intravenous GCs therapy for 2 courses. Patient 1,2,3 showed an improvement of TAO at the final follow-up. Patient 4,5 showed no improvement of TAO at the final follow-up. When TAO present in patients with thyroid nodules, the possibility of thyroid carcinoma should be considered, and the nature of these nodules should be carefully evaluated. In some patients with thyroid carcinoma and TAO, the remission of TAO can be seen post total thyroidectomy. But for other patients, besides thyroidectomy, an adequate dose and course of intravenous GCs treatment and even ocular surgery are also needed. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  11. Dietary patterns as risk factors of differentiated thyroid carcinoma.

    Science.gov (United States)

    Przybylik-Mazurek, Elwira; Hubalewska-Dydejczyk, Alicja; Kuźniarz-Rymarz, Sylwia; Kieć-Klimczak, Małgorzata; Skalniak, Anna; Sowa-Staszczak, Anna; Gołkowski, Filip; Kostecka-Matyja, Marta; Pach, Dorota

    2012-01-10

    Nutritional factors are known to be important in the development of different metabolic diseases. The history of nodular or diffuse goiter is closely related to risk of thyroid carcinoma. On account of the function of the thyroid gland, many studies focus on iodine intake. The aim of the study was to assess whether dietary patterns could be risk factors of differentiated thyroid carcinoma. The case-control study was based on a questionnaire, which included information about dietary patterns and was carried out on 284 patients comprising 30 males (mean age 58.4±13.7 years), and 254 females (mean age 52.1±13.8 years), as well as 345 randomly selected controls: 58 males (mean age 60.2±12 years) and 287 females (mean age 53.4±14.3 years) randomly selected from the Population Register and adjusted by age and gender to the group of TC. The main groups of nutritional products, i.e. starchy foods, meat, dairy products, vegetables, fruits, and beverages, were analyzed. Consumption of vegetables, fruits, saltwater fish and cottage cheese was significantly lower in patients with differentiated thyroid carcinoma than in controls, quite the contrary to starchy foods, especially white bread. Dietary patterns appear to modify the risk of thyroid carcinoma. A diet rich in vegetables and fruit, as well as saltwater fish (a source of iodine) and low-fat meat, could be an important protective factor.

  12. [Thyroid differenciated carcinoma in children. Study from Normandy].

    Science.gov (United States)

    Blanchard, D; Choussy, O; Rame, J; Bequigon, A; Dehesdin, D; De Raucourt, D; Bardet, S; Babin, E

    2011-01-01

    Definition of a strategy for the management of thyroid differenciated carcinoma in children. Retrospective cohort study from the Normandy area in France. Analysis of the medical records of 13 children and adolescents (age > 15 years), presenting with thyroid differenciated carcinoma in three Normandy French hospitals from 1994 to 2006, to determine the clinical features and treatment of the disease. X of the patients were male and y were female, with a mean age at presentation of 11 years. Most frequently symptom was solitary nodes in the thyroid gland (69%). Most frequent histological type was papillary cancer (92%). Size of tumor was > 4 cm in 23% of cases. Children had undergone surgery with total thyroidectomy, radio-iodine treatment and suppressive hormonotherapy. We observed 46% post surgery complications. All patients were alive and none developed a recurrence. Thyroid differenciated carcinoma in children and adolescents were more agressif with most frequently metastasis and recurrence than thyroid differenciated carcinoma of adults. Pronostic is good with 90% of survival at 20 years. We propose a coherent plan of treatment: 1. Thyroidectomy with cervical central lymph node dissection (group VI) completed bilateral selected head neck dissection compartments (groups IIa, III, IV) if macroscopic lymph node metastases in lateral cervical compartment. 2. Postoperative radioiodine is done in all tumor > T1N0 and completed with hormonotherapy.

  13. Diagnosis of bone metastasis from thyroid carcinoma: a multidisciplinary approach

    International Nuclear Information System (INIS)

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

    2015-01-01

    Sarcomas are rare tumors originating from soft tissue or bone. Diagnosis and treatment of sarcomas should be performed at specialized sarcoma centers, where patients are evaluated at a multidisciplinary tumor conference. We present a case where sarcoma was suspected from magnetic resonance imaging (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-evaluation of previous pathology and a thorough patient history enabled a final diagnosis

  14. [Analysis of long-term survivors in anaplastic thyroid carcinoma].

    Science.gov (United States)

    Yoshida, Akira; Matuzu, Kenichi

    2012-07-01

    We analyzed the clinicopathologic and therapeutic factors associated with long-term survival in 449 patients with anaplastic carcinoma registered with the Anaplastic Thyroid Carcinoma Consortium of Japan. Univariate analysis showed a significant relationship between long-term survival of more than 1 year and the following factors: the appearance of acute symptom; WBC thyroid gland after surgery; no distant metastasis at initial diagnosi; complete resection of gross tumor; and administration of external irradiation (40 Gy) and chemotherapy. In multivariate analysis, only tumor diameter (disease.

  15. Radioactive Iodine Therapy of Differentiated Thyroid Carcinoma: Redesigning the Paradigm

    Directory of Open Access Journals (Sweden)

    Stanley J. Goldsmith

    2017-02-01

    Full Text Available Radioactive iodine therapy has evolved over the past 70 years from treatment of known metastatic thyroid carcinoma to include adjuvant use to decrease the incidence of recurrent disease and to ablation of normal remnant tissue following thyroidectomy, even for minimal tumor involvement. Advances in laboratory testing, development of drugs useful in radioiodine treatment, as well as advances in radiation detection and imaging instrumentation, have progressively improved the utility of radioiodine therapy of differentiated thyroid carcinoma. Guidelines have proliferated and they have become more detailed and complex. This trend is likely to continue as the science and technology involved increases in sophistication and efficacy.

  16. Significance of Interleukin-6 in Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Toral P. Kobawala

    2016-01-01

    Full Text Available This study sought to reveal the significance of IL-6 in papillary thyroid carcinoma by determining its circulating levels, tumoral protein, and mRNA expressions. As compared to the healthy individuals, serum IL-6 was significantly higher in patients with benign thyroid diseases and PTC. Further, its level was significantly higher in PTC patients as compared to patients with benign thyroid diseases. ROC curves also confirmed a good discriminatory efficacy of serum IL-6 between healthy individuals and patients with benign thyroid diseases and PTC. The circulating IL-6 was significantly associated with poor overall survival in PTC patients. IL-6 immunoreactivity was significantly high in PTC patients as compared to the benign thyroid disease patients. Significantly higher IL-6 mRNA expression was also observed in the primary tumour tissues of PTC patients than the adjacent normal tissues. The protein expression of IL-6 at both the circulating and tissue level correlated with disease aggressiveness in PTC patients. Moreover, a significant positive correlation was observed between the IL-6 protein and mRNA expression in the primary tumours of PTC patients. Finally in conclusion, IL-6 has an important role in thyroid cancer progression. Thus targeting IL-6 signalling can help in clinical management of thyroid carcinoma patients.

  17. Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma

    Science.gov (United States)

    Asa, Sylvia L.; Dralle, Henning; Elisei, Rossella; Evans, Douglas B.; Gagel, Robert F.; Lee, Nancy; Machens, Andreas; Moley, Jeffrey F.; Pacini, Furio; Raue, Friedhelm; Frank-Raue, Karin; Robinson, Bruce; Rosenthal, M. Sara; Santoro, Massimo; Schlumberger, Martin; Shah, Manisha; Waguespack, Steven G.

    2015-01-01

    Introduction: The American Thyroid Association appointed a Task Force of experts to revise the original Medullary Thyroid Carcinoma: Management Guidelines of the American Thyroid Association. Methods: The Task Force identified relevant articles using a systematic PubMed search, supplemented with additional published materials, and then created evidence-based recommendations, which were set in categories using criteria adapted from the United States Preventive Services Task Force Agency for Healthcare Research and Quality. The original guidelines provided abundant source material and an excellent organizational structure that served as the basis for the current revised document. Results: The revised guidelines are focused primarily on the diagnosis and treatment of patients with sporadic medullary thyroid carcinoma (MTC) and hereditary MTC. Conclusions: The Task Force developed 67 evidence-based recommendations to assist clinicians in the care of patients with MTC. The Task Force considers the recommendations to represent current, rational, and optimal medical practice. PMID:25810047

  18. Likelihood ratio-based differentiation of nodular Hashimoto thyroiditis and papillary thyroid carcinoma in patients with sonographically evident diffuse hashimoto thyroiditis: preliminary study.

    Science.gov (United States)

    Wang, Liang; Xia, Yu; Jiang, Yu-Xin; Dai, Qing; Li, Xiao-Yi

    2012-11-01

    To assess the efficacy of sonography for discriminating nodular Hashimoto thyroiditis from papillary thyroid carcinoma in patients with sonographically evident diffuse Hashimoto thyroiditis. This study included 20 patients with 24 surgically confirmed Hashimoto thyroiditis nodules and 40 patients with 40 papillary thyroid carcinoma nodules; all had sonographically evident diffuse Hashimoto thyroiditis. A retrospective review of the sonograms was performed, and significant benign and malignant sonographic features were selected by univariate and multivariate analyses. The combined likelihood ratio was calculated as the product of each feature's likelihood ratio for papillary thyroid carcinoma. We compared the abilities of the original sonographic features and combined likelihood ratios in diagnosing nodular Hashimoto thyroiditis and papillary thyroid carcinoma by their sensitivity, specificity, and Youden index. The diagnostic capabilities of the sonographic features varied greatly, with Youden indices ranging from 0.175 to 0.700. Compared with single features, combinations of features were unable to improve the Youden indices effectively because the sensitivity and specificity usually changed in opposite directions. For combined likelihood ratios, however, the sensitivity improved greatly without an obvious reduction in specificity, which resulted in the maximum Youden index (0.825). With a combined likelihood ratio greater than 7.00 as the diagnostic criterion for papillary thyroid carcinoma, sensitivity reached 82.5%, whereas specificity remained at 100.0%. With a combined likelihood ratio less than 1.00 for nodular Hashimoto thyroiditis, sensitivity and specificity were 90.0% and 92.5%, respectively. Several sonographic features of nodular Hashimoto thyroiditis and papillary thyroid carcinoma in a background of diffuse Hashimoto thyroiditis were significantly different. The combined likelihood ratio may be superior to original sonographic features for

  19. Collision tumor of the thyroid: follicular variant of papillary carcinoma and squamous carcinoma

    Directory of Open Access Journals (Sweden)

    Kane Subhadra V

    2006-09-01

    Full Text Available Abstract Background Collision tumors of the thyroid gland are a rare entity. We present a case of a follicular variant of papillary carcinoma and squamous carcinoma in the thyroid. To the best of our knowledge, this is the first documentation of a collision tumor with a papillary carcinoma and a squamous carcinoma within the thyroid gland. The clinicopathological features and immunohistochemical profile are reported. The theories of origin, epidemiology and management are discussed with a literature review. Case presentation A 65 year old woman presented with a large thyroid swelling of 10 years duration and with swellings on the back and scalp which were diagnosed to be a follicular variant of papillary thyroid carcinoma with metastasis. Clinical examination, radiology and endoscopy ruled out any other abnormality of the upper aerodigestive tract. The patient was treated surgically with a total thyroidectomy with central compartment clearance and bilateral selective neck dissections. The histopathology revealed a collision tumor with components of both a follicular variant of papillary carcinoma and a squamous carcinoma. Immunohistochemical analysis confirmed the independent origin of these two primary tumors. Adjuvant radio iodine therapy directed toward the follicular derived component of the thyroid tumor and external beam radiotherapy for the squamous component was planned. Conclusion Collision tumors of the thyroid gland pose a diagnostic as well as therapeutic challenge. Metastasis from distant organs and contiguous primary tumors should be excluded. The origins of squamous cancer in the thyroid gland must be established to support the true evolution of a collision tumor and to plan treatment. Treatment for collision tumors depends upon the combination of primary tumors involved and each component of the combination should be treated like an independent primary. The reporting of similar cases with longer follow-up will help define the

  20. Update on Anaplastic Thyroid Carcinoma: Morphological, Molecular, and Genetic Features of the Most Aggressive Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Moira Ragazzi

    2014-01-01

    Full Text Available Anaplastic thyroid carcinoma (ATC is the most aggressive form of thyroid cancer. It shows a wide spectrum of morphological presentations and the diagnosis could be challenging due to its high degree of dedifferentiation. Molecular and genetic features of ATC are widely heterogeneous as well and many efforts have been made to find a common profile in order to clarify its cancerogenetic process. A comprehensive review of the current literature is here performed, focusing on histopathological and genetic features.

  1. Protocol for thyroid remnant ablation after recombinant TSH in thyroid carcinoma

    International Nuclear Information System (INIS)

    Pitoia, F.; Salvai, M.E.; Niepomniszcze, H.; Tamer, E. El

    2009-01-01

    In some countries, in order to perform rhTSH-aided thyroid remnant ablation (TRA) after surgery, it is generally necessary to confirm that thyroidectomy has been almost complete. Otherwise, the nuclear medicine specialist will not administer a high radioiodine dose because it might be hazardous due to the possibility of thyroid remnant actinic thyroiditis. Considering this, it would be necessary to use two rhTSH kits (one for diagnostic purposes and the other one to administer the 131 I dose). In this study, we used an alternative protocol for TRA with the use of one kit of rhTSH in twenty patients diagnosed with low risk papillary thyroid carcinoma. All patients had negative titers of anti-thyroglobulin antibodies. Successful thyroid remnant ablation was confirmed with an undetectable rhTSH stimulated thyroglobulin level ( [es

  2. "Nodule in Nodule" on Thyroid Ultrasonography: Possibility of Follicular Carcinoma Transformed from Benign Thyroid Tumor.

    Science.gov (United States)

    Kobayashi, Kaoru; Ota, Hisashi; Hirokawa, Mitsuyoshi; Yabuta, Tomonori; Fukushima, Mitsuhiro; Masuoka, Hiroo; Higashiyama, Takuya; Kihara, Minoru; Ito, Yasuhiro; Miya, Akihiro; Miyauchi, Akira

    2017-04-01

    It is generally considered impossible to differentiate follicular carcinomas from follicular adenomas by means of ultrasonography or cytology before surgery. Therefore, follicular carcinoma is histopathologically diagnosed by verifying capsular and/or vascular invasion after surgery. However, ultrasonography may play an important role in diagnosing follicular carcinoma preoperatively in a small number of cases. Four cases of follicular carcinoma or follicular neoplasm that transformed from a benign thyroid tumor and demonstrated a "nodule in nodule" appearance on ultrasonography are presented in this report. Characteristic ultrasound features of such patients are: (1) a "nodule in nodule" appearance, (2) a well-defined boundary line between the nodules, and (3) separate distribution of blood signals within each nodule. A small number of patients with follicular carcinomas or follicular neoplasms may present with a "nodule in nodule" appearance on ultrasonography. It was suggested a long time ago that follicular carcinomas may develop from benign thyroid tumors. The fact that follicular carcinomas appear within benign tumors may be evidence of thyroid tumorigenesis.

  3. Gene-expression Classifier in Papillary Thyroid Carcinoma

    DEFF Research Database (Denmark)

    Londero, Stefano Christian; Jespersen, Marie Louise; Krogdahl, Annelise

    2016-01-01

    BACKGROUND: No reliable biomarker for metastatic potential in the risk stratification of papillary thyroid carcinoma exists. We aimed to develop a gene-expression classifier for metastatic potential. MATERIALS AND METHODS: Genome-wide expression analyses were used. Development cohort: freshly...

  4. Post-radiotherapy hypothyroidism in dogs treated for thyroid carcinomas.

    Science.gov (United States)

    Amores-Fuster, I; Cripps, P; Blackwood, L

    2017-03-01

    Hypothyroidism is a common adverse event after head and neck radiotherapy in human medicine, but uncommonly reported in canine patients. Records of 21 dogs with histologically or cytologically confirmed thyroid carcinoma receiving definitive or hypofractionated radiotherapy were reviewed. Nine cases received 48 Gy in 12 fractions, 10 received 36 Gy in 4 fractions and 2 received 32 Gy in 4 fractions. Seventeen cases had radiotherapy in a post-operative setting. Ten cases developed hypothyroidism (47.6%) after radiotherapy. The development of hypothyroidism was not associated with the radiotherapy protocol used. Median time to diagnosis of hypothyroidism was 6 months (range, 1-13 months). Hypothyroidism is a common side effect following radiotherapy for thyroid carcinomas. Monitoring of thyroid function following radiotherapy is recommended. No specific risk factors have been identified. © 2015 John Wiley & Sons Ltd.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Medullary Thyroid Carcinoma Presenting as a Predominantly Cystic Mass on Ultrasonography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Kim, Ah Hyun; Moon, Hee Jung; Kim, Eun Kyung; Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Jun Jeong [Wonju College of Medicine, Wonju (Korea, Republic of); Kim, Myung Hyun [Gangnam MizMedi Hospital, Seoul (Korea, Republic of)

    2012-03-15

    Most medullary thyroid carcinomas show suspicious malignant features such as hypoechogenicity, a spiculated margin and/or intranodular calcifications, which are well known features of papillary carcinoma. We report here on a case of medullary carcinoma that was seen as a predominantly cystic thyroid mass on ultrasonography. This type of case is not common in the literature and we discuss the way to diagnose a medullary thyroid carcinoma

  7. Magnetic resonance spectroscopy as a diagnostic modality for carcinoma thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Nikhil [Department of Surgery, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi (India)], E-mail: nikhil_ms26@yahoo.co.in; Kakar, Arun K. [Department of Surgery, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi (India); Chowdhury, Veena [Department of Radiodiagnosis, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi (India); Gulati, Praveen [MR Centre, A-23 Green Park, New Delhi (India); Shankar, L. Ravi [Department of Radioiodine Uptake and Imaging, Institute of Nucler Medicine and Allied Sciences (INMAS), Timarpur, New Delhi (India); Vindal, Anubhav [Department of Surgery, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi (India)

    2007-12-15

    Aim: The aim of this study was to observe the findings of magnetic resonance spectroscopy of solitary thyroid nodules and its correlation with histopathology. Materials and methods: In this study, magnetic resonance spectroscopy was carried out on 26 patients having solitary thyroid nodules. Magnetic resonance spectroscopy (MRS) was performed on a 1.5 T super conductive system with gradient strength of 33 mTs. Fine needle aspiration cytology was done after MRS. All 26 patients underwent surgery either because of cytopathologically proven malignancy or because of cosmetic reasons. Findings of magnetic resonance spectroscopy were compared with histopathology of thyroid specimens. Results and conclusion: It was seen that presence or absence of choline peak correlates very well with presence or absence of malignant foci with in the nodule (sensitivity = 100%; specificity = 88.88%). These results indicate that magnetic resonance spectroscopy may prove to be an useful diagnostic modality for carcinoma thyroid.

  8. Papillary thyroid carcinoma in Denmark 1996-2008

    DEFF Research Database (Denmark)

    Londero, Stefano Christian; Krogdahl, Annelise; Bastholt, Lars

    2012-01-01

    Background: A rise in the incidence of thyroid cancer has been reported in several countries, and the increase is only seen in the papillary type. Increased detection due to higher resolution ultrasound and fine needle aspiration has been proposed as the explanation, recent registry studies however...... question this assumption. Methods: National, unselected, prospective cohort study of 1350 papillary thyroid cancer patients in Denmark from 1996 to 2008. Objective: To analyze changes in incidence by time and to identify factors which might influence detection rate. Results: A rise in incidence is seen...... thyroid surgery could not be confirmed. Conclusion: This study shows a significant rise in incidence of papillary thyroid carcinoma in Denmark from 1996 to 2008, which is not explained by increased use of preoperative diagnostic modalities. Other reasons need to be considered....

  9. Thyroid metastasis as initial presentation of clear cell renal carcinoma.

    Science.gov (United States)

    Ramírez-Plaza, César Pablo; Domínguez-López, Marta Elena; Blanco-Reina, Francisco

    2015-01-01

    Metastatic tumors account for 1.4-2.5% of thyroid malignancies. About 25-30% of patients with clear cell renal carcinoma (CCRC) have distant metastasis at the time of diagnosis, being the thyroid gland a rare localization [5%]. A 62-year woman who underwent a cervical ultrasonography and a PAAF biopsy reporting atypical follicular proliferation with a few intranuclear vacuoles "suggestive" of thyroid papillary cancer in the context of a multinodular goiter was reported. A total thyroidectomy was performed and the histology of a clear cell renal carcinoma (CCRC) was described in four nodules of the thyroid gland. A CT scan was performed and a renal giant right tumor was found. The patient underwent an eventful radical right nephrectomy and the diagnosis of CCRC was confirmed. Thyroid metastasis (TM) from CCRC are usually apparent in a metachronic context during the follow-up of a treated primary (even many years after) but may sometimes be present at the same time than the primary renal tumor. Our case is exceptional because the TM was the first evidence of the CCRC, which was subsequently diagnosed and treated. 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. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Well-differentiated thyroid carcinoma in Martinique

    International Nuclear Information System (INIS)

    Azaloux, H.; Dieye, M.; Draganescu, C.; Istrate, M.; Dorival, M.J.; Baudin-Veronique, J.; Escarmant, P.; Amar, A.; Francois, H.

    2002-01-01

    The thyroid neoplasm is easily entered in the accounts in Martinique with the Tumor Registry created in 1981. This is not a frequent cancer but its frequency grew since 1981 till 1995. The treatment of the well differentiated thyroid cancer is well standardized with a total thyroidectomy generally followed by a metabolic thyroidectomy with 131 I. The follow-up is composed by clinical exam, TSH and thyroglobulin measurements. The results are very good and we mean to continue this strategy refining it for the little papillary tumors and using the recombinant TSH. The Tchernobyl event in 1986 generated new epidemiological considerations and has been the object of multiples studies.The studies realized in such a very distant site like Martinique permitted the realization of comparisons with the Tumor Registry of the 'Bas Rhin' in France a geographical area that could have been concerned by the disaster. The result of this study fends a growth of the incidence of the thyroid neoplasm almost identical with that registered in the mainland with a net increase for the papillary neoplasms. We may then conclude that the growth percentage since 1981 till 1995 due to the availability and more frequent using of many new diagnostic means less operator-dependent than before. By this descriptive study we may purport that the incidence of the thyroid cancer is low (4,45 per 100000 population for women and 0,9 per 100000 population for men). Treatment is consensual and thanks to the lifelong administration of exogenous thyroid hormone the quality of life of these patients is maintained along with a sure recovery in most of the cases. The mortality due to the thyroid cancer is very low in the orthoplasic form (less than 1 % of all types of cancer). The precocious screening of the thyroid neoplasm has to enter then in the guidelines in medical education. It consists in the systematical exploring of a thyroid nodule by clinical exam and by ultrasonography, radioisotope scanning with Tc

  11. Disseminated medullary thyroid carcinoma despite early thyroid surgery in the multiple endocrine neoplasia-2A syndrome

    NARCIS (Netherlands)

    van Santen, H. M.; Aronson, D. C.; van Trotsenburg, A. S. P.; ten Kate, F. J. W.; van de Wetering, M. D.; Wiersinga, W. M.; de Vijlder, J. J. M.; Vulsma, T.

    2005-01-01

    A 5 1/2-year-old boy, with a family history of multiple endocrine neoplasia (MEN)-2A syndrome, was evaluated for presence of MEN-2A and medullary thyroid carcinoma (MTC). DNA diagnostics confirmed MEN-2A. Basal (360 ng/L) and pentagastrin stimulated (430 ng/L) calcitonin (CT) levels were slightly

  12. Poorly Differentiated Thyroid Carcinoma Arising in Struma Ovarii

    Directory of Open Access Journals (Sweden)

    Surapan Khunamornpong

    2015-01-01

    Full Text Available Struma ovarii is an uncommon type of ovarian mature teratoma with a predominant thyroid component. The morphological spectrum of the thyroid tissue ranges from that of normal thyroid to proliferative adenoma-like lesions and thyroid-type carcinomas (malignant transformation. The histologic features of ovarian strumal lesions sometimes cause diagnostic problems due to the confusion with other types of ovarian neoplasms and the difficulty in the prediction of their clinical behavior. We report an extremely rare case of poorly differentiated thyroid carcinoma arising in struma ovarii. A 22-year-old woman presented with a 15 cm right ovarian mass. The tumor showed a predominantly tubular pattern which raised a differential diagnosis between endometrioid adenocarcinoma and Sertoli cell tumor. A review of the gross specimen with additional tissue sampling helped identify the teratomatous and strumal nature, with a support by immunohistochemical staining. Despite FIGO stage IA by optimal staging procedure and the absence of identifiable lymphovascular invasion, the patient developed pulmonary metastasis 15 months after surgery and died from the progression of the disease 7 years after the diagnosis. This case emphasizes the importance of macroscopic examination of the specimen and the awareness of this uncommon tumor in the differential diagnosis of ovarian neoplasms.

  13. Dietary patterns as risk factors of differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Elwira Przybylik-Mazurek

    2012-01-01

    Full Text Available Nutritional factors are known to be important in the development of different metabolic diseases. The history of nodular or diffuse goiter is closely related to risk of thyroid carcinoma. On account of the function of the thyroid gland, many studies focus on iodine intake.The aim of the study was to assess whether dietary patterns could be risk factors of differentiated thyroid carcinoma.Material/Methods:The case-control study was based on a questionnaire, which included information about dietary patterns and was carried out on 284 patients comprising 30 males (mean age 58.4±13.7 years, and 254 females (mean age 52.1±13.8 years, as well as 345 randomly selected controls: 58 males (mean age 60.2±12 years and 287 females (mean age 53.4±14.3 years randomly selected from the Population Register and adjusted by age and gender to the group of TC. The main groups of nutritional products, i.e. starchy foods, meat, dairy products, vegetables, fruits, and beverages, were analyzed.Results:Consumption of vegetables, fruits, saltwater fish and cottage cheese was significantly lower in patients with differentiated thyroid carcinoma than in controls, quite the contrary to starchy foods, especially white bread.Conclusions:Dietary patterns appear to modify the risk of thyroid carcinoma. A diet rich in vegetables and fruit, as well as saltwater fish (a source of iodine and low-fat meat, could be an important protective factor.

  14. Old and New Insights in the Treatment of Thyroid Carcinoma

    Science.gov (United States)

    Gasent Blesa, Joan Manel; Grande Pulido, Enrique; Provencio Pulla, Mariano; Alberola Candel, Vicente; Laforga Canales, Juan Bautista; Grimalt Arrom, Miguel; Martin Rico, Patricia

    2010-01-01

    Thyroid cancer is the endocrine tumor that bears the highest incidence with 33 550 new cases per year. It bears an excellent prognosis with a mortality of 1530 patients per year (Jemal et al.; 2007). We have been treating patients with thyroid carcinoma during many years without many innovations. Recently, we have assisted to the development of new agents for the treatment of this disease with unexpected good results. Here we present a review with the old and new methods for the treatment of this disease. PMID:21048836

  15. [RET/PTCrearrangement affects multifocal formation of papillary thyroid carcinoma].

    Science.gov (United States)

    Zhang, X; Su, X; Chen, W C; Li, Y; Yang, Z Y; Deng, W Z; Deng, T C; Yang, A K

    2017-06-07

    Objective: RET / PTC gene rearrangement can lead to aberrant activation of tyrosine kinase receptors, which is a common mutation in papillary thyroid carcinoma (PTC). This study focuses on the association of RET / PTC rearrangements with PTC clinical factors. Methods: From January 2011 to December 2013, a total of 114 patients with PTC were enrolled in this study. Clinicopathological parameters, lifestyle, and thyroid hormone levels were collected. RET / PTC rearrangements were detected by TaqMan PCR and verified by Sanger sequencing.Data were analyzed with SPSS software, including chi-square test, Fisher ' s exact test, Mann - Whitney U test, Student ' s t -test, and Logistic regression. Results: RET / PTC rearrangements were not found in all paracancerous normal thyroid tissues, and were detected in 23.68% (27/114) of PTC. Further analysis revealed no correlation between RET / PTC rearrangement and thyroid function, clinicopathologic parameters, and lifestyle in the total PTC group or in the subgroup of patients with concomitant diseases (including Hashimoto's thyroiditis and nodular goiter). But in the subgroup of PTC without concomitant disease, RET / PTC rearrangement was associated with tumor multifocal ( P =0.018), and RET / PTC -positive PTC patients had an increased risk of tumor multifocal ( OR =5.57, 95% CI 1.39-22.33). It was also found that RET / PTC rearrangement was associated with an abnormal increase in TSH level of one month after surgery ( P = 0.037). Conclusion: Nodular goiter and Hashimoto 's thyroiditis may be a confounding factor in PTC. RET / PTC rearrangement may play an important role in the occurrence of thyroid carcinoma multifocal after exclusion of this confounding factor.

  16. SPECTRUM OF THYROID CARCINOMAS IN COASTAL ANDHRA PRADESH: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Madhuri Sepuri

    2016-09-01

    Full Text Available BACKGROUND Thyroid carcinoma accounts for less than 1% of cancer cases. In the Indian subcontinent, thyroid carcinoma exhibits a varied disease profile and geographic differences in the pattern of cancer, the knowledge of which impacts a more favourable clinical outcome. The present study aims to profile Thyroid carcinoma in areas of age, gender, geographic domicile, morphology & clinical features and referral paradigm of cases in King George Hospital, Visakhapatnam, the tertiary referral hospital for coastal Andhra Pradesh. METHODS & MATERIALS The Retrospective Study 1988-2004 includes 188 patients who attended Department of Nuclear Medicine for pre & postoperative nuclear scan, thyroid carcinoma treatment protocol, whose clinical features, relevant laboratory data, histopathological reports & prognosis were analysed. RESULTS Papillary thyroid carcinoma was present in 79% and Follicular thyroid carcinoma in 19%, Anaplastic & Medullary Thyroid Carcinoma in 2% of cases (n=188, male to female ratio 1:0.62. Coastal city of Visakhapatnam recorded highest 59% of cases who were in their 3rd and 4th decades. West Godavari District had lowest at 5%. Clinical presentation of cases of Thyroid carcinoma as a Nodule (61% which was the most common form lead to maximum number of referrals (n=82 from the Department of Surgery, King George Hospital. CONCLUSION In coastal Andhra Pradesh, papillary thyroid carcinoma was the most dominant form. Women were more affected than men. Painless thyroid nodule was the most common clinical feature. Coastal city of Visakhapatnam recorded highest number of cases and maximum referrals were from Department of Surgery.

  17. Two breast metastases from thyroid carcinoma presented 6 years later after total thyroidectomy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Gene Hyuk; Kang, Bong Joo; Kim, Sung Hun; Lee, Ah Won [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Jung, Na Young [Dept. of Radiology, Bucheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Bucheon (Korea, Republic of)

    2016-04-15

    Thyroid carcinoma is usually indolent with good prognosis, as compared to other malignancy. Distant metastases from thyroid cancer are rare and usually manifest as multiple lesions especially in lungs, bones and lymph nodes, in advanced stages of the disease. Metastasis to the breast from thyroid carcinoma is extremely rare, with about 16 cases reported in the English literature. Herein, we reported a case of metastatic poorly differentiated thyroid carcinoma, which presented as 2 breast masses in a 72-year-old woman, 6 years after total thyroidectomy for papillary thyroid carcinoma. Although the computed tomography (CT) and ultrasonography (USG) image findings are nonspecific oval mass with circumscribed or partially indistinct margin, metastases from thyroid cancer should be included in the differential diagnosis when recurrence of thyroid carcinoma is suspected. Also, fusion images of CT and USG are helpful to the radiologists in localizing the targeted lesion and conducting accurate USG-guided biopsy.

  18. Use of tracheal stenting in the palliation of anaplastic thyroid carcinoma: tertiary centre experience.

    Science.gov (United States)

    Varadharajan, K; Mathew, R; Odutoye, B; Williamson, P; Madden, B

    2015-06-01

    Anaplastic thyroid carcinoma is rare but carries a poor prognosis. Anaplastic thyroid carcinoma leads to tracheal compression, airway compromise and eventually death. Airway compromise, a particularly distressing symptom, can be palliated with tracheal stenting. A retrospective case note analysis was conducted of patients diagnosed with anaplastic thyroid carcinoma between July 2003 and July 2013. Twelve patients with anaplastic thyroid carcinoma were identified. Four patients underwent palliative tracheal stenting. Three patients had no dyspnoea at the time of stenting. Two stented patients subsequently developed dyspnoea secondary to stent migration; this was managed successfully with stent exchange. The other stented patient remained asymptomatic with regards to dyspnoea. All non-stented patients died with or from airway compromise. Tracheal stenting is a relatively safe and effective method for palliation of distressing airway symptoms in patients with anaplastic thyroid carcinoma. Early prophylactic tracheal stenting in anaplastic thyroid carcinoma may be an effective option to prevent development of airway compromise as the disease progresses.

  19. Hashimotos Thyroiditis with Coexistent Papillary Carcinoma and ...

    African Journals Online (AJOL)

    tomography (CT) neck, thorax, abdomen and pelvis, positron emission tomography-CT, total body scintigraphy with MIB. Figure 1: (a) Thyroidectomy specimen on the cut surface showing homogenous grey white areas with tiny colloid filled area,. (b) Hashimoto's thyroiditis with lymphocytic infiltrate and follicles lined.

  20. Iodine I-131 With or Without Selumetinib in Treating Patients With Recurrent or Metastatic Thyroid Cancer

    Science.gov (United States)

    2018-03-30

    Metastatic Thyroid Gland Carcinoma; Poorly Differentiated Thyroid Gland Carcinoma; Recurrent Thyroid Gland Carcinoma; Stage IV Thyroid Gland Follicular Carcinoma; Stage IV Thyroid Gland Papillary Carcinoma; Stage IVA Thyroid Gland Follicular Carcinoma; Stage IVA Thyroid Gland Papillary Carcinoma; Stage IVB Thyroid Gland Follicular Carcinoma; Stage IVB Thyroid Gland Papillary Carcinoma; Stage IVC Thyroid Gland Follicular Carcinoma; Stage IVC Thyroid Gland Papillary Carcinoma

  1. CD56, HBME-1 and cytokeratin 19 expressions in papillary thyroid carcinoma and nodular thyroid lesions

    Science.gov (United States)

    Erdogan-Durmus, Senay; Ozcan, Deniz; Yarikkaya, Enver; Kurt, Ali; Arslan, Aynur

    2016-01-01

    Background: Carcinomas of the thyroid follicular epithelium are the most common cancers of the endocrine system. In the diagnosis of thyroid nodules and tumors, the gold standard is histological evaluation. In cases which have morphological overlap, immunohistochemistry is needed for differential diagnosis. The purpose of this study is to investigate the expressions of CD56, HBME-1, cytokeratin 19 (CK19) antibodies in papillary thyroid carcinoma (PTC) and thyroid nodular lesions and their contributions to differential diagnosis. Materials and Methods: In this study, 47 PTCs (26 follicular variant, 21 classic type) and 26 benign thyroid lesions (15 nodular hyperplasia, 10 follicular adenomas, 1 Hurtle cell adenoma) were analyzed retrospectively. HBME-1, CK19, and CD56 antibodies were performed with immunohistochemical methods. The results were evaluated statistically. Results: +3 staining with HBME-1 and CK19 was observed in 72.3% and 83% of patients with PTC. In 95.7% of PTC cases, loss of CD56 expressions in various degrees was identified. A statistically significant difference was detected in HBME-1, CK19, and CD56 expressions between PTCs and benign lesions (P < 0.001). Conclusion: In our study, positive staining of HBME-1, CK19, and loosing expression of CD56 that supports malignancy was found and concluded that CD56 is a helpful antibody for the differential diagnosis of benign and malignant lesions and may increase the diagnostic accuracy when used with HBME-1 and CK19. PMID:27904595

  2. Report of a Rare Case of Papillary Thyroid Carcinoma Associated with Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Sh. Borzouei

    2012-10-01

    Full Text Available Introduction: Papillary thyroid cancer (PTC is the most common well-differentiated cancer of the thyroid. Only in few cases of PTC entity of renal cell carcinoma has been observed in patients affected with PTC. Case Report: In this study we report a case of sporadic PTC and renal cell carcinoma in a 63 year-old woman. Conclusion: After surgery the patient was hospitalized for 1 month in ICU section. 3 months after being discharged from the hospital, she was still in a good condition and is under the follow-up treatment.(Sci J Hamadan Univ Med Sci 2012; 19 (3:75-77

  3. Anaplastic thyroid carcinoma in Denmark 1996-2012

    DEFF Research Database (Denmark)

    Hvilsom, Gitte Bjørn; Londero, Stefano Christian; Hahn, Christoffer Holst

    2018-01-01

    BACKGROUND: Anaplastic thyroid carcinoma (ATC) is the least common but most malignant thyroid cancer. We aimed to examine the characteristics as well as evaluate the incidence, prognostic factors, and if introduction of a fast track cancer program might influence survival in a cohort of ATC...... patients. METHODS: A cohort study based on prospective data from the national Danish thyroid cancer database DATHYRCA and the national Danish Pathology Register including 219 patients diagnosed from 1996 to 2012, whom were followed until death or through September 2014. RESULTS: We found the median age...... in the 7th decade, the majority of patients being women presenting with a growing mass at the neck, diagnosed with stage T4b disease. At diagnosis, 56% of the patients had lymph node metastasis and 38% distant metastasis. We observed one- and five-year survival of 20.7% and 11.0%, respectively. Both...

  4. Unusual Thyroid Carcinoma Metastases: a Case Series and Literature Review.

    Science.gov (United States)

    Farina, Eleonora; Monari, Fabio; Tallini, Giovanni; Repaci, Andrea; Mazzarotto, Renzo; Giunchi, Francesca; Panzacchi, Riccardo; Cammelli, Silvia; Padula, Gilbert D A; Deodato, Francesco; Pasquali, Renato; Fanti, Stefano; Fiorentino, Michelangelo; Morganti, Alessio G

    2016-03-01

    The most common sites of metastatic differentiated thyroid cancer are the neck lymph nodes, while distant metastases typically involve the lungs, the bones, and less frequently the brain. Uncommon metastatic sites include the liver, adrenal gland, kidney, pancreas, and skin. The epidemiological aspects of thyroid metastases in rare sites are largely unknown and their identification could have a significant impact on patients management. A mini-series of unusual metastatic sites of thyroid carcinoma is proposed as a contribution to current knowledge on anatomopathological characteristics and clinical outcome. Of the six cases that were assessed, the metastases were the following: skin metastases (2), skin and pancreas metastases (1), renal metastasis (1), adrenal metastasis (1), and liver metastasis (1). In our experience, metastases in rare sites do not always represent a negative prognostic factor for disease outcome. In fact they can occur as single distant lesion and if surgically resectable, their treatment can also lead to local disease remission.

  5. Definitive radiation therapy for infiltrative thyroid carcinoma in dogs.

    Science.gov (United States)

    Pack, L; Roberts, R E; Dawson, S D; Dookwah, H D

    2001-01-01

    The medical records of eight dogs with histopathologically confirmed infiltrative thyroid carcinoma treated with external beam radiation were reviewed and a retrospective analysis of survival and local tumor control were performed. The dogs received a definitive radiotherapy protocol of 46.8-48 Gray. All dogs had a reduction in tumor size to a clinically undetectable level on follow up examinations. Kaplan-Meier analysis indicated a median survival time of 24.5 months. Pulmonary metastasis was detected in three dogs and one of these dogs had concurrent bone metastasis. One dog had bone metastasis alone. Two dogs were alive at the censor. This study suggests that fractionated, definitive radiation therapy using multiple, moderate doses of radiation is an effective treatment for local control of invasive thyroid carcinoma in dogs.

  6. Contemporary Management of Recurrent Nodal Disease in Differentiated Thyroid Carcinoma

    Science.gov (United States)

    Na’ara, Shorook; Amit, Moran; Fridman, Eran; Gil, Ziv

    2016-01-01

    Differentiated thyroid carcinoma (DTC) comprises over 90% of thyroid tumors and includes papillary and follicular carcinomas. Patients with DTC have an excellent prognosis, with a 10-year survival rate of over 90%. However, the risk of recurrent tumor ranges between 5% and 30% within 10 years of the initial diagnosis. Cervical lymph node disease accounts for the majority of recurrences and in most cases is detected during follow-up by ultrasound or elevated levels of serum thyroglobulin. Recurrent disease is accompanied by increased morbidity. The mainstay of treatment of nodal recurrence is surgical management. We provide an overview of the literature addressing surgical management of recurrent or persistent lymph node disease in patients with DTC. PMID:26886954

  7. Choroid metastasis of papillary thyroid carcinoma. Color doppler ultrasound study

    International Nuclear Information System (INIS)

    Ganado, T.; Torre, S. de la; Contreras, E.; Hernandez, J.

    1997-01-01

    The most common causes of intraocular metastases are breast and lung cancers, although many other neoplasms can metastasize to the eye. Most of the metastases are located in the posterior pole and the choroid is more often involved than the retina. We present a case of a choroidal metastasis from a papillary carcinoma of the thyroid, associated with a massive subretinal hemorrhage. Findings with color Doppler ultrasound are emphasized. (Author) 9 refs

  8. Follicular thyroid carcinoma mimicking meningioma: A case report

    Directory of Open Access Journals (Sweden)

    Krishnalatha Buandasan

    2012-02-01

    Full Text Available Follicular thyroid carcinoma (FTC is a well-differentiated tumor which resembles the normal microscopic pattern of the thyroid. Although intracranial metastasis to the brain is frequent in adults, metastasis from FTC is very rare. Dural metastases mimicking meningioma have been documented in the literature now and then. However, cases arising from a FTC are again very rare. We report the case of a middle-aged lady who presented with progressive, painless left eye proptosis. She was noted to have a non-axial proptosis with dystopia, compressive optic neuropathy and exposure keratitis. She also had a painless swelling over the occipital region. She was initially misdiagnosed to have multiple foci of meningioma based on magnetic resonance imaging findings. Subsequent histopathological examination revealed presence of FTC. She was euthyroid but was found to have multiple small thyroid nodules by ultrasonography. Hence, the definite diagnosis of all dural masses must be histological wherever possible and thyroid carcinoma should be considered as a potential primary tumour in such presentations.

  9. The molecular biological characteristics of childhood thyroid carcinoma

    International Nuclear Information System (INIS)

    Cherstvoy, E; Nerovnya, A.; Voskoboinic, L.; Bogdanova, T.; Tronko, N.D.; Tonnachera, M.; Dumont, J.E.; Lamy, F.; Keller, G.; Boehm, J.; Hoefler, H.; Vecchio, G.C.; Viglietto, G.; Chiappetta, G.; Williams, G.H.; Thomas, G.A.; Williams, E.D.

    1996-01-01

    We have used molecular biology to study mutation and expression of key oncogenes in childhood thyroid carcinomas from Belarus and Ukraine. All cases were histologically verified by two or more pathologists including at least one from the CIS and one from the EU. We chose to study six genes which have been shown to be involved in thyroid carcinogenesis in adults: ret. Ha, Ki and N ras genes, p53 and the TSH receptor. Expression of the ret oncogene, which has been shown to be activated by translocation in a proportion of papillary carcinomas has been studied by two independent methods. The first, used by the Cambridge group uses RT-PCR to identify the expression of the tyrosine kinase domain of the gene; as the gene is normally silent in follicular cells, this approach allows demonstration of activation of ret, but does not identify the particular translocation involved. The second approach, used by the Naples group, also uses RT-PCR, but amplifies across the breakpoint of each of the three translocations already identified to provide information on the proportion of tumors which express the individual translocations of this gene. Mutations in the TSH receptor, a key modulator of thyroid follicular growth have been sought by the Brussels group using SSCP and direct sequencing. The Munich group have analyzed the samples for presence of mutation in p53, which is believed to play a role in genetic instability which is a features of carcinomas derived from may different tissues. Mutations in the common sites of the ras oncogenes have been studied by the Cambridge group. Analysis of 26 papillary carcinomas so far studied has shown that mutations in the TSH receptor and in p53 do not play a significant role in the genesis of the tumours studied. The proportion of tumours showing ret expression does not differ significantly from that found in a control non exposed population from the UK. However, the pathological study shows that nearly all the increased number of thyroid

  10. Brain metastases from thyroid carcinoma : studies of cases

    International Nuclear Information System (INIS)

    Perumal, N.S.; Kotze, T.; Vangu, M.D.T.H.W.

    2004-01-01

    Full text: Introduction: Because brain metastasis from well differentiated thyroid carcinoma is rare, management of patients presenting with this condition lacks consensus. A recent review of the literature found 17 reports of 75 cases from 1966-2001 in which 28 metastasis were from the brain, 5 from the spinal cord, 2 to both brain and spinal cord, We report our 5 cases with a focus on the last patient. Clinical presentation: A 66-year-old female treated by us for the past 10 years for papillary carcinoma of the thyroid with metastasis to bone. She presented in July 2003 with sudden onset of seizure. A non contrast CT scan demonstrated a solitary lesion in the right anterior high parietal region with a possible second lesion. Intervention: She underwent right frontal craniotomy to expose superior sagittal sinus. An inter-hemispheric approach demonstrated a tumor in the supra-meningeal gyrus that was attached to the calloso-meningeal artery. The histopathology of the surgical specimen confirmed a follicular variant of papillary carcinoma of the thyroid. She then received 11100 MBq 1-131 irradiation, Conclusion: the best therapeutic option for brain metastasis seems to be surgical resection with or without post operative Irradiation with 1-131. Central nervous system metastasis should always be investigated and treated aggressively to improve patients' long term outcome. (author)

  11. Detection of metastatic thyroid carcinoma through whole body counting

    International Nuclear Information System (INIS)

    Novenario, H.S.; Pascacio, F.M.; Cruz, Benjamin de la; Anden, A.B.

    Whole body counters are not only used in measuring radioactivity in the body for radiation protection purposes but also in the measurement of iron absorption, body potassium and cesium, chronic blood loss, and also in the determination of the effectiveness of surgery, thyroid hormone and radioactive iodine therapy in thyroid carcinoma. This report deals with our experience in the use of a shadow-shield whole body counter in the determination of I-131 uptake by metastatic lesions of cancer of thyroid after total thyroidectomy and ablation therapy with I-131. This study was undertaken jointly by the Department of Nuclear Medicine, Veterans Memorial Hospital and the Biomedical Research Division of the Philippine Atomic Energy Commission. Preliminary results indicate that the 22 patients who underwent whole body counting after total thyroidectomy I-131 ablation therapy, 9 patients had elevated percentage retention of I-131, 10 patients with normal values and 3 patients with rising values. Foci of I-131 concentration in those with elevated and rising percentage concentration values were seen in the thyroidal bed scintiscans, while the 10 patients with normal values had negative scintiscans. The results of our observations confirm the results obtained by other workers abroad. Our preliminary results indicate that with the use of whole body counters a sensitive method of assessing whether functioning metastatic lesion of cancer of the thyroid still exist after total thyroidectomy and I-131 ablation therapy can be provided. (author)

  12. Metastatic thyroid carcinoma without identifiable primary tumor within the thyroid gland: a retrospective study of a rare phenomenon.

    Science.gov (United States)

    Xu, Bin; Scognamiglio, Theresa; Cohen, Perry R; Prasad, Manju L; Hasanovic, Adnan; Tuttle, Robert Michael; Katabi, Nora; Ghossein, Ronald A

    2017-07-01

    Metastatic papillary thyroid carcinoma (PTC) without an identifiable primary tumor despite extensive microscopic examination of the thyroid gland is a rare but true phenomenon.We retrieved 7 of such cases and described in detail the clinical and pathologic features of these tumors. BRAF V600E immunohistochemistry and Sequenom molecular profile were conducted in selected cases. All patients harbored metastatic disease in the central (n=3), lateral (n=3), or both neck compartments (n=1). The histotype of the metastatic disease was PTC (n=5), poorly differentiated thyroid carcinoma in association with a PTC columnar variant (n=1), and anaplastic thyroid carcinoma in association with a PTC tall cell variant (n=1). Fibrosis was present in the thyroid of 5 patients. All patients with PTC were alive without evidence of recurrence. The 76-year-old patient with poorly differentiated thyroid carcinoma did not recur and died of unknown causes. Finally, the patient with anaplastic thyroid carcinoma was alive with distant metastasis at last follow-up. The median follow-up for this cohort was 2.2years (range, 0.8-17). BRAF V600E was detected in 4 of 6 cases by immunohistochemistry. In conclusion, metastatic nodal disease without identifiable thyroid primary is a rare but real phenomenon of unknown mechanisms. Although most tumors are low grade and well differentiated, aggressive behavior due to poorly differentiated or anaplastic carcinoma can happen. Most cases are BRAF V600E -positive thyroid tumors. A papillary carcinoma phenotype is found in all reported cases. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Thyroid carcinoma: A follow-up study of 11 years

    International Nuclear Information System (INIS)

    Ritzl, F.; Siebers, G.; Neumann, C.; Ritzl, E.K.

    1987-01-01

    During a follow-up of 11 years of thyroid carcinoma 136 patients were repeatedly examined. 43% papillary, 43% follicular, 11% anaplastic and 2% medullary carcinomas was found. The incidence of these types of carcinoma differed considerably; the frequency peak of papillary carcinomas was reached in 45-year-old humans, that of the follicular carcinomas in people aged 60, that of the anaplastic carcinomas in 70-year-old humans. 84% of the patients was female. Classification in pTNM-system: 8% in pT1, 27% in pT2, 12% in pT3 and 49% in pT4. Local and distant metastases were found at a low rate equally in pT1, pT2 and pT3; 26% of patients in pT4 had local metastases and 18% had distant ones in addition. There were 6 patients with metastases of a differentiated adenocarcinoma accumulating no 131-iodine and with no thyroglobulin in serum. 29% of patients had after thyroidectomy an unilateral paresis of the nervus recurrens and 4% a bilateral one. 26% of patients had a permanent hypoparathyroidism after thyroidectomy. (orig.)

  14. Thyroid carcinoma: A follow-up study of 11 years

    Energy Technology Data Exchange (ETDEWEB)

    Ritzl, F.; Siebers, G.; Neumann, C.; Ritzl, E.K.

    1987-09-01

    During a follow-up of 11 years of thyroid carcinoma 136 patients were repeatedly examined. 43% papillary, 43% follicular, 11% anaplastic and 2% medullary carcinomas was found. The incidence of these types of carcinoma differed considerably; the frequency peak of papillary carcinomas was reached in 45-year-old humans, that of the follicular carcinomas in people aged 60, that of the anaplastic carcinomas in 70-year-old humans. 84% of the patients was female. Classification in pTNM-system: 8% in pT1, 27% in pT2, 12% in pT3 and 49% in pT4. Local and distant metastases were found at a low rate equally in pT1, pT2 and pT3; 26% of patients in pT4 had local metastases and 18% had distant ones in addition. There were 6 patients with metastases of a differentiated adenocarcinoma accumulating no 131-iodine and with no thyroglobulin in serum. 29% of patients had after thyroidectomy an unilateral paresis of the nervus recurrens and 4% a bilateral one. 26% of patients had a permanent hypoparathyroidism after thyroidectomy.

  15. Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumor with lymph node metastasis: A case report

    Directory of Open Access Journals (Sweden)

    Sadat Alavi Mehr

    2011-12-01

    Full Text Available Abstract Introduction Papillary thyroid carcinoma and medullary thyroid carcinoma are two different thyroid neoplasia. The simultaneous occurrence of medullary thyroid carcinoma and papillary thyroid carcinoma as a collison tumor with metastases from both lesions in the regional lymph nodes is a rare phenomenon. Case presentation A 32-year-old Iranian man presented with a fixed anterior neck mass. Ultrasonography revealed two separate thyroid nodules as well as a suspicious neck mass that appeared to be a metastatic lesion. The results of thyroid function tests were normal, but the preoperative calcitonin serum value was elevated. Our patient underwent a total thyroidectomy with neck exploration. Two separate and ill-defined solid lesions grossly in the right lobe were noticed. Histological and immunohistochemical studies of these lesions suggested the presence of medullary thyroid carcinoma and papillary thyroid carcinoma. The lymph nodes isolated from a neck dissection specimen showed metastases from both lesions. Conclusions The concomitant occurrence of papillary thyroid carcinoma and medullary thyroid carcinoma and the exact diagnosis of this uncommon event are important. The treatment strategy should be reconsidered in such cases, and genetic screening to exclude multiple endocrine neoplasia 2 syndromes should be performed. For papillary thyroid carcinoma, radioiodine therapy and thyroid-stimulating hormone suppressive therapy are performed. However, the treatment of medullary thyroid carcinoma is mostly radical surgery with no effective adjuvant therapy.

  16. Dissecting Molecular Events in Thyroid Neoplasia Provides Evidence for Distinct Evolution of Follicular Thyroid Adenoma and Carcinoma

    OpenAIRE

    Krause, Kerstin; Prawitt, Susanne; Eszlinger, Markus; Ihling, Christian; Sinz, Andrea; Schierle, Katrin; Gimm, Oliver; Dralle, Henning; Steinert, Frank; Sheu, Sien-Yi; Schmid, Kurt W.; Fuhrer, Dagmar

    2011-01-01

    Benign hypofunctional cold thyroid nodules (CTNs) are a frequent scintiscan finding and need to be distinguished from thyroid carcinomas. The origin of CTNs with follicular morphologic features is unresolved. The DNA damage response might act as a physiologic barrier, inhibiting the progression of preneoplastic lesions to neoplasia. We investigated the following in hypofunctional follicular adenoma (FA) and follicular thyroid cancer (FTC): i) the mutation rate of frequently activated oncogene...

  17. Report of a case of papillary thyroid carcinoma in association with Hashimoto's thyroiditis.

    Science.gov (United States)

    Okani, Chukwudi Onyeaghana; Otene, Benjamin; Nyaga, Terhemba; Ngbea, Joseph; Eke, Agaba; Edegbe, Felix; Anyiam, Daniel

    2015-01-01

    Hashimoto thyroiditis (HT) is an autoimmune disease, known to be the most common cause of hypothyroidism in nonendemic goitrous areas. It is usually characterized by symmetric, painless, and diffused but sometimes localized swelling of the thyroid gland with features of hypothyroidism. Papillary thyroid carcinoma (PTC), on the other hand, is the most common yet less aggressive form of thyroid cancer, especially in iodine-deficient areas. The coexistence of the two diseases is possible but not common. This case study reports a 50-year-old female with a 10-year history of a huge goiter, which was essentially symptom-free until about 3 months prior to presentation when the patient started complaining of neck pain, dysphagia, productive cough, and cold intolerance. Physical examination revealed focal cystic and tender area in the multinodular swelling and associated cervical lymphadenopathy on the left side of the neck. The serum thyroid stimulating hormone was high, sub-normal T3, and the T4 was low. The fine needle aspiration cytology yielded 10 ml of aspirate of pus admixed with altered blood which on microscopy showed a few suspicious follicular epithelial cells with open nuclei admixed with mainly neutrophil polymorphs, siderophages, and foam cells in a hemorrhagic background. The patient had an incision biopsy that showed areas displaying PTC and HT.

  18. Surgical Management of Bulky Mediastinal Metastases in Follicular Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Zainal Adwin

    2016-01-01

    Full Text Available Follicular thyroid adenoma and carcinoma are very common. Benign and malignant lesions are usually indistinguishable from cytology alone and often require confirmatory resection. The spread of follicular carcinoma is usually hematogenous and is treated with surgery and adjuvant radioactive iodine. Very rarely, metastases occur in the mediastinum. Patients usually present with severe compressive symptoms. With proper treatment and follow-up, the prognosis for these type of thyroid malignancies is excellent. In the case presented here, our patient presented to the Universiti Kebangsaan Malaysia Medical Center with a progressively enlarging anterior neck swelling. The swelling had started 10 years before his presentation. We diagnosed him with an advanced thyroid malignancy with bulky mediastinal metastases. After extensive investigations and counseling, we chose to treat the patient with tumor excision and mediastinal metastases resection. Typically, mediastinal resection involves the removal of the sternum and use of an acrylic implant to recreate the sternum. In this case, the sternum and ribs were removed with subsequent myocutaneous flap coverage for the wound defect. Our experience represents an alternative treatment option in cases where implant use is unsuitable.

  19. Safety of Completion Thyroidectomy for Initially Misdiagnosed Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Gangiti Kranthikumar

    2016-07-01

    Full Text Available Introduction Completion thyroidectomy is defined as the surgical removal of the remnant thyroid tissue following procedures of less than total or near-total thyroidectomy. Whether thyroid reoperations are associated with an increased complication risk is controversial. Objective A retrospective analysis was done of patients undergoing completion thyroidectomy for cancer of the thyroid who had undergone surgery elsewhere for solitary thyroid nodule. The incidence of surgical complications in these patients after reoperation was investigated in this study. Material and methods The study included a total of 53 patients who had undergone thyroid lobectomy for a solitary nodule as initial surgery elsewhere and were referred to our institute for completion thyroidectomy when the histopathology revealed malignancy. Results There were 53 patients, 43 females and 10 males. Their mean age was 34.7±12.12 years (range 19–65 years. After initial surgery, the histopathology revealed papillary carcinoma in 46 patients (86.8%, follicular carcinoma in 7 (13.2%. Fourteen out of 53 patients had recurrent laryngeal nerve palsy after initial surgery (26.4%. None of the patients had clinical hypocalcemia after the first surgery. One or more parathyroid glands were identified and preserved in 52 patients (98.1% in the process of completion thyroidectomy. No patient had additional recurrent nerve injury at the second surgery. The mean serum calcium value preoperatively was 8.96±0.39 mg/dL, and six months after surgery serum calcium was 8.74±0.56 mg/dL. Mean follow-up was 18 months. Transient hypoparathyroidism occurred in 24.5% patients. Five patients were lost to follow-up. Permanent and symptomatic hyperparathyroidism occurred in eight patients (16.67%. Conclusions Completion thyroidectomy is a safe and appropriate option in the management of well-differentiated thyroid cancer. It removes disease on the ipsilateral and contralateral side of the thyroid and

  20. The Immune Interplay between Thyroid Papillary Carcinoma and Hepatic Fibrosis.

    Directory of Open Access Journals (Sweden)

    Nidal Muhanna

    Full Text Available A high prevalence of thyroid papillary cancer was reported in hepatitis-C-virus (HCV positive patients. However, the mechanistic role of hepatic-fibrosis in thyroid malignancy progressions is still unclear.We aimed to study the immune-modulatory interactions between thyroid papillary carcinoma and hepatic-fibrosis.Hepatic-fibrosis was induced in nude-nu-male mice by intra-peritoneal administration of carbon-tetrachloride. To induce thyroid-tumor, a thyroid papillary carcinoma cell line (NPA was injected subcutaneously in the backs. Fibrotic profile was estimated by α-smooth-muscle-actin (αSMA expression in liver tissue extracts using western-blots and RT-PCR. Intra-hepatic NK cells were isolated and stained for NK activity (CD107a by flow cytometry. Liver histopathology (H&E staining, thyroid tumor mass and serum alanine aminotransferase (ALT, serum vascular endothelial growth factor (VEGF and free-T4 levels were also assessed.Ex-vivo: NPA cells were co-cultured with intra-hepatic NK cells isolated from fibrotic mice with/without the tumor were analyzed for CFSE-proliferations. Both tumor groups (with/without hepatic-fibrosis excreted higher serum free T4 levels. Hepatic-fibrosis increased tumor weight and size and serum free-T4 levels. In addition, tumor induction increased liver injury (both hepatic-fibrosis, necro-inflammation and serum ALT levels. In addition, tumor-bearing animals with hepatic-fibrosis had increased NK activity. NPA tumor-bearing animals increased fibrosis in spite of increased NK activity; probably due to a direct effect through increased serum free-T4 excretions. Serum VEGF levels were significantly increased in the fibrotic- bearing tumor groups compared to the non-fibrotic groups. In-vitro, NK cells from fibrotic tumor-bearing animals reduced proliferation of NPA cells. This decrease is attributed to increase NK cells activity in the fibrotic animals with the NPA tumors.Our results propose that NK cells although were

  1. Anaplastic thyroid carcinoma with rhabdomyoblastic differentiation : A case report with a good clinical outcome

    NARCIS (Netherlands)

    Olthof, Marijke; Persoon, Adrienne C. M.; Plukker, John T. M.; van der Wal, Jacqueline E.; Links, Thera P.

    2008-01-01

    Anaplastic thyroid carcinoma is a rare and highly malignant disease. Usually, this type of tumor is irresectable, and almost all patients die within 1 year after diagnosis. We present a case of anaplastic thyroid carcinoma with rhabdomyoblastic differentiation and good therapeutic outcome. A

  2. Follicular thyroid carcinoma with metastasis to skin diagnosed by fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Agarwal Shweta

    2008-07-01

    Full Text Available In April 2006, a 55-year-old female presented with a thyroid mass and multiple skin nodules on scalp, forehead and neck. Fine needle aspiration cytology of thyroid mass and multiple skin nodules show tumor cells clusters in a repetitive microfollicular pattern on May-Grunwald-Giemsa stain suggestive of follicular thyroid carcinoma with metastasis to skin. Although follicular carcinoma have a propensity for vascular invasion and hematogenous dissemination, skin is not commonly involved. Only a few cases of cutaneous metastasis from follicular thyroid carcinoma are reported in the English language literature.

  3. Trace elemental analysis of adenoma and carcinoma thyroid by PIXE method

    Science.gov (United States)

    Reddy, S. Bhuloka; John Charles, M.; Ravi Kumar, M.; Reddy, B. Seetharami; Anjaneyulu, Ch.; Naga Raju, G. J.; Sundareswar, B.; Vijayan, V.

    2002-11-01

    Trace elemental analysis was carried out in the biological samples of normal, adenoma and carcinoma thyroids using particle induced X-ray emission technique (PIXE). A 2 MeV proton beam was employed to excite the samples. The elements Cl, K, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Sr, I, Hg and Pb were identified and their concentrations were estimated. The concentrations of the elements Ca, Cu, Zn, As, I and Hg are found to be much lower in carcinoma thyroid than those in the normal thyroid while the concentration of the elements K, Ti, V, Cr, Mn, Fe, Co and Sr in carcinoma thyroid are higher than the concentrations in normal thyroid. The lower and higher values of some of the elements in carcinoma thyroid may be attributed to some pathological factors.

  4. RET proto oncogene mutation detection and medullary thyroid carcinoma prevention.

    Science.gov (United States)

    Yeganeh, Marjan Zarif; Sheikholeslami, Sara; Hedayati, Mehdi

    2015-01-01

    Thyroid cancer is the most common endocrine neoplasia. The medullary thyroid carcinoma (MTC) is one of the most aggressive forms of thyroid malignancy,accounting for up to 10% of all types of this disease. The mode of inheritance of MTC is autosomal dominantly and gain of function mutations in the RET proto-oncogene are well known to contribute to its development. MTC occurs as hereditary (25%) and sporadic (75%) forms. Hereditary MTC has syndromic (multiple endocrine neoplasia type 2A, B; MEN2A, MEN2B) and non-syndromic (Familial MTC, FMTC) types. Over the last two decades, elucidation of the genetic basis of tumorigenesis has provided useful screening tools for affected families. Advances in genetic screening of the RET have enabled early detection of hereditary MTCs and prophylactic thyroidectomy for relatives who may not show any symptom sof the disease. In this review we emphasize the main RET mutations in syndromic and non syndromic forms of MTC, and focus on the importance of RET genetic screening for early diagnosis and management of MTC patients, based on American Thyroid Association guidelines and genotype-phenotype correlation.

  5. Metastasis from renal cell carcinoma to thyroid presenting as rapidly growing neck mass.

    Science.gov (United States)

    Mohammadi, Afshin; Toomatari, Seyed Babak Mosavi; Ghasemi-Rad, Mohammad

    2014-01-01

    Renal cell carcinoma (RCC) is commonly known as the "internist's tumor" because of its unpredictable behavior. Metastasis to the thyroid gland is rarely found in clinical practice. We report a rare case of non-thyroid malignancies NTM from renal cell carcinoma 1.5 years after radical nephrectomy in a 58-year-old man with a rapidly growing neck mass. Malignant melanoma, breast carcinoma, lung, and skin cancer are the most common sources of non-thyroid malignancies (NTM). Although metastases of NTMs to the thyroid gland are uncommon in clinical practice, it should be considered in patients with a history of prior malignancy and a new thyroid mass. Isolated thyroid metastasis should be considered in patients with a previous history of cancer and newly developing thyroid mass. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Advanced Tracheal Adenoid Cystic Carcinoma with Thyroid Invasion Mimicking Thyroid Cancer Treated with Definitive Radiation: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sondos Al Khatib

    2017-08-01

    Full Text Available A 54-year-old female patient, a breast cancer survivor and a case of unresectable adenoid cystic carcinoma of the trachea, with thyroid invasion, presented with suprasternal neck swelling mimicking thyroid primary. A literature search was undertaken to highlight this rare presentation. There have been few reports in the literature describing tracheal adenoid cystic carcinoma involving the thyroid.

  7. High relative frequency of thyroid papillary carcinoma in northern Portugal.

    Science.gov (United States)

    Sambade, M C; Gonçalves, V S; Dias, M; Sobrinho-Simões, M A

    1983-05-01

    Two hundred and twelve papillary and 40 follicular carcinomas were found in 3002 thyroid glands examined from 1931 to 1975 in four Laboratories of Pathology that fairly cover northern Portugal. There was a striking preponderance of women both in papillary (female:male = 6.9:1) and follicular carcinoma (5.7:1). Sex-specific frequency of malignancy was significantly greater in men (13.3%) than in women (8.8%). The overall papillary/follicular ratio was 5.3:1 and did not significantly change throughout the study period. Papillary/follicular ratio was not significantly greater in litoral (5.5:1) than in regions with a low iodine intake and a relatively high prevalence of goiter (3.5:1). It is advanced that this high relative frequency of papillary carcinoma in northern Portugal, even in goiter areas, may reflect the existence of a racial factor since there is not enough evidence to support the influence of dietary iodine, previous irradiation and concurrent thyroiditis.

  8. Thyroid Gland Involvement in Carcinoma Larynx and Hypopharynx-Predictive Factors and Prognostic Significance.

    Science.gov (United States)

    Iype, Elizabeth Mathew; Jagad, Vijay; Nochikattil, Santhosh Kumar; Varghese, Bipin T; Sebastian, Paul

    2016-02-01

    Intraoperative management of thyroid gland in laryngeal and hypopharyngeal cancer is controversial. The objectives of this study were to determine the incidence of thyroid gland invasion in patients undergoing surgery for laryngeal or hypopharyngeal carcinoma, to assess predictive factors and to assess the prognosis in patients with and without thyroid gland invasion. One hundred and thirty-three patients who underwent surgery for carcinoma larynx and hypopharynx from 2006 to 2010 were reviewed retrospectively. Surgical specimens were examined to determine the incidence of thyroid gland invasion and predictive factors were analysed. The recurrence rate and the survival in patients with and without thyroid gland invasion were also analysed. Out of the 133 patients with carcinoma larynx and hypopharynx who underwent surgery, histological thyroid gland invasion was observed in 28/133 (21%) patients. Significant relationship was found between histological thyroid gland invasion and preoperative evidence of thyroid cartilage erosion by CT scan and also when gross thyroid gland involvement observed during surgery. There is significant association between thyroid gland invasion when there is upper oesophageal or subglottic involvement. After analysing the retrospective data from our study, we would like to suggest that thyroid gland need not be removed routinely in all laryngectomies, unless there is advanced disease with thyroid cartilage erosion and gross thyroid gland involvement or disease with significant subglottic or oesophageal involvement.

  9. Papillary Carcinoma of Thyroid Gland in a Two-year-old Child.

    Science.gov (United States)

    Uhliarová, B; Hajtman, A

    2016-01-01

    Thyroid nodules are less common among children than among adults. By contrast, thyroid nodules are more often malignant in childhood than in adulthood. In children, 26% of thyroid nodules are malignant, while in adults the corresponding value is 5-10%. Risk factors for developing thyroid nodules in children are female sex, post-pubertal age, previous or co-existing thyroid disease, previous irradiation of the neck, and a family history of thyroid disease. In children younger than 10 years, when no risk factors are present, the incidence rates are practically negligible. A two-year-old girl presented with a right thyroid mass. Laboratory evaluation revealed normal levels of triiodothyronine and thyroid-stimulating hormone. Thyroid ultrasonography revealed a 4.8 × 3.2 × 2.5 cm nonhomogenous nodule. The patient underwent right hemithyroidectomy. The pathology was consistent with papillary thyroid carcinoma; therefore, total thyroidectomy and selective neck dissection were performed. We report a very rare case of papillary thyroid carcinoma in a two-year-old child with no risk factors. The detection of a thyroid nodule in such a young child with no pre-disposing risk factors does not exclude the possibility of thyroid carcinoma and warrants careful evaluation and appropriate therapy.

  10. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    International Nuclear Information System (INIS)

    Junor, E.J.; Paul, J.; Reed, N.S.

    1992-01-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author)

  11. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Junor, E.J.; Paul, J.; Reed, N.S. (Beatson Oncology Centre, Glasgow (United Kingdom))

    1992-04-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author).

  12. Prognostic factors in well-differentiated carcinoma of the thyroid

    International Nuclear Information System (INIS)

    Rao, R.S.; Parikh, H.K.

    1999-01-01

    The choice of treatment for a well-differentiated carcinoma (WDC) of the thyroid has remained controversial for several decades. This is unfortunate because WDC occurs in the young, particularly in women, and is compatible with several years of survival. A retrospective analysis of 417 cases of WDC of the thyroid treated by definitive surgery at the Tata Memorial Hospital for the 15-year period (1970 to 1985) form the basis of the conclusion drawn in the present report. These include cases that were referred primarily and those who underwent revision or completion thyroidectomy at the hospital after being treated elsewhere. All relevant data of the cases with WDC, including histopathology slides, were reviewed by an experienced pathologist

  13. Morphometric analysis in cytologic evaluation of papillary thyroid carcinoma.

    Science.gov (United States)

    Kefeli, Mehmet; Akpolat, Ilkser; Yildirim, Arzu; Sunter, Ahmet Tevfik; Kandemir, Bedri

    2010-08-01

    To compare the morphometric features of papillary carcinomas with follicular neoplasias and benign lesions and to determine the potential role of nuclear morphometric features in their differential diagnosis. Morphometric features were investigated in the cytologic samples of 64 cases, including 27 benign lesions, 6 follicular neoplasias and 31 papillary carcinomas. We analyzed 6 morphometric parameters: nuclear area, nuclear perimeter, maximum diameter (MaxD), minimum diameter (MinD), form factor and ratio of MaxD/MinD. There were no significant differences between the benign lesion and follicular neoplasia groups for any nuclear parameters. However, between benign lesions and papillary carcinomas, there were significant differences for all parameters, except for form factor. Between follicular neoplasms and papillary carcinomas, only the MaxD/MinD ratio was significantly different. The results of this study indicate that the ratio of MaxD/MinD is a distinct nuclear morphometric feature for distinguishing papillary carcinoma from other thyroid lesions, and it may be employed with other cytologic criteria in diagnosing problematic cases.

  14. Two case reports of metastases from colon carcinoma to the thyroid.

    Science.gov (United States)

    Poon, D; Toh, H C; Sim, C S

    2004-01-01

    Secondary malignancy of the thyroid gland is uncommon, but it is a problem requiring ongoing recognition. As it is more common than primary thyroid malignancy, metastatic disease involving the thyroid gland should be actively excluded in a patient with enlarging or abnormal thyroid gland and a previously known primary tumour. We report 2 cases of primary colon carcinoma with metastasis to the thyroid gland that mimicked thyroid anaplastic carcinoma. In both cases, airway compromise was evident. Emergency tracheostomy was necessary in the first case with subsequent oxaliplatin-based chemotherapy providing palliation of symptom of breathlessness, with significant reduction in size of thyroidal metastasis. Palliative thyroidectomy relieved airway compromise in the second case. Our case report highlights the importance of early recognition of thyroidal metastases from a colonic primary as life-threatening airway compromise may otherwise rapidly ensue.

  15. SPECT/CT imaging in children with papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hwa-Young; Gelfand, Michael J.; Sharp, Susan E. [Cincinnati Children' s Hospital, Department of Radiology, Cincinnati, OH (United States)

    2011-08-15

    SPECT/CT improves localization of single photon-emitting radiopharmaceuticals. To determine the utility of SPECT/CT in children with papillary thyroid carcinoma. 20 SPECT/CT and planar studies were reviewed in 13 children with papillary thyroid carcinoma after total thyroidectomy. Seven studies used I-123 and 13 used I-131, after elevating TSH by T4 deprivation or intramuscular thyrotropin alfa. Eight children had one study and five children had two to four studies. Studies were performed at initial post-total thyroidectomy evaluation, follow-up and after I-131 treatment doses. SPECT/CT was performed with a diagnostic-quality CT unit in 13 studies and a localization-only CT unit in 7. Stimulated thyroglobulin was measured (except in 2 cases with anti-thyroglobulin antibodies). In 13 studies, neck activity was present but poorly localized on planar imaging; all foci of uptake were precisely localized by SPECT/CT. Two additional foci of neck uptake were found on SPECT/CT. SPECT/CT differentiated high neck uptake from facial activity. In six studies (four children), neck uptake was identified as benign by SPECT/CT (three thyroglossal duct remnants, one skin contamination, two by precise anatomical CT localization). In two children, SPECT/CT supported a decision not to treat with I-131. When SPECT/CT was unable to identify focal uptake as benign, stimulated thyroglobulin measurements were valuable. In three of 13 studies with neck uptake, SPECT/CT provided no useful additional information. SPECT/CT precisely localizes neck iodine uptake. In small numbers of patients, treatment is affected. SPECT/CT should be used when available in thyroid carcinoma patients. (orig.)

  16. Metastasis of renal cell carcinoma to the thyroid gland 19 years after nephrectomy: a case report.

    Science.gov (United States)

    Kihara, Minoru; Yokomise, Hiroyasu; Yamauchi, Akira

    2004-03-01

    Although metastases to the thyroid are never uncommon at autopsy in patients who died of malignancy, metastatic thyroid carcinomas are rarely detected in clinical practice in most cases and cases of secondary thyroid cancer which require thyroid surgery clinically are few. A clinical case of thyroid metastasis from renal cell carcinoma with thyroidectomy is described herein. An 87-year-old Japanese woman was referred to us for a slow-growing palpable neck tumor with dysphagia. She had undergone a nephrectomy for renal clear cell carcinoma 19 years earlier at another hospital. Preoperative imaging examinations suspected an adenomatous goiter and a fine needle aspiration (FNA) cytology was suggestive of an atypical follicular tumor. Hemithyroidectomy was performed as a follicular tumor of thyroid for restriction of subjective symptom. A pathological examination of the thyroid tumor revealed clear cell carcinoma, postoperatively. The negative result of immunohistochemical staining for thyroglobulin also suggested metastatic renal cell carcinoma to the thyroid. Clinically significant metastases to the thyroid gland are relatively infrequent. However, if patient who bears a thyroid tumor has a history of malignancy, the possibility of metastatic disease should be taken under consideration.

  17. Papillary thyroid carcinoma does not have standard course in children.

    Science.gov (United States)

    Karnak, Ibrahim; Ardıçlı, Burak; Ekinci, Saniye; Ciftçi, Arbay Ozden; Orhan, Diclehan; Kale, Gülsev; Tanyel, Feridun Cahit; Senocak, Mehmet Emin

    2011-09-01

    Papillary thyroid carcinoma has a favorable outcome in children. Recent experience with young children cases with early recurrences, after the total thyroidectomy and excision of palpable lymph nodes, in contrast to usual course of disease in adolescent cases, prompted us to review our experience on papillary carcinoma surgery. Sixteen children who underwent surgery for papillary carcinoma between 1997 and 2010 were included. The charts and surgery notes were evaluated retrospectively and age, sex, complaints and physical findings at presentation, past medical history, results of laboratory tests, imaging findings, aspiration biopsy, extent of disease, details of surgery, complications and postoperative course were noted. Male to female ratio was 3:1. The mean age was 10.9 years (range, 5-16). The presenting symptom was palpable swelling in the neck (n = 12) or asymptomatic nodule was detected incidentally (n = 4). Physical examination findings were palpable nodule (n = 7), lymphadenopathy (n = 6) or both (n = 4). Thyroid ultrasound (US) revealed nodule (n = 9), heterogenisity of the parenchyma and enlargement of thyroid (n = 9), and microcalcifications (n = 5). Fine-needle aspiration biopsy was performed in 12 patients and was suggestive for malignancy in most cases (91%). Pulmonary metastasis was detected at presentation in two patients and appeared after thyroidectomy in one patient. Complementary thyroidectomy was performed in nine patients because the total thyroidectomy with or without cervical lymph node dissection was the treatment of choice (n = 15). Iodine scan was performed 4 weeks later following thyroidectomy. Radioactive iodine ablation (RIA) therapy was given to 11 patients who had residual or recurrent disease. Postoperative complications were permanent hypoparathyroidism (n = 4), recurrent laryngeal nerve injury (n = 3), lymphorea (n = 1) and Horner's syndrome (n = 1). Total thyroidectomy and excision of affected lymph nodes is the current mode of

  18. [Propofol-induced pancreatitis after surgery for thyroid carcinoma].

    Science.gov (United States)

    Lange, Karoline; Rostgaard-Knudsen, Martin; Rasmussen, Bodil Steen

    2014-05-19

    Propofol is a hypnotic agent for induction and maintainance of general anaesthesia and it is used for sedation of critically ill intensive care patients. As a rare adverse effect propofol can cause acute pancreatitis. We report a case of post-operative pancreatitis in an otherwise healthy 62-year-old male who was anaesthezised with propofol during an otherwise uncomplicated surgery for thyroid carcinoma. Other common causes could be excluded. Since this is a possible lethal complication in post-operative patients, medical doctors should be aware of this adverse effect.

  19. Carcinoma of the Thyroid. Preoperative diagnostic and prognostic factors

    International Nuclear Information System (INIS)

    Tennvall, J.

    1984-01-01

    By improving preoperative diagnosis and identification of important prognostic factors of thyroid carcinoma (TC) it might be possible to decrease the number of diagnostic surgical intervantions and to give patients with a confirmed TC a more adequate treatment. Preoperative diagnosis: consecutive series of 83 patients with scintigrams and of 203 patients with fine-needle aspiration (AC) with subsequently histologically confirmed TC were evaluated as well as 217 patients with confirmed benign thyroid disorders. The most common scintigraphic appearance was a solitary reduced uptake (70%). The sensitivity of AC for medullary and undifferentiated TC was 0.82-0.84, but it was for papillary (occult TC excluded) 0.58 and for follicular TC 0.42. A 'cold' nodule with also a decreased thallium-uptake is mostly a benign disorder, but with an increased uptake it might be a well-differentiated TC or a follicular adenoma. These could, however, be significantly separated by the thallium-elimination rate (p=0.0001). Prognostic factors: During 1955-1972, 262 patients with histologically verified TC were referred to the Department and 226 of these (86%) with a median follow-up of 11 years form the basis for prognostic multivariate analyses. According to these analyses, and when deaths in intercurrent disease were estimated, neither age at diagnosis nor sex were found to be important predictors of survival of TC. The following predictors were identified: for papillary TC: tumour extension beyond the thyroid capsule and marked cellular atypia; for follicular TC: tumour extension beyond the thyroid capsule, marked cellular atypia and distant metastases; for medullary TC: tumour extension beyond the thyroid capsule. (Author)

  20. HABP2 G534E Variant in Papillary Thyroid Carcinoma.

    Directory of Open Access Journals (Sweden)

    Jerneja Tomsic

    Full Text Available The main nonmedullary form of thyroid cancer is papillary thyroid carcinoma (PTC that accounts for 80-90% of all thyroid malignancies. Only 3-10% of PTC patients have a positive family history of PTC yet the familiality is one of the highest of all cancers as measured by case control studies. A handful of genes have been implicated accounting for a small fraction of this genetic predisposition. It was therefore of considerable interest that a mutation in the HABP2 gene was recently implicated in familial PTC. The present work was undertaken to examine the extent of HABP2 variant involvement in PTC. The HABP2 G534E variant (rs7080536 was genotyped in blood DNA from 179 PTC families (one affected individual per family, 1160 sporadic PTC cases and 1395 controls. RNA expression of HABP2 was tested by qPCR in RNA extracted from tumor and normal thyroid tissue from individuals that are homozygous wild-type or heterozygous for the variant. The variant was found to be present in 6.1% familial cases, 8.0% sporadic cases (2 individuals were homozygous for the variant and 8.7% controls. The variant did not segregate with PTC in one large and 6 smaller families in which it occurred. In keeping with data from the literature and databases the expression of HABP2 was highest in the liver, much lower in 3 other tested tissues (breast, kidney, brain but not found in thyroid. Given these results showing lack of any involvement we suggest that the putative role of variant HABP2 in PTC should be carefully scrutinized.

  1. FOXP3 expression in papillary thyroid carcinoma with and without Hashimoto's thyroiditis

    Directory of Open Access Journals (Sweden)

    Murilo Pedreira Neves Junior

    2013-08-01

    Full Text Available INTRODUCTION: The forkhead box P3 (FOXP3 plays a role in cell development and control. In the presence of abnormal FOXP3 expression, tumor cells may evade the immunosurveillance of lymphoid cells, the first step for the maintenance of cancer cells in the thyroid tissue. OBJECTIVE: To identify the presence of FOXP3 in papillary thyroid carcinoma (PTC with and without Hashimoto's Thyroiditis (HT. METHODS: We conducted a series study of cases collected from 2000 to 2008, when 1,438 thyroidectomies were performed. We selected those diagnosed with PTC, comprising 466 cases. 30 patients were randomly selected for purposes of immunohistochemistry with antibodies against FOXP3. RESULT: FOXP3 revealed high positivity for PTC and positive immunostaining was present in 21 (72.4% from all analyzed cases. There was no difference regarding coexistent HT or not. DISCUSSION AND CONCLUSION: In the present study, it was evidenced that the focal or diffuse FOXP3 expression was commonly observed in neoplastic cells from PTC, hence indicating that the assessment of this molecule expression in suspected cases of thyroid cancer may contribute to its diagnosis.

  2. FAP Associated Papillary Thyroid Carcinoma: A Peculiar Subtype of Familial Nonmedullary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Francesco Cetta

    2015-01-01

    Full Text Available Familial Nonmedullary Thyroid Carcinoma (FNMTC makes up to 5–10% of all thyroid cancers, also including those FNMTC occurring as a minor component of familial cancer syndromes, such as Familial Adenomatous Polyposis (FAP. We give evidence that this extracolonic manifestation of FAP is determined by the same germline mutation of the APC gene responsible for colonic polyps and cancer but also shows some unusual features (F : M ratio = 80 : 1, absence of LOH for APC in the thyroid tumoral tissue, and indolent biological behaviour, despite frequent multicentricity and lymph nodal involvement, suggesting that the APC gene confers only a generic susceptibility to thyroid cancer, but perhaps other factors, namely, modifier genes, sex-related factors, or environmental factors, are also required for its phenotypic expression. This great variability is against the possibility of classifying all FNMTC as a single entity, not only with a unique or prevalent causative genetic factor, but also with a unique or common biological behavior and a commonly dismal prognosis. A new paradigm is also suggested that could be useful (1 for a proper classification of FAP associated PTC within the larger group of FNMTC and (2 for making inferences to sporadic carcinogenesis, based on the lesson from FAP.

  3. "Hidden" bone metastasis from thyroid carcinoma: a clinical note.

    Science.gov (United States)

    Sioka, C; Skarulis, M C; Tulloch-Reid, M K; Heiss, J D; Reynolds, J C

    2014-01-01

    The (131)I-iodide ((131)I) whole-body scan, for thyroid carcinoma is at times difficult to interpret. In a diagnostic whole body (131)I scan of a patient with follicular carcinoma, a posterior skull lesion was partially hidden by overlapping facial structures. On lateral head view, the abnormality was clearly evident. SPECT/CT and MRI showed the lesion originated in the occipital bone and had enlarged into the posterior fossa. The mass was surgically removed and the patient received (131)I therapy for residual tissue. The study demonstrates a pitfall in the reading of two dimensional radioiodine images which can be overcome by SPECT or lateral imaging. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  4. Solitary cystic lymph neck node metastasis of occult thyroid papillary carcinoma

    OpenAIRE

    González García, R.; Román Romero, Leticia; Sastre Pérez, Jesús; Rodríguez Campo, Francisco José; Naval Gias, Luis

    2008-01-01

    The appearance of a solitary lateral cervical cystic mass as the only initial presenting symptom of occult thyroid carcinoma is uncommon. Its presence is often misdiagnosed due to the more frequent branchial cyst in young people. Although oronasopharyngeal squamous cell carcinoma has been reported as the main cause of lymph neck node metastasis, thyroid papillary carcinoma may be responsible for solitary cervical cystic masses as the initial manifestation of the disease. This situation ha...

  5. Metastasis from renal cell carcinoma to thyroid presenting as rapidly growing neck mass

    OpenAIRE

    Mohammadi, Afshin; Toomatari, Seyed Babak Mosavi; Ghasemi-Rad, Mohammad

    2014-01-01

    INTRODUCTION: Renal cell carcinoma (RCC) is commonly known as the “internist's tumor” because of its unpredictable behavior. Metastasis to the thyroid gland is rarely found in clinical practice. PRESENTATION OF CASE: We report a rare case of non-thyroid malignancies NTM from renal cell carcinoma 1.5 years after radical nephrectomy in a 58-year-old man with a rapidly growing neck mass. DISCUSSION: Malignant melanoma, breast carcinoma, lung, and skin cancer are the most common sources of ...

  6. Primary follicular thyroid carcinoma metastasis to the kidney and widespread dissemination: A case report

    OpenAIRE

    CAI, DI-MING; WANG, HUI-YAO; JIANG, YONG; PARAJULY, SHYAM SUNDAR; TIAN, YE; MA, BU-YUN; LI, YONG-ZHONG; SONG, BIN; LUO, YAN

    2016-01-01

    Distant metastases are more common in follicular thyroid carcinoma (FC) than in papillary thyroid carcinoma. However, FC metastasis to the kidney with eggshell calcification, as observed in the present case, is rare. The current report presents a case of a 67-year-old woman exhibiting a solitary tumor in the mid pole of the left kidney. Radical nephrectomy was performed, as the tumor was diagnosed as a primary renal carcinoma using contrast-enhanced computed tomography. Once the tumor was con...

  7. Primary mucinous carcinoma with rhabdoid cells of the thyroid gland: a case report.

    Science.gov (United States)

    Matsuo, Mioko; Tuneyoshi, Masazumi; Mine, Mari

    2016-06-10

    Primary mucinous carcinoma of the thyroid gland is a rare disease; only 6 cases of primary mucinous carcinoma of the thyroid have been previously reported. Primary mucinous carcinoma of the thyroid gland with incomplete tumor resection tends to be associated with a poor prognosis, resulting in death within a few months. An early and appropriate diagnosis may contribute to improvement in patient prognosis; however, it is extremely difficult to diagnose primary mucinous carcinoma of the thyroid. We present the seventh reported case of primary mucinous carcinoma in the thyroid gland; moreover, rhabdoid cells were detected, which, to our knowledge, is a novel finding. An 81-year-old Japanese woman was initially diagnosed with a poorly differentiated thyroid carcinoma, and she underwent a hemithyroidectomy. Pathological examination revealed the presence of abundant mucus and agglomeration of large atypical cells. Rhabdoid cells were also seen scattered among the tumor cells. Immunostaining was performed for various markers, and on the basis of these results, we diagnosed the lesion as primary mucinous carcinoma with rhabdoid cells in the thyroid gland. Ten months after surgery, recurrence was noted in the paratracheal lymph nodes; therefore, total resection of the residual thyroid gland and paratracheal lymphadenectomy with thyroid-stimulating hormone suppression were performed. The patient is currently alive and disease-free. The current case is of interest not only because of the rare histological findings, but also because the patient achieved long-term survival following diagnosis of a mucinous carcinoma. We believe this report will be helpful for diagnosing future cases of mucinous carcinoma of the thyroid.

  8. Less aggressive disease in patients with primary squamous cell carcinomas of the thyroid gland and coexisting lymphocytic thyroiditis.

    Science.gov (United States)

    Asik, Mehmet; Binnetoglu, Emine; Sen, Hacer; Gunes, Fahri; Muratli, Asli; Kankaya, Duygu; Uysal, Fatma; Sahin, Mustafa; Ukinc, Kubilay

    2015-01-01

    Primary squamous cell carcinoma (SCC) of the thyroid gland is extremely rare. Infrequently, primary SCC of the thyroid gland is accompanied by other thyroid diseases such as Hashimoto's thyroiditis (HT). Recently, studies have demonstrated that differentiated thyroid cancer with coexisting HT has a better prognosis. However, the prognosis of patients with primary SCC of the thyroid gland and coexistent HT has not been clearly identified. We compared the clinical characteristics and disease stages of patients with primary SCC with and without lymphocytic thyroiditis (LT). We reviewed reports of primary SCC of the thyroid gland published in the English literature. We identified 46 papers that included 17 cases of primary SCC of the thyroid gland with LT and 77 cases of primary SCC of the thyroid gland without LT. Lymph node metastasis and local invasion rates did not differ between these two groups. Distant metastases were absent in patients with LT, and were observed in 13 (16.9%) patients without LT. A greater proportion of patients without LT had advanced stage disease (stage IV A-B-C) than patients with LT (p thyroid gland and coexisting LT had lower tumour-node-metastasis stage and frequency of distant metastasis than those without LT. Lymphocytic infiltration in patients with SCC appears to limit tumour growth and distant metastases.

  9. Ovarian metastasis from thyroid carcinoma: a case report and literature review.

    Science.gov (United States)

    Corrado, Giacomo; Pomati, Giulia; Russo, Andrea; Visca, Paolo; Vincenzoni, Cristina; Patrizi, Lodovico; Vizza, Enrico

    2014-10-30

    Papillary thyroid carcinoma is rarely associated with metastatic disease. The most common sites of metastasis are the lungs and bones, while only few cases of ovarian metastasis are described in literature. We report the case of a 51 years old woman, treated 9 years before for papillary thyroid carcinoma, presenting to our Institute with a pelvic ovarian mass revealed by ultrasound imaging. After bilateral salpingo-oophorectomy, the histologic examination detected a left ovarian metastasis from papillary thyroid carcinoma. Even if the diagnosis of ovarian metastasis from thyroid carcinoma is often controversial, it should be considered when a woman with an ovarian lesion of unknown origin, has a personal history of malignant thyroid disease. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_193.

  10. Clinicopathological study of anaplastic carcinoma of the thyroid gland

    International Nuclear Information System (INIS)

    Maeda, Akiteru; Umeno, Hirohito; Chijiwa, Hideki; Mihashi, Hiroyuki; Chitose, Shunichi; Nakashima, Tadashi

    2010-01-01

    Seventeen cases (5 males and 12 females) of anaplastic carcinoma of the thyroid gland treated at the Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, between January 1999 and January 2009 were reviewed. Ages of the patients ranged from 54 to 94 years. Six cases were treated by radical surgery. All cases were treated by radiotherapy and 5 cases received additional chemotherapy. The 6 cases treated by radical surgery were able to experience home life. Survival time of the radical surgery cases ranged from 8 to 36 months, with a median of 17 months. In cases without surgery, the survival time ranged from 1 to 8 months, with a median of 4 months. As the final outcome, only 1 case is alive after 36 months; 8 cases died by primary tumor, 7 by lung metastasis and 1 by suicide. Although the prognosis of anaplastic carcinoma of the thyroid gland is generally poor, radical surgery, if possible, may provide better survival results. (author)

  11. TPO gene mutations associated with thyroid carcinoma: Case report and literature review.

    Science.gov (United States)

    Zhu, Hong; Peng, Yi-Gen; Ma, Shao-Gang; Liu, Hong

    2015-01-01

    The thyroperoxidase (TPO) genetic variants in thyroid carcinoma is scarcely reported. We report on a pedigree of thyroid papillary carcinoma and hypoechoic thyroid nodules with the TPO gene mutations. The compound heterozygotic mutations of the TPO gene (c.2268-2269 insT and c.2090 G>A) in two patients with congenital goiters hypothyroidism were demonstrated. Fifteen family members of the proband and 105 control individuals were enrolled. The participants underwent clinical examination and molecular screening for TPO mutation. The hypoechoic thyroid nodules underwent fine needle aspiration biopsy. The mutation c.2268-2269 insT was detected in the four family members with normal thyroid hormone levels. The other two members harbored the c.2090 G>A mutation. The heterozygotes had degeneratively hypoechoic thyroid nodules. The control individuals showed no mutation. The maternal grandfather developed a multifocal papillary thyroid carcinoma with lymph gland and nerve invasion in the left lobe of the thyroid gland. The maternal grandfather harbored the TPO c.2268-2269 insT mutation but without BRAFV600E mutation. Malignant cells were not observed in other members by fine needle aspiration biopsy. TPO genetic variants may be associated with thyroid carcinoma and hypoechoic thyroid nodules in a few cases. Long-term follow-up in the pedigree with congenital goiter is reasonable.

  12. Radiotherapy in anaplastic thyroid carcinoma: An Australian experience

    International Nuclear Information System (INIS)

    So, Kevin; Smith, Robin E.; Davis, Sidney R.

    2017-01-01

    Anaplastic thyroid cancer is a rare and fatal malignancy, associated with significant local tumour and often treatment related morbidity. We report our experience in treating this cancer over a 20-year period. A retrospective review of prospectively collected data from a single Australian Institution (Alfred Health Radiation Oncology) was carried out on patients referred with anaplastic thyroid carcinoma between 1992 and 2013. Thirty patients (17 females and 13 males) were identified with a median age at presentation of 72 years. At presentation, six (20%), 14 (47%) and 10 (33%) patients had stage IVA, IVB and IVC disease respectively. Thirteen patients underwent radical surgical resection with five having microscopic residual (R1) and eight having macroscopic residual (R2) disease. Twenty-eight patients were offered radiotherapy with 27 proceeding with treatment. Of those who received radiotherapy, three, six and 18 were treated with adjuvant, definitive and palliative intent respectively. Six patients had concomitant chemotherapy of which three received trimodality therapy. Only one patient experienced a grade 3 toxicity (oesophagitis). Median survival was 5.3 months and at last follow-up or time of death, 19 of 27 (70.4%) maintained loco-regional control. All patients who had R1 surgical resections and radiotherapy had loco-regional control. Seven of nine (77.8%) and 12 of 18 (66.7%) achieved loco-regional control after receiving definitive or palliative radiotherapy, respectively. Our study suggests that radiotherapy with or without surgery or chemotherapy is well-tolerated and results in durable loco-regional control in a high proportion of patients with anaplastic thyroid carcinoma.

  13. Seven cases of brain metastasis from papillary thyroid carcinoma

    International Nuclear Information System (INIS)

    Ikekubo, Katsuji; Hino, Megumu; Ito, Hidetomi; Hirao, Kazuyuki; Ueshima, Miho; Tanaka, Tomohiro; Kobayashi, Hiromasa; Ishihara, Takashi; Kurahachi, Hiroyuki

    2000-01-01

    Brain metastases from differentiated thyroid carcinoma are extremely rare and carry a poor prognosis. We describe here clinical details of 7 cases of brain metastases from papillary thyroid carcinoma. Of 153 patients with metastases from differentiated thyroid carcinoma (papillary in 123, follicular in 30) treated at our institution between 1981 and 1999, 7 patients (4.6%) had brain metastases. Histologically, the primary tumor was papillary carcinoma in all 7 cases. Four were males and 3 were females. The median age at first diagnosis of distant metastases was 63 yr (range, 47-76 yr). Of these patients, one had brain metastases only and six and metastases to the lungs as well. Five of these patients were treated with 131 I. Three of these 5 patients had marked uptake in the metastases ( 131 I positive) on post-therapy 131 I scans and another 2 patients had no significant activity ( 131 I negative) in both pulmonary and brain metastatic lesions. One of 3 patients with 131 I positive lesions had intense activity in the brain tumor, but no uptake in multiple pulmonary metastatic tumors. In a patient with 131 I positive brain metastases, the tumors progressed rapidly after 131 I therapy. In another one patient, acute hemorrhage of the tumor occurred four days after 131 I therapy, requiring surgical removal. Loner case of 131 I negative 2 patients was treated with radiosurgery (γ-knife) and complete reduction in tumor volume was observed. On the other hand, one of 2 patients receiving no 131 I therapy had radiosurgery (x-knife) and remaining one received conventional external radiation and chemotherapy for small solitary brain and pulmonary metastatic tumors. These therapeutic interventions were useful in both cases. The mean length of survival after the development of brain metastases in the five patients who died of the disease was 30 months. One patient treated with x-knife has been alive at 21 months and another one who has 131 I uptake in the brain tumor without

  14. Expression of PACAP and PAC1 Receptor in Normal Human Thyroid Gland and in Thyroid Papillary Carcinoma.

    Science.gov (United States)

    Bardosi, Sebastian; Bardosi, Attila; Nagy, Zsuzsanna; Reglodi, Dora

    2016-10-01

    Pituitary adenylate cyclase activating polypeptide (PACAP) belongs to the vasoactive intestinal peptide-secretin-glucagon peptide family, isolated first from ovine hypothalamus. The diverse physiological effects of PACAP are known mainly from animal experiments, including several actions in endocrine glands. Alteration of PACAP expression has been shown in several tumors, but changes in expression of PACAP and its specific PAC1 receptor in human thyroid gland pathologies have not yet been investigated. Therefore, the aim of the present study was to investigate expression of PACAP and its PAC1 receptor in human thyroid papillary carcinoma, the most common endocrine malignant tumor. PACAP and PAC1 receptor expressions were investigated from thyroid gland samples of patients with papillary carcinomas. The staining intensity of follicular epithelial cells and thyroid colloid of tumor tissue was compared to that of tumor-free tissue in the same thyroid glands in a semi-quantitative way. Our results reveal that both PACAP(-like) and PAC1 receptor(-like) immunoreactivities are altered in papillary carcinoma. Stronger PACAP immunoreactivity was observed in active follicles. Colloidal PACAP immunostaining was either lacking or very weak, and more tumorous cells displayed strong apical immunoreactivity. Regarding PAC1 receptor, cells of the normal thyroid tissue showed strong granular expression, which was lacking in the tumor cells. The cytoplasm of tumor cells displayed weak, minimal staining, while in a few tumor cells we observed strong PAC1 receptor expression. This pattern was similar to that observed in the PACAP expression, but fewer in number. In summary, we showed alteration of PACAP and PAC1 receptor expression in human thyroid papillary carcinoma, indicating that PACAP regulation is disturbed in tumorous tissue of the thyroid gland. The exact role of PACAP in thyroid tumor growth should be further explored.

  15. MIBI-SPECT in hypofunctioning thyroid nodules for detection of thyroid carcinoma; MIBI-SPECT bei kalten Knoten zur Schilddruesenkarzinomdetektion

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    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. Synchronous papillary thyroid carcinoma and primary hyperparathyroidism: diagnosis and management issues.

    Science.gov (United States)

    Vysetti, Suneetha; Sridhar, Preethi; Theckedath, Boby; Gilden, Janice L; Morawiecki, Peter

    2012-10-01

    The occurrence of a papillary thyroid carcinoma in a patient with primary hyperparathyroidism is rare. Awareness of this condition will enable clinicians to evaluate for possible thyroid pathology in patients with primary hyperparathyroidism. Both of these endocrine conditions could then be managed with a single surgery involving concomitant resection of the thyroid and parathyroid glands. We report a case of a 53-year-old woman with a parathyroid adenoma and a unilateral papillary thyroid carcinoma, and detail the clinical features, diagnosis, and management.

  17. Concurrent Endometrial Carcinosarcoma and Thyroid Papillary Carcinoma: PET CT Imaging Findings

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    Mine Genc

    2015-06-01

    Full Text Available The aim of this study is to report a patient who was diagnosed with a concurrent primary tumor by 18-fluoro-2-deoxy-glucose positron emission tomography (FDG PET imaging performed for staging of an endometrial cancer. FDG uptake was detected in the uterus, where the primary cancer was located, and in the left lobe of the thyroid gland. The biopsy sample from the hypermetabolic nodular lesion in thyroid gland revealed intermediate cytology according to Bethesda Classification. The patient underwent hysterectomy and thyroidectomy. An endometrial carcinoma in the uterus and a multicentric thyroid papillary carcinoma in the thyroid gland were diagnosed.

  18. Natural history, treatment, and course of papillary thyroid carcinoma

    International Nuclear Information System (INIS)

    DeGroot, L.J.; Kaplan, E.L.; McCormick, M.; Straus, F.H.

    1990-01-01

    We have analyzed the course of papillary thyroid carcinoma in 269 patients managed at the University of Chicago, with an average follow-up period of 12 yr from the time of diagnosis. Patients were categorized by clinical class; I, with intrathyroidal disease; II, with cervical nodal metastases; III, with extrathyroidal invasion; and IV, with distant metastases. Half of the patients had a history of thyroid enlargement known, on the average, for over 3 yr. In 15% of patients given thyroid hormone, the mass decreased in size. The peak incidence of cancer was when subjects were between 20-40 yr of age. Tumors averaged 2.4 cm in size; 21.6% had tumor capsule invasion, and 46% of patients had multifocal tumors. Sixty-six percent of the patients had near-total or total thyroidectomy. The overall incidence of postoperative hypoparathyroidism was 8.4%, but the incidence was zero in 83 near-total or total thyroidectomies carried out by 1 surgeon. Twenty-five percent of the patients had continuing or recurrent disease, and 8.2% died from cancer. Deaths occurred largely in patients with class III or IV disease. Cervical lymph nodes were associated with increased recurrences, but not increased deaths. Extrathyroidal invasion carried an increased risk of 5.8-fold for death, and distant metastases increased this risk 47-fold. Age over 45 yr at diagnosis increased the risk of death 32-fold. Tumor size over 3 cm increased the risk of death 5.8-fold. Surgical treatment combining lobectomy plus at least contralateral subtotal thyroidectomy was associated, by Cox proportional hazard analysis, with decreased risk of death in patients with tumors larger than 1 cm and decreased risk of recurrence among all patients, including patients in classes I and II, compared to patients who underwent unilateral thyroid surgery or bilateral subtotal resections

  19. Natural history, treatment, and course of papillary thyroid carcinoma

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    DeGroot, L.J.; Kaplan, E.L.; McCormick, M.; Straus, F.H. (Univ. of Chicago, IL (USA))

    1990-08-01

    We have analyzed the course of papillary thyroid carcinoma in 269 patients managed at the University of Chicago, with an average follow-up period of 12 yr from the time of diagnosis. Patients were categorized by clinical class; I, with intrathyroidal disease; II, with cervical nodal metastases; III, with extrathyroidal invasion; and IV, with distant metastases. Half of the patients had a history of thyroid enlargement known, on the average, for over 3 yr. In 15% of patients given thyroid hormone, the mass decreased in size. The peak incidence of cancer was when subjects were between 20-40 yr of age. Tumors averaged 2.4 cm in size; 21.6% had tumor capsule invasion, and 46% of patients had multifocal tumors. Sixty-six percent of the patients had near-total or total thyroidectomy. The overall incidence of postoperative hypoparathyroidism was 8.4%, but the incidence was zero in 83 near-total or total thyroidectomies carried out by 1 surgeon. Twenty-five percent of the patients had continuing or recurrent disease, and 8.2% died from cancer. Deaths occurred largely in patients with class III or IV disease. Cervical lymph nodes were associated with increased recurrences, but not increased deaths. Extrathyroidal invasion carried an increased risk of 5.8-fold for death, and distant metastases increased this risk 47-fold. Age over 45 yr at diagnosis increased the risk of death 32-fold. Tumor size over 3 cm increased the risk of death 5.8-fold. Surgical treatment combining lobectomy plus at least contralateral subtotal thyroidectomy was associated, by Cox proportional hazard analysis, with decreased risk of death in patients with tumors larger than 1 cm and decreased risk of recurrence among all patients, including patients in classes I and II, compared to patients who underwent unilateral thyroid surgery or bilateral subtotal resections.

  20. Multicentricidade no carcinoma diferenciado da tireóide Multicentricity in the thyroid differentiated carcinoma

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    José Francisco Salles Chagas

    2009-02-01

    Full Text Available O tratamento cirúrgico de escolha no carcinoma diferenciado da tireóide sempre foi controverso. OBJETIVO: Analisar o acometimento tumoral do lobo contralateral da tireóide no carcinoma diferenciado, correlacionando risco e benefício com as complicações decorrentes da segunda intervenção. CASUÍSTICA E MÉTODO: Estudo retrospectivo, de 1998 a 2006, com 27 pacientes submetidos à tireoidectomia menos que total, sendo 21 lobectomias, cinco tireoidectomias subtotais e uma istmectomia. Foram analisados: gênero, idade, tipo de cirurgia, complicações, histopatológico do espécime cirúrgico e invasão do lobo contralateral. As idades variaram de 17 a 89 anos; o tipo histopatológico mais freqüente foi o carcinoma papilífero clássico (18 casos, seguido do carcinoma folicular (seis casos, do carcinoma papilífero variante folicular (dois casos e do carcinoma de células Hürthle (um caso. Vinte e um pacientes foram submetidos à totalização da tireoidectomia, 15 a 30 dias depois. RESULTADOS: A análise do lobo contralateral foi negativa para carcinoma em 16 (76,5% e positiva nos cinco restantes (23,8%. As complicações observadas foram: disfonia temporária (três casos e hipoparatireoidismo (dois casos, sendo um permanente. CONCLUSÃO: A totalização da tireoidectomia é um procedimento importante no tratamento do carcinoma bem diferenciado da tireóide pelo elevado acometimento contralateral (23,8%. A incidência de complicações é pequena.The treatment of choice for the well differentiated thyroid carcinoma has always been controversial. AIM: to analyze tumor invasion of the thyroid gland's contralateral lobe in cases of differentiated carcinoma, correlating risk/benefit with the complications of a second surgical approach. MATERIALS AND METHODS: Retrospective study, from 1998 to 2006, of 27 patients undergoing less than total thyroidectomy: lobectomy (21, subtotal thyroidectomy (5 or isthmusectomy (1. Gender, age, type of surgery

  1. Collision tumours, squamous cell carcinoma of larynx, papillary thyroid carcinoma, metastatic lymphatic node. Clinical Presentation

    International Nuclear Information System (INIS)

    Villalba, V; Gomez, R; Yoffe, I.; Liu, T.; Arias, J.; Quiroz, J.; Gonzalez, M; Ayala, E.

    2010-01-01

    Male patient with 35 years old, merchant from Capiata, no history of smoking or alcoholism, with 2 months history of bilateral neck nodes, sore throat, weight loss of 8 kg., dysphonia, progressive dyspne a on medium efforts dyspne a at rest so you see the urgency of the Hospital de Clinicas. On examination: lucid, collaborator, normosomico, with dysphonia, stri dor and dyspne a. P S: 2. No hemodynamic or fever. Neck: tumor mass of 6 cm in diameter, infrahiodea right, accompanying the movement of swallowing, bilateral jugular carotid lymphadenopathy high of 2 cm in diameter, solid-elastic smooth, mobile; lymphadenopathy average lower right carotid and jugular similar characteristics. Laryngoscopy smooth, submucosal, nodular lesion on right vocal cord, paralytic in middle position; aritenoides edematous law, glottal gap of 10%. Mobile left vocal cord. Remainder of the examination: Normal. Emergency tracheotomy performed. Biopsy of the lesion: invasive carcinoma, without other specifications. Laboratory tests: Hb: 11gr% eosinophilia. ECG, Rx. Chest and abdominal ultrasound: within normal limits. CT: tumor mass of 4.5 cm in diameter in right vocal cord, which is in middle position, and infiltrates the thyroid cartilage soft tissue. In thyroid lobe right: node 5 cm diameter. Cervical lymphadenopathy 2 cm in diameter in bilateral high carotid jugular region, medium and low carotid jugular right. 2/9/09 Surgery: Tumor infiltrating infrahiodea right muscles, jugular Total laryngectomy with bilateral carotid dissection, level 2,3 and 4. Right Thyroid lobectomy. Infrahiodea muscle resection. Pathology: 1-larynx neoplasms consist collision, poorly differentiated right infraglotis (3.2 cm.) Keratinizing squamous carcinoma infiltrating focally in depth the laryngeal cartilage through it, and a papillary carcinoma right thyroid lobe (3.4 cm.) massively infiltrating peritiroideo fibroadipose and skeletal muscle tissue infiltrating through the laryngeal cartilage and extending to

  2. Human Telomerase Reverse Transcriptase (hTERT) Gene Expression in Thyroid Carcinoma: Diagnostic and Prognostic Role

    International Nuclear Information System (INIS)

    Asaad, N.Y.; Abdel Wahed, M.M.; Mohammed, A.G.

    2006-01-01

    Background: The catalytic component of telomerase, human telomerase reverse transcriptase (hTERT) has been found to be reactivated in immortalized cell lines and considered as a diagnostic marker for malignancy in different body tissues. Aim of Work: Therefore we thought to determine whether hTERT gene detection could serve as an adjunct in the diagnosis of thyroid lesions together with evaluation of its prognostic value. Patients and Methods: The study included 50 cases of primary thyroid carcinoma including; 28 papillary carcinoma, 14 follicular carcinoma,S anaplastic carcinoma and 3 medullary carcinoma in addition to 5 cases of nodular hyperplasia and 5 cases of follicular adenoma. RNA was extracted from paraffin sections of those patients and hTERT gene expression was identified by Reverse Transcription - Polymerase Chain Reaction (RT-PCR). Results: RT-PCR of hTERT gene revealed expression in 43/50 (86%) malignant thyroid cases; including 25 papillary, 11 follicular, 4 anaplastic and 3 medullary carcinoma cases. On the other hand, hTERT gene expression could not be detected in either hyperplastic nodule or in follicular adenoma cases. The diagnostic validity of hTERT gene detection in benign and malignant thyroid lesions was in the form of 88.3% accuracy, 86% sensitivity, 100% specificity, 100% positive predictive value and 90% negative predictive value. No significant association has been found between hTERT gene expression and any clinico pathologic parameters concerned in this study. In thyroid carcinoma cases, hTERT gene detection was the most independent predictor of poor survival by multivariate survival analysis. Conclusion: Detection of hTERT gene expression should be considered in confirmation of malignant thyroid lesions. Moreover it could be one of the helpful tools in addition to grade, tumor type, and age to stratify patients with thyroid carcinoma into different prognostic categories. Hence, inhibition of hTERT could be of use prospectively in the

  3. Coexistence of chronic lymphocytic thyroiditis with papillary thyroid carcinoma: clinical manifestation and prognostic outcome.

    Science.gov (United States)

    Jeong, Jun Soo; Kim, Hyun Ki; Lee, Cho-Rok; Park, Seulkee; Park, Jae Hyun; Kang, Sang-Wook; Jeong, Jong Ju; Nam, Kee-Hyun; Chung, Woong Youn; Park, Cheong Soo

    2012-08-01

    The study aimed to identify the clinical characteristics of coexisting chronic lymphocytic thyroiditis (CLT) in papillary thyroid carcinoma (PTC) and to evaluate the influence on prognosis. A total of 1,357 patients who underwent thyroid surgery for PTC were included. The clinicopathological characteristics were identified. Patients who underwent total thyroidectomy (n = 597) were studied to evaluate the influence of coexistent CLT on prognosis. Among the total 1,357 patients, 359 (26.5%) had coexistent CLT. In the CLT group, the prevalence of females was higher than in the control group without CLT (P CLT were smaller than without CLT (P = 0.040, P = 0.047, respectively). Extrathyroidal extension in the patients with CLT was significantly lower than without CLT (P = 0.016). Among the subset of 597 patients, disease-free survival rate in the patients with CLT was significantly higher than without CLT (P = 0.042). However, the multivariate analysis did not reveal a negative association between CLT coexistence and recurrence. Patients with CLT display a greater female preponderance, smaller size, younger and lower extrathyroidal extension. CLT is not a significant independent negative predictive factor for recurrence, although presence of CLT indicates a reduced risk of recurrence.

  4. Clinical implications of the BRAF mutation in papillary thyroid carcinoma and chronic lymphocytic thyroiditis.

    Science.gov (United States)

    Kim, Woon Won; Ha, Tae Kwun; Bae, Sung Kwon

    2018-01-09

    The purpose of this study was to examine the possible prognostics and clinicopathologic characteristics underlying the BRAFV600E mutation and papillary thyroid carcinoma (PTC) coexisting or in absence of chronic lymphocytic thyroiditis (CLT). This study was conducted on 172 patients who had undergone total thyroidectomy or unilateral total thyroidectomy for PTC; the patients were then examined for the BRAFV600E mutation using specimens obtained after their surgery from January 2013 to August 2015. BRAF mutations were found in 130 of 172 patients (75.6%). CLT was present in 27.9% of patients (48/172). The incidence of the BRAFV600E mutation was significantly increased in the group with no CLT (P = 0.001). The findings of the multivariate analysis pertaining to the coexistence of CLT and PTC showed no significant correlation other than the BRAFV600E mutation. No significant difference was noted in the clinicopathologic factors between the two groups based on the coexistence of CLT in univariate and multivariate analyses. The BRAFV600E mutation is less frequent in PTC coexisting with CLT presumably because CLT and the BRAFV600E mutation operate independently in the formation and progression of thyroid cancer.

  5. The clinicopathologic differences in papillary thyroid carcinoma with or without co-existing chronic lymphocytic thyroiditis.

    Science.gov (United States)

    Yoon, Yeo-Hoon; Kim, Hak Joon; Lee, Jin Woo; Kim, Jin Man; Koo, Bon Seok

    2012-03-01

    The goal of this study is to determine the clinicopathologic differences in patients with papillary thyroid carcinoma (PTC) with or without chronic lymphocytic thyroiditis (CLT). We reviewed the medical records of 195 consecutive PTC patients who underwent total thyroidectomy and bilateral central lymph node dissection from April 2008 to March 2010. The differences in clinicopathologic factors, such as age, gender, size of primary tumor, perithyroidal invasion, lymphovascular invasion, capsular invasion, and central lymph node (CLN) metastasis, were analyzed in PTC patients with or without CLT. Among 195 patients, 56 (28.7%) had co-existing CLT. Patients with CLT had the following characteristics as compared to patients without CLT: significantly younger, female predominance, smaller tumor size, and lower incidence of capsular invasion (p = 0.038, 0.006, 0.037, and 0.026, respectively). Also, patients with CLT (12.5%) had a significantly lower incidence of CLN metastases than patients without CLT (28.1%; p = 0.025) based on univariate analysis. Moreover, multivariate analysis showed that younger age (p = 0.042, odds ratio = 1.033) and female gender (p = 0.012, odds ratio = 6.865) are independent clinical factors in patients with CLT compared to patients without CLT. CLT was shown to be commonly associated with PTC. Compared to patients with PTC without CLT, patients with CLT were younger with a female predominance, which are the most important and well-known prognostic variables for thyroid cancer mortality.

  6. BCNT studies for application to the undifferentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Dagrosa, Maria A.; Viaggi, Mabel E.; Cabrini, Romulo L.; Juvenal, Guillermo J.; Pisarev, Mario A.; Garavaglia, Ricardo N.; Farias, Silvia S.; Belli, Carolina; Larripa, Irene; Gangitano, David

    2000-01-01

    Undifferentiated thyroid carcinoma (UTC) lacks an effective treatment. Boron neutron capture therapy (BNCT) is based on the selective uptake of 10 B-boronated compounds by some tumours, followed by irradiation with an appropriate neutron beam. The radioactive boron originated ( 11 B) decays releasing 7 Li, gamma rays and alpha particles, and these latter will destroy the tumour. In order to explore the possibility of applying BNCT to UTC we have studied the biodistribution of BPA. Animal Model: To develop an animal model of undifferentiated thyroid carcinoma (UTC), which may be useful to study of BNCT. The UTC human cell line ARO was implanted into the back of the nude mice. We performed successive passages in mouse after tumor culturing in order to obtain an animal model similar to the human tumor. We studied the kinetics and the tumoral histology, the capability to induce metastasis, the biokinetics of in vitro growth, as well as cytogenetic and molecular aspects. Histological specimens of tumor showed extensive viability with high mitotic activity. At 117 days, the tumors reached a size of 1700 mm 3 and showed a central necrotic portion with a thin layer of viable cells presence of micro metastasis could be observed in the lung. The kinetics of growth both in vivo and in vitro showed that when the number of passages in mouse increases the growth rate decreases. The cytogenetic and molecular studies did not show differences between the original line and the sublines that could explain this phenotypic change. Moreover, the cytogenetic studies proved that the ARO cell line and its sublines showed a complex clonal karyotype including structural alterations with deletions and translocations involving chromosomes 5, 7, 8, 9p, 11p, 17q 19p, and 20q that were consistent with earlier reported data in UTC. In vivo BNCT studies: ARO cells were transplanted into the scapular region of NIH nude mice, and after 2 weeks BPA (350 or 600 mg/kg bw) was injected via i.p. The

  7. [Late thyroid and pancreas metastases from a clear cell renal carcinoma. Report of two cases].

    Science.gov (United States)

    Urdiales-Viedma, Mariano; Luque, Rafael J; Elósegui-Martínez, Fernando; Martos-Padilla, Sebastián; López-Urdiales, Rafael

    2008-01-01

    To report two cases of late metastases of clear cell renal cell carcinoma. Two patients, a male and a female with history of nephrectomy 17 and 16 years before for renal cell carcinomas, presented new tumours in the thyroid and pancreas, which were excised. Pathology reported that both lesions were clear cell tumours and immunohistochemically they were consistent with metastases from clear renal cell carcinomas. 1) Previous history of any type of carcinoma should suggest the possibility of metastases when facing a thyroid or pancreatic nodule. 2) All-life follow-up should be made, nephrectomy (resection) for a renal cell carcinoma. 3) In the presence of a clear cell tumour of the thyroid or pan-creatic glands, the differential diagnosis must always include metastatic renal cell carcinoma. 4) The treatment of choice is surgical resection.

  8. Frontal bone metastasis from an occult follicular thyroid carcinoma: Diagnosed by FNAC

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    Rajnish Kalra

    2017-01-01

    Full Text Available Metastatic deposits in skull bones from follicular thyroid carcinoma is rare, and metastatic disease in skull being the presenting symptom without obvious thyroid lesion (occult primary is even rarer. A 60-year-old female patient presented with a mass in the frontal region of the skull. Fine needle aspiration cytology was done which revealed an adenocarcinoma with repeated follicular pattern, reminiscent of follicular neoplasm of thyroid, which on immunocytochemistry revealed positivity for thyroglobulin. Patient was investigated further for primary thyroid malignancy, and imaging revealed a nodule in the left lobe of thyroid. Neuroimaging showed osteolytic lesion involving the cranium.

  9. Frontal bone metastasis from an occult follicular thyroid carcinoma: Diagnosed by FNAC.

    Science.gov (United States)

    Kalra, Rajnish; Pawar, Richa; Hasija, Sonia; Chandna, Abha; Sankla, Manoj; Malhotra, Chanchal

    2017-01-01

    Metastatic deposits in skull bones from follicular thyroid carcinoma is rare, and metastatic disease in skull being the presenting symptom without obvious thyroid lesion (occult primary) is even rarer. A 60-year-old female patient presented with a mass in the frontal region of the skull. Fine needle aspiration cytology was done which revealed an adenocarcinoma with repeated follicular pattern, reminiscent of follicular neoplasm of thyroid, which on immunocytochemistry revealed positivity for thyroglobulin. Patient was investigated further for primary thyroid malignancy, and imaging revealed a nodule in the left lobe of thyroid. Neuroimaging showed osteolytic lesion involving the cranium.

  10. Follicular Thyroid Carcinoma Metastatic to the Kidney: Report of a Case with Cytohistologic Correlation

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    Vikas Nath

    2015-01-01

    Full Text Available Here we report a case of a 45-year-old female who underwent thyroidectomy for thyroid cancer and presented 20 years later with a left renal mass. CT-guided core biopsy was performed, and imprints and histologic sections of the biopsy showed cells resembling thyroid follicular cells with a background containing colloid. Immunohistochemistry revealed positivity for thyroglobulin and thyroid transcription factor 1, consistent with metastatic follicular thyroid carcinoma (FTC. The patient later underwent radical nephrectomy; histologic sections of the resected tumor revealed an encapsulated lesion morphologically similar to the biopsy specimen. Thyroid metastases to the kidney are extremely rare and are often detected during postthyroidectomy surveillance by elevation in thyroid hormone levels, 131I scintigraphy, or 18F-fluorodeoxyglucose uptake in positron emission tomography studies. Treatment involves total thyroidectomy, resection of the metastatic foci, and 131I therapy. The differential diagnoses of renal metastasis of FTC include the encapsulated follicular variant of papillary thyroid carcinoma (PTC, which possesses some of the nuclear features seen in conventional PTC but may occasionally be indistinguishable from FTC in cytologic preparations, and renal lesions such as benign thyroidization of the kidney and thyroid-like follicular carcinoma of the kidney, which mimic FTC in histologic appearance but do not stain with thyroid markers.

  11. Evaluating the Degree of Conformity of Papillary Carcinoma and Follicular Carcinoma to the Reported Ultrasonographic Findings of Malignant Thyroid Tumor

    International Nuclear Information System (INIS)

    Jeh, Su Kyoung; Jung, So Lyung; Kim, Bum Soo; Lee, Yoen Soo

    2007-01-01

    We wanted to evaluate the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor. Between January 2003 and December 2004, fine needle aspiration biopsy was performed in 1,036 patients with palpable and nonpalpable thyroid lesions. We retrospectively reviewed the ultrasonographic findings of patients with papillary carcinomas (n = 127) and follicular carcinomas (n 23) that were proven by operation or fine needle aspiration biopsy. We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic change. The echogenicity was hypoechoic in 72.4% (92/127) of the papillary carcinomas, but it was isoechoic in 65.2% (15/23) of the follicular carcinomas (p < 0.001). The nodule shape was tall or round in 74.1% of the papillary carcinomas, but it was flat in 72.7% of the follicular carcinomas (p < 0.001). The tumor margin was microlobulated or irregular in 92.9% of the papillary carcinomas and in 60.9% of the follicular carcinomas (p < 0.001). A hypoechoic rim was seen in 26% of the papillary carcinomas (thin rim: 13.4%, thick rim: 12.6%) and in 86.6% of the follicular carcinomas (thin rim: 39.1%, thick rim: 47.8%, p < 0.001). Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (p < 0.001). A solid mass without cystic change were seen in 98.4% of the papillary carcinomas and in 82.6% of the follicular carcinomas (p < 0.001). The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas. The current ultrasonographic features for thyroid malignancy should be cautiously applied as the indication for

  12. The usefulness of 131I radioiodine to thyroid papillary carcinoma with extra thyroidal extension

    International Nuclear Information System (INIS)

    Shinohara, Shogo; Kikuchi, Masahiro; Naito, Yasushi; Fujiwara, Keizo; Hori, Shinya; Tona, Yosuke; Yamazaki, Hiroshi

    2009-01-01

    Extra thyroidal extension (ETE) of thyroid papillary carcinoma (PAC) is known as a risk factor of poor prognosis. The American Thyroid Association (ATA) Guideline recommends total thyroidectomy (TT) with radioiodine ablation for patients of PACs with ETE and we have been following this strategy for cases of PACs with ETE. In this paper, we retrospectively examined the patients of PACs with ETE in terms of the following two issues: Does 131 I total body scan ( 131 I-TBS) after TT enable us to detect subclinical distant metastases of PACs? and Can 131 I ablation eliminate microscopic remnants of PACs after TT? The subjects consisted of 68 patients who had PACs with ETE and underwent 131 I-TBS and/or 131 I ablation after TT in our hospital in the past 20 years. Tumor, nodes and metastasis (TNM) classifications of the patients were pT3:pT4=12:56, pN0:pN1a:pN1b=13:15:40, M0:M1=62:6. Twenty-two cases underwent only 131 I-TBS and 46 cases underwent 131 I-ablation. Fourteen cases diagnosed as M0 preoperatively had distant focus detected using 131 I-TBS. Including M1 cases, 20 out of 68 cases (29%) turned out to have clinical or subclinical distant lesions in our study. 131 I ablation eliminated thyroid bed in 18 out of 22 cases, and distant foci in 5 out of 13 cases. However, the distant lesions which had been apparent before operation (M1 cases) did not reach complete response (CR) by 131 I ablation. In 22 out of those 23 cases successfully treated with the ablation, serum-thyroglobulin level was almost undetected after therapy. The overall 10-year survival rate was 82% and the cause-specific survival rate was 91%. (author)

  13. Medullary carcinoma of the thyroid - an unusual case of hyalinizing trabecular adenoma - like variant (encapsulated

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    Madhusmita Jena

    2012-07-01

    Full Text Available Medullary thyroid carcinoma is a neoplasm occurring in sporadic and familial patterns. A rare variant of medullary thyroid carcinoma shows microscopic features similar to hyalinizing trabecular adenoma of thyroid. Detection of this variant requires a high index of suspicion and immunohistochemical confirmation by calcitonin positivity. We present a 36 years old female patient with a thyroid nodule, which, on microscopy, displayed an encapsulated tumor with elongated cells arranged in trabecular pattern separated by hyalinized fibrous septae simulating a hyalinizing trabecular adenoma. Also present were spindle cells arranged in an organoid fashion. Most of the cells showed salt and pepper chromatin pattern. The lesion was negative for amyloid but showed diffuse calcitonin positivity indicative of a tumor of C-cell origin i.e. medullary carcinoma of thyroid – hyalinizing trabecular variant.

  14. Ultrasonography findings of thyroid metastasis in a patient with hepatocellular carcinoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Ho; Park, Noh Hyuck; Lim, Jae Hoon; Park, Chan Sub; Seong, Su Ok; Kwon, Tae Jung [Myongji Hospital, Goyang (Korea, Republic of)

    2015-03-15

    Although the thyroid gland is one of the most vascular organs of the body, metastatic disease in the thyroid is encountered infrequently. However, at autopsy, the incidence rate of thyroid metastasis ranges from 1.25% to 24%. The primary sites are the kidney, lung, breast, and gastrointestinal tract. We report a rare case of a hepatocellular carcinoma metastatic to the thyroid gland. The patient had multiple palpable masses in the anterior and left lateral neck along the internal jugular chain on physical examination 9 months after the initial diagnosis of liver tumor. These masses were confirmed as metastasis from hepatocellular carcinoma by ultrasonography-guided 16-G core needle biopsy. We discuss the sonographic findings of thyroid metastasis and their use as an additional aid for differentiating between unknown primary tumor and thyroid metastasis.

  15. Diffuse Follicular Variant of Papillary Thyroid Carcinoma: A Case Report with a Revision of Literature.

    Science.gov (United States)

    Vinciguerra, Gian Luca Rampioni; Noccioli, Niccolò; Bartolazzi, Armando

    2016-11-17

    The diffuse follicular variant of papillary thyroid carcinoma (DFV-PTC) is a rare malignant thyroid condition. It represents an uncommon variant of papillary carcinoma characterized by a diffuse involvement of thyroid parenchyma, follicular architecture and nuclear features of PTC in absence of a surrounding capsule. Up to date few data have been collected about this entity and, at the best of our knowledge, only 24 cases have been reported in the literature. According to these reports DFV-PTC seems to occur preferentially in young women and shows more aggressive behavior than other papillary thyroid tumors. Herein we present an unusual case of DFV-PTC occurring in an 83 years old woman, involving the entire thyroid gland, without distinct or prevalent thyroid nodules. The tumor was clinically misdiagnosed as obstructive goiter.

  16. Management of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma.

    Science.gov (United States)

    Arslanoğlu, Seçil; Eren, Erdem; Özkul, Yılmaz; Ciğer, Ejder; Kopar, Aylin; Önal, Kazım; Etit, Demet; Tütüncü, G Yazgı

    2016-02-01

    The objective of this study was to determine the incidence of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma; and the association between clinicopathological parameters and thyroid gland invasion. Medical records of 75 patients with laryngeal and hypopharyngeal squamous cell carcinoma who underwent total laryngectomy with thyroidectomy were reviewed, retrospectively. Preoperative computed tomography scans, clinical and operative findings, and histopathological data of the specimens were evaluated. There were 73 male and two female patients with an age range of 41-88 years (mean 60.4 years). Hemithyroidectomy was performed in 62 (82.7 %) and total thyroidectomy was performed in 13 patients (17.3 %). Four patients had histopathologically proven thyroid gland invasion (5.3 %). In three patients, thyroid gland involvement was by means of direct invasion. Thyroid gland invasion was significantly correlated with thyroid cartilage invasion. Therefore, prophylactic thyroidectomy should not be a part of the treatment policy for these tumors.

  17. Baseline and lifetime alcohol consumption and risk of differentiated thyroid carcinoma in the EPIC study

    NARCIS (Netherlands)

    Sen, Abhijit; Tsilidis, Konstantinos K.; Allen, Naomi E.; Rinaldi, Sabina; Appleby, Paul N.; Almquist, Martin; Schmidt, Julie A.; Dahm, Christina C.; Overvad, Kim; Tjønneland, Anne; Rostgaard-Hansen, Agnetha L.; Clavel-Chapelon, Françoise; Baglietto, Laura; Boutron-Ruault, Marie Christine; Kühn, Tilman; Katze, Verena A.; Boeing, Heiner; Trichopoulou, Antonia; Tsironis, Christos; Lagiou, Pagona; Palli, Domenico; Pala, Valeria; Panico, Salvatore; Tumino, Rosario; Vineis, Paolo; Bueno-de-Mesquita, H. B.; Peeters, Petra H.; Hjartåker, Anette; Lund, Eiliv; Weiderpass, Elisabete; Quirós, J. Ramón; Agudo, Antonio; Sánchez, María José; Arriola, Larraitz; Gavrila, Diana; Gurrea, Aurelio Barricarte; Tosovic, Ada; Hennings, Joakim; Sandström, Maria; Romieu, Isabelle; Ferrari, Pietro; Zamora-Ros, Raul; Khaw, Kay Tee; Wareham, Nicholas J.; Riboli, Elio; Gunter, Marc; Franceschi, Silvia

    2015-01-01

    Background: Results from several cohort and case-control studies suggest a protective association between current alcohol intake and risk of thyroid carcinoma, but the epidemiological evidence is not completely consistent and several questions remain unanswered. Methods: The association between

  18. Choroidal Metastasis of Papillary Thyroid Carcinoma Demonstrated on SPECT-CT.

    Science.gov (United States)

    Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; Karatas, Muge

    2016-05-01

    We report a 68-year-old woman with papillary thyroid carcinoma metastasizing to choroid. The choroid metastasis was diagnosed with SPECT-CT and then was treated with high-dose radioactive iodine therapy.

  19. Outcome after intensity modulated radiotherapy for anaplastic thyroid carcinoma

    International Nuclear Information System (INIS)

    He, Xiayun; Li, Duanshu; Hu, Chaosu; Wang, Zhuoying; Ying, Hongmei; Wu, Yi

    2014-01-01

    Anaplastic thyroid carcinoma (ATC) is a malignancy with one of the highest fatality rates. We reviewed our recent clinical experience with intensity modulated radiotherapy (IMRT) combined with surgery and chemotherapy for the management of ATC. 13 patients with ATC who were treated by IMRT in our institution between October 2008 and February 2011, have been analyzed. The target volume for IMRT was planned to include Gross tumor volume (GTV): primary tumor plus any N + disease (66 Gy/33 F/6.6 W), with elective irradiation of thyroid bed, bilateral level II through VI and mediastinal lymph nodes to the level of the carina (54-60 Gy). Seven patients received surgical intervention and eleven patients had chemotherapy. The median radiotherapy dose to GTV was 60 Gy/30 fractions/6 weeks. The median survival time of the 13 patients was 9 months. The direct causes of death were distant metastases (75%) and progression of the locoregional disease (25%). Ten patients were spared dyspnea and tracheostomy because their primary neck lesion did not progress. The results showed that IMRT combined by surgery and chemotherapy for ATC might be beneficial to improve locoregional control. Further new therapies are needed to control metastases

  20. Advances and controversies in the management of medullary thyroid carcinoma.

    Science.gov (United States)

    Maia, Ana Luiza; Wajner, Simone Magagnin; Vargas, Carla Vaz Ferreira

    2017-01-01

    Medullary thyroid carcinoma (MTC) comprises approximately 4% of all malignant thyroid neoplasms. Although the majority of patients have a good prognosis, a subgroup of patients develops progressive disease and requires systemic therapy. Here, we focused on the current MTC therapeutic approaches and discussed the advantages and disadvantages of molecular targeted therapies. Targeted molecular therapies that inhibit RET and other tyrosine kinase receptors involved in angiogenesis have been shown to improve progression-free survival in patients with advanced MTC. Two drugs, vandetanib and cabozantinib, have been approved for the treatment of progressive or symptomatic MTC, and several others have exhibited variable efficacy. No tyrosine kinase inhibitor has been shown to improve survival. Although no definitive recommendation can currently be made, cumulative data indicate that knowledge of the tumor mutational profile may facilitate improvements in targeted therapy for MTC. Tyrosine kinase inhibitors are effective therapeutic agents for the treatment of progressive MTC. Nevertheless, it is not clear who will benefit the most from therapy, and the decision regarding when and how to initiate the treatment should be made based on the patient's medical history and tumor behavior. Hopefully, in the near future, molecular profiling of MTC can be used to determine the most effective molecular therapeutic target.

  1. Brain metastasis of follicular carcinoma of the thyroid gland

    International Nuclear Information System (INIS)

    Yodonawa, Masahiko; Tanaka, Sohkichi; Kohno, Kazuyuki; Ishii, Zenichiro; Tamura, Masaru; Ohye, Chihiro.

    1987-01-01

    A 33-year-old woman had been operated on for a tumor of the thyroid gland in December of 1976, and was admitted to Saku Central Hospital in April of 1983 because of pulmonary and ovarian metastases. She underwent surgical removal of the metastatic ovarian tumor and chemotherapy, but developed headaches in June of 1983. Computed tomography (CT) scan revealed a well-defined, homogeneously enhanced mass in the right occipital region. Angiography showed a homogeneous, well-defined tumor stain supplied by the right posterior cerebral artery, the posterior branch of the middle meningeal artery, and the meningeal branch of the occipital artery. The tumor was removed in July of 1983. It was situated in the right occipital lobe and was supplied by numerous small meningeal vessels. Histologically, it was composed of small, oval-shaped cells, some with mitotic figures, and giant cells, occasionally forming a follicular structure. Three months later, the headaches reappeared, and a recurrence of brain metastasis was demonstrated by CT. In October of 1983, the second metastatic brain tumor and the dural bed were removed and local radiation therapy was administered. In this case, meningioma-like features were demonstrated by CT scan and angiography, and these findings may be characteristic of brain metastasis of follicular carcinoma of the thyroid gland. (author)

  2. Video-Assisted Thyroidectomy for Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Celestino Pio Lombardi

    2010-01-01

    Full Text Available Background. The results of video-assisted thyroidectomy (VAT were evaluated in a large series of patients with papillary thyroid carcinoma (PTC, especially in terms of completeness of the surgical resection and short-to-medium term recurrence. Methods. The medical records of all patients who underwent video-assisted thyroidectomy for PTC between June 1998 and May 2009 were reviewed. Results. Three hundred fifty-nine patients were included. One hundred twenty-six patients underwent concomitant central neck node removal. Final histology showed 285 pT1, 26 pT2, and 48 pT3 PTC. Lymph node metastases were found in 27 cases. Follow-up was completed in 315 patients. Mean postoperative serum thyroglobulin level off levothyroxine was 5.4 ng/mL. Post operative ultrasonography showed no residual thyroid tissue in all the patients. Mean post-operative 131I uptake was 1.7%. One patient developed lateral neck recurrence. No other recurrence was observed.

  3. Papillary thyroid carcinoma treated with radiofrequency ablation in a patient with hypertrophic cardiomyopathy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Jian Yi; Liu, Xiao Sun; Zhang, Qing; Hong, Yan Yun; Song, Bin; Teng, Xiao Dong; Yu, Ji Ren [The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou (China)

    2016-07-15

    Standard therapy has not been established for thyroid cancer when a thyroidectomy is contraindicated due to systemic disease. Herein, we reported a patient who had hypertrophic cardiomyopathy and papillary thyroid carcinoma treated by radiofrequency ablation because of inability to tolerate a thyroidectomy. Radiofrequency ablation can be used to treat thyroid cancer when surgery is not feasible, although the long-term outcome needs further observation.

  4. Papillary Thyroid Carcinoma Treated with Radiofrequency Ablation in a Patient with Hypertrophic Cardiomyopathy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Jianyi; Liu, Xiaosun; Zhang, Qing; Hong, Yanyun; Song, Bin [Department of Gastrointestinal and Thyroid Surgery, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China); Teng, Xiaodong [Department of Pathology, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China); Yu, Jiren [Department of Gastrointestinal and Thyroid Surgery, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China)

    2016-11-01

    Standard therapy has not been established for thyroid cancer when a thyroidectomy is contraindicated due to systemic disease. Herein, we reported a patient who had hypertrophic cardiomyopathy and papillary thyroid carcinoma treated by radiofrequency ablation because of inability to tolerate a thyroidectomy. Radiofrequency ablation can be used to treat thyroid cancer when surgery is not feasible, although the long-term outcome needs further observation.

  5. Frontal bone metastasis from an occult follicular thyroid carcinoma: Diagnosed by FNAC

    OpenAIRE

    Kalra, Rajnish; Pawar, Richa; Hasija, Sonia; Chandna, Abha; Sankla, Manoj; Malhotra, Chanchal

    2017-01-01

    Metastatic deposits in skull bones from follicular thyroid carcinoma is rare, and metastatic disease in skull being the presenting symptom without obvious thyroid lesion (occult primary) is even rarer. A 60-year-old female patient presented with a mass in the frontal region of the skull. Fine needle aspiration cytology was done which revealed an adenocarcinoma with repeated follicular pattern, reminiscent of follicular neoplasm of thyroid, which on immunocytochemistry revealed positivity for ...

  6. Warthin-Like Papillary Carcinoma of the Thyroid Gland: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Panagiotis Paliogiannis

    2012-01-01

    Full Text Available We present a case of Warthin-like papillary thyroid carcinoma in a 22-year-old woman and a review of the literature on the topic. The patient had the occasional discovery of a hypoechoic thyroid nodule of approximately 18 mm, characterized by irregular margins, hyperechoic spots, rich intra- and perilesional vascularization, and a suspicious enlarged right laterocervical lymph node. Fine-needle aspiration was performed for both lesions and the diagnosis of papillary thyroid carcinoma without lymph node involvement was made. The patient underwent thyroidectomy and central neck lymphadenectomy without complications. Histopathological examination suggested a Warthin-like papillary carcinoma of the thyroid gland, with all the removed lymph nodes being free of disease. The patient subsequently underwent iodine ablative therapy and she remains free of disease one year after surgery. Warthin-like papillary thyroid carcinoma is a recently described variant of papillary thyroid cancer that is frequently associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T and B lymphocytes infiltrating the stalks of papillae lined with oncocytic cells. Surgical and postoperative management is identical to that of classic differentiated thyroid cancer, while prognosis seems to be favourable.

  7. Thyroid carcinoma induced by irradiation for Hodgkin's disease. Report of a case.

    Science.gov (United States)

    Weshler, Z; Krasnokuki, D; Peshin, Y; Biran, S

    1978-01-01

    In a 22-year-old male, who had been irradiated 16 years previously for Hodgkin's disease, a radiation-induced thyroid carcinoma developed. This was the only case with such development in a group of 207 cases with Hodgkin's disease who were treated by irradiation including the thyroid gland.

  8. Acute paraparesis as presentation of an occult follicular thyroid carcinoma: A case report

    Directory of Open Access Journals (Sweden)

    José Miguel Baião

    Full Text Available Introduction: Follicular thyroid carcinoma is the second most frequent type of well differentiated thyroid tumours. It is usually confined to the thyroid gland, however it can metastasize in a later stage of the disease. Signs and symptoms associated with bone metastasis are rare as first clinical manifestations. Case report: An 84-year-old female complained with acute paraparesis. Magnetic resonance imaging revealed an extensive intraosseous infiltrating lesion compatible with a bone metastasis from an occult tumour. Biopsy samples were compatible with bone metastasis from a follicular thyroid carcinoma. The patient was submitted to total thyroidectomy followed by iodine ablative therapy. Discussion: Follicular thyroid carcinoma presentation with symptoms related to bone metastasis is rare. Patients with bone lesions, such as pathological fractures or compressive symptoms should be studied since they may have clinically unapparent lesions from an unknown tumour. Patients with FTC should be submitted to total thyroidectomy. Bone lesions may be addressed to improve quality of life however this decision depends on disease extent. Conclusion: Acute paraparesis is a rare form of presentation of thyroid carcinoma. These neoplasms must be taken into account when investigating metastasis to the bone from unknown neoplasms. Keywords: Acute paraparesis, Follicular thyroid carcinoma, Bone metastasis, Case report

  9. Solitary cystic lymph neck node metastasis of occult thyroid papillary carcinoma.

    Science.gov (United States)

    González-García, Raúl; Román-Romero, Leticia; Sastre-Pérez, Jesús; Rodríguez-Campo, Francisco J; Naval-Gías, Luis

    2008-12-01

    The appearance of a solitary lateral cervical cystic mass as the only initial presenting symptom of occult thyroid carcinoma is uncommon. Its presence is often misdiagnosed due to the more frequent branchial cyst in young people. Although oronasopharyngeal squamous cell carcinoma has been reported as the main cause of lymph neck node metastasis, thyroid papillary carcinoma may be responsible for solitary cervical cystic masses as the initial manifestation of the disease. This situation has been rarely reported, although solid masses are much more frequent. In most of these cases all such lesions may initially be considered as metastatic foci from a primary thyroid lesion. However, an alternative explanation by means of which ectopic thyroid tissue is associated with a branchial cyst has to be considered, especially if no primary tumour is observed in the histological examination of the thyroid gland. We present a rare case of solitary cystic lymph node metastasis of occult papillary carcinoma of the thyroid. We also discuss possible etiology for thyroid papillary carcinoma in lateral neck cysts.

  10. Thyroiditis

    Science.gov (United States)

    ... Anaplastic Thyroid Cancer Complementary and Alternative Medicine in Thyroid Disease FNA Biopsy of Thyroid Nodules Goiter Graves’ Disease ... Cancer Nuclear Radiation & the Thyroid Older Patients and Thyroid Disease Papillary & Follicular Thyroid Cancer Postpartum Thyroiditis Pregnancy and ...

  11. Papillary thyroid carcinoma: comparison between CT features and pathologic findings

    International Nuclear Information System (INIS)

    Tan Hongna; Gu Yajia; Peng Weijun; Yang Wentao; Huang Dan

    2009-01-01

    Objective: To evaluate the relationship between the CT imaging features and pathologic findings of papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC), as well as the CT appearances of Non-papillary thyroid carcinoma(N-PTC). Methods: CT features of 229 PTC, 42 PTMC and 36 N-PTC patients with 264, 57 and 41 lesions respectively were analyzed retrospectively, and comparison was made with the pathologic findings. All data were analyzed by X 2 test. Results: (1) Of PTC lesions, 25.4% (67/264)of the lesions and 2.9% (24/828) of metastatic lymph nodes showed cystic changes. Cyst formation with intracystic high density papillary-like nodules were found in 31.3% (21/67)of the PTC lesions and 37.5% (9/24) of metastatic lymph nodes. The histologic appearances of these tumors demonstrated fibrous tissue forming the wall of cyst, and papillary-like tumor tissue. (2) 75.2% (112/149) of PTC and 33.3% (5/15) of PTMC showed multiple small granular and fine calcifications, and there was statiscally significant difference between the two (P 0.05). However, the degree of enhancement in PTC lesions were less than that of N-PTC, 36.6% (94/257) of PTC and 54.1% (20/37)of N-PTC lesions showed significant enhancement, and there was statistically significant difference (P<0.05). 75.1% of PTC (172/229) and 52.8% of (19/36)N-PTC had cervical lymph node metastases, with a propensity fbr PTC to have more VI region metastatic lymph nodes, 80.8% (139/172)vs 57.9% (11/19), which was statistically significant (both P<0.05). (4)Distant metastases to bone or lung were rare, but N-PTC (5/36) were more likely to produce distant metastases than PTC (5/229), and there was statistically significant difference (P<0.01). Conclusion Multiple, small granular and fine calcifications were found more frequently in PTC than PTMC. Compared with N-PTC, the papillary-like mural nodules of PTC showed less enhancement on post-contrast CT and cervical lymph node metastases were more

  12. [Comparative rate of regional metastasis of high differentiated carcinoma of the thyroid gland].

    Science.gov (United States)

    Konstantinova, N N; Evmenova, T D; Drozdova, D É

    2014-01-01

    The rate of metastasis of high differentiated carcinoma of the thyroid glands to the neck lymph nodes was studied in people of Kemerovo Region. The metastatic lesions of pretracheal lymph nodes (VI group) were detected in 49.5% patients with papillary carcinoma and 21.0% of patients with follicular cancer. Metastases in jungular lymph nodes were revealed in 37.3% patients with papillary carcinoma. It was noted that an extension of metastatic lesions of regional lymph nodes was observed in the case of primary tumour foci spread beyond borders of the capsula glandularis in patients with papillary carcinoma. There wasn't such a relation in a case of follicular cancer. Metastases in regional lymph nodes were detected more often (67.6%) in the case of papillary carcinoma in uncontaminated zone of the thyroid gland compared with other thyroid pathology (31.7%).

  13. Thyroid, Renal, and Breast Carcinomas, Chondrosarcoma, Colon Adenomas, and Ganglioneuroma: A New Cancer Syndrome, FAP, or Just Coincidence

    OpenAIRE

    Ihab Shafek Atta; Fahd Nasser AlQahtani

    2016-01-01

    We are presenting a case associated with papillary thyroid carcinoma, renal cell carcinoma, invasive mammary carcinoma, chondrosarcoma, benign ganglioneuroma, and numerous colon adenomas. The patient had a family history of colon cancer, kidney and bladder cancers, lung cancer, thyroid cancer, leukemia, and throat and mouth cancers. She was diagnosed with colonic villous adenoma at the age of 41 followed by thyroid, renal, and breast cancers and chondrosarcoma at the ages of 48, 64, 71, and 7...

  14. Amiodarone-induced hyperthyroidism in a patient with functioning papillary carcinoma of the thyroid and extensive hepatic metastases.

    Science.gov (United States)

    Mackie, Gavin C; Shulkin, Barry L

    2005-12-01

    Thyroid hormone producing thyroid carcinoma is an uncommon cause of thyrotoxicosis. A patient with extensive hepatic metastases from well-differentiated carcinoma is presented. Administration of amiodarone for atrial fibrillation led to the development of hyperthyroidism. Precipitation of thyrotoxicosis by iodine-containing compounds in patients with thyroid carcinoma is rare. The relatively high iodine load and the slow elimination of amiodarone complicate the clinical management of such patients.

  15. Chronic lymphocytic thyroiditis and BRAF V600E in papillary thyroid carcinoma.

    Science.gov (United States)

    Kim, Seo Ki; Woo, Jung-Woo; Lee, Jun Ho; Park, Inhye; Choe, Jun-Ho; Kim, Jung-Han; Kim, Jee Soo

    2016-01-01

    It has been reported that papillary thyroid carcinoma (PTC) with chronic lymphocytic thyroiditis (CLT) is less associated with extrathyroidal extension (ETE), advanced tumor stage and lymph node (LN) metastasis. Other studies have suggested that concurrent CLT could antagonize PTC progression, even in BRAF-positive patients. Since the clinical significance of the BRAF mutation has been particularly associated with conventional PTC, the purpose of this study was to determine the clinical significance of CLT according to BRAF mutation status in conventional PTC patients. We retrospectively reviewed the medical records of 3332 conventional PTC patients who underwent total thyroidectomy with bilateral central neck dissection at the Thyroid Cancer Center of Samsung Medical Center between January 2008 and June 2015. In this study, the prevalence of BRAF mutation was significantly less frequent in conventional PTC patients with CLT (76.9% vs 86.6%). CLT was an independent predictor for low prevalence of ETE in both BRAF-negative (OR=0.662, P=0.023) and BRAF-positive (OR=0.817, P=0.027) conventional PTC patients. In addition, CLT was an independent predictor for low prevalence of CLNM in both BRAF-negative (OR=0.675, P=0.044) and BRAF-positive (OR=0.817, P=0.030) conventional PTC patients. In conclusion, BRAF mutation was significantly less frequent in conventional PTC patients with CLT. However, CLT was an independent predictor for less aggressiveness in conventional PTC patients regardless of BRAF mutation status. © 2016 Society for Endocrinology.

  16. Comparison of primary thyroid lymphoma with anaplastic thyroid carcinoma on computed tomographic imaging

    International Nuclear Information System (INIS)

    Ishikawa, Hitoshi; Mitsuhashi, Norio; Niibe, Hideo

    2002-01-01

    Primary non-Hodgkin's lymphoma (LY) and anaplastic carcinoma (AC) of the thyroid gland are rare malignant tumors, and the initial symptoms of these diseases are very similar. The aim of our study was to compare the characteristics of the two diseases using computed tomographic (CT) scans in order to make an accurate differential diagnosis. Ten patients with LY and 10 with AC were analyzed. Differences in the CT findings of the two diseases were evaluated before treatment and statistically tested with either Student's t-test or the chi-square test. In the analysis of characteristics of CT imaging, the existence of calcification and necrosis, and heterogeneous tumor were dominant findings in AC, and there was a statistically significant difference in frequency between the two diseases (p<0.01). Calcification detected in AC was usually multiple and/or gross (mean size: φ8.2 mm). All lymphadenopathies were delineated as having the same homogeneous attenuation as the tumors in the thyroid gland in LY, but were shown as irregular rim enhancement in AC. The CT features of the two diseases are characteristic in terms of calcification, necrosis, and tumor composition. Evaluation by means of CT imaging is useful in distinguishing between LY and AC. (author)

  17. Papillary carcinoma arising in struma ovarii versus ovarian metastasis from primary thyroid carcinoma: a case report and review of the literature.

    Science.gov (United States)

    Leite, Inês; Cunha, Teresa Margarida; Figueiredo, José Pinto; Félix, Ana

    2013-10-01

    We present a case of a postmenopausal woman diagnosed with an ovarian mass containing thyroid follicles and foci of papillary thyroid carcinoma during pathological examination. This patient referred having had a metachronous thyroid malignancy 10 years before. The differential diagnosis between a thyroid malignancy arising from a struma ovarii and a metastatic ovarian tumor originating from thyroid-cancer is challenging. Struma ovarii should be considered when thyroid components are the predominant element or when thyroid malignant tissue is identified within an ovarian lesion. Thyroid carcinoma arising from a struma ovarii is reported to occur in a minority of cases. Of these, papillary carcinoma is the most frequent subtype encountered. Regarding primary thyroid carcinomas, papillary carcinomas have a lower metastatic potential when compared to follicular carcinomas, and most of the metastases occur in the cervical lymph nodes. Ovarian metastases are exceedingly rare and generally associated with widespread disease. However, they must be considered in the presence of previous history of malignant thyroid carcinoma. The authors review the main clinical, imaging and therapeutic aspects of both these entities and present the most likely diagnosis.

  18. Chronic thyroiditis in patients with advanced breast carcinoma: metabolic and morphologic changes on PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Tateishi, Ukihide [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan); University of Texas MD Anderson Cancer Center, Division of Diagnostic Imaging, Houston, TX (United States); Gamez, Cristina; Yeung, Henry W.D.; Macapinlac, Homer A. [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Dawood, Shaheenah; Cristofanilli, Massimo [University of Texas, MD Anderson Cancer Center, Division of Breast Medical Oncology, Houston, TX (United States); Inoue, Tomio [Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan)

    2009-06-15

    To investigate clinical implications of FDG uptake in the thyroid glands in patients with advanced breast carcinoma by comparing metabolic and morphologic patterns on positron emission tomography (PET)/computed tomography (CT). The institutional review board waived the requirement for informed consent. A retrospective analysis was performed in 146 women (mean age 54 years) with advanced breast carcinoma who received systemic treatment. All patients underwent PET-CT before and after treatment. All PET-CT studies were reviewed in consensus by two reviewers. Morphologic changes including volume and mean parenchymal density of the thyroid glands were evaluated. Maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG) were determined to evaluate metabolic changes. These parameters were compared between patients with chronic thyroiditis who received thyroid hormone replacement therapy and those who did not. Of the 146 patients, 29 (20%) showed bilaterally diffuse uptake in the thyroid glands on the baseline PET-CT scan. The SUVmax showed a linear relationship with volume (r = 0.428, p = 0.021) and the mean parenchymal density (r = -0.385, p = 0.039) of the thyroid glands. In 21 of the 29 patients (72%) with hypothyroidism who received thyroid hormone replacement therapy, the volume, mean parenchymal density, SUVmax, and TLG of the thyroid glands showed no significant changes. In contrast, 8 of the 29 patients (28%) who did not receive thyroid hormone replacement therapy showed marked decreases in SUVmax and TLG. Diffuse thyroid uptake on PET-CT represents active inflammation caused by chronic thyroiditis in patients with advanced breast carcinoma. Diffuse thyroid uptake may also address the concern about subclinical hypothyroidism which develops into overt disease during follow-up. (orig.)

  19. [Papillary thyroid carcinoma in a child with congenital dyshormonogenetic hypothyroidism. Case report].

    Science.gov (United States)

    Orellana, María José; Fulle, Angelo; Carrillo, Diego; Escobar, Lucía; Ebensperger, Alicia; Martínez, Raúl; Rumié Carmi, Hana

    Papillary thyroid carcinoma (PTC) is a rare childhood disease. The development of PTC in dyshormonogenetic congenital hypothyroidism (CH) is infrequent, with very few case reports in literature. To report a case of PTC in a boy with dyshormonogenetic CH without goitre and exposed to ionising radiation. To evaluate relationships between these factors and development of PTC. We present a boy with dyshormonogenetic CH since birth. Early hormonal substitution was initiated, with subsequent normal levels of thyrotropin and thyroid hormones. He has also congenital cardiomyopathy, exposed to interventional treatment with 10 heart catheterisations, and approximately 26 chest X-rays at paediatric doses. A thyroid nodule was found in thyroid echography at the age of 6 years old. Fine needle aspiration biopsy confirmed high probability of thyroid carcinoma (Bethesda 5). The pre-surgical thorax and cerebral scan showed no evidence of metastasis. The patient underwent total thyroidectomy. Pathological examination revealed a 0.5cm papillary thyroid micro-carcinoma in the right lobe, with no evidence of dissemination. Genetic mutations and radiation exposure may play an important role in the development of PTC. There may be common pathways between dyshormonogenetic CH and thyroid carcinoma that need further investigation. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Primary Thyroid-Like Follicular Renal Cell Carcinoma: An Emerging Entity

    Directory of Open Access Journals (Sweden)

    S. Malde

    2013-01-01

    Full Text Available Primary thyroid-like follicular carcinoma of the kidney is a rare but newly emerging histological variant of renal cell carcinoma RCC, with only nine cases reported in the literature to date. We present a further case of this unique condition, discuss the workup and typical histological findings, and review the literature regarding this rare histological variant.

  1. Metastatic carcinoma of the thyroid gland as the initial manifestation of the disease.

    Science.gov (United States)

    SEARLS, H H; DAVIES, O; LINDSAY, S

    1952-02-01

    During the past 38 years, 260 patients with thyroid carcinoma have been operated upon at the University of California Hospital. In 26 of these patients the first symptom was a mass distant from the thyroid gland, and the gland was considered normal on clinical examination. In all but three of the 26 cases a small carcinoma of the thyroid gland was observed at operation or in pathological examination. Radical neck dissection with either total lobectomy or total thyroidectomy would seem to be the operation of choice in the treatment of these patients. The ultimate prognosis, even in the presence of metastases, is relatively good.Primary carcinoma of the thyroid gland should be considered in the presence of tumors of the side of the neck even in the absence of palpable nodules in the gland itself.

  2. Accounting for tissue heterogeneity in infrared spectroscopic imaging for accurate diagnosis of thyroid carcinoma subtypes.

    Science.gov (United States)

    Martinez-Marin, David; Sreedhar, Hari; Varma, Vishal K; Eloy, Catarina; Sobrinho-Simões, Manuel; Kajdacsy-Balla, André; Walsh, Michael J

    2017-07-01

    Fourier transform infrared (FT-IR) microscopy was used to image tissue samples from twenty patients diagnosed with thyroid carcinoma. The spectral data were then used to differentiate between follicular thyroid carcinoma and follicular variant of papillary thyroid carcinoma using principle component analysis coupled with linear discriminant analysis and a Naïve Bayesian classifier operating on a set of computed spectral metrics. Classification of patients' disease type was accomplished by using average spectra from a wide region containing follicular cells, colloid, and fibrosis; however, classification of disease state at the pixel level was only possible when the extracted spectra were limited to follicular epithelial cells in the samples, excluding the relatively uninformative areas of fibrosis. The results demonstrate the potential of FT-IR microscopy as a tool to assist in the difficult diagnosis of these subtypes of thyroid cancer, and also highlights the importance of selectively and separately analyzing spectral information from different features of a tissue of interest.

  3. Carcinoma Showing Thymus-Like Differentiation (CASTLE of Thyroid: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Leong-Perng Chan

    2008-11-01

    Full Text Available Carcinoma showing thymus-like differentiation (CASTLE is a rare malignant neoplasm that occurs in the thyroid gland, or head and neck. This tumor arises from either ectopic thymus tissue or remnants of branchial pouches, which retain the potential to differentiate along the thymus line. Clinical presentation and imaging can be consistent with a malignant lesion such as thyroid cancer or thymic carcinoma. Immunohistochemical staining with CD5 can differentiate CASTLE from other malignant thyroid neoplasms. A 54-year-old male had initially presented with a painless, left neck mass for 3 months. He underwent left thyroid lobectomy via a median sternotomy approach. Carcinoma showing thymus-like differentiation was the final histopathologic diagnosis. After 36 months of follow-up, no evidence of recurrence was observed. A median sternotomy is an excellent approach for CASTLE with anterior mediastinum involvement. Complete resection is important to improve the long-term survival rate and the locoregional recurrence rate.

  4. Maternal and obstetrical outcome in 35 cases of well-differentiated thyroid carcinoma during pregnancy

    DEFF Research Database (Denmark)

    Boucek, Jan; de Haan, Jorine; Halaska, Michael J

    2018-01-01

    study. Data on histopathological characteristics, diagnostic and therapeutic interventions, outcome (obstetrical, neonatal, and maternal) and maternal follow-up were analyzed. RESULTS: Thirty-five patients with well-differentiated thyroid carcinoma were eligible. All 35 patients underwent surgery, 29...... of primary well-differentiated thyroid carcinoma during pregnancy and fetal and maternal outcomes. STUDY DESIGN: This is an international cohort study. METHODS: Primary thyroid cancer patients were identified from the database of the International Network on Cancer, Infertility, and Pregnancy registration...... outcomes were uncomplicated, regardless of gestational age during surgery. CONCLUSIONS: Well-differentiated thyroid carcinoma diagnosed during pregnancy has a favorable outcome for both mother and child. Surgical management during pregnancy has no negative impact on the pregnancy regardless...

  5. The role of Tl-201 total body scintigraphy in follow up of thyroid carcinoma

    International Nuclear Information System (INIS)

    Hoefnagel, C.A.; Delprat, C.C.; Marcuse, H.R.

    1985-01-01

    To evaluate the reliability of the procedure T1-201 total body scintigraphy was performed in 294 patients (449 studies) after total thyroidectomy for thyroid carcinoma. Results were correlated with I-131-scintigraphy and tumor-marker levels (Tgb or Calcitonin/CEA). T1-201 total body scintigraphy was negative in 196 patients with no evidence of disease. T1-201-scintigraphy correctly detected tumor localizations in 24 of 30 patients with I-131-positive metastases. In 28 patients T2-201 total body scintigraphy revealed metastases which did not concentrate I-131. Histology/cytology confirmed thyroid carcinoma metastases in 16 patients and other pathology in 5 cases. 9 of 18 patients with medullary thyroid carcinoma (I-131-negative) had elevated Calcitonin/CEA-levels. The T1-201 scintigram was positive in 8 of these patients. Comparison of T1-201, I-131 and tumor markers showed that only combined use of these parameters provide complete reliability. The authors conclude that T1-201 total body scintigraphy is useful in follow up of thyroid carcinoma, especially when a discrepancy of the other parameters exists and particularly in medullary carcinoma. In long term follow up of patients who are unsuspected of disease after successful therapy for thyroid carcinoma one can rely on T1-201 total body scintigraphy in combination with tumor marker assays

  6. Metastatic Follicular Thyroid Carcinoma Secreting Thyroid Hormone and Radioiodine Avid without Stimulation: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Syed A. Abid

    2014-01-01

    Full Text Available Introduction. This is an extremely rare case of a patient with metastatic follicular thyroid cancer who continued to produce thyroid hormone and was iodine scan positive without stimulation after thyroidectomy and radioiodine (I-131 therapy. Patient Findings. A 76-year-old Caucasian male was diagnosed with metastatic follicular thyroid carcinoma on lung nodule biopsy. Total thyroidectomy was performed and he was ablated with 160 mCi of I-131 after recombinant human thyrotropin (rhTSH stimulation. Whole body scan (WBS after treatment showed uptake in bilateral lungs, right sacrum, and pelvis. The thyroglobulin decreased from 2,063 to 965 four months after treatment but rapidly increased to 2,506 eleven months after I-131. Thyroid stimulating hormone (TSH remained suppressed and free T4 remained elevated after I-131 therapy without thyroid hormone supplementation. He was treated with an additional 209 mCi with WBS findings positive in lung and pelvis. Despite I-131, new metastatic lesions were noted in the left thyroid bed and large destructive lesion to the first cervical vertebrae four months after the second I-131 dose. Conclusions. This case is exceptional because of its rarity and also due to the dissociation between tumor differentiation and aggressiveness. The metastatic lesions continued to secrete thyroid hormone and remained radioiodine avid with rapid progression after I-131 therapy.

  7. Shear wave elastography in medullary thyroid carcinoma diagnostics

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    Katarzyna Dobruch-Sobczak

    2015-12-01

    Full Text Available Shear wave elastography (SWE is a modern method for the assessment of tissue stiffness. There has been a growing interest in the use of this technique for characterizing thyroid focal lesions, including preoperative diagnostics. Aim: The aim of the study was to assess the clinical usefulness of SWE in medullary thyroid carcinoma (MTC diagnostics. Materials and methods: A total of 169 focal lesions were identifi ed in the study group (139 patients, including 6 MTCs in 4 patients (mean age: 45 years. B-mode ultrasound and SWE were performed using Aixplorer (SuperSonic, Aix-en-Provence, with a 4–15 MHz linear probe. The ultrasound was performed to assess the echogenicity and echostructure of the lesions, their margin, the halo sign, the height/width ratio (H/W ratio, the presence of calcifi cations and the vascularization pattern. This was followed by an analysis of maximum and mean Young’s (E modulus values for MTC (EmaxLR, EmeanLR and the surrounding thyroid tissues (EmaxSR, EmeanSR, as well as mean E-values (EmeanLRz for 2 mm region of interest in the stiffest zone of the lesion. The lesions were subject to pathological and/or cytological evaluation. Results: The B-mode assessment showed that all MTCs were hypoechogenic, with no halo sign, and they contained micro- and/ or macrocalcifi cations. Ill-defi ned lesion margin were found in 4 out of 6 cancers; 4 out of 6 cancers had a H/W ratio > 1. Heterogeneous echostructure and type III vascularity were found in 5 out of 6 lesions. In the SWE, the mean value of EmaxLR for all of the MTCs was 89.5 kPa and (the mean value of EmaxSR for all surrounding tissues was 39.7 kPa Mean values of EmeanLR and EmeanSR were 34.7 kPa and 24.4 kPa, respectively. The mean value of EmeanLRz was 49.2 kPa. Conclusions: SWE showed MTCs as stiffer lesions compared to the surrounding tissues. The lesions were qualifi ed for fi ne needle aspiration biopsy based on B-mode assessment. However, the diagnostic algorithm

  8. Incidental versus non-incidental thyroid carcinoma: Clinical presentation, surgical management and prognosis.

    Science.gov (United States)

    González-Sánchez-Migallón, Elena; Flores-Pastor, Benito; Pérez-Guarinos, Carmen Victoria; Miguel-Perelló, Joana; Chaves-Benito, Asunción; Illán-Gómez, Fátima; Carrillo-Alcaraz, Andrés; Aguayo-Albasini, José Luis

    2016-11-01

    Thyroid cancer may be clinically evident as a tumor mass in the neck or as a histopathological incidental finding after thyroid surgery for an apparent benign condition. Our objective was to assess the differences in clinical signs, surgical management, and course between incidental and clinically diagnosed thyroid tumors. A retrospective study was conducted on patients operated on for benign or malignant thyroid disease from January 2000 to March 2014. Among the 1415 patients who underwent any thyroid surgery, 264 neoplasms were found, of which 170 were incidental. A comparison was made of incidental versus non-incidental carcinomas. Among incidental carcinomas, cases whose indication for surgery was Graves' disease were compared to those with multinodular goiter. Incidental carcinomas were in earlier stages and required less aggressive surgery. There were no differences in surgical complications between incidental and clinical tumors, but mortality and relapses were markedly higher in non-incidental cancers (4.4% vs 0% and 13.2% vs 4.8% respectively). Carcinomas developing on Graves' disease showed no differences from all other incidental tumors in terms of complications, mortality, or relapse after surgery. Early stage thyroid cancer has better survival and prognosis after surgical treatment. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Impact of lymphocytic thyroiditis on incidence of pathological incidental thyroid carcinoma.

    Science.gov (United States)

    Farrell, Eric; Heffron, Cynthia; Murphy, Matthew; O'Leary, Gerard; Sheahan, Patrick

    2017-01-01

    The purpose of this study was to investigate the impact of lymphocytic thyroiditis on incidence of incidental thyroid cancers. We conducted a retrospective review of 713 consecutive patients who underwent thyroidectomies. Incidental thyroid cancer was defined as an unexpected cancer discovered on pathological examination outside the index nodule undergoing preoperative cytology. We excluded 65 cases because of preoperative diagnosis of thyroid cancer, and 68 because of nonincidental cancer within the index nodule. Among the remaining 580 cases, there were 43 cases (7.4%) of incidental thyroid cancers. Incidental thyroid cancers were significantly associated with moderate/severe lymphocytic thyroiditis (relative risk = 2.5; p = .03). Sixteen of 56 patients with moderate/severe lymphocytic thyroiditis had Graves' disease, none of whom had incidental thyroid cancer. The risk of incidental thyroid cancer associated with moderate/severe lymphocytic thyroiditis was significantly higher in non-Graves' than patients with Graves' disease (p = .05). The risk of incidental thyroid cancer is significantly increased in patients with moderate/severe lymphocytic thyroiditis. Moderate/severe lymphocytic thyroiditis associated with Graves' disease seems to have a lower risk of incidental thyroid cancer. © 2016 Wiley Periodicals, Inc. Head Neck 39: 122-127, 2017. © 2016 Wiley Periodicals, Inc.

  10. Management of the thyroid gland during total laryngectomy in patients with laryngeal squamous cell carcinoma.

    Science.gov (United States)

    Mourad, Moustafa; Saman, Masoud; Sawhney, Raja; Ducic, Yadranko

    2015-08-01

    The goal of the study was to determine the role of routine total thyroidectomy and hemithyroidectomy in patients undergoing total laryngectomy for laryngeal squamous cell carcinoma. The study group consisted of 343 patients who underwent total laryngectomy (98 treated with surgery alone, 136 treated following radiation failure, and 109 following chemoradiation failure). Total thyroidectomy was performed in all obstructing and bilateral lesions or if there was suspicion of contralateral lobe involvement. Hemithyroidectomy was performed in all lateralized lesions. Retrospective histopathologic analysis of thyroid specimens was subsequently performed. In all, 262 patients underwent total thyroidectomy during total laryngectomy, six of which demonstrated squamous cell carcinoma evident within the thyroid gland (4 from transglottic lesions, 2 from subglottic lesions). Hemithyroidectomy was performed in 81 patients, with only one patient demonstrating evidence of squamous cell carcinoma within the thyroid gland. Hypothyroidism was observed in 88% (n = 61) of patients who underwent thyroid lobectomy alone, requiring hormone supplementation. Routine surgical management of the thyroid gland should not be performed, except in cases of subglottic primary lesions, lesions with significant subglottic extension, or transglottic lesions. Despite efforts to preserve the contralateral thyroid lobe in cases of selective lobectomy, these patients often have a high rate of hypothyroidism, and a total thyroidectomy should be considered when involvement of the thyroid gland is suspected. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Therapeutic implications of thymic uptake of radioiodine in thyroid carcinoma

    International Nuclear Information System (INIS)

    Wilson, L.M.; Barrington, S.F.; Kettle, A.G.; O'Doherty, M.J.; Coakley, A.J.; Morrison, I.D.

    1998-01-01

    The management of 38 consecutive patients with differentiated thyroid carcinoma in the period 1991-1996, who each received at least one therapy dose of iodine-131, was reviewed, looking in particular at those in whom anterior mediastinal uptake was demonstrated on scans taken 3 and 7 days post-therapy. Such activity was noted in ten patients. On the basis of clinical follow-up, thyroglobulin measurement and radiological and other scintigraphic imaging, in nine of the ten patients the anterior mediastinal activity was attributed to physiological thymic uptake. Of those nine, all were under 50 years of age; seven were considered disease free, one had residual disease in the neck and one had distant metastases. Physiological uptake by the thymus was more prominent on the 7-day scans and in patients with low tumour volumes. For appropriate patient management it is essential to recognise that physiological uptake of 131 I by the thymus in patients under 50 years of age is a potential cause of false-positive therapy scans. (orig.)

  12. Muscular metastasis heralding medullary carcinoma of the thyroid

    Directory of Open Access Journals (Sweden)

    Rawdha Tekaya

    2013-09-01

    Full Text Available Medullary thyroid carcinoma (MTC commonly metastasizes locally to the cervical lymph nodes and distantly to the liver, lungs and bones. Metastatic involvement of the muscles is extremely rare. We reported an unusual case of undiagnosed MTC presenting with symptoms related to metastatic lesions of the brachoradialis and the gluteus medius muscles. A 53-year-old man consulted for a painful mass of the right forearm and atrophy of the quadriceps. Ultrasonography revealed a heterogeneous collection in the forearm. Computed tomographic scan showed a mass in the right lung, an enlargement of mediastinal lymph nodes and solid masses in the right gluteus medius and the left iliopoas muscle extending to the left iliac bone. Pulmonary biopsies displayed findings consistent with metastatic MTC. Fine needle aspiration cytology from the right arm swelling revealed a lesion with the same calcitonin immunostaining patterns as the lung metastasis. The diagnosis of multiple metastases (lung, muscle and bone of MTC is established. The patient has received local radiation therapy and was planned for chemotherapy. Muscular metastases from MTC are rare and although their prognosis is poor, local treatment may be worthwhile.

  13. Therapeutic implications of thymic uptake of radioiodine in thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, L.M.; Barrington, S.F.; Kettle, A.G.; O`Doherty, M.J.; Coakley, A.J. [Department of Nuclear Medicine, Kent and Canterbury Hospital, Canterbury CT1 3NG (United Kingdom); Morrison, I.D. [Department of Radiology, Kent and Canterbury Hospital, Canterbury CT1 3NG (United Kingdom)

    1998-06-01

    The management of 38 consecutive patients with differentiated thyroid carcinoma in the period 1991-1996, who each received at least one therapy dose of iodine-131, was reviewed, looking in particular at those in whom anterior mediastinal uptake was demonstrated on scans taken 3 and 7 days post-therapy. Such activity was noted in ten patients. On the basis of clinical follow-up, thyroglobulin measurement and radiological and other scintigraphic imaging, in nine of the ten patients the anterior mediastinal activity was attributed to physiological thymic uptake. Of those nine, all were under 50 years of age; seven were considered disease free, one had residual disease in the neck and one had distant metastases. Physiological uptake by the thymus was more prominent on the 7-day scans and in patients with low tumour volumes. For appropriate patient management it is essential to recognise that physiological uptake of {sup 131}I by the thymus in patients under 50 years of age is a potential cause of false-positive therapy scans. (orig.) With 5 figs., 1 tab., 20 refs.

  14. Isolated Spinal Metastasis with Spinal Cord Compression Leads to a Diagnosis of a Follicular Thyroid Carcinoma.

    Science.gov (United States)

    Toshkezi, Gentian; Galgano, Michael; Libohova, Silva; Marawar, Satya

    2015-10-12

    Thyroid carcinoma initially presents with clinical symptoms due to metastatic lesions in less than 5% of cases. Spinal cord compression from an epidural metastatic lesion as a first symptom is extremely rare. One would expect such a presentation to occur much later in the course of the disease. We are presenting a case report of a follicular thyroid carcinoma that presented with spinal cord compression from a thoracic epidural metastatic lesion in a previously healthy 55-year-old male. A single metastasis of follicular thyroid carcinoma presenting with posterior spinal cord compression is rare. In this particular case, our management included a mid-thoracic laminectomy, followed by resection of the epidural lesion. Once the surgical pathology confirmed the diagnosis of a follicular thyroid carcinoma, the general surgery team performed a near total thyroidectomy, after which he received radioactive iodine therapy. The patient is symptom-free at his three-year follow-up. Initial presentation of follicular thyroid carcinoma with symptomatic thoracic myelopathy from an epidural metastasis is very uncommon. An early diagnosis and prompt surgical intervention provided an excellent outcome.

  15. Coexistence of parathyroid adenoma and papillary thyroid carcinoma: Experience of a single center

    Directory of Open Access Journals (Sweden)

    Ebubekir Gündeş

    2013-01-01

    Full Text Available Objective: The aim of this study was to describe experienceswith concurrent parathyroid adenoma and papillarythyroid carcinoma.Methods: Eight patients with concurrent parathyroid adenomaand papillary thyroid carcinoma were identifiedbetween 2005 and 2012, and their medical records werereviewed retrospectively.Results: Of the eight patients identified, two were maleand six were female; their mean age was 53.6 years.The mean serum calcium concentration was 11.7 mg/dL.Intact parathyroid hormone (iPTH concentrations werehigh in all patients, with a mean concentration of 338 pg/mL. The most frequently used surgical technique was totalthyroidectomy plus parathyroid adenoma excision (n=6.The mean size of the thyroid carcinoma was 1.2 cm, andone case showed metastatic lymph nodes in the centralcompartment. The mean parathyroid adenoma size wasfound to be 2.1(0.6- 3.5 cm, according to the longest sizeof the adenom. Six patients (75% developed postoperativecomplications, including temporary symptomatic hypocalcemiain 4 patients (50%, hematoma developmentin 1 patient (12.5% and temporary vocal cord paralysis inone patient (12.5%.Conclusion: Thyroid carcinoma and parathyroid adenomaare rarely concomitant. Rarely hyperparathyroidismmay be accompanied with thyroid carcinomas so preoperativelythyroid gland should be properly examined. Thyroidwith parathyroid surgery are risk factors of recurrentlaryngeal nerve injury and hypoparathyroidism.Key words: Papillary thyroid cancer; parathyroid adenoma;thyroidectomy

  16. Medullary thyroid carcinoma: Application of Thyroid Imaging Reporting and Data System (TI-RADS) Classification.

    Science.gov (United States)

    Yun, Gabin; Kim, Yeo Koon; Choi, Sang Il; Kim, Ji-Hoon

    2018-04-21

    To evaluate the applicability of ultrasound (US)-based Thyroid Imaging Reporting and Data System (TI-RADS) for evaluating medullary thyroid carcinoma (MTC). US images and medical records of patients with cytopathology-confirmed MTC between June 2003 and November 2016 were retrospectively reviewed. Four independent reviewers (two experienced and two inexperienced radiologists) evaluated 57 pre-operative US images of patients with MTC for shape, composition, echogenicity, margin, calcification of the MTC nodules, and categorized the nodules using TI-RADS classification. Weighted Kappa statistics was used to determine the inter-observer agreement of TI-RADS. Univariate and multivariate analyses were performed to assess US findings associated with lymph node metastasis. Ninety-five percent of nodules were classified as either high suspicion (68%) or intermediate suspicion (26%). The overall inter-rater agreement was good (Kappa 0.84, agreement 91.52%), and inexperienced reviewers also showed good agreements with the most experienced reviewer (weighted Kappa 0.73 and 0.81). According to the univariate analysis, TI-RADS category 5, shape, microcalcification, and extrathyroid extension were significantly associated with lymph node metastasis in MTC patients (p = 0.003, 0.008, 0.001, and 0.021, respectively). As per the multivariate analysis, the presence of microcalcification and the irregular shape of the nodule were significantly associated with metastatic lymph nodes in MTC patients (odds ratio, 26.6; 95% CI, 2.7-263.7, p = 0.005, odds ratio, 14.7; 95% CI, 1.3-170, p = 0.031, respectively). TI-RADS is applicable for the evaluation of MTC nodules with good inter-observer agreement.

  17. Thyroid metastasis from renal cell carcinoma-A case report after 9 years.

    Science.gov (United States)

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

    2015-01-01

    The thyroid gland is a rare site of clinically detectable tumor metastasis. As thyroid tumors are usually assumed to be primary in origin, its recognition as a secondary is difficult. We report a case of an 80-year old female who was referred to the Department of Surgery for a symptomatic thyroid nodule. Her medical history included a radical nephrectomy for renal cell carcinoma (RCC) nine years ago. During follow-up a pancreatic nodule was noted suggestive of a neuroendocrine tumor and the von Hippel-Lindau syndrome had to be ruled out. The fine-needle aspiration biopsy (FNAB) guided by ultrasound (US) of the thyroid nodule was inconclusive and a hemithyroidectomy and isthmectomy were performed. Histological examination revealed metastasis of a clear cell carcinoma. RCC disseminates in an unpredictable manner and can show late recurrences. Although secondary involvement of the thyroid gland by RCC is rare, it is still one of the more common neoplasms to metastasize to this site. There are no specific clinical features and few characteristic findings of metastatic thyroid carcinoma on imaging studies. FNAB is a useful procedure to diagnose metastatic thyroid cancer, but one should remain suspicious when the result for malignant cells is negative or indeterminate. After thyroidectomy the diagnosis of RCC is confirmed immunohistochemically. There is a clear survival benefit if a surgical approach to the thyroid metastasis is chosen. Thyroid metastasis should be considered in patients with a thyroid nodule and positive history for RCC. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Size discrepancy between sonographic and pathological evaluation of solitary papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Bachar, Gideon, E-mail: gidybahar@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Buda, Inon, E-mail: inonbuda@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Cohen, Maya, E-mail: mayac@clalit.org.il [Department of Imaging, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Hadar, Tuvia, E-mail: hadartuv@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Hilly, Ohad, E-mail: ohadhilly@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Schwartz, Nofrat, E-mail: nofrat@gmail.com [Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Department of Otolaryngology, Meir Hospital, Kefar Sabah, Tel Aviv University, Tel Aviv (Israel); Shpitzer, Thomas, E-mail: thomas-s@013net.net [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Segal, Karl, E-mail: segalk@clalit.org.il [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2013-11-01

    Background: Sonographic size of suspicious thyroid lesions is an essential parameter in the evaluation of thyroid nodules, determining the need for needle biopsy and has impact on the extent of surgery. Limited data is available on the correlation between the size of the thyroid nodule on sonography and the actual size measured during histological examination. The aim of the present study was to compare these two modalities and to discuss the potential clinical implications of the findings in the study population. Methods: The database of Rabin Medical Center was reviewed for all patients with histologically proven papillary carcinoma of the thyroid treated by thyroid surgery between 2005 and 2010. Results: 292 patients with papillary thyroid carcinoma were included. The mean sonographic size of the nodule was 2.19 ± 1.15 cm. The mean pathological diameter was 1.69 ± 1.09 cm. Discrepancies between tumor histological diameter and the sonographically measurement were more prominent in tumors larger than 1.5 cm. Nonetheless, 18.8% of thyroid nodules that were measured by US as larger than 1 cm, were found to be smaller than 1 cm on final pathology. Similarly, 7.2% of nodules evaluated by sonography were determined as being larger than 4 cm, while their definitive size was smaller than 4 cm. Conclusions: We noted a significant discrepancy between the preoperative sonographic and the pathologic size measurements for papillary thyroid carcinoma. The sonographic evaluation misclassifies both patients with small and large thyroid tumors, and consequently exposes them to unnecessary workup and more extensive operation. This discrepancy between the ultrasound findings and actual tumor size should be taken into account in clinical practice and help guide the evaluation and treatment of patients with thyroid nodules.

  19. Protocolo de diagnóstico y tratamiento del cáncer tiroideo Protocol of diagnosis and treatment of thyroid cancer

    Directory of Open Access Journals (Sweden)

    Ramón González Fernández

    2004-06-01

    Full Text Available En este trabajo se plasma el manejo de los pacientes con de cáncer del tiroides, teniendo en cuenta, el uso de los medios diagnósticos, en particular la importancia del uso de la biopsia aspirativa con aguja fina para el diagnóstico precoz. Se sabe que en las últimas décadas han existido criterios más conservadores en lo referido a la suficiencia en la extensión de la operación, en los cánceres bien diferenciados, motivado esto por el mayor conocimiento de la biología del tumor, el desarrollo de pruebas de inmunohistoquímica, tratamiento adyuvante y un seguimiento más estrecho. Por lo que esto ha motivado ciertos criterios controvertidos. Se expone un protocolo de diagnóstico y tratamiento, teniendo en cuenta un adecuado estadiamiento, y definición de los grupos de riesgo, parámetro importante y novedoso en esta entidadIn this paper, the management of patients with thyroid cancer is dealt with taking into account the use of the diagnostic tools and, in particular, the importance of the use of fine-needle aspiration biopsy for the early diagnosis. In the last decades, there have been more conservative criteria regarding the sufficiency in the extension of surgery in the well differentiated cancers, motivated by the greater knowledge of tumor biology, the development of immunohistochemical tests, adjuvant treatment and a closer follow-up. This has led to the appearance of certain controversial criteria. A protocol of diagnosis and treatmemt is exposed taking into consideration an adequate staging and definition of the risk groups, an important and novel parameter in this entity

  20. Thyroid adenomas and carcinomas following radiotherapy for a hemangioma during infancy

    Energy Technology Data Exchange (ETDEWEB)

    Haddy, N.; Andriamboavonjy, T.; Paoletti, C.; Mousannif, A.; Shamsaldin, A.; Doyon, F.; Labbe, M.; Diallo, I.; Vathaire, F. de [INSERM, Institut Gustave Roussy, Villejuif (France); Dondon, M.G. [INSERM, Institut Curie, Paris (France); Robert, C. [Dermatology, Institut Gustave Roussy, Villejuif (France); Avril, M.F. [Dermatology, Hopital Cochin, Paris (France); Fragu, P.; Schlumberger, M. [Nuclear Medicine, Institut Gustave Roussy, Villejuif (France); Eschwege, F.; Chavaudra, J.; Lefkopoulos, D. [Radiotherapy, Institut Gustave Roussy, Villejuif (France); Schvartz, C. [Reseau des registres des cancers, Francim, Toulouse (France)

    2012-07-01

    A cohort study was performed to investigate the carcinogenic effect of treating skin hemangioma with ionizing radiation during early childhood. This paper presents the incidence of differentiated thyroid adenomas and carcinomas after radiotherapy in this cohort. This study confirms that radiation treatment performed in the past for hemangioma during infancy increased the risk of thyroid carcinoma and adenoma. Patients treated with external radiotherapy or with Radium 226 applicators for hemangiomas have to be more specifically followed up because this is the subgroup in whom the highest doses were received by the thyroid gland (more than 90% of the radiation doses were higher than 100 mGy). They are therefore more at risk of developing thyroid cancer

  1. Ultrasound surveillance for radiation-induced thyroid carcinoma in adult survivors of childhood cancer.

    Science.gov (United States)

    Brignardello, Enrico; Felicetti, Francesco; Castiglione, Anna; Gallo, Marco; Maletta, Francesca; Isolato, Giuseppe; Biasin, Eleonora; Fagioli, Franca; Corrias, Andrea; Palestini, Nicola

    2016-03-01

    The optimal surveillance strategy to screen for thyroid carcinoma childhood cancer survivors (CCS) at increased risk is still debated. In our clinical practice, beside neck palpation we routinely perform thyroid ultrasound (US). Here we describe the results obtained using this approach. We considered all CCS referred to our long term clinic from November 2001 to September 2014. One hundred and ninety-seven patients who had received radiation therapy involving the thyroid gland underwent US surveillance. Thyroid US started 5 years after radiotherapy and repeated every 3 years, if negative. Among 197 CCS previously irradiated to the thyroid gland, 74 patients (37.5%) developed thyroid nodules, and fine-needle aspiration was performed in 35. In 11 patients the cytological examination was suspicious or diagnostic for malignancy (TIR 4/5), whereas a follicular lesion was diagnosed in nine. Patients with TIR 4/5 cytology were operated and in all cases thyroid cancer diagnosis was confirmed. The nine patients with TIR 3 cytology also underwent surgery and a carcinoma was diagnosed in three of them. Prevalence of thyroid cancer was 7.1%. Tumour size ranged between 4 and 25 mm, but six (43%) were classified T3 because of extra-thyroidal extension. Six patients had nodal metastases; in eight patients the tumour was multifocal. At the time of the study all patients are disease free, without evidence of surgery complications. Applying our US surveillance protocol, the prevalence of radiation-induced thyroid cancer is high. Histological features of the thyroid cancers diagnosed in our cohort suggest that most of them were clinically relevant tumours. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Management of the Patient with Aggressive and Resistant Papillary Thyroid Carcinoma

    Science.gov (United States)

    Miftari, Rame; Topçiu, Valdete; Nura, Adem; Haxhibeqiri, Valdete

    2016-01-01

    Purpose: Papillary carcinoma is the most frequent type of thyroid cancer and was considered the most benign of all thyroid carcinomas, with a low risk of distant metastases. However, there are some variants of papillary thyroid carcinoma that have affinity to spread in many organs, such as: lymph nodes, lungs and bones. Aim: The aim of this study was presentation of a case with papillary carcinoma of the thyroid gland, very persistent and resistant in treatment with I 131. Material and results: A man 56 years old were diagnosed with papillary carcinoma of thyroid gland. He underwent a surgical removal of the tumor and right lobe of thyroid gland. With histopathology examination, were confirmed follicular variant of papillary carcinoma pT4. Two weeks later he underwent total thyroidectomy and was treated with 100 mCi of J 131. Six months later, the value of thyroglobulin was found elevated above upper measured limits (more than 500 ng/ml). Patient underwent surgical removal of 10 metastatic lymph nodes in the left side of the neck and has been treated with 145 mCi of radioiodine I 131. The examination after 5 months shows elevation of thyroglobulin, more than 20000 ng/ml and focally uptake of J 131 in the left lung. Patient was treated once again with 150 mCi radioiodine J 131. Whole body scintigraphy was registered focal uptake of radioiodine in the middle of the left collarbone. After a month, patient refers the enlargement of the lymph node in the right side of the neck. Currently patient is being treated with kinase inhibitor drug sorafenib and ibandronate. We have identified first positive response in treatment. Enlarged lymph node in the neck was reduced and the patient began feeling better. Conclusion: This study suggests that some subtypes of papillary thyroid carcinoma appear to have more aggressive biological course. Subtypes of papillary thyroid carcinoma such as diffuse sclerosing carcinoma, tall cell or columnar cell and insular variants, appears to

  3. Cerebral edema following iodine-131 therapy for thyroid carcinoma metastatic to the brain

    International Nuclear Information System (INIS)

    Datz, F.L.

    1986-01-01

    Brain metastases are rare in well-differentiated thyroid carcinoma but when present they can lead to the patient's death. Iodine-131 therapy for intracerebral thyroid carcinoma metastases causes radiation-induced acute cerebral edema that can lead to CNS complications and even death. We present a case in which a patient with intracerebral 131 I uptake developed seizures, slurred speech, and muscle weakness 12 hr following 131 I therapy. The patient's CT scan, post-therapy, confirmed an intracranial metastasis with a significant amount of surrounding edema. Radiotherapists, when using external beam radiation to treat intracerebral metastases, commonly place these patients on steroids, glycerol, or mannitol prior to instituting therapy, to prevent complications from radiation-induced cerebral edema. This technique could be applied to 131 I therapy of intracranial thyroid carcinoma metastases as well

  4. Histopathological and immunohistochemical findings of primary and metastatic medullary thyroid carcinoma in a young dog.

    Science.gov (United States)

    Piñeyro, Pablo; Vieson, Miranda D; Ramos-Vara, José A; Moon-Larson, Martha; Saunders, Geoffrey

    2014-01-01

    This report describes the gross, histological, and immunohistochemical features of medullary thyroid carcinoma (MTC) with pulmonary metastases in a young dog. Sheets of pleomorphic cells supported by fibrous stroma characterized the primary mass, while metastatic nodules had a neuroendocrine pattern. Despite differing histologic features, all masses showed marked immunoreactivity against calcitonin and multiple neuroendocrine markers consistent with MTC. Although MTC is a well-recognized entity, it may be difficult to distinguish this mass from other thyroid neoplasms, necessitating immunohistochemical characterization.

  5. p53 constrains progression to anaplastic thyroid carcinoma in a Braf-mutant mouse model of papillary thyroid cancer

    Science.gov (United States)

    McFadden, David G.; Vernon, Amanda; Santiago, Philip M.; Martinez-McFaline, Raul; Bhutkar, Arjun; Crowley, Denise M.; McMahon, Martin; Sadow, Peter M.; Jacks, Tyler

    2014-01-01

    Anaplastic thyroid carcinoma (ATC) has among the worst prognoses of any solid malignancy. The low incidence of the disease has in part precluded systematic clinical trials and tissue collection, and there has been little progress in developing effective therapies. v-raf murine sarcoma viral oncogene homolog B (BRAF) and tumor protein p53 (TP53) mutations cooccur in a high proportion of ATCs, particularly those associated with a precursor papillary thyroid carcinoma (PTC). To develop an adult-onset model of BRAF-mutant ATC, we generated a thyroid-specific CreER transgenic mouse. We used a Cre-regulated BrafV600E mouse and a conditional Trp53 allelic series to demonstrate that p53 constrains progression from PTC to ATC. Gene expression and immunohistochemical analyses of murine tumors identified the cardinal features of human ATC including loss of differentiation, local invasion, distant metastasis, and rapid lethality. We used small-animal ultrasound imaging to monitor autochthonous tumors and showed that treatment with the selective BRAF inhibitor PLX4720 improved survival but did not lead to tumor regression or suppress signaling through the MAPK pathway. The combination of PLX4720 and the mapk/Erk kinase (MEK) inhibitor PD0325901 more completely suppressed MAPK pathway activation in mouse and human ATC cell lines and improved the structural response and survival of ATC-bearing animals. This model expands the limited repertoire of autochthonous models of clinically aggressive thyroid cancer, and these data suggest that small-molecule MAPK pathway inhibitors hold clinical promise in the treatment of advanced thyroid carcinoma. PMID:24711431

  6. Comparison of clinical characteristics of patients with follicular thyroid carcinoma and Hürthle cell carcinoma.

    Science.gov (United States)

    Ernaga Lorea, Ander; Migueliz Bermejo, Iranzu; Anda Apiñániz, Emma; Pineda Arribas, Javier; Toni García, Marta; Martínez de Esteban, Juan Pablo; Insausti Serrano, Ana María

    2018-03-01

    Hürthle cell carcinoma (HCC) is an uncommon thyroid cancer historically considered to be a variant of follicular thyroid carcinoma (FTC). The aim of this study was to assess the differences between these groups in terms of clinical factors and prognoses. A total of 230 patients (153 with FTC and 77 with HCC) with a median follow-up of 13.4 years were studied. The different characteristics were compared using SPSS version 20 statistical software. Patients with HCC were older (57.3±13.8 years vs. 44.6±15.2 years; P<.001). More advanced TNM stages were also seen in patients with HCC and a greater trend to distant metastases were also seen in patients with HCC (7.8% vs. 2.7%, P=.078). The persistence/recurrence rate at the end of follow-up was higher in patients with HCC (13% vs. 3.9%, P=.011). However, in a multivariate analysis, only age (hazard ratio [HR] 1.10, confidence interval [CI] 1.04-1.17; P=.001), size (HR 1.43, CI 1.05-1.94; P=.021), and histological subtype (HR 9.79, CI 2.35-40.81; P=.002), but not presence of HCC, were significantly associated to prognosis. HCC is diagnosed in older patients and in more advanced stages as compared to FTC. However, when age, size, and histological subtype are similar, disease-free survival is also similar in both groups. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. The role of thyrotropin suppression in patients with differentiated thyroid carcinoma.

    LENUS (Irish Health Repository)

    Deasy, J

    2010-07-01

    Thyroid carcinoma is the commonest endocrine malignancy. The majority of these are differentiated thyroid carcinomas, which have a good overall prognosis. Treatment includes surgical excision, radio-iodine ablation and long-term thyrotropin suppression. The degree and length of suppression required, as well as the potential side-effect remain controversial. Therefore, the aim of this study was to establish the degree of thyrotropin suppression achieved in a cohort of patients with differentiated thyroid carcinoma. A retrospective review was performed of a prospectively maintained database. All patients with a diagnosis of differentiated thyroid carcinoma between January 1998 and January 2008 were identified. Demographic data, pathological stage and the treatment that the patient received was documented. TSH and free T4 levels were identified at specific time points post-operatively. Eighty-eight patients with differentiated thyroid carcinoma were identified. Seventy patients (79.5%) were female. The mean age was 55, with a range of 18 to 79 years. The majority of patients underwent a total thyroidectomy (n=79; 89.7%) and of those 29 (32.9%) had an associated modified neck dissection. Accurate follow-up was available on forty-nine patients. TSH and free T4 were measured at 3 and 6 months, as well as at 1 and 2 years post-operatively. Adequate TSH suppression was taken at a level < 0.1 mU\\/L. The majority of patients (69.5%) had achieved adequate TSH suppression at 2 years. However, 65% of these same patients had a high free T4 at 2 years indicating a degree of hyperthyroidism. This study has demonstrated that TSH suppression is being adequately achieved in the majority of patients with differentiated thyroid carcinoma. However, this must be carefully weighed against the potential detrimental side-effects of long-term sub-clinical hyperthyroidism.

  8. Extending the Impact of RAC1b Overexpression to Follicular Thyroid Carcinomas

    Directory of Open Access Journals (Sweden)

    Márcia Faria

    2016-01-01

    Full Text Available RAC1b is a hyperactive variant of the small GTPase RAC1 known to be a relevant molecular player in different cancers. Previous studies from our group lead to the evidence that its overexpression in papillary thyroid carcinoma (PTC is associated with an unfavorable prognosis. In the present study, we intended to extend the analysis of RAC1b expression to thyroid follicular neoplasms and to seek for clinical correlations. RAC1b expression levels were determined by RT-qPCR in thyroid follicular tumor samples comprising 23 follicular thyroid carcinomas (FTCs and 33 follicular thyroid adenomas (FTAs. RAC1b was found to be overexpressed in 33% of carcinomas while no RAC1b overexpression was documented among follicular adenomas. Patients with a diagnosis of FTC were divided into two groups based on longitudinal evolution and final outcome. RAC1b overexpression was significantly associated with both the presence of distant metastases (P = 0.01 and poorer clinical outcome (P = 0.01 suggesting that, similarly to that previously found in PTCs, RAC1b overexpression in FTCs is also associated with worse outcomes. Furthermore, the absence of RAC1b overexpression in follicular adenomas hints its potential as a molecular marker likely to contribute, in conjunction with other putative markers, to the preoperative differential diagnosis of thyroid follicular lesions.

  9. Incidence of thyroid carcinoma in patients who had diagnostic iodine-131 tests during childhood and adolescence

    International Nuclear Information System (INIS)

    Hahn, K.; Schnell-Inderst, P.; Haenseler, G.J.; Kandziora, C.; Meyer, G.

    1999-01-01

    To determine the carcinogenic effects of diagnostic amounts of radioactive iodine-131 on the infantile thyroid gland a multi-center retrospective cohort study was conducted which included data of 4973 subjects who had either been referred to diagnostic iodine-131 uptake tests (2262 subjects) or had had a diagnostic procedure of the thyroid without 131-iodine (2711 subjects) until the age of 18 years. Follow-up examinations of 35 percent of the subjects in the iodine-131 group and 41 percent of the subjects in the control group took place after a mean time period of 20 years after the first examination. Dosimetry of the thyroid burden of iodine-131 was carried out according to ICRP 53. The median of the thyroid organ dose was 1012 mGy. The report compares prevalences or incidences of thyroid disorders resp. occurring in both groups and gives a stratified analysis of primary diagnosis, age at exposure, and organ dose. A total number of five carcinomas of the thyroid was found. In the radioiodine group two carcinomas were assessed in a period of 16500 person-years. The control group yielded three carcinomas over 21000 person-years (Relative rate: 0,89, 95% confidence interval: 0,14-5,13). (orig.) [de

  10. Ultrasound findings of diffuse metastasis of gastric signet-ring-cell carcinoma to the thyroid gland.

    Science.gov (United States)

    Morita, Koji; Sakamoto, Takahiko; Ota, Shuji; Masugi, Hideo; Chikuta, Ikumi; Mashimo, Yamato; Edo, Naoki; Tokairin, Takuo; Seki, Nobuhiko; Ishikawa, Toshio

    2017-01-01

    It has been shown that metastases to the thyroid from extrathyroidal malignancies occur as solitary or multiple nodules, or may involve the whole thyroid gland diffusely. However, diffuse metastasis of gastric cancer to the thyroid is extremely rare. Here, we report a case of a 74-year-old woman with diffuse infiltration of gastric adenocarcinoma (signet-ring-cell carcinoma/poorly differentiated adenocarcinoma) cells in the thyroid. The pathological diagnosis was made based on upper gastrointestinal endoscopy with biopsy and fine-needle aspiration cytology of the thyroid. An 18F-FDG PET/CT revealed multiple lesions with increased uptake, including the bilateral thyroid gland. On thyroid ultrasound examination, diffuse enlargement with internal heterogeneity and hypoechoic reticular lines was observed. On color Doppler imaging, a blood-flow signal was not detected in these hypoechoic lines. These findings were similar to those of diffuse metastases caused by other primary cancers, such as lung cancer, as reported earlier. Therefore, the presence of hypoechoic reticular lines without blood-flow signals is probably common to diffuse thyroid metastasis from any origin and an important diagnostic finding. This is the first report to show detailed ultrasound findings of diffuse gastric cancer metastasis to the thyroid gland using color Doppler.

  11. Thyroglobulin and other tumor markers in the follow-up of differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, C.; Becker, W.; Berger, P.; Eilles, C.; Gerhards, W.; Rendl, J.; Schaede, B.; Scheler, S.; Schneider, P.; Spiegel, W.

    1986-04-01

    The diagnostic value of thyroglobulin (hTg) serum measurements for the follow-up of papillary, follicular and oncocytic thyroid carcinoma has been re-evaluated after more than 6 years of clinical experience with this tumor marker in 370 cancer patients. The sensitivity of hTg RIA for the detection of metastases or recurrence amounts to 94%, provided that residual thyroid tissue has been totally ablated and that serum samples are drawn after withdrawal of thyroid hormone replacement. The I-131 scan may be replaced under certain conditions by hTg RIA which has proven a valid, reasonable and convenient diagnostic method for long time follow-up of differentiated thyroid cancer. The somewhat reduced sensitivity of hTg determinations under continued thyroid hormone medication can be tolerated, provided that a standardised follow-up protocol is used including clinical, sonographic and radiological investigations. (orig./TRV).

  12. Thyroglobulin and other tumor markers in the follow-up of differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Reiners, C.; Becker, W.; Berger, P.; Eilles, C.; Gerhards, W.; Rendl, J.; Schaede, B.; Scheler, S.; Schneider, P.; Spiegel, W.; Boerner, W.

    1986-01-01

    The diagnostic value of thyroglobulin (hTg) serum measurements for the follow-up of papillary, follicular and oncocytic thyroid carcinoma has been re-evaluated after more than 6 years of clinical experience with this tumor marker in 370 cancer patients. The sensitivity of hTg RIA for the detection of metastases or recurrence amounts to 94%, provided that residual thyroid tissue has been totally ablated and that serum samples are drawn after withdrawal of thyroid hormone replacement. The I-131 scan may be replaced under certain conditions by hTg RIA which has proven a valid, reasonable and convenient diagnostic method for long time follow-up of differentiated thyroid cancer. The somewhat reduced sensitivity of hTg determinations under continued thyroid hormone medication can be tolerated, provided that a standardised follow-up protocol is used including clinical, sonographic and radiological investigations. (orig./TRV) [de

  13. Unusual Metastasis of Medullary Thyroid Carcinoma to the Breast: A Cytological and Histopathological Correlation.

    Science.gov (United States)

    Tanwar, Parul; Gandhi, Jatin S; Sharma, Anila; Gupta, Manoj; Choudhary, Partha S

    2018-01-01

    Breast metastases are a relatively rare condition and account for approximately 0.5-2% of all breast tumors. Recognition of metastatic tumors in the breast is important because it would prevent unnecessary mutilating surgery and would lead to appropriate treatment of the primary tumor. Breast metastases from medullary thyroid cancer (MTC) are very rare with only 21 reported cases in the literature. Some MTCs mimic primary invasive lobular carcinoma of the breast histopathologically and radiologically, making the distinction between the two diagnostically challenging. We present the case of a 45-year-old female presenting with a lump breast, which was later found out to be metastasis from medullary carcinoma thyroid.

  14. Is thyroidectomy necessary in RET mutations carriers of the familial medullary thyroid carcinoma syndrome?

    DEFF Research Database (Denmark)

    Hansen, H S; Torring, H; Godballe, C

    2000-01-01

    BACKGROUND: The results and consequences of genetic testing in a family with familial medullary thyroid carcinoma (FMTC) are described. METHODS: In the screening of relatives, serum calcitonin is replaced by RET mutation analysis that was performed in families suspected of hereditary medullary...... thyroid carcinoma (MTC). In 4 of 10 families, mutation in exon 10 was found in codon 611. RESULTS: One hundred fifty persons belonging to 30 families were tested, of which 10 families were carriers of RET mutation in exon 10. In 1 of these families with MTC only, 2 brothers were gene carriers of a RET...

  15. [Clinical guideline for management of patients with low risk differentiated thyroid carcinoma].

    Science.gov (United States)

    Díez, Juan José; Oleaga, Amelia; Álvarez-Escolá, Cristina; Martín, Tomás; Galofré, Juan Carlos

    2015-01-01

    Incidence of thyroid cancer is increasing in Spain and worldwide. Overall thyroid cancer survival is very high, and stratification systems to reliably identify patients with worse prognosis have been developed. However, marked differences exist between the different specialists in clinical management of low-risk patients with thyroid carcinoma. Almost half of all papillary thyroid carcinomas are microcarcinomas, and 90% are tumors < 2 cm that have a particularly good prognosis. However, they are usually treated more aggressively than needed, despite the lack of adequate scientific support. Surgery remains the gold standard treatment for these tumors. However, lobectomy may be adequate in most patients, without the need for total thyroidectomy. Similarly, prophylactic lymph node dissection of the central compartment is not required in most cases. This more conservative approach prevents postoperative complications such as hypoparathyroidism or recurrent laryngeal nerve injury. Postoperative radioiodine remnant ablation and strict suppression of serum thyrotropin, although effective for the more aggressive forms of thyroid cancer, have not been shown to be beneficial for the treatment of low risk patients, and may impair their quality of life. This guideline provides recommendations from the task force on thyroid cancer of the Spanish Society of Endocrinology and Nutrition for adequate management of patients with low-risk thyroid cancer. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  16. Thyroid metastasis as initial presentation of clear cell renal carcinoma

    Directory of Open Access Journals (Sweden)

    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.

  17. BRAFV600Emutation contributes papillary thyroid carcinoma and Hashimoto thyroiditis with resistance to thyroid hormone: A case report and literature review.

    Science.gov (United States)

    Xing, Wanjia; Liu, Xiaohong; He, Qingqing; Zhang, Zongjing; Jiang, Zhaoshun

    2017-09-01

    Resistance to thyroid hormone (RTH) is a rare autosomal hereditary disorder characterized by increased serum thyroid hormone (TH) levels with unsuppressed or increased thyrotropin concentration. It remains unknown whether the coexistence of RTH with papillary thyroid carcinoma (PTC) and Hashimoto thyroiditis (HT) is incidental or whether it possesses a genetic or pathophysiological association. In the present study, a case of RTH with PTC and HT in an 11-year-old Chinese patient was examined and the clinical presentation of RTH with PTC was discussed. In addition, the possible associations between RTH, PTC and HT were determined. HT was confirmed in the patient using an autoimmune assay and thyroid ultrasound. RTH was diagnosed on the basis of clinical manifestations, laboratory information and gene analysis, and PTC was diagnosed according to histological results. Results of BRAF V600E mutation analysis were positive. A literature review of 14 cases of RTH with PTC was included for comparison. The present case report indicates an association of RTH with PTC and HT coexistence in the patient. Close follow-up, histological evaluation and BRAF V600E mutation detection should be performed in each RTH case with HT, since a persistent increase in TSH may be a risk factor for the development of thyroid neoplasm.

  18. Influence of presence/absence of thyroid gland on the cutoff value for thyroglobulin in lymph-node aspiration to detect metastatic papillary thyroid carcinoma.

    Science.gov (United States)

    Zhao, Huan; Wang, Yong; Wang, Min-Jie; Zhang, Zhi-Hui; Wang, Hai-Rui; Zhang, Bing; Guo, Hui-Qin

    2017-04-28

    Thyroglobulin measurement with fine-needle aspiration (Tg-FNA) is a sensitive method for detecting metastatic papillary thyroid carcinoma (PTC). However, the diagnostic threshold is not well established and the influence of the thyroid gland on the cutoff value is also controversial. In this study, patients were classified into two groups according to the presence or absence of thyroid tissue, to determine an appropriate cutoff value for clinical practice. Patients with a history of thyroid nodules or surgery for PTC and with enlarged cervical lymph nodes on an FNA examination were enrolled for Tg-FNA detection. One hundred ninety-six lymph nodes (189 patients) were included: 100 from preoperative patients, 49 from patients treated with partial thyroid ablation, and 47 from patients with total thyroid ablation. In 149 lymph nodes from patient with thyroids, the cutoff value for Tg-FNA was 55.99 ng/mL (sensitivity, 95.1%; specificity, 100%), whereas in 47 lymph nodes from patients without a thyroid, it was 9.71 ng/mL (sensitivity, 96.7%; specificity, 100%). Thus, the cutoff value for Tg-FNA was higher in patients with thyroids than in patients without thyroids. The cutoff value for Tg-FNA is influenced by residual thyroid tissue, and a higher cutoff value is recommended for patients with thyroids than for patients without thyroids.

  19. Dissecting molecular events in thyroid neoplasia provides evidence for distinct evolution of follicular thyroid adenoma and carcinoma.

    Science.gov (United States)

    Krause, Kerstin; Prawitt, Susanne; Eszlinger, Markus; Ihling, Christian; Sinz, Andrea; Schierle, Katrin; Gimm, Oliver; Dralle, Henning; Steinert, Frank; Sheu, Sien-Yi; Schmid, Kurt W; Fuhrer, Dagmar

    2011-12-01

    Benign hypofunctional cold thyroid nodules (CTNs) are a frequent scintiscan finding and need to be distinguished from thyroid carcinomas. The origin of CTNs with follicular morphologic features is unresolved. The DNA damage response might act as a physiologic barrier, inhibiting the progression of preneoplastic lesions to neoplasia. We investigated the following in hypofunctional follicular adenoma (FA) and follicular thyroid cancer (FTC): i) the mutation rate of frequently activated oncogenes, ii) the activation of DNA damage response checkpoints, and iii) the differential proteomic pattern between FA and FTC. Both FTC and FA, which did not harbor RAS, phosphoinositide-3-kinase, or PAX/peroxisome proliferator activated receptor-γ mutations, express various proteins in common and others that are more distinctly expressed in FTC rather than in FA or normal thyroid tissue. This finding is in line with the finding of constitutive DNA damage checkpoint activation (p-Chk2, γ-H2AX) and evidence for replicative stress causing genomic instability (increased cyclin E, retinoblastoma, or E2F1 mRNA expression) in FTC but not FA. We discuss the findings of the increased expression of translationally controlled tumor protein, phosphatase 2A inhibitor, and DJ-1 in FTC compared with FA identified by proteomics and their potential implication in follicular thyroid carcinogenesis. Our present findings argue for the definition of FA as a truly benign entity and against progressive development of FA to FTC. Copyright © 2011 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  20. Carcinoma papilífero da tireoide associado à tireoidite de Hashimoto Thyroid papillary carcinoma associated to Hashimoto's thyroiditis

    Directory of Open Access Journals (Sweden)

    Luiz Alexandre Albuquerque Freixo Campos

    2012-12-01

    Full Text Available Existe controvérsia na literatura quanto à associação entre Carcinoma Papilífero de Tireoide (CPT e Tireoidite de Hashimoto (TH e também quanto a qual seria a relação etiológica entre ambos. OBJETIVO: Determinar a proporção de casos de TH entre pacientes com CPT, correlacionando com aspectos histomorfológicos. MÉTODO: Foi realizado estudo retrospectivo de pacientes consecutivos submetidos à tireoidectomia parcial ou total por CPT, entre 2007 e 2009, totalizando de 41 casos. RESULTADOS: Em relação à associação de TH e CPT, foram encontrados 11 casos (26,8%, sendo todos do sexo feminino, porém, sem significância estatística. Nos casos em que havia CPT coexistente com TH a idade média foi de 44,9 anos e sem a associação, 49,1 anos. O tamanho médio dos tumores entre os sem TH foi 20,53mm e os com TH foi de 12,72 mm - p = 0,4. Em relação ao estadiamento anatomopatológico, as proporções entre os que apresentam TH e os que não apresentam foram mantidas em T1a, T1b e T3. Em T2, não houve casos de coexistência entre TH e CPT. CONCLUSÃO: Há uma proporção de 26,8% de pacientes que possuem associação entre TH e CPT, porém, sem diferenças em relação ao tamanho do tumor.There is controversy in the literature regarding the association between papillary thyroid carcinoma (PTC and Hashimoto's thyroiditis (HT and as to what would be the etiological relationship between them. OBJECTIVE: To establish the proportion of cases among patients with TH and CPT, correlating it with histomorphological aspects. METHOD: A retrospective study of patients undergoing partial or total thyroidectomy for PTC between 2007 and 2009, a total of 41 cases. RESULTS: Regarding the association of HT and CPT, we found 11 cases (26.8%, all females, but without statistical significance. The mean age was 44.9 years among the patients with coexistent TH and CPT, whereas it was 49.1 years without that association. The average size of tumors in those

  1. Next-generation sequence detects ARAP3 as a novel oncogene in papillary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Wang QX

    2016-11-01

    Full Text Available Qing-Xuan Wang, En-Dong Chen, Ye-Feng Cai, Yi-Li Zhou, Zhou-Ci Zheng, Ying-Hao Wang, Yi-Xiang Jin, Wen-Xu Jin, Xiao-Hua Zhang, Ou-Chen Wang Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China Purpose: Thyroid cancer is the most frequent malignancies of the endocrine system, and it has became the fastest growing type of cancer worldwide. Much still remains unknown about the molecular mechanisms of thyroid cancer. Studies have found that some certain relationship between ARAP3 and human cancer. However, the role of ARAP3 in thyroid cancer has not been well explained. This study aimed to investigate the role of ARAP3 gene in papillary thyroid carcinoma. Methods: Whole exon sequence and whole genome sequence of primary papillary thyroid carcinoma (PTC samples and matched adjacent normal thyroid tissue samples were performed and then bioinformatics analysis was carried out. PTC cell lines (TPC1, BCPAP, and KTC-1 with transfection of small interfering RNA were used to investigate the functions of ARAP3 gene, including cell proliferation assay, colony formation assay, migration assay, and invasion assay. Results: Using next-generation sequence and bioinformatics analysis, we found ARAP3 genes may play an important role in thyroid cancer. Downregulation of ARAP3 significantly suppressed PTC cell lines (TPC1, BCPAP, and KTC-1, cell proliferation, colony formation, migration, and invasion. Conclusion: This study indicated that ARAP3 genes have important biological implications and may act as a potentially drugable target in PTC. Keywords: papillary thyroid carcinoma, next-generation sequence, ARAP3, oncogene

  2. Adipokines and inflammation markers and risk of differentiated thyroid carcinoma

    DEFF Research Database (Denmark)

    Dossus, Laure; Franceschi, Silvia; Biessy, Carine

    2018-01-01

    Other than the influence of ionizing radiation and benign thyroid disease, little is known about the risk factors for differentiated thyroid cancer (TC) which is an increasing common cancer worldwide. Consistent evidence shows that body mass is positively associated with TC risk. As excess weight...

  3. Predictors of thyroid gland involvement in hypopharyngeal squamous cell carcinoma.

    Science.gov (United States)

    Chang, Jae Won; Koh, Yoon Woo; Chung, Woong Youn; Hong, Soon Won; Choi, Eun Chang

    2015-05-01

    Decision to perform concurrent ipsilateral thyroidectomy on patients with hypopharyngeal cancer is important, and unnecessary thyroidectomy should be avoided if oncologically feasible. We hypothesized that concurrent ipsilateral thyroidectomy is not routinely required to prevent occult metastasis. This study aimed to determine the prevalence of histological thyroid invasion in patients with hypopharyngeal cancer, and to refine the indications for prophylactic ipsilateral thyroidectomy in patients with hypopharyngeal cancer. A retrospective review of the medical records from the Department of Otolaryngology at Yonsei University College of Medicine was conducted from January 1994 to December 2009. A total of 49 patients underwent laryngopharyngectomy with thyroidectomy as a primary treatment of hypopharyngeal cancer. The incidence of thyroid gland involvement was 10.2%. The most common route of invasion was direct extension through the thyroid cartilage. Thyroid cartilage invasion (p=0.034) was the most significant factor associated with thyroid invasion. Disease-specific survival at 5 years was lower in patients with than without thyroid gland invasion (26.7% vs. 55.2%, respectively; p=0.032). Disease-free survival at 5 years was also lower in patients with than without thyroid gland invasion (20.0% vs. 52.1%, respectively; p=0.024). Ipsilateral thyroidectomy in combination with total laryngopharyngectomy is indicated when invasion of the thyroid cartilage is suspected in patients with hypopharyngeal cancer.

  4. Metastatic papillary carcinoma of the thyroid in a patient previously ...

    African Journals Online (AJOL)

    ... the patient was referred to our nuclear medicine department with a clinical diagnosis of suspected metastatic lymph nodes presumably from a thyroid malignancy.She had an 123I diagnostic whole body scan that showed 123I avid areas in the thyroid bed as well as left cervical lymph nodes, which later turned out to be.

  5. Predictors of Thyroid Gland Involvement in Hypopharyngeal Squamous Cell Carcinoma

    Science.gov (United States)

    Chang, Jae Won; Koh, Yoon Woo; Chung, Woong Youn; Hong, Soon Won

    2015-01-01

    Purpose Decision to perform concurrent ipsilateral thyroidectomy on patients with hypopharyngeal cancer is important, and unnecessary thyroidectomy should be avoided if oncologically feasible. We hypothesized that concurrent ipsilateral thyroidectomy is not routinely required to prevent occult metastasis. This study aimed to determine the prevalence of histological thyroid invasion in patients with hypopharyngeal cancer, and to refine the indications for prophylactic ipsilateral thyroidectomy in patients with hypopharyngeal cancer. Materials and Methods A retrospective review of the medical records from the Department of Otolaryngology at Yonsei University College of Medicine was conducted from January 1994 to December 2009. A total of 49 patients underwent laryngopharyngectomy with thyroidectomy as a primary treatment of hypopharyngeal cancer. Results The incidence of thyroid gland involvement was 10.2%. The most common route of invasion was direct extension through the thyroid cartilage. Thyroid cartilage invasion (p=0.034) was the most significant factor associated with thyroid invasion. Disease-specific survival at 5 years was lower in patients with than without thyroid gland invasion (26.7% vs. 55.2%, respectively; p=0.032). Disease-free survival at 5 years was also lower in patients with than without thyroid gland invasion (20.0% vs. 52.1%, respectively; p=0.024). Conclusion Ipsilateral thyroidectomy in combination with total laryngopharyngectomy is indicated when invasion of the thyroid cartilage is suspected in patients with hypopharyngeal cancer. PMID:25837190

  6. [Expressions of RASSF1A, Galectin-3 and TPO mRNA in papillary thyroid carcinoma and their clinical significance].

    Science.gov (United States)

    Xu, Mei-rong; Chen, Yun; Zhou, Shao-rong; Chi, Ming-ming; Chen, Sen-lin; Liu, Lei-yu

    2009-05-01

    To investigate the mRNA expressions of RASSF1A, Galectin-3 and TPO in papillary thyroid carcinoma and some other thyroid benign lesions, and evaluate their diagnostic significance. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the mRNA expression of RASSF1A, galectin-3 and TPO in the samples from 73 cases, including 23 cases with papillary thyroid cancer, 16 with nodular goiter, 29 with thyroid adenoma and 5 with Hashimoto's disease. A statistically significant difference in the mRNA expression of RASSF1A, Galectin-3 and TPO was observed between papillary thyroid carcinoma and follicular benign lesions (P0.05). A negative correlation of the expression of RASSF1A and Galectin-3 mRNA was found between thyroid benign lesions and malignant ones (P = 0.000). While the mRNA expression of RASSF1A and TPO was positively correlated between benign and malignant lesions (P = 0.028). Loss of expression of RASSF1A and TPO mRNA but high expression of Galectin-3 mRNA in papillary thyroid carcinoma are common. Therefore, the products of these three genes may be closely related to the development of thyroid papillary carcinoma, and may be used as useful markers in differential diagnosis of papillary thyroid carcinoma from the benign lesions. The results are more reliable if this detection method is used in combination with other techniques.

  7. The indication for sup 131 I-therapy in occult thyroid carcinoma. Zur Indikation der Radiojodtherapie beim Mikrokarzinom der Schilddruese

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, S.; Reiners, C. (Essen Univ. (Gesamthochschule) (Germany, F.R.). Klinik und Poliklinik fuer Nuklearmedizin)

    1991-02-01

    The prevalence of occult papillary thyroid carcinoma in the normal population is several orders of magnitude higher than the incidence of clinically apparent thyroid cancer, and the recurrence rate or mortality is very low, even after conservative therapy. Therefore, occult papillary thyroid carcinoma has to be considered as distinct biologic entity. Therefore, we recommend no further surgery or ablation of the thyroid remnant with {sup 131}I for patients less than 40 years old with occult papillary carcinoma without metastases. In case of metastases, however, {sup 131}I-therapy should be performed after total thyroidectomy. All follicular thyroid carcinomas, regardless of their size, are to be treated by total thyroidectomy and {sup 131}I-therapy. All patients receive TSH-suppressive levothyroxine therapy and undergo regular follow-up. (orig.).

  8. Analysis of pattern of occurrence of thyroid carcinoma between 2001 and 2010

    Directory of Open Access Journals (Sweden)

    Fábio Muradás Girardi

    2015-10-01

    Full Text Available ABSTRACT INTRODUCTION: An ongoing discussion is found in medical literature about the reasons for changes in thyroid carcinoma incidence patterns over the last decades. OBJECTIVE: To analyze the clinical and pathological characteristics of thyroid carcinoma cases over a decade. METHODS: Cross-sectional study over an historical cohort. Medical records of 628 thyroid cancer cases in a single center were reviewed. 597 patients were included. Microcarcinoma cases were selected for a qualitative analysis phase, in which medical records were reviewed for better understanding of thyroid nodule and thyroid cancer diagnosis process. RESULTS: An increase in the proportion of cases with thyroid cancer diagnosis was observed throughout the decade; new cases were predominantly tumors of less than 2 cm, with histopathological signs of low aggressiveness. There was an increase in proportion of cases with malignant cytological results among microcarcinomas. CONCLUSION: There is a trend for increase in thyroidectomies due to cancer in this institution, with proportional increment of cases with histopathological characteristics indicative of early disease. Among microcarcinomas, there is an increasing group represented by cancer cases that were not incidentally diagnosed, related to an enhancement in preoperative diagnostic methods.

  9. Application of AGES prognostic rate for treatment of a well differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Sosa Martin, Gimel; Morales Portuondo, Kelvis; Martinez Valenzuela, Noslen

    2009-01-01

    At the present times, the selection a suitable surgical treatment for patients presenting with an early differentiated thyroid carcinoma is a controversial question. The aim of present research was to describe and to assessment the diagnosis results and the treatment of this condition during 5 years

  10. Reproductive and menstrual factors and risk of differentiated thyroid carcinoma : The EPIC study

    NARCIS (Netherlands)

    Zamora-Ros, Raul; Rinaldi, Sabina; Biessy, Carine; Tjonneland, Anne; Halkjaer, Jytte; Fournier, Agnes; Boutron-Ruault, Marie-Christine; Mesrine, Sylvie; Tikk, Kaja; Fortner, Renee T.; Boeing, Heiner; Foerster, Jana; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Papatesta, Eleni-Maria; Masala, Giovanna; Tagliabue, Giovanna; Panico, Salvatore; Tumino, Rosario; Polidoro, Silvia; Peeters, Petra H. M.; Bueno-de-Mesquita, H. B(as); Weiderpass, Elisabete; Lund, Eiliv; Argueelles, Marcial; Agudo, Antonio; Molina-Montes, Esther; Navarro, Carmen; Barricarte, Aurelio; Larranaga, Nerea; Manjer, Jonas; Almquist, Martin; Sandstrom, Maria; Hennings, Joakim; Tsilidis, Konstantinos K.; Schmidt, Julie A.; Khaw, Kay-Thee; Wareham, Nicholas J.; Romieu, Isabelle; Byrnes, Graham; Gunter, Marc J.; Riboli, Elio; Franceschi, Silvia

    2015-01-01

    Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among

  11. Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis?

    NARCIS (Netherlands)

    Clement, S.C.; Kremer, L.C.M.; Links, T.P.; Mulder, R.L.; Ronckers, C.M.; van Eck-Smit, B.L.; van Rijn, R.R.; Pal van der, H.J.H.; Tissing, W.J.E.; Janssens, G.O.; van den Heuvel-Eibrink, M.M.; Neggers, S.J.; Nieveen van Dijkum, E.J.; Peeters, R.P.; van Santen, H.M.

    Background: There is no international consensus on surveillance strategies for differentiated thyroid carcinoma (DTC) after radiotherapy for childhood cancer. Ultrasonography could allow for early detection of DTC, however, its value is yet unclear since the prognosis of DTC is excellent. We

  12. Kidney Involvement in Systemic Calcitonin Amyloidosis Associated With Medullary Thyroid Carcinoma

    NARCIS (Netherlands)

    Koopman, Timco; Niedlich-den Herder, Cindy; Stegeman, Coen A.; Links, Thera P.; Bijzet, Johan; Hazenberg, Bouke P. C.; Diepstra, Arjan

    A 52-year-old woman with widely disseminated medullary thyroid carcinoma developed nephrotic syndrome and slowly decreasing kidney function. A kidney biopsy was performed to differentiate between malignancy-associated membranous glomerulopathy and tyrosine kinase inhibitor-induced focal segmental

  13. Medical evaluations of ionizing radiation effects during I131 therapy in patients after thyroid carcinoma surgery

    International Nuclear Information System (INIS)

    Hermida, J.C.

    1996-01-01

    This study shows the para-clinical studies on a 39 years old patient who was operated on of a thyroid carcinoma and who, under the beirwaltes medical record (in use in our country), received in the post surgical stage, a Iodine-131 dose of about 2960 MBq (80 mCi) for ablation, having been noted subsequently her pregnancy condition. (author). 6 refs

  14. Integrated data analysis reveals potential drivers and pathways disrupted by DNA methylation in papillary thyroid carcinomas

    DEFF Research Database (Denmark)

    Beltrami, Caroline Moraes; Dos Reis, Mariana Bisarro; Barros-Filho, Mateus Camargo

    2017-01-01

    BACKGROUND: Papillary thyroid carcinoma (PTC) is a common endocrine neoplasm with a recent increase in incidence in many countries. Although PTC has been explored by gene expression and DNA methylation studies, the regulatory mechanisms of the methylation on the gene expression was poorly clarifi...

  15. Comparison of three radiolabelled peptide analogues for CCK-2 receptor scintigraphy in medullary thyroid carcinoma

    NARCIS (Netherlands)

    A.C. Fröberg (Alida); M. de Jong (Marion); B.A. Nock (Berthold); W.A.P. Breeman (Wouter); J.L. Erion (Jack); T. Maina (Theodosia); M. Verdijsseldonck (Marion); W.W. de Herder (Wouter); A. van der Lugt (Aad); P.P.M. Kooij (Peter); E.P. Krenning (Eric)

    2009-01-01

    textabstractPurpose: Cholecystokinin 2 (CCK-2) receptor overexpression has been demonstrated in a high percentage of medullary thyroid carcinomas (MTC). Analogous to somatostatin receptors, CCK-2 receptors might be viable targets for radionuclide scintigraphy and/or radionuclide therapy. Several

  16. A young woman with a supraclavicular swelling; some diagnostic aspects of thyroid carcinoma

    International Nuclear Information System (INIS)

    Logmans, S.C.; Jobsis, A.C.; Schoot, J.V. van der; Schipper, M.E.I.; Kromhout, J.G.

    1983-01-01

    The case is reported of a woman aged 24 years who presented a supraclavicular swelling caused by a lymph-node metastasis of an adenopapillary carcinoma. The primary tumour was found in the thyroid in which palpation and scintigraphy failed to reveal any abnormalities. The diagnosis and the diagnostic value of scintigraphic and immunohistological examination are considered. (Auth.)

  17. Gene-expression Classifier in Papillary Thyroid Carcinoma: Validation and Application of a Classifier for Prognostication

    DEFF Research Database (Denmark)

    Londero, Stefano Christian; Jespersen, Marie Louise; Krogdahl, Annelise

    2016-01-01

    BACKGROUND: No reliable biomarker for metastatic potential in the risk stratification of papillary thyroid carcinoma exists. We aimed to develop a gene-expression classifier for metastatic potential. MATERIALS AND METHODS: Genome-wide expression analyses were used. Development cohort: freshly...

  18. Is thyroidectomy necessary in RET mutations carriers of the familial medullary thyroid carcinoma syndrome?

    DEFF Research Database (Denmark)

    Hansen, H S; Torring, H; Godballe, C

    2000-01-01

    BACKGROUND: The results and consequences of genetic testing in a family with familial medullary thyroid carcinoma (FMTC) are described. METHODS: In the screening of relatives, serum calcitonin is replaced by RET mutation analysis that was performed in families suspected of hereditary medullary th...

  19. The Profile of Heparanase Expression Distinguishes Differentiated Thyroid Carcinoma from Benign Neoplasms.

    Science.gov (United States)

    Matos, Leandro Luongo; Suarez, Eloah Rabello; Theodoro, Thérèse Rachell; Trufelli, Damila Cristina; Melo, Carina Mucciolo; Garcia, Larissa Ferraz; Oliveira, Olivia Capela Grimaldi; Matos, Maria Graciela Luongo; Kanda, Jossi Ledo; Nader, Helena Bonciani; Martins, João Roberto Maciel; Pinhal, Maria Aparecida Silva

    2015-01-01

    The search for a specific marker that could help to distinguish between differentiated thyroid carcinoma and benign lesions remains elusive in clinical practice. Heparanase (HPSE) is an endo-beta-glucoronidase implicated in the process of tumor invasion, and the heparanase-2 (HPSE2) modulates HPSE activity. The aim of this study was to evaluate the role of heparanases in the development and differential diagnosis of follicular pattern thyroid lesions. HPSE and HPSE2 expression by qRT-PCR, immunohistochemistry evaluation, western blot analysis and HPSE enzymatic activity were evaluated. The expression of heparanases by qRT-PCR showed an increase of HPSE2 in thyroid carcinoma (P = 0.001). HPSE activity was found to be higher in the malignant neoplasms than in the benign tumors (P<0.0001). On Western blot analysis, HPSE2 isoforms were detected only in malignant tumors. The immunohistochemical assay allowed us to establish a distinct pattern for malignant and benign tumors. Carcinomas showed a typical combination of positive labeling for neoplastic cells and negative immunostaining in colloid, when compared to benign tumors (P<0.0001). The proposed diagnostic test presents sensitivity and negative predictive value of around 100%, showing itself to be an accurate test for distinguishing between malignant and benign lesions. This study shows, for the first time, a distinct profile of HPSE expression in thyroid carcinoma suggesting its role in carcinogenesis.

  20. Clinico-pathological and prognostic findings on 27 cases of medullary thyroid carcinoma.

    Science.gov (United States)

    Gabsi, Azza; El Amine El Hadj, Olfa; Goucha, Aida; Said, Gritli; Laabidi, Besma; Gamoudi, Amor

    2017-02-01

    Medullary thyroid carcinoma is a rare tumor accounting for less than 10% of thyroid neoplasm. This tumor is characterized by important histological polymorphism which makes morphological diagnosis difficult and immunohistochemical study often necessary. We aim to perform a retrospective review of clinical and pathological characteristics of medullary carcinoma. We will discuss the place of immunohistochemistry in the positive diagnosis and as a prognostic factor. patients with thyroid medullary carcinoma diagnosed in department of pathology at carcinologic institute between 1998 and 2013 were retrospectively included. Clinic, radiologic and prognostic variables were assessed. Slides were reviewed for all the patients with confirmed tumors. Twenty-seven patients with CMT were identified. The average age was 55 years with predominance of males. The average consultation time was 16 months. The most common presentation symptom was a cervical lymph node. Total thyroidectomy was performed in 23 patients. Tumor was nodular and unique in 22 cases. The average size was 2.1 cm. CMT was of mixed type containing both medullary and papillary compound in four cases. Amyloid substance was present and abundant in 21cases. Positive staining for calcitonin was observed in 16 cases. Distant metastasis or metastatic lymph nodes was observed in eight cases with an average period of 42 months. Radiotherapy was performed in fifteen cases and two patients received chemotherapy. In the absence of amyloid deposits, immunohistochemical staining with calcitonin is useful to confirm the diagnosis. The prognosis of this entity is more pejorative than papillary thyroid carcinoma.

  1. Glycerol as a chemical chaperone enhances radiation-induced apoptosis in anaplastic thyroid carcinoma cells

    Directory of Open Access Journals (Sweden)

    Emoto Mie

    2002-10-01

    Full Text Available Abstract Introduction Anaplastic thyroid carcinoma, which is one of the most aggressive, malignant tumors in humans, results in an extremely poor prognosis despite chemotherapy and radiotherapy. The present study was designed to evaluate therapeutic effects of radiation by glycerol on p53-mutant anaplastic thyroid carcinoma cells (8305c cells. To examine the effectiveness of glycerol in radiation induced lethality for anaplastic thyroid carcinoma 8305c cells, we performed colony formation assay and apoptosis analysis. Results Apoptosis was analyzed with Hoechst 33342 staining and DNA ladder formation assay. 8305c cells became radiosensitive when glycerol was added to culture medium before X-ray irradiation. Apoptosis was induced by X-rays in the presence of glycerol. However, there was little apoptosis induced by X-ray irradiation or glycerol alone. The binding activity of whole cell extracts to bax promoter region was induced by X-rays in the presence of glycerol but not by X-rays alone. Conclusion These findings suggest that glycerol is effective against radiotherapy of p53-mutant thyroid carcinomas.

  2. [Comparison of differentiated thyroid carcinoma staging systems in a Spanish population].

    Science.gov (United States)

    Andía Melero, Víctor Manuel; Martín de Santa-Olalla Llanes, María; Sambo Salas, Marcel; Percovich Hualpa, Juan Carlos; Motilla de la Cámara, Marta; Collado Yurrita, Luis

    2015-04-01

    Differentiated thyroid carcinoma staging is increasingly important due to the current trends to a less intensive therapy in low-risk patients. The TNM system is most widely used, but other systems based on follow-up of several patient cohorts have been developed. When these systems have been applied to other populations, results have been discordant. Our study evaluates the suitability of several differentiated thyroid carcinoma staging systems in a Spanish population. 729 patients with differentiated thyroid carcinoma and staging data available were enrolled. Mean follow-up time was 10.8 years. The TNM, EORTC, AMES, Clinical class, MACIS, Ohio, NTCTCS, and Spanish systems were applied to all histological types. The Kaplan-Meier survival curves for each system were analyzed, and compared using the proportion of explained variation (PEV). The demographic and clinical characteristics of our population were similar to those of other Spanish and international cohorts reported. The best systems were NTCTCS, with 74.7% PEV, and TNM (68.3%), followed by the Ohio, MACIS, EORTC, and AMES systems with minimal differences between them, while the least adequate were the Spanish (55.2%) and Clinical class (47.1%) systems. The NTCTCS staging system was found to be better than TNM in our population but, because of its simplicity and greater dissemination, the TNM appears to be recommended for staging of patients with differentiated thyroid carcinoma. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

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

    International Nuclear Information System (INIS)

    Chiofalo, Maria Grazia; Losito, Nunzia Simona; Fulciniti, Franco; Setola, Sergio Venanzio; Tommaselli, Antonio; Marone, Ugo; Di Cecilia, Maria Luisa; Pezzullo, Luciano

    2012-01-01

    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

  4. Korean Thyroid Imaging Reporting and Data System features of follicular thyroid adenoma and carcinoma: a single-center study

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    Park, Jung Won; Kim, Dong Wook; Kim, Dong Hyun; Baek, Jin Wook; Lee, Yoo Jin [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Baek, Hye Jin [Dept. of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon (Korea, Republic of)

    2017-10-15

    This study aimed to assess the diagnostic efficacy of Korean Thyroid Imaging Reporting and Data System (K-TIRADS) features for distinguishing follicular thyroid adenoma (FTA) from follicular thyroid carcinoma (FTC). From January 2013 to July 2016, 46 follicular neoplasms in 45 patients who underwent preoperative thyroid ultrasonography (US) and thyroid surgery were included. The US features of each thyroid nodule were retrospectively evaluated by a single radiologist using a picture archiving and communication system. The diagnostic indices of K-TIRADS for follicular neoplasms were calculated according to whether K-TIRADS category 4 lesions were excluded or classified as benign or malignant. Of the 46 follicular neoplasms (mean size, 3.1±1.6 cm), 37 were FTAs (mean size, 3.1±1.7 cm) and nine were FTCs (mean size, 3.0±1.5 cm). A statistically significant difference was found between FTAs and FTCs regarding the margin (P=0.035), while no significant differences were observed in the composition, echogenicity, shape, orientation, calcification, or vascularity of the lesions (P<0.05). The FTAs belonged to K-TIRADS categories 3 (n=22) and 4 (n=15), while the FTCs belonged to K-TIRADS categories 3 (n=4), 4 (n=4), and 5 (n=1). However, there was no statistically significant difference in the distribution of K-TIRADS categories between FTAs and FTCs (P=0.184).K-TIRADS features were not helpful for distinguishing FTA from FTC, although follicular neoplasms showed a high prevalence of K-TIRADS categories 3 and 4.

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

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Sang Yu; Shin, Jung Hee; Ko, Eun Young; Hahn, Soo Yeon [Dept. of Radiology, Samsung Medicine Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    The aim of this study was to compare ultrasonographic features in patients with lymphocytic thyroiditis (LT) and papillary thyroid carcinoma (PTC) having suspicious thyroid nodule(s) in a background of heterogeneous parenchyma and to determine the clinical and radiological predictors of malignancy. We reviewed the cases of 100 patients who underwent ultrasonography between April 2011 and October 2012, and showed suspicious thyroid nodule(s) in a background of heterogeneous parenchyma. Eight patients who did not undergo ultrasonography-guided fineneedle aspiration cytology (FNAC) and 34 cases of follow-up ultrasonography after initial FNAC were excluded. We compared the benign and malignant nodules in terms of their clinical and radiological factors. For the 58 nodules including 31 LTs (53.4%) and 27 PTCs (46.6%), the mean tumor sizes of the two groups were 0.96 cm for LT and 0.97 cm for PTC. A univariate analysis revealed that PTCs were more frequent in patients younger than 45 years and having microcalcifications than was LT. An independent predictor of PTC after adjustment was an age of <45 years. LT mimics malignancy in a background of heterogeneous parenchyma on ultrasonography. A young age of <45 years is the most important predictor of malignancy in this condition.

  6. Anaplastic transformation of metastatic papillary thyroid carcinoma at shoulder mimicking soft tissue sarcoma

    Directory of Open Access Journals (Sweden)

    Seema Kaushal

    2011-01-01

    Full Text Available A 52-year-old woman presented with fracture upper end of the left humerus after trivial trauma and aspiration cytology from the lytic lesion in the upper humerus seen on X-ray revealed a metastatic papillary carcinoma from the thyroid. Total thyroidectomy confirmed the papillary carcinoma thyroid. Post-operatively, she was given radioactive iodine (I-131 ablation therapy for 8 years and was asymptomatic during this period; however, for the last 1 year, she has been complaining of swelling in the shoulder, which did not respond to palliative radiotherapy and rapidly increased in size. Disarticulation of the shoulder joint was performed, which showed anaplastic carcinoma on histopathological examination. Anaplastic transformation of papillary carcinoma at the metastatic sites is well documented in the literature and is rare. However, the same has not been reported at the shoulder and from India before. Although soft tissue sarcomas are most common at this site, however, the possibility of anaplastic transformation should be kept in the differential diagnosis of rapidly enlarging painful mass in a known case of metastatic thyroid carcinoma to prevent misdiagnosis.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Thyroid gland involvement in carcinoma of the hypopharynx.

    Science.gov (United States)

    Joshi, P; Nair, S; Chaturvedi, P; Nair, D; Shivakumar, T; D'Cruz, A K

    2014-01-01

    The thyroid gland is removed en bloc during laryngectomy. There are no objective criteria for deciding the extent of thyroid gland resection in primary hypopharyngeal cancer cases. The present study aimed to determine the incidence of thyroid gland involvement in hypopharyngeal cancer and identify the various predictors of this involvement. This paper reports a retrospective analysis of 358 patients with hypopharyngeal cancer, who underwent total laryngectomy with partial or total pharyngectomy at Tata Memorial Hospital, Mumbai between 2004 and 2010. The mean age of this population was 61 years. The pyriform sinus was the most common hypopharyngeal subsite involved (in 89 per cent of cases). Most patients underwent hemi-thyroidectomy as part of their surgery. The thyroid gland was involved in only 13 per cent of cases. Thyroid gland involvement is not common in hypopharyngeal cancer. Cases that involved the post-cricoid area, subglottic extension, extralaryngeal spread or prior tracheostomy were associated with a higher risk of thyroid gland involvement. Ipsilateral thyroidectomy is sufficient in most patients undergoing surgery (laryngectomy with partial or total pharyngectomy) for hypopharyngeal cancers.

  9. Proteomic analysis reveals differential protein expression in variants of papillary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Yasemin Ucal

    2017-12-01

    Full Text Available Introduction: Fine Needle Aspiration Biopsy (FNAB allows the cytological differentiation of benign and malignant thyroid nodules. However, the method itself is not adequate in determining some cases. For example, the diagnosis of Follicular Variant Papillary Thyroid Carcinoma (FV-PTC can be challenging. In the current study we investigate the protein profiles of FV-PTC and classical variant PTC (CV-PTC with no lymph node metastasis and compare it with benign thyroid tissue. Method: We used CV-PTC (n = 6, FV-PTC (n = 6 and benign thyroid tissues (n = 6 to prepare tissue lysates. Proteins from each group were trypsin and lys-C digested. The samples were analyzed on a Q Exactive Orbitrap mass spectrometer. Results: We identified 2560 proteins across all 18 specimens. Protein profiles revealed that there was no clear distinction between benign and FV-PTC samples. However, further examination of our data showed that proteins in energy metabolism have altered in FV-PTC. Proteomic pathway analysis showed marked alteration of the actin cytoskeleton proteins, especially several members of Arp2/3 complex were significantly increased in CV-PTC. We made the novel observation that IQGAP1 protein was significantly increased in CV-PTC, whereas IQGAP2 protein was highly expressed in FV-PTC lesions, suggesting differential roles of IQGAP proteins in thyroid pathology. Conclusion: In the present study, mass spectrometry based label free quantification approach was applied to investigate the protein profiles of FV-PTC, CV-PTC and benign thyroid tissues. This study pointed out that actin cytoskeleton proteins, IQGAP proteins and changes in energy metabolism play predominant roles in thyroid pathology. Keywords: Papillary thyroid carcinoma, IQGAP, Proteomics, Mass spectrometry

  10. Lymph Node Metastases in Papillary and Medullary Thyroid Carcinoma Are Independent of Intratumoral Lymphatic Vessel Density

    Science.gov (United States)

    Pereira, Filipe; Pereira, Sofia S.; Mesquita, Marta; Morais, Tiago; Costa, Madalena M.; Quelhas, Pedro; Lopes, Carlos; Monteiro, Mariana P.; Leite, Valeriano

    2017-01-01

    Background Blood and lymph vessel invasion are well-recognized markers of tumor aggressiveness, as these are the routes that lead to metastases. Thyroid tumors, depending on the histological variant, tend to have distinctive biological behaviors and use different vascular routes to metastasize, yet the mechanisms underlying the metastatic process are still poorly understood. Objectives The aim of this study was to assess how the lymph vessel density (LVD) in different histological types of thyroid tumors, and in their surrounding tissue, correlate with the presence of lymph node metastases (LNM) and tumor pathological features. Methods Lymph vessels of papillary thyroid carcinomas (PTC), of the classical (CVPTC, n = 50) and follicular variants (FVPTC, n = 18), and medullary thyroid carcinomas (MTC, n = 34) were immunohistochemically stained against antigen D2-40. The stained area was quantified using a computerized morphometric analysis tool and correlated with the tumor pathological characteristics. Results LVD within all analyzed thyroid tumor subtypes was significantly lower than in the surrounding thyroid tissues (p < 0.001). Despite intratumoral LVD being significantly higher in CVPTC than in FVPTC, and peritumoral LVD being significantly higher in MTC than in PTC (p < 0.05), no correlations were found between LVD (either intratumoral or peritumoral) and the presence of lymph node metastasis. Conclusions As no LVD differences were found amongst thyroid tumors with or without LNM, dissemination is more likely to depend on the tumor ability to invade the abundant lymph vessel network of the surrounding thyroid tissue than on the ability of the tumor to promote de novo lymphangiogenesis. PMID:28589086

  11. Cytodiagnosis of papillary thyroid carcinoma--a study of 37 cases at RIMS Hospital, Imphal.

    Science.gov (United States)

    Sharma, A Barindra; Laishram, Sharmila; Singh, A Meina; Sharma, L Durlav Chandra

    2007-04-01

    Papillary carcinoma is the most common malignant tumour of thyroid gland which can occur in any age group with most tumours diagnosed in the third and fifth decades predominantly in the females. FNAC is emerging as the first line of investigation for any thyroid enlargement including tumours as a safe, rapid and cost -effective procedure. Many studies have reported diagnostic accuracy of FNAC in detecting neoplasms. The present study aims to evaluate the diagnostic accuracy of FNAC in the cytodiagnosis of papillary carcinoma and to highlight the clinco-pathologic correlation. A total of 37 cases were diagnose cytologically as papillary carcinoma, out ofwhich 28 cases were histologically proved. The remaining 9 cases were not available for biopsy. It was observed that careful cytomorphologic assessment with particular attention to cellular arrangement and nuclear characteristics aided in the correct diagnosis.

  12. CBX7 Expression in Oncocytic Thyroid Neoplastic Lesions (Hürthle Cell Adenomas and Carcinomas)

    Science.gov (United States)

    Monaco, Mario; Chiappetta, Gennaro; Aiello, Concetta; Federico, Antonella; Sepe, Romina; Russo, Daniela; Fusco, Alfredo; Pallante, Pierlorenzo

    2014-01-01

    Background Previous analysis of CBX7 expression in a large number of thyroid adenoma and carcinoma samples revealed a progressive reduction of CBX7 levels that was well related with the malignant grade of thyroid neoplasias. Hürthle cell tumors are unusual thyroid neoplasms characterized by the presence of particular cells called oncocytes. Objectives In order to develop new tools for a more accurate diagnosis of Hürthle cell tumors of the thyroid, we evaluated CBX7 protein levels to verify the possible presence of an expression signature. Methods CBX7 expression was evaluated by immunohistochemistry in a panel of thyroid tissue sections including normal thyroids, goiters, follicular adenomas and oncocytic lesions. Results CBX7 expression was low or null in 68% of Hürthle adenomas, whereas it was comparable to normal thyroid tissue in Hürthle hyperplasias and follicular adenomas. Conclusions Reduced expression of CBX7 suggests a more aggressive identity of Hürthle adenomas with respect to non-Hürthle ones. PMID:25759796

  13. Control of treatment of differentiated thyroid carcinoma by measurement of thyroglobulin in serum

    International Nuclear Information System (INIS)

    Hagemann, J.; Schneider, C.

    1978-01-01

    The presence of thyroglobulin in serum of patients with differentiated thyroid carcinoma was studied by a specific radioimmunoassay. Seventy-three patients with thyroid carcinomata were examined, 16 of whom had pulmonary or skeletal metastase, 11 local metastases, and the others no metastases. Patients with generalized metastases had very high serum thyroglobulin concentrations while those with local metastases had slightly elevated or normal concentrations. Those with remaining thyroid tissue had mainly normal thyroglobulin levels and patients with neither metastases nor remaining thyroid tissue had undetectable serum thyroglobulin. In seven patients with metastases it was possible to observe the development of serum thyroglobulin after 131 I treatment. In all cases the serum thyroglobulin concentration paralleled the development of the clinical status. Elevated serum thyroglobulin was also found in benign thyroid diseases such as hyperthyroidism and endemic goitre. Measurement of thyroglobulin in serum is therefore of little value in differentiating between benign and malignant thyroid diseases, but it is a good method for the follow-up control of patients with differentiated thyroid carcinomata. Because normal thyroglobulin levels do not exclude local metastases, additional examinations are necessary if normal thyroglobulin levels are found. When thyroglobulin is undetectable, metastases can be excluded and the measurement of thyroglobulin in serum can replace all other methods in the follow-up control. (author)

  14. Shrinkage of thyroid volume in sunitinib-treated patients with renal-cell carcinoma: a potential marker of irreversible thyroid dysfunction?

    Science.gov (United States)

    Rogiers, Aljosja; Wolter, Pascal; Op de Beeck, Katya; Thijs, Marleen; Decallonne, Brigitte; Schöffski, Patrick

    2010-03-01

    The multitargeted tyrosine kinase inhibitor sunitinib is known to induce thyroid dysfunction in a substantial proportion of patients treated for advanced renal-cell carcinoma or gastrointestinal stromal tumors. Although sunitinib-induced hypothyroidism seems to be reversible in the majority of patients, some patients develop irreversible thyroid damage resulting in long-lasting thyroid hormone replacement therapy. We report on two cancer patients with a preexisting nodular thyroid gland, who developed thyroid dysfunction and showed marked shrinkage of the thyroid during treatment with the tyrosine kinase inhibitor, necessitating permanent thyroid hormone replacement therapy even after discontinuation of the anticancer agent. Sunitinib treatment in patients with a nodular thyroid can induce a significant decrease in the volume of the enlarged endocrine gland, associated with abnormal thyroid function tests leading to clinical hypothyroidism. The exact pathophysiology remains unknown but we discuss several possible mechanisms of sunitinib-induced thyroid shrinkage. Morphological changes of the thyroid gland can be associated with the well-described adverse biochemical effects of treatment with sunitinib and can be a potential marker of the irreversible organ damage.

  15. Thyrotoxicosis caused by functioning metastatic thyroid carcinoma. A rare and elusive cause of hyperthyroidism with low radioactive iodine uptake

    International Nuclear Information System (INIS)

    Ober, K.P.; Cowan, R.J.; Sevier, R.E.; Poole, G.J.

    1987-01-01

    A patient with progressively worsening thyrotoxicosis, refractory to medical therapy, is described. Repeated measurements of thyroidal RAI uptake over a 13 month period were low consistently and could not be explained by iodine ingestion, thyroiditis, or administration of exogenous thyroid hormone. An I-131 scan ultimately revealed striking activity at the base of the skull, reflecting ectopic excessive production of thyroid hormone by a solitary functioning metastatic thyroid carcinoma. The thyrotoxic state resolved after large doses of therapeutic I-131. Typical features of this rare cause of hyperthyroidism are discussed

  16. [Tuberculosis of the thyroid gland mimicking thyroid carcinoma in the elderly].

    Science.gov (United States)

    Niiya, Tetsuji; Kawamoto, Eriko; Watanabe, Sayaka; Sakao, Hitomi; Manabe, Kenichi; Ogawa, Akiko; Furukawa, Shinya

    2014-01-01

    A 76-year-old woman with a 10-year history of chronic glomerulonephritis was treated at a clinic after presenting with a gradual worsening of the renal function. The patient had no history of tuberculosis. She was subsequently hospitalized for uremic symptoms and treated with internal shunt insertion and dialysis. Thyroid ultrasonography was performed to screen for secondary hyperparathyroidism, which revealed a calcified thyroid mass and cervical lymph node swelling. Fine-needle aspiration biopsy was thus conducted to assess suspected thyroid cancer. The cytological findings showed few follicular epithelial cells, without any signs of malignancy. However, a diagnosis of thyroid cancer continued to be strongly suspected based on the imaging features. Total thyroidectomy and bilateral cervical regional lymph node dissection were therefore performed, and the pathological examination of the thyroidectomy specimen disclosed scattered epithelioid granulomas with caseous necrosis in the entire right lobe as well as the cervical lymph nodes. Based on these findings, the patient was diagnosed with thyroid tuberculosis. As the symptoms and imaging findings of tuberculosis are nonspecific in elderly patients, it is necessary to consider this disease in this population. We therefore propose the inclusion of thyroid tuberculosis in the differential diagnosis of elderly patients who present with malignant thyroid tumors on aspiration biopsy cytology, regardless of whether or not they have a previous history of tuberculosis.

  17. Thyroid metastasis in a patient with hepatocellular carcinoma: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Chai Chiah-Yang

    2007-12-01

    Full Text Available Abstract Background Despite the apparent low incidence of cancer metastatic to the thyroid, autopsy and clinical series suggest it is more common than generally. Although lung, renal, and breast cancer are probably the most common primary sites, a number of cancers have been reported to metastasize to the thyroid synchronously with diagnosis of primary tumor or years after apparently curative treatment. Case presentation We report a rare case of a hepatocellular carcinoma metasatic to the thyroid. The patient presented seven months after original diagnosis and treatment with hepatic lobectomy with multiple neck lesions producing a mass effect on the trachea and bilateral lymphadenopathy. Fine-needle aspiration revealed highly anaplastic carcinoma, and immunohistochemistry confirmed hepatocellular carcinoma. The patient received total thyroidectomy as palliative therapy because of the presence of multiple recurrent lesions in the liver. Conclusion Clinicians should consider the possibility of metastatic cancer in each patient who presents with a new thyroid mass, especially those with a history of cancer, however remote. In cases where cytology or histology is not diagnostic, immunohistochemistry may be definitive in making the diagnosis.

  18. Diagnosis, Surgical Treatment, Recovery, and Eventual Necropsy of a Leopard (Panthera pardus with Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Ashley Malmlov

    2014-01-01

    Full Text Available An 18-year-old, male, castrated, captive-born leopard (Panthera pardus presented to Colorado State University’s Veterinary Teaching Hospital with a two-week history of regurgitation. Thoracic radiographs and ultrasound revealed a well-differentiated cranioventral mediastinal mass measuring 7.5 × 10 × 5.5 cm, impinging the esophagus. A sternotomy followed by mass excision was performed. The mass was diagnosed as an ectopic thyroid carcinoma. The leopard recovered from surgery with minimal complications and returned to near-normal activity levels for just under 6 months before rapidly declining. He had an acute onset of severe dyspnea and lethargy and was euthanized. On postmortem examination the tumor was found to involve the lung, liver, thyroid, parietal pleura, bronchial lymph nodes, and the internal intercostal muscles. This case report describes the history, diagnosis, surgical treatment, postoperative care, and recovery as well as the eventual decline, euthanasia, and necropsy of a leopard with thyroid carcinoma. When compared to thyroid carcinomas of domestic animals, the leopard’s disease process more closely resembles the disease process seen in domestic canines compared to domestic cats.

  19. Differentiated thyroid carcinoma in a scintigraphically hot nodule: diagnosis and interdisciplinary therapeutical approach

    International Nuclear Information System (INIS)

    Stahl, A.; Hess, U.; Langhammer, H.; Harms, J.; Zwicknagl, M.

    2002-01-01

    A hyperfunctioning differentiated thyroid carcinoma is a rare occurrence. Nevertheless, this diagnosis must be considered in a scintigraphically hot nodule if there is a clinical or sonographic suggestion of malignancy. The case of a 57-year old patient with hyperthyreosis and a scintigraphically hot thyroid nodule is presented. Further evaluation led to the diagnosis of a differentiated thyroid carcinoma with extensive lymph node and pulmonary metastases (pT2b, pN1b, pM1). The scintigraphically hot nodule corresponded to the primary tumor, whereas scintigraphic detection of the lymph node metastases was only possible postoperatively. Extensive resection of the lymph node metastases was achieved by the intraoperative application of a gamma probe (2nd operation). This allowed sufficient uptake of radioiodine in the pulmonary metastases for their detection and subsequent devitalization by radioiodine therapy. Complete elimination of all tumor tissue was documented at a control follow-up after six months. Gamma probe-guided surgery may allow for additional removement of non-palpable lymph node metastases. In selected cases this may optimize the surgical results and thereby facilitate the subsequent radioiodine elimination of advanced differentiated thyroid carcinomas. (author)

  20. [Anaplastic Thyroid Carcinoma in a 17-Year-Old Female Patient].

    Science.gov (United States)

    Ivanišević, P; Čolović, Z; Pešutić-Pisac, V; Škrabić, V; Kontić, M; Kljajić, Z

    2016-04-01

    Anaplastic carcinoma of thyroid gland is one of the four most malignant tumors in humans. It appears in one or two patients per million per year. It is very rare in children. A 17-year-old female patient was admitted to the Clinical Department of ENT and Head and Neck Surgery, Split University Hospital Center, for thyroid gland surgery due to rapid growth of a node in the thyroid gland left lobe. Preoperative examination indicated benign nature of changes. Total thyroidectomy with levels VI and VII neck dissection was done. Intraoperative slide of the left lobe was malignant. Positron emission tomography and computed tomography were also done. The finding was negative. The patient was examined by an ENT-oncology team and juvenile radiotherapy was administered. It was found to be carcinoma stage IVa according to TNM classification. One year after the operation, the patient was well and had no signs of illness. This case report is a contribution to the existing but scarce knowledge of anaplastic carcinoma of thyroid gland in young patients in the world.

  1. Association of differentiated thyroid carcinoma with HLA-DR7

    International Nuclear Information System (INIS)

    Sridama, V.; Hara, Y.; Fauchet, R.; DeGroot, L.J.

    1985-01-01

    Seventy-four American white thyroid cancer patients were typed for HLA-A, B, and DR antigens. A significant increase in HLA-DR7 was found in the nonradiation-associated thyroid cancer patients (42.5%, 20/47 cases), compared to 22.8% of 979 normal controls. The association is stronger in the follicular and mixed papillary-follicular subgroup (52.0%, 13/25 cases, P corrected less than 0.01). The occurrence of various malignancies in family members was found in 57.9% of HLA-DR7 positive patients, versus 20% of HLA-DR7 negative patients, in a retrospective record review. Although the frequency of HLA-DR7 was not increased in the radiation-associated thyroid cancer patients (22.2%, 6/27 cases), the interval from the irradiation date to the onset date of thyroid cancer was shorter in HLA-DR7 positive cases (17.3 +/- 6.2 years) than in HLA-DR7 negative patients (29.4 +/- 11.5 years). This data suggest that HLA-DR7 is associated with and may influence development of thyroid cancer

  2. Obstructive nephropathy caused by renal metastasis of papillary thyroid carcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Ljubica Juretić Kuščić

    2016-03-01

    Full Text Available The aim of this report is to present a rare case of papillary thyroid cancer metastasis to the kidney manifesting with obstructive nephropathy. A 68 year-old man was referred to ultrasound examination because of a multinodular goiter. Ultrasound guided fine needle aspiration biopsy (US-FNAB suggested follicular adenoma of the right thyroid lobe and a right lobectomy with isthmectomy was performed. Pathohistologic findings confirmed a follicular variant of papillary thyroid carcinoma and the patient underwent a total thyroidectomy followed by radioiodine ablation. A few years later, scintigraphy revealed radioiodine avid metastatic foci in the right kidney as well as an intramuscular lesion in the left thigh. At the same time, non-small cell lung cancer was diagnosed. Papillary thyroid carcinoma is the most common thyroid malignancy, but renal or muscular metastases are extremely rare in this type of cancer and can be found in poorly differentiated cancers, which should be clearly stated in the final pathohistologic report. In order to better the interpretation of these pathohistological findings and allow successful monitoring of these patients, close cooperation with pathologists and immunohistochemical profiling is suggested.

  3. Tall cell variant of papillary thyroid carcinoma: a population-based study in Iceland.

    Science.gov (United States)

    Axelsson, Tomas A; Hrafnkelsson, Jon; Olafsdottir, Elinborg J; Jonasson, Jon G

    2015-02-01

    The tall cell variant (TCV) of papillary thyroid carcinoma (PTC) is an aggressive variant of PTC that is believed to have worse outcomes than classical PTC. The objective of this study was to investigate the incidence, survival, and disease recurrence of patients with TCV and compare them with other PTC in a whole population. Information on all thyroid carcinomas diagnosed in Iceland from 1990 to 2009 was obtained from the Icelandic Cancer Registry. PTC diagnosed postmortem was excluded. The date of diagnosis, sex, and age at diagnosis were registered. All histopathology material was re-evaluated, and papillary thyroid tumors classified as either TCV or other types of PTC. Tumors were classified as TCV if >50% of cells were tall (height > twice the width). TNM stage was determined for all the cases. Endpoints were thyroid cancer-specific death and thyroid cancer recurrence. Out of 376 patients diagnosed with PTC in the study period, 49 (13%) were classified as TCV. Patients with TCV were older (66 years vs. 49 years, pIceland with an incidence of 0.5/100,000 for men and 0.7/100,000 for women. Patients diagnosed with TCV have worse five-year disease-specific survival than patients with other PTC. TCV histology is an independent risk factor for disease recurrence but not for disease-specific survival.

  4. Clinical relevance of18F-FDG PET and18F-DOPA PET in recurrent medullary thyroid carcinoma

    NARCIS (Netherlands)

    H.H.G. Verbeek (Hans H.); J.T. Plukker (John); K.P. Koopmans (Klaas Pieter); J. de Groot (Jan); R.M.W. Hofstra (Robert); A.C. Muller Kobold (Anneke); A.N.A. van der Horst-Schrivers (Anouk); A.H. Brouwers (A.); T.P. Links (Thera)

    2012-01-01

    textabstractThe transition from stable to progressive disease is unpredictable in patients with biochemical evidence of medullary thyroid carcinoma (MTC). Calcitonin and carcinoembryonic antigen (CEA) doubling times are currently the most reliable markers for progression, but for accurate

  5. Clinical Relevance of F-18-FDG PET and F-18-DOPA PET in Recurrent Medullary Thyroid Carcinoma

    NARCIS (Netherlands)

    Verbeek, Hans H. G.; Plukker, John T. M.; Koopmans, Klaas Pieter; de Groot, Jan Willem B.; Hofstra, Robert M. W.; Kobold, Anneke C. Muller; van der Horst-Schrivers, Anouk N. A.; Brouwers, Adrienne H.; Links, Thera P.

    2012-01-01

    The transition from stable to progressive disease is unpredictable in patients with biochemical evidence of medullary thyroid carcinoma (MTC). Calcitonin and carcinoembryonic antigen (CEA) doubling times are currently the most reliable markers for progression, but for accurate determination, serial

  6. Molecular Network-Based Identification of Competing Endogenous RNAs in Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Minjia Lu

    2018-01-01

    Full Text Available RNAs may act as competing endogenous RNAs (ceRNAs, a critical mechanism in determining gene expression regulations in many cancers. However, the roles of ceRNAs in thyroid carcinoma remains elusive. In this study, we have developed a novel pipeline called Molecular Network-based Identification of ceRNA (MNIceRNA to identify ceRNAs in thyroid carcinoma. MNIceRNA first constructs micro RNA (miRNA–messenger RNA (mRNAlong non-coding RNA (lncRNA networks from miRcode database and weighted correlation network analysis (WGCNA, based on which to identify key drivers of differentially expressed RNAs between normal and tumor samples. It then infers ceRNAs of the identified key drivers using the long non-coding competing endogenous database (lnCeDB. We applied the pipeline into The Cancer Genome Atlas (TCGA thyroid carcinoma data. As a result, 598 lncRNAs, 1025 mRNAs, and 90 microRNA (miRNAs were inferred to be differentially expressed between normal and thyroid cancer samples. We then obtained eight key driver miRNAs, among which hsa-mir-221 and hsa-mir-222 were key driver RNAs identified by both miRNA–mRNA–lncRNA and WGCNA network. In addition, hsa-mir-375 was inferred to be significant for patients’ survival with 34 associated ceRNAs, among which RUNX2, DUSP6 and SEMA3D are known oncogenes regulating cellular proliferation and differentiation in thyroid cancer. These ceRNAs are critical in revealing the secrets behind thyroid cancer progression and may serve as future therapeutic biomarkers.

  7. Thyroid gland invasion in advanced squamous cell carcinoma of the larynx and hypopharynx.

    Science.gov (United States)

    Mangussi-Gomes, João; Danelon-Leonhardt, Fernando; Moussalem, Guilherme Figner; Ahumada, Nicolas Galat; Oliveira, Cleydson Lucena; Hojaij, Flávio Carneiro

    Squamous cell carcinoma of the larynx and hypopharynx has the potential to invade the thyroid gland. Despite this risk, the proposition of either partial or total thyroidectomy as part of the surgical treatment of all such cases remains controversial. To evaluate the frequency of invasion of the thyroid gland in patients with advanced laryngeal or hypopharyngeal squamous cell carcinoma submitted to total laryngectomy or pharyngolaryngectomy and thyroidectomy; to determine whether clinic-pathological characteristics can predict glandular involvement. A retrospective case series with chart review, from January 1998 to July 2013, was undertaken in a tertiary care university medical center. An inception cohort of 83 patients with larynx/hypopharynx squamous cell carcinoma was considered. All patients had advanced stage disease (clinically T3-T4) and underwent total laryngectomy or total pharyngolaryngectomy in association with thyroidectomy. Adjuvant therapy was indicated when tumor or neck conditions required. Frequency of thyroid cartilage invasion was calculated; univariate and multivariate analysis of demographic, clinical and pathological characteristics associated with cartilage invasion were performed. The overall frequency of invasion of the thyroid gland was 18.1%. Glandular involvement was associated with invasion of the following structures: anterior commissure (odds ratio=5.13; 95% confidence interval 1.07-24.5), subglottis (odds ratio=12.44; 95% confidence interval 1.55-100.00) and cricoid cartilage (odds ratio=15.95; 95% confidence interval 4.23-60.11). Invasion of the thyroid gland is uncommon in the context of laryngopharyngeal squamous cell carcinoma. Clinical and pathological features such as invasion of the anterior commissure, subglottis and cricoid cartilage are more associated with glandular invasion. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights

  8. Identification of novel therapeutic targets in anaplastic thyroid carcinoma using functional genomic mRNA-profiling: Paving the way for new avenues?

    Science.gov (United States)

    Jonker, Pascal K C; van Dam, Gooitzen M; Oosting, Sjoukje F; Kruijff, Schelto; Fehrmann, Rudolf S N

    2017-01-01

    Currently, anaplastic thyroid carcinoma has a very poor prognosis and there is an unmet need for new therapeutic options. Therefore, this study aims to identify upregulated genes in anaplastic thyroid carcinoma with known drug interactions that could serve as new therapeutic targets. Publicly available microarray expression profiles of anaplastic thyroid carcinoma and normal thyroid tissue were collected. FGmRNA-profiling was applied, which is a recently developed method that enhances the ability to capture the downstream effects of genomic alterations on gene expression levels. Next, a comparison between FGmRNA-profiles of anaplastic thyroid carcinoma and normal thyroid samples was performed. Significantly upregulated genes in ATC were prioritized based on: 1) known interaction with antineoplastic drugs, 2) current drug development status in human, and 3) association with biologic pathways known to be involved in anaplastic thyroid carcinoma carcinogenesis. In the study, 25 anaplastic thyroid carcinoma and 80 normal thyroid samples were included for FGmRNA-profiling. Class comparison identified 301 significantly upregulated genes. Following prioritization, MTOR, MET, WEE1, PSMD1, MERTK, FGFR3, RARG, and ESR2 were identified as potential therapeutic targets. We prioritized 8 potential therapeutic druggable targets in anaplastic thyroid carcinoma. Ultimately, inhibition of these therapeutic targets might improve patient outcome in anaplastic thyroid carcinoma by reducing locoregional disease and distant metastases. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. A two miRNA classifier differentiates follicular thyroid carcinomas from follicular thyroid adenomas

    DEFF Research Database (Denmark)

    Stokowy, Tomasz; Wojtaś, Bartosz; Krajewska, Jolanta

    2015-01-01

    The inherent diagnostic limitations of thyroid fine needle aspiration (FNA), especially in the "indeterminate" category, can be partially overcome by molecular analyses. We aimed at the identification of miRNAs that could be used to improve the discrimination of indeterminate FNAs. miRNA expression...... in cytology material for its capability to discriminate (mutation negative) indeterminate cytologies and thereby improving the pre-surgical diagnostics of thyroid nodules....

  10. Thirty six treatments with radiodine after the administration of TSH recombinant in 26 patients with carcinoma differentiated from thyroid gland

    International Nuclear Information System (INIS)

    Pitoia, F.; Passerieu, M.; Bruno, O.D.; Niepomniszcze, H.

    2004-01-01

    The released studies that confirm the safety and efficacy the TSH recombinant (rhTSH) led to an increase in the interest for the use in the patients' preparation with thyroid remanents normal or differenced thyroid carcinoma persistent/recurrent, before the administration of therapeutic radioiodine doses in some situations, when it is impossible the suspension of the hormonal therapy thyroid. The objective is to evaluate the effectiveness of the administration of therapeutic doses of radioiodine after the administration of rhTSH

  11. Emergency total thyroidectomy for bleeding anaplastic thyroid carcinoma: A viable option for palliation

    Directory of Open Access Journals (Sweden)

    Sunil Kumar

    2011-01-01

    Full Text Available Anaplastic thyroid carcinoma (ATC is a rare and highly aggressive thyroid neoplasm. Bleeding from tumor is an uncommon, but potentially life-threatening complication requiring sophisticated intervention facilities which are not usually available at odd hours in emergency. We report the case of a 45-year-old woman who presented with exsanguinating hemorrhage from ATC and was treated by emergency total thyroidectomy. The patient is well three months postoperatively. Emergency total thyroidectomy is a viable option for palliation in ATC presenting with bleeding.

  12. Evaluation of the presence of Epstein-Barr virus (EBV) in Iranian patients with thyroid papillary carcinoma.

    Science.gov (United States)

    Homayouni, Maryam; Mohammad Arabzadeh, Seyed Ali; Nili, Fatemeh; Razi, Farideh; Amoli, Mahsa Mohammad

    2017-07-01

    Papillary thyroid carcinoma (PTC) is the most common thyroid cancer. EBV is one of the most important viruses related to different types of malignancies. This study investigated the relationship between EBV and papillary thyroid carcinoma. In this study the presence of Epstein-Barr Nuclear Antigen 1 (EBNA1) gene in papillary thyroid carcinoma tissues were examined by nested-PCR method. Paraffin-embedded tissues (N=41) blocks of thyroid cancer were used. DNA was extracted from all samples and then samples were evaluated for the presence of EBV gene. In 41 samples, EBNA1 was detected in 65.8% of patients with papillary thyroid carcinoma which was significantly higher in younger ages. The significant presence of EBV genome in papillary thyroid carcinoma suggests that this virus may play a role in this cancer especially in younger ages. As a result, monitoring of patients with EBV latent infection for PTC can be very important. Copyright © 2017 Elsevier GmbH. All rights reserved.

  13. Anaplastic carcinoma of thyroid gland with widespread soft tissue metastasis: an unusual presentation.

    Science.gov (United States)

    Hassan, Muhammad; Janjua, Taimoor Khalid; Afridi, Hira Khan; Zahid, Naila Anjum

    2017-07-13

    Anaplastic thyroid cancer is the rarest tumour of the thyroid gland, representing only 2% of clinically recognised thyroid cancers. The most common metastatic sites are lungs, followed by the intrathoracic and neck lymph nodes. We report the case of a 62-year-old woman who presented to our setting with multiple soft tissue nodules, thyroid mass, head swelling and weight loss. Radiological investigation showed a large thyroid mass with widespread metastasis in subcutaneous tissues of both upper limbs, chest and abdomen. Metastasis was also found in lungs, skull and adrenal glands after which the patient was diagnosed with stage IVc anaplastic thyroid carcinoma (ATC). After careful consideration of patient's clinical condition with multiple poor prognostic factors, medical therapy was withheld and she was discharged on hospice care. The patient expired after 1 month. In ATC, metastasis to subcutaneous tissue is an extremely rare occurrence of which there is hardly any evidence in literature. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Radioactive iodine treatment of a functional thyroid carcinoma producing hyperthyroidism in a dog

    International Nuclear Information System (INIS)

    Peterson, M.E.; Kintzer, P.P.; Hurley, J.R.; Becker, D.V.

    1989-01-01

    Radioactive iodine ( 131 I) was used in the treatment of a 12-year-old female dog with hyperthyroidism resulting from a large, unresectable (and metastatic) thyroid carcinoma associated with signs of severe inspiratory stridor and dyspnea. Hyperthyroidism was diagnosed on the basis of clinical signs (polyuria, polydipsia, polyphagia, weight loss, nervousness) and high basal serum thyroxine (T4) concentrations, as well as thyroid radioiodine kinetic studies that showed a high radioiodine uptake into the thyroid (% thyroid uptake) and markedly increased serum concentrations of protein-bound iodine-131 (PB 131 I) after 131 I tracer injection. Thyroid imaging revealed diffuse radionuclide accumulation by the tumor, which involved both thyroid lobes. The dog was treated with three large doses of radioiodine ( 131 I), ranging from 60 to 75 mCi, given at intervals of 5 to 7 months. The dog became euthyroid, and the size of the tumor decreased by approximately 25% after each 131 I treatment, improving the severe inspiratory stridor and dyspnea, but both the hyperthyroid state and breathing difficulty recurred within a few months of each treatment. The dog was euthanatized 5 months after the last treatment because of progressive tracheal compression and pulmonary metastasis

  15. The frequency of carcinoma in solitary thyroid nodules and in ...

    African Journals Online (AJOL)

    Muhimbili Medical Centre, Dar es Salaam was made to determine the frequency of malignancy in patients with solitary non-toxic thyroid nodule (STN) and in those with multinodular goitre (MNG). There were 60 cases of STN and. 178 with MNG. Nodular goitre was found to be predominantly a disease of females with sex.

  16. Direct spread of thyroid follicular carcinoma to the parotid gland and the internal jugular vein: a case report

    Directory of Open Access Journals (Sweden)

    Alzaraa Ahmed

    2008-09-01

    Full Text Available Abstract Introduction The parotid gland and the great cervical veins are very rarely involved in a metastatic thyroid cancer. Case presentation We report an interesting case of an unusual metastasis of a thyroid follicular carcinoma including the histopathological and radiological findings. A woman was seen in the otolaryngology clinic with a mass at the angle of the left side of her jaw. Clinical examination and investigations confirmed a thyroid follicular carcinoma with metastases to the parotid gland and the internal jugular vein. Conclusion This is an educational case which highlights the importance of close communication between clinicians, histopathologists and radiologists to ensure that such rare cases are not missed.

  17. Unusual metastasis of medullary thyroid carcinoma to the breast: A cytological and histopathological correlation

    Directory of Open Access Journals (Sweden)

    Parul Tanwar

    2018-01-01

    Full Text Available Breast metastases are a relatively rare condition and account for approximately 0.5–2% of all breast tumors. Recognition of metastatic tumors in the breast is important because it would prevent unnecessary mutilating surgery and would lead to appropriate treatment of the primary tumor. Breast metastases from medullary thyroid cancer (MTC are very rare with only 21 reported cases in the literature. Some MTCs mimic primary invasive lobular carcinoma of the breast histopathologically and radiologically, making the distinction between the two diagnostically challenging. We present the case of a 45-year-old female presenting with a lump breast, which was later found out to be metastasis from medullary carcinoma thyroid.

  18. Follicular thyroid carcinoma characterized by abundant stromal components with chondroid and osseous metaplasia in a dog.

    Science.gov (United States)

    Kobayashi, Ryosuke; Yamada, Naoaki; Kitamori, Takashi; Kitamori, Fumiyo; Sato, Kazunari; Doi, Takuya; Wako, Yumi; Sato, Junko; Tsuchitani, Minoru

    2014-08-01

    A dog developed a cervical mass, and computed tomography verified a mass surrounding the trachea with some pulmonary masses. Histopathologically, the cervical mass was composed of malignant neoplastic cells showing follicular appearance which reacted positive for thyroglobulin on immunohistochemistry. A characteristic feature of the tumor was abundant and metaplastic stromal components. Anastomosed collagenous tissues connecting to capsule of the tumor were abundant in the stroma. In parts of the collagenous tissues, mature cartilages and bones were continuously formed. There was no cellular atypia or invasion in the components. We diagnosed this case as follicular thyroid carcinoma with metaplastic stroma. This is the first case report that characterizes stromal components with chondroid and osseous metaplasia in a canine thyroid carcinoma.

  19. Hypofractionated radiation therapy for invasive thyroid carcinoma in dogs: a retrospective analysis of survival.

    Science.gov (United States)

    Brearley, M J; Hayes, A M; Murphy, S

    1999-05-01

    Thirteen dogs with invasive thyroid carcinoma (WHO classification T2b or T3b) seen between January 1991 and October 1997 were treated by external beam irradiation. Four once-weekly fractions of 9 gray of 4 MeV X-rays were administered. Four of the dogs died of progression of the primary disease and four from metastatic spread. Of the remaining dogs, three died of unrelated problems, although two were still alive at the time of the censor. Kaplan-Meier analysis of the survival time from first dose to death from either primary or metastatic disease gave a median survival time of 96 weeks (mean 85 weeks, range six to 247 weeks). Radiographic evidence of pulmonary metastatic disease at presentation had no prognostic value whereas crude growth rate was a highly significant factor. The present series indicates that radiation therapy should be considered an important modality for the control of invasive thyroid carcinoma in the dog.

  20. Seric thyroglobulin behavior in thyroid carcinoma patients treated with 131I

    International Nuclear Information System (INIS)

    Viterbo, B.G.

    1988-01-01

    The thyroid carcinomas, mainly the differentiated ones, for involving originally young patients and for showing relatively benign course, require a long term follow-up. So, every new available method that may be useful for the follow-up of these patients soon becomes very important. The advent of radioimmunoassay made the determination of thyroglobulin seric levels possible and this practice has been incorporated into medical routine in the past few years. The analysis of the results permit to conclude that the administration of 131 I therapeutic dose to differentiated and medular thyroid carcinoma patients is followed by imediate and transitory rise in circulating thyroglobulin levels. It denotes immediate effect of the 131 I that can be observed in a short period of time independently of L-T3 administration and endogen TSH levels. After this period the thyroglobulin is at least in a partial way, TSH-dependent. (author) [pt

  1. Malignant thyroglossal duct cyst with synchronous occult thyroid gland papillary carcinoma

    Directory of Open Access Journals (Sweden)

    R Senthilkumar

    2013-01-01

    Full Text Available A 52-year-old male was referred to our department with complaints of a painless midline neck swelling. Clinico-radiological evaluation suggested a 6 × 5 cm thyroglossal cyst with non-palpable nodules in isthmus and right lobe of thyroid gland. FNAC of the thyroglossal cyst was suggestive of papillary carcinoma. He underwent Sistrunk′s operation, total thyroidectomy, and central compartment neck dissection. Co-existence of papillary carcinoma of thyroid gland and thyroglossal cyst is a rare presentation and in this report, we describe our management and propose an evidence-based algorithm to assist decision-making in the management of these patients in future.

  2. The potential value of somatostatin receptor scintigraphy in medullary thyroid carcinoma

    International Nuclear Information System (INIS)

    Doerr, U.; Bihl, H.; Frank-Raue, K.; Raue, F.; Sautter-Bihl, M.L.; Buhr, H.J.; Guzman, G.; Inst. de Neurocirugia, Investigationes Cerebrales 'Dr Asenjo' Santiago

    1993-01-01

    In a prospective study, ten patients with recurrent medullary thyroid carcinoma (markedly elevated calcitonin levels) were investigated by means of somatostatin receptor scintigraphy (SRS) with 111 In-pentetreotide. Scintigraphically, 30 sites of pathological uptake were found, mostly located in the neck and upper mediastinum. So far, 18 suspected tumour sites underwent histological examination and 14 of them could be verified as metastases of medullary thyroid carcinoma (MTC). The remaining four putative tumour lesions turned out to be false positive scintigraphic findings caused by chronic inflammation and somatostatin receptor positive tumours other than MTC. We conclude that SRS is a promising imaging modality for localization of MTC recurrence and may thus make a contribution to better management of this patient group. (Author)

  3. Hypofractionated radiation therapy for invasive thyroid carcinoma in dogs: a retrospective analysis of survival

    International Nuclear Information System (INIS)

    Brearley, M.J.; Hayes, A.M.; Murphy, S.

    1999-01-01

    Thirteen dogs with invasive thyroid carcinoma (WHO classification T2b or T3b) seen between January 1991 and October 1997 were treated by external beam Irradiation. Four once-weekly fractions of 9 gray of 4 MeV X-rays were administered. Four of the dogs died of progression of the primary disease and four from metastatic spread. Of the remaining dogs, three died of unrelated problems, although two were still alive at the time of the censor. Kaplan-Meier analysis of the survival time from first dose to death from either primary or metastatic disease gave a median survival time of 96 weeks (mean 85 weeks, range six to 247 weeks). Radiographic evidence of pulmonary metastatic disease at presentation had no prognostic value whereas crude growth rate was a highly significant factor. The present series Indicates that radiation therapy should be considered an important modality for the control of invasive thyroid carcinoma in the dog

  4. Poorly Differentiated Thyroid Carcinoma Arising in Struma Ovarii: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Pisutt Srichaikul

    2016-03-01

    Full Text Available An 81-year-old woman presented with a pelvic mass. The computed tomography scan showed a non- calcifiedsolidcysticmass,10.4x11.5x6.7centimeters.Sheunderwent totalabdominalhysterectomy withbilateral salpingo-oophorectomy,omentectomyandascitic fluidforcytology. Histopathologyreportedpoorlydifferentiated thyroid carcinoma arising in struma ovarii. Currently she has been free of disease for 5 months from the date of diagnosis.

  5. Histopathological and immunohistochemical findings of primary and metastatic medullary thyroid carcinoma in a young dog

    OpenAIRE

    Piñeyro, Pablo; Vieson, Miranda D.; Ramos-Vara, José A.; Moon-Larson, Martha; Saunders, Geoffrey

    2014-01-01

    This report describes the gross, histological, and immunohistochemical features of medullary thyroid carcinoma (MTC) with pulmonary metastases in a young dog. Sheets of pleomorphic cells supported by fibrous stroma characterized the primary mass, while metastatic nodules had a neuroendocrine pattern. Despite differing histologic features, all masses showed marked immunoreactivity against calcitonin and multiple neuroendocrine markers consistent with MTC. Although MTC is a well-recognized enti...

  6. Targeting of slug sensitizes anaplastic thyroid carcinoma SW1736 cells to doxorubicin via PUMA upregulation

    OpenAIRE

    Dong, Anbing; Jiao, Xuelong; Chen, Dong; Hao, Fengyun; Zhang, Kejun

    2016-01-01

    Objective: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human cancers and often shows resistance to multimodal therapeutic approaches. It has been shown that the transcriptional repressor Slug inhibits the chemotherapeutic agent-induced apoptosis of cancer cells. We evaluated whether targeting of Slug could augment doxorubicin (DOX)-induced apoptosis of ATC cells. We also determined changes in PUMA (p53-upregulated modulator of apoptosis) expression levels to identify poss...

  7. Medullary Thyroid Carcinoma: Targeted Therapies and Future Directions

    Directory of Open Access Journals (Sweden)

    Scott N. Pinchot

    2009-01-01

    Full Text Available Medullary thyroid cancer (MTC is a rare neuroendocrine neoplasm that accounts for approximately 5% of all thyroid malignancies. The natural history of MTC is characterized by early lymph node and distant metastases, making complete surgical cure often impossible. Conventional chemotherapy and external beam radiation have been largely ineffective in altering the natural history of MTC. Therefore, there is a great need to develop novel therapeutic strategies to affect symptom control and reduce tumor burden in patients with widely disseminated disease. Here, we review several pathways which have been shown to be vital in MTC tumorigenesis and focus on the pathways of interest for which targeted drug therapies are currently being developed.

  8. Surgical options in the management of well differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    Goitre is a common every day problem but cancer of the thyroid is a comparatively rare disease. It constitutes only 1.3 % of all cancers seen at the Tata Memorial Hospital. The surgeon has a central role in the management of cancer of the thyroid. All other modalities of treatment, like radioiodine therapy follow his surgery and depend on the extent of surgery performed. It is therefore important that the surgeon has a clear cut policy of management. Although surgery is the prime mode of treatment, the extent of surgery has been a matter of debate. Additionally, what constitutes adequate surgical treatment itself is highly controversial. A policy for management based on the natural history, biological behaviour of the disease and the previous treatment methods is discussed

  9. Fine-needle aspiration study of cystic papillary thyroid carcinoma: Rare cytological findings

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    Maral Mokhtari

    2016-01-01

    Full Text Available Background: Cystic papillary thyroid carcinoma (CPTC is a variant of papillary carcinoma that has many mimickers in cytological grounds. Aim: To study the cytomorphologic features of CPTC and compare them to those of other cystic thyroid lesions using fine-needle aspiration cytology (FNAC. We also aimed to identify the cytomorphologic features that distinguish CPTC from other cystic thyroid lesions. Materials and Methods: Seventy-three cases of CPTC were included in the study. The cytomorphologic features of these cases were analyzed. The FNA smears of other thyroid lesions with cystic changes (300 colloid goiters, 290 adenomatoid nodules, 11 follicular neoplasms, and 9 hurtle cell neoplasm were also studied. Results: The smears in CPTC revealed isolated follicular cells, small groups of cells with scalloped margins, cell swirls, small clusters with a cartwheel pattern, papillary clusters, intranuclear inclusions, nuclear grooves, sticky colloid, intracellular colloids, psammoma bodies, multinucleated giant cells, and foamy and hemosiderin laden macrophages. Small groups of cells with scalloped borders, cellular swirls, and small clusters with a cartwheel pattern were seen in CPTC, but not in other cystic lesions. Interestingly, mesothelial-like cells and hemophagocytic cells were seen in five and three cases of CPTC, respectively, but not in other cystic lesions. Conclusion: Mesothelial-like cells and hemophagocytic cells were observed in five and three cases of CPTC, respectively. Similar finding have not been previously reported in the literature.

  10. Papillary thyroid carcinoma, dermoid cyst and polycystic ovary syndrome: a case report

    International Nuclear Information System (INIS)

    Plaizier, M.A.B.D.; Pieters, J.J.P.M.; Hamming, J.F.; Heul, C. van der; Misere, J.

    2002-01-01

    Full text: Total body scintigraphy after the I-131 treatment for thyroid carcinoma is a routine procedure in staging. For smaller tumors uptake outside the neck is seldomly seen, usually benign and without clinical significance. However, a conscientious analysis of there accumulations can be relevant. A 33 year-old female presented in December 1998 with a T2N1M0 papillary thyroid carcinoma. Thyroidectomy, neck dissection and 50 mCi 1-131 treated her. The post-therapy scan was negative except for a small spot in the neck (thyroidremnant: 3.0 %). In September 1999 150 mCi was administered and the scan afterwards showed a focus median in the neck (thyroid remnant: 0.3 %) and a persistent hotspot in the left lower quadrant of the abdomen (figure). The thyreoglobuline was 3.8 μg/l (unchanged to the first I-131 therapy) during maximal TSH Stimulation (174 mu/l). Transvaginal ultrasound revealed an enlarged left ovary which was laparoscopical removed and appeared to be a dermoid cyst with hair- and skincomponents, respiratory epithelia and bone. Only after staining on thyreoglobuline thyroid tissue was demonstrated; there were no signs of malignancy. Six months later a 10 mCi I-131 scintigraphy was negative; thyreoglobuline was < 0.5 μg/l and TSH 161 mg/l suggesting no thyroid tissue was present in the Body. Her medical history showed a polycystic ovary syndrome (PCOS). She received treatment for ovulation induction including clomiphene, HCG, FSH and LH. Her thyroid function was normal. After two miscarriages She gave birth to a daughter. Germ cells must been present since birth to form a dermoid cyst during life. In our patient, the dermoid cyst with benign thyroid cells was visualized only after the second I-131 therapy. We assume that the sensitivity of a scan after 50 mCi and 150 mCi I-131 is equal. Therefore, probably not the ovulation induction medication but the TSH stimulation for the I-131 therapy is the reason for the development of the dermoid cyst. That only

  11. Malignant Solitary Fibrous Tumor Metastatic to Widely Invasive Hurthle Cell Thyroid Carcinoma: A Distinct Tumor-to-Tumor Metastasis.

    Science.gov (United States)

    Kolson Kokohaare, Eva; Riva, Francesco M G; Bernstein, Jonathan M; Miah, Aisha B; Thway, Khin

    2018-04-01

    We illustrate a case of synchronous malignant solitary fibrous tumor of the thoracic cavity, and widely invasive thyroid Hurthle cell carcinoma. The Hurthle cell carcinoma was found to harbor distinct areas of malignant solitary fibrous tumor. This is a unique case of tumor-to-tumor metastasis that, to the best of our knowledge, has not been previously reported.

  12. Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid gland in a male patient: a case report and literature review.

    Science.gov (United States)

    Lai, Chi-Yun; Chao, Tzu-Chieh; Lin, Jen-Der; Hsueh, Chuen

    2015-01-01

    Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) was first described by Chan et al in 1991. It is characterized by nest or strands of epidermoid tumor cells with squamous differentiation, rare mucous cells, prominent sclerotic stroma, eosinophilic and lymphoplasmacytic infiltration, and a background of chronic lymphocytic thyroiditis in the non-neoplastic thyroid gland. It is important to recognize SMECE of thyroid and differentiate it from squamous cell carcinoma or other neoplasms with squamous differentiation/metaplasia. In published cases, the SMECE of thyroid gland predominantly occurs in women. We report a case of SMECE of thyroid in a 45-year-old male patient. All cases in male patients were Caucasian described in English literature, and our case is the first one in Asian.

  13. Dual-Phase 99MTc-MIBI Parathyroid Imaging Reveals Synchronous Parathyroid Adenoma and Papillary Thyroid Carcinoma: A Case Report

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    Ming-Che Chang

    2008-10-01

    Full Text Available The possibility of a coincidental appearance of hyperparathyroidism and thyroid cancer is not often considered because of its low incidence. Here, we present a case of a 49-year-old woman with a parathyroid adenoma coexisting with two sites of papillary thyroid carcinoma. Dual-phase 99mTc-methoxyisobutylisonitrile (MIBI parathyroid imaging before the operation correctly visualized the site of the parathyroid adenoma. In addition, two papillary thyroid carcinomas showed faint uptake of 99mTc-MIBI on delayed image. Total thyroidectomy and parathyroidectomy of a solitary parathyroid adenoma were performed. The patient subsequently underwent radioiodine-131 ablation and was treated with T4 suppression. This case illustrates the need for clinical awareness of concomitant hyperparathyroidism and thyroid cancer. Dual-phase 99mTc-MIBI parathyroid imaging may be useful for detecting indolent thyroid cancer before it becomes a distinct disease.

  14. Clinical features and prognostic factors for survival in patients with poorly differentiated thyroid carcinoma and comparison to the patients with the aggressive variants of papillary thyroid carcinoma

    International Nuclear Information System (INIS)

    Jung, Tae-Sik; Kim, Tae-Yong; Kim, Kyung-Won

    2007-01-01

    We performed this study to compare the clinicopathologic features and outcomes between the patients with poorly differentiated thyroid carcinoma (PDTC) and the patients with the aggressive variants of papillary thyroid carcinoma (PTC). To evaluate the prognostic factors for survival of the patients with PDTC, we selected 49 patients with PDTC and 23 patients with the aggressive variants of PTC from three hospitals during the recent 15 years. The five-year survival rate and clinicopathologic features of the patients with PDTC were not different from those of the patients with the aggressive variants of PTC. Univariate analysis revealed the significant poor prognostic factors for survival of the patients with PDTC and the aggressive variants of PTC as follows: an age more than 45 years, a tumor size larger than 4 cm, the presence of tumor invasion to extrathyroidal tissue or the trachea, the presence of cervical lymph node invasion, the presence of distant metastasis, the absence of high-dose radioactive iodine (RAI) therapy, and tumor, nodes and metastasis (TNM) stage II, III and IV. Distant metastasis and high-dose RAI therapy were independent significant predictors for survival of the patients with PDTC and the aggressive variants of PTC on multivariate analysis. However, distant metastasis was the only independent significant predictors for survival of the patients with PDTC excluding patients with the aggressive variants of PTC. (author)

  15. Papillary thyroid carcinoma associated to Hashimoto's thyroiditis: frequency and histopathological aspects

    OpenAIRE

    Camboim, Denise Cruz; Figueirôa, Vivina Marta Simões da Motta; Lima, Daisy Nunes de Oliveira; Abreu-e-Lima, Paula; Abreu-e-Lima, Maria do Carmo Carvalho de

    2009-01-01

    INTRODUÇÃO: O carcinoma papilífero é o tipo mais comum de câncer da tireoide e a tireoidite de Hashimoto é a causa mais frequente de hipotireoidismo em áreas onde os níveis de iodo são adequados. Vários investigadores detectaram incidência aumentada de carcinoma papilífero da tireoide em pacientes com tireoidite de Hashimoto. Na rotina de diagnósticos histopatológicos há uma aparente associação entre as duas patologias. OBJETIVO: Determinar a relação entre tireoidite de Hashimoto e carcinoma ...

  16. Thyroidectomy and Lymph Node Dissection in Papillary Thyroid Carcinoma

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    Yasuhiro Ito

    2011-01-01

    Full Text Available Papillary carcinoma is a prominent malignancy originating from follicular cells. This disease generally shows an indolent character, but patients demonstrating certain clinicopathological features have a dire prognosis. At present, Western countries adopted almost routine total thyroidectomy with radioactive iodine (RAI ablation, while limited thyroidectomy with extensive prophylactic lymph node dissection has traditionally been performed for most patients in Japan. Recently, accurate evaluation of carcinoma stage can be performed on preoperative imaging studies, especially on ultrasonography. It is therefore important to treat papillary carcinoma patients depending on clinicopathological features rather than in a stereotyped fashion. In this paper, appropriate extension of thyroidectomy and lymph node dissection is discussed based on Western and recently published Japanese guidelines and the experience in Kuma Hospital.

  17. Thyroidectomy and lymph node dissection in papillary thyroid carcinoma.

    Science.gov (United States)

    Ito, Yasuhiro; Miyauchi, Akira

    2010-11-10

    Papillary carcinoma is a prominent malignancy originating from follicular cells. This disease generally shows an indolent character, but patients demonstrating certain clinicopathological features have a dire prognosis. At present, Western countries adopted almost routine total thyroidectomy with radioactive iodine (RAI) ablation, while limited thyroidectomy with extensive prophylactic lymph node dissection has traditionally been performed for most patients in Japan. Recently, accurate evaluation of carcinoma stage can be performed on preoperative imaging studies, especially on ultrasonography. It is therefore important to treat papillary carcinoma patients depending on clinicopathological features rather than in a stereotyped fashion. In this paper, appropriate extension of thyroidectomy and lymph node dissection is discussed based on Western and recently published Japanese guidelines and the experience in Kuma Hospital.

  18. 99mTc radio-guided completion thyroidectomy for differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Karyagar, Savas; Mulazimoglu, Mehmet; Oezpacaci, Tevfik; Uyanik, Ercan; Karyagar, Sevda S.; Oezdenkaya, Yasar; Karatape, Oguzhan; Bender, Oemer; Yalcin, Orhan

    2010-01-01

    The purpose of this study is to investigate whether or not radio-guided surgery has any beneficial effects on completion thyroidectomy (CT) and the associated complication rates. Twenty seven patients were scheduled for CT, for thyroid carcinoma, from December 2004 to June 2005, and were included in the study. All the patients had initial thyroid surgery in other centers and been referred to our clinic for CT. Operation findings and the effectiveness of 99m Tc radio-guided CT were analyzed. The intraoperative mean ratio of thyroid activity to background activity counted with a gamma probe was 1.3 ± 0.3. Average operation timing was 74 ± 9 minutes. Postoperatively, no residual tissue was detected in any of the patients with ultrasonography and thyroid scintigraphy. In the first postoperative month, serum TSH level was 61 ± 16.4 mlU/L, when preoperatively it was 7.3 ± 3.1 mlU/L (P < 0.001). In the postoperative period, one patient experienced temporary hypoparathyroidism (3.9%). Permanent hypoparathyroidism or recurrent laryngeal nerve damage was not detected in any patient. Tc-99 radio-guided CT is a reliable surgical method, which provides the detection and removal of residual thyroid tissues with minimal complications. (author)

  19. TPO genetic variants and risk of differentiated thyroid carcinoma in two European populations.

    Science.gov (United States)

    Cipollini, Monica; Pastor, Susana; Gemignani, Federica; Castell, Juan; Garritano, Sonia; Bonotti, Alessandra; Biarnés, Josefina; Figlioli, Gisella; Romei, Cristina; Marcos, Ricard; Cristaudo, Alfonso; Elisei, Rossella; Landi, Stefano; Velázquez, Antonia

    2013-12-15

    Thyroid cancer risk involves the interaction of genetic and environmental factors. The thyroperoxidase (TPO) has a key role in the iodine metabolism, being essential for the thyroid function. Mutations in the TPO gene are common in congenital hypothyroidism, and there are also signs of the implication of TPO in thyroid cancer. We performed a case-control association study of genetic variants in TPO and differentiated thyroid carcinoma (DTC) in 1,586 DTC patients and 1,769 controls including two European populations (Italy: 1,190 DTC and 1,290 controls; Spain: 396 DTC and 479 controls). Multivariate logistic regression analyses were performed separately for each population and each single-nucleotide polymorphism (SNP). From the three studied polymorphisms, significant associations were detected between DTC and rs2048722 and rs732609 in both populations (p TPO polymorphism in the Italian and the Spanish populations. Our results, for the first time, point to TPO as a gene involved in the risk of DTC, and suggest the importance of interactions between TPO variants and other unidentified population-specific factors in determining thyroid cancer risk. Copyright © 2013 UICC.

  20. Carcinoma papilífero da tireoide associado à tireoidite de Hashimoto: frequência e aspectos histopatológicos Papillary thyroid carcinoma associated to Hashimoto's thyroiditis: frequency and histopathological aspects

    Directory of Open Access Journals (Sweden)

    Denise Cruz Camboim

    2009-02-01

    Full Text Available INTRODUÇÃO: O carcinoma papilífero é o tipo mais comum de câncer da tireoide e a tireoidite de Hashimoto é a causa mais frequente de hipotireoidismo em áreas onde os níveis de iodo são adequados. Vários investigadores detectaram incidência aumentada de carcinoma papilífero da tireoide em pacientes com tireoidite de Hashimoto. Na rotina de diagnósticos histopatológicos há uma aparente associação entre as duas patologias. OBJETIVO: Determinar a relação entre tireoidite de Hashimoto e carcinoma papilífero de tireoide, avaliando os aspectos histomorfológicos, quando concomitantes ou apresentando-se de forma isolada. MÉTODO: Foi realizado estudo retrospectivo a partir dos dados do arquivo do Serviço de Patologia do Hospital Barão de Lucena, afiliado ao Sistema Único de Saúde (SUS (Recife-PE, incluindo 95 casos, entre 472 cirurgias de tireoide realizadas no período de janeiro de 1995 a janeiro de 2005. RESULTADOS: Houve 35 casos (7,4% de tireoidite de Hashimoto, 48 (10,2% de carcinoma papilífero e 12 (2,5% de associação significativa (p INTRODUCTION: Papillary carcinoma is the most common type of thyroid cancer and Hashimoto's thyroiditis is the most frequent cause of hypothyroidism in areas where iodine levels are adequate. Several investigators have detected an increased incidence of papillary thyroid carcinoma in patients with Hashimoto's thyroiditis. In histopathological diagnosis routine, there is an apparent association between these two pathologies. OBJECTIVE: To determine the association between Hashimoto's thyroiditis and papillary thyroid carcinoma, evaluating the histopathological aspects, when concomitantly present or isolated. METHODS: A retrospective study was carried out with data from the archives of the Pathology Service at hospital Barão de Lucena, SUS (Recife-PE, Brazil, which included 95 cases amongst 472 thyroid surgeries performed from January 1995 through January 2005. RESULTS: There were 35 cases

  1. The incidence and mechanism of sunitinib-induced thyroid atrophy in patients with metastatic renal cell carcinoma.

    Science.gov (United States)

    Shinohara, N; Takahashi, M; Kamishima, T; Ikushima, H; Otsuka, N; Ishizu, A; Shimizu, C; Kanayama, H; Nonomura, K

    2011-01-18

    To elucidate the incidence and mechanisms of sunitinib-induced thyroid atrophy, we investigated serial volumetric and functional changes, and evaluated histological changes of the thyroid gland in metastatic renal cell carcinoma patients who received sunitinib. Thyroid volume (by computed tomography volumetry) and thyroid function were measured at baseline, during the treatment, and at post-treatment periods. Histological evaluation of the thyroid gland was performed in four autopsied patients. The median reduction rate in thyroid volume at last evaluation during sunitinib treatment was 30% in all 17 patients. The incidence of hypothyroidism during sunitinib treatment was significantly higher in the high reduction rate group (n=8; more than 50% reduction in volume) than in the low reduction rate group (n=9; less than 50% reduction in volume). Half of the patients in the high reduction rate group exhibited a transient thyroid-stimulating hormone suppression, suggesting thyrotoxicosis during sunitinib treatment. Histological evaluation demonstrated atrophy of thyroid follicles and degeneration of follicular epithelial cells without critical diminution of vascular volume in the thyroid gland. Thyroid atrophy is frequently observed following sunitinib treatment and may be brought about by sunitinib-induced thyrotoxicosis or the direct effects of sunitinib that lead to degeneration of thyroid follicular cells.

  2. Demographic and Clinical Features of Thyroid Carcinomas in Republic of Macedonia (1999-2010).

    Science.gov (United States)

    Makazlieva, Tanja; Vaskova, Olivija; Majstorov, Venjamin; Stojanoski, Sinisha; Manevska, Nevena; Jovanovic, Rubens

    2017-12-15

    Thyroid carcinomas (TC) are the most common endocrine malignancies. In some parts of the world, the incidence of TCs has increased over the past few decades, especially in females according to some studies. We have set as the objective for our study to analyse the demographic, ultrasound features, thyroid hormonal status and frequency of thyroid carcinomas in the Republic of Macedonia according to histopathological type. Retrospective analysis of medical data from all diagnosed and treated patients with TC at the Institute of Pathophysiology and Nuclear Medicine for the period 1999-2010 was performed. Demographic characteristics: age at diagnosis, gender, histopathological type of TC and from clinical features: US findings and thyroid hormonal state at initial examination and their distribution in eight state regions were evaluated. Total number of 204 patients with TC in the Republic of Macedonia was registered. Papillary thyroid carcinoma (PTC) was the most frequent with 131 pts (64.21%), follicular (FTC) with 13 pts (6.37%) was second thyroid malignoma, followed by medullary (MTC) with 12 pts (5.88%), anaplastic (ATC) 11 pts (5.39%) and the rarest types were Hurtle cell carcinoma and intrathyroid sarcoma with only 1 diagnosed case. Age varied widely from 7 yrs to 88 yrs age (average 47.9 ± 16.6 yrs). PTC was more prevalent in younger age groups, while ATC was diagnosed in elderly patients. In all of the eight-country regions, the prevalence rate was higher for females than males (3:1) or 15.21/10 5 female to 5.03/10 5 male prevalence rate. According to US appearance mostly TC was unilateral in 42.65% and multifocal in 7.84% with dimensions from 15 to 50 mm. There is an increase in incidence and prevalence rate of TCs in our country, mostly PTC, while reduction exists in the number of diagnosed cases of ATC and FTC, comparing with previous studies before iodine prophylaxis program. Different from described in the literature is female: male (4:1) ratio for ATC

  3. Mammary Analog Secretory Carcinoma (MASC) Involving the Thyroid Gland: A Report of the First 3 Cases.

    Science.gov (United States)

    Dettloff, Jennifer; Seethala, Raja R; Stevens, Todd M; Brandwein-Gensler, Margaret; Centeno, Barbara A; Otto, Kristen; Bridge, Julia A; Bishop, Justin A; Leon, Marino E

    2017-06-01

    Salivary gland-type tumors have been rarely described in the thyroid gland. Mammary Analog Secretory Carcinoma (MASC) is a recently defined type of salivary gland carcinoma characterized by a t(12;15)(p13;q25) resulting in an ETV6-NTRK3 fusion gene. We report 3 cases of MASC involving the thyroid gland without clinical evidence of a salivary gland or breast primary; the clinico-pathologic characteristics are reviewed. Assessment for rearrangement of the ETV6 (12p13) locus was conducted by fluorescence in situ hybridization (FISH) on representative FFPE sections using an ETV6 break apart probe (Abbott Molecular, Des Plaines, IL, USA). The patients were two females (52 and 55 years-old) and 1 male (74 years-old). The tumors were poorly circumscribed solid white tan nodules involving the thyroid. Histologically, they were invasive and showed solid, microcystic, cribriform, and tubular growth patterns composed of variably bland polygonal eosinophilic cells with vesicular nuclear chromatin and conspicuous nucleoli. All three cases showed metastasis to lymph nodes; one case showed lateral neck involvement. The tumor cells were positive for S100 and mammaglobin. GATA-3 and PAX-8 were positive in 2 cases, one of which only focally so. All three cases were negative for TTF-1 and thyroglobulin. Rearrangement of the ETV6 locus was confirmed in all cases and a diagnosis of MASC rendered for each case. A site of origin distinct from the thyroid gland was not identified, with a median follow up of 24 months. MASC may rarely involve the thyroid gland. The origin of these lesions is unknown; while an origin from ectopic salivary gland-type cells is entertained, a metastatic origin from an occult primary cannot be definitively excluded at this time. Given the histologic (follicular-like microcystic pattern with colloid-like secretions and papillary pattern), immunophenotypic (PAX-8), and even molecular overlap, MASC can be mistaken for papillary thyroid carcinoma and should be

  4. Mutual regulation of TGF-β1, TβRII and ErbB receptors expression in human thyroid carcinomas

    International Nuclear Information System (INIS)

    Mincione, Gabriella; Tarantelli, Chiara; Vianale, Giovina; Di Marcantonio, Maria Carmela; Cotellese, Roberto; Francomano, Franco; Di Nicola, Marta; Costantini, Erica; Cichella, Annadomenica; Muraro, Raffaella

    2014-01-01

    The role of EGF and TGF-β1 in thyroid cancer is still not clearly defined. TGF-β1 inhibited the cellular growth and migration of follicular (FTC-133) and papillary (B-CPAP) thyroid carcinoma cell lines. Co-treatments of TGF-β1 and EGF inhibited proliferation in both cell lines, but displayed opposite effect on their migratory capability, leading to inhibition in B-CPAP and promotion in FTC-133 cells, by a MAPK-dependent mechanism. TGF-β1, TβRII and EGFR expressions were evaluated in benign and malignant thyroid tumors. Both positivity (51.7% and 60.0% and 80.0% in FA and PTC and FTC) and overexpression (60.0%, 77.7% and 75.0% in FA, PTC and FTC) of EGFR mRNA correlates with the aggressive tumor behavior. The moderate overexpression of TGF-β1 and TβRII mRNA in PTC tissues (61.5% and 62.5%, respectively), counteracted their high overexpression in FTC tissues (100% and 100%, respectively), while EGFR overexpression was similar in both carcinomas. Papillary carcinomas were positive to E-cadherin expression, while the follicular carcinomas lose E-cadherin staining. Our findings of TGF-β1/TβRII and EGFR overexpressions together with a loss of E-cadherin observed in human follicular thyroid carcinomas, and of increased migration ability MAPK-dependent after EGF/TGF-β1 treatments in the follicular thyroid carcinoma cell line, reinforced the hypothesis of a cross-talk between EGF and TGF-β1 systems in follicular thyroid carcinomas phenotype. - Highlights: • We reinforce the hypothesis of a cross talk between EGF and TGF-β1 in follicular thyroid carcinoma. • Increased migration MAPK-dependent is observed after EGF+TGF-β1 treatment in follicular thyroid carcinoma cells. • EGF and TGF-β1 caused opposite effect on the migratory ability in B-CPAP and in FTC-133 cells. • TGF-β1, TβRII and EGFR are overexpressed in follicular thyroid carcinoma

  5. Contemporary post surgical management of differentiated thyroid carcinoma.

    Science.gov (United States)

    Tala, H; Tuttle, R M

    2010-08-01

    Risk assessment is the cornerstone of contemporary management of thyroid cancer. Following thyroid surgery, an initial risk assessment of recurrence and disease-specific mortality is made using important intra-operative findings, histologic characteristics of the tumor, molecular profile of the tumor, post-operative serum thyroglobulin and any available cross-sectional imaging studies. This initial risk assessment is used to guide recommendations regarding the need for remnant ablation, external beam irradiation, systemic therapy, degree of TSH suppression, and follow-up disease detection strategy over the first 2 years after initial therapy. While this initial risk stratification provides valuable information, it is a static representation of the patient in the first few weeks post-operatively that does not change over time. Depending on how the patient responds to our initial therapies, the risk of recurrence and death may change significantly during follow-up. In order to account for differences in response to therapy in individual patients and to incorporate the impact of treatment on our initial risk estimates, we recommend a re-stratification of risk at the 2-year point of follow-up. This re-stratification provides an updated risk estimate that can be used to guide ongoing management recommendations including the frequency and intensity of follow-up, degree of ongoing TSH suppression, and need for additional therapies. Ongoing management recommendations must be tailored to realistic, evolving risk estimates that are actively updated during follow-up. By individualizing therapy on the basis of initial and ongoing risk assessments, we can maximize the beneficial effects of aggressive therapy in patients with thyroid cancer who are likely to benefit from it, while minimizing potential complications and side effects in low-risk patients destined to have a full healthy and productive life after minimal therapeutic intervention. Copyright (c) 2010 The Royal College

  6. Hemangioendothelioma of the thyroid gland--true endothelioma or anaplastic carcinoma?

    Science.gov (United States)

    Krisch, K; Holzner, J H; Kokoschka, R; Jakesz, R; Niederle, B; Roka, R

    1980-12-01

    After a critical histological re-examination of 26 cases of malignant hemangioendothelioma of the thyroid, and a comparison with 51 cases of anaplastic spindle and giant cell carcinoma, it becomes obvious that traumatic and shrinkage artefacts due to fixation, as well as superimposition of neoplastic and repair processes due to regressive changes--almost always seen in malignant hemangioendothelioma associated nodular goiter--may be misinterpreted as neoplastic vascular spaces (and therefore angioblastic tumour differentiation). Focal epithelial arrangements of tumour cells often observed in these malignant hemangioendotheliomas and the lack of objective light microscopic differential diagnostic criteria of anaplastic spindle and giant cell carcinoma make the high incidence of endotheliomas of the thyroid in European endemic goiter regions very questionable. Compared with anaplastic spindle and giant cell carcinoma, the incidence for (1) extrathyroid tumours that infiltrate into the trachea or the oesophagus, (2) lymph node metastases and (3) distant metastases is not statistically different in malignant hemangioendothelioma. Therefore we conclude that the tumours classified as malignant hemangioendothelioma in goitrous areas represent a special growth pattern of anaplastic spindle and giant cell carcinoma within adenomatous glands rather than a distinct tumour type.

  7. Differentiation between healthy thyroid remnants and tumor tissue after radioiodine therapy in patients with differentiated thyroid carcinoma using in-vitro phosphorus-31 magnetic resonance spectroscopy

    International Nuclear Information System (INIS)

    Moka, D.; Dietlein, M.; Schicha, H.; Raffelt, K.; Hahn, J.

    2002-01-01

    Full text: In many tumors, tumor growth and spread is triggered by changes in cell membrane metabolism, which can lead to systemic alterations in levels of phospholipids. The aim of this study was to differentiate between healthy remnants of thyroid tissue and residual/recurrent tumor tissue or metastases in patients with thyroid carcinoma by measurement of plasma levels of various phospholipids. Phospholipid concentrations was measured by in-vitro phosphorus-31-magnetic resonance spectroscopy ( 31 P-MRS) in blood samples from 30 patients with thyroid cancer, who had been rendered hypothyroid in preparation for diagnostic/therapeutic administration of iodine-131. All patients were already thyroidectomized. 131 I-whole-body scintigraphy and measurements of thyroglobulin values in a 2-year-follow-up were used to distinguish between patients in remission, patients with only healthy thyroid remnants and patients with cancerous thyroid tissue and/or metastases. Significantly lower blood plasma levels of systemic sphingomyelin (0.33±0.06 vs. 0.46±0.03 (controls) mmol/l; p 31 P-MRS can be used to differentiate between the presence of tumor tissue, healthy remnants of thyroid tissue not requiring further treatment and remission in patients with thyroid cancer. In future, therefore, plasma 31 P-MRS could be developed as an additional diagnostic tool for the follow-up of differentiated thyroid cancer. (author)

  8. Toxoplasmic Lymphadenitis Mimicking a Metastatic Thyroid Carcinoma at 18F-FDG-PET/CT

    International Nuclear Information System (INIS)

    Treglia, Giorgio; Bongiovanni, Massimo; Ceriani, Luca; Paone, Gaetano; Giovanella, Luca

    2013-01-01

    A 28-year-old woman underwent total thyroidectomy for a papillary thyroid carcinoma in the right thyroid lobe (pTx, pN1b). Subsequently a 131 I-ablation (4.4 GBq) was performed. Four years later the patient presented increased thyroglobulin (Tg) serum levels (8.4 μg/l) during thyroxine treatment. Furthermore, enlarged hypoechoic and round-shaped bilateral cervical lymph nodes were detected at cervical ultrasonography (US). Based on laboratory and US findings suspicious for lymph nodal recurrence of thyroid carcinoma, the patient underwent an 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) to check for distant metastases (Fig. 1). The patient underwent a US-guided fine-needle aspiration cytology on an 18 F-FDG-avid cervical lymph-node. The smears were hypercellulated and consisted of numerous small- to medium-sized lymphocytes, macrophages, dendritic cells and tingible body macrophages. The cytological diagnosis was consistent with that of reactive lymphadenitis. Serological test revealed elevated IgM and IgG anti-Toxoplasma antibodies with a very low IgG-avidity, indicating an acute toxoplasmosis. Serum Tg was then measured by using heterophilic antibody blocking tubes, as previously reported, and serum value dropped to 18 F-FDG-PET/CT in oncological patients. Few reports have described toxoplasmic infection mimicking malignancy at 18 F-FDG-PET/CT; these findings were found mainly in immunodepressive patients or with history of lymphoma. Conversely, we described here a case of toxoplasmosis inducing false-positive Tg measurement, neck US and 18 F-FDG-PET/CT findings in a patient with papillary thyroid carcinoma

  9. Long Non-coding RNA Linc-ROR Is Upregulated in Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Zhang, Ranran; Hardin, Heather; Huang, Wei; Buehler, Darya; Lloyd, Ricardo V

    2018-03-01

    Long non-coding RNAs (lncRNAs) may contribute to carcinogenesis and tumor progression by regulating transcription and gene expression. The role of lncRNAs in the regulation of thyroid cancer progression is being extensively examined. Here, we analyzed three lncRNAs that were overexpressed in papillary thyroid carcinomas, long intergenic non-protein coding RNA, regulator of reprogramming (Linc-ROR, ROR) PVT1 oncogene (PVT1), and HOX transcript antisense intergenic RNA (HOTAIR) to determine their roles in thyroid tumor development and progression. ROR expression has not been previously examined in thyroid carcinomas. Tissue microarrays (TMAs) of formalin-fixed paraffin-embedded tissue sections from 129 thyroid cases of benign and malignant tissues were analyzed by in situ hybridization (ISH), automated image analysis, and real-time PCR. All three lncRNAs were most highly expressed in the nuclei of PTCs. SiRNA experiments with a PTC cell line, TPC1, showed inhibition of proliferation with siRNAs for all three lncRNAs while invasion was inhibited with siRNAs for ROR and HOTAIR. SiRNA experiments with ROR also led to increased expression of miR-145, supporting the role of ROR as an endogenous miR-145 sponge. After treatment with TGF-β, there was increased expression of ROR, PVT1, and HOTAIR in the PTC1 cell line compared to control groups, indicating an induction of their expression during epithelial to mesenchymal transition (EMT). These results indicate that ROR, PVT1, and HOTAIR have important regulatory roles during the development of PTCs.

  10. Radioiodine therapy in management of thyroid carcinoma - A review of 138 patients

    International Nuclear Information System (INIS)

    Hossain, A.S.; Hossain, S.; Hafiz, N.; Taslima, D.A.; Rashid, H.

    2001-01-01

    Differentiated thyroid carcinomas are being treated by using a widely accepted protocol of surgery and radioiodine therapy followed by supplementation of thyroid hormones in the Nuclear Medicine Centre (NMC), Dhaka Medical College Hospital (DMCH) since 1990. In the present study 138 patients(Male-54, Female-84) with differentiated thyroid cancers received radioiodine therapy for ablation of residual thyroid tissue with a dose of 2.77-3.7 GBq (75-100 mCi), for lymph node metastases 5.55-6.5 GBq(150-175mCi), for lung metastases 5.55 GBq(150 mCi) and for bony metastases 7.4 GBq (200 mCi). Among 138 patients papillary carcinoma was observed in 94 cases (68%; Male-42, Female-52), follicular type was found in 30 cases (22%; Male-8, Female-22) and mixed type in 14 patients (10%, Male-4, Female-10). Single dose of 2.77-3.7 GBq(75-100 mCi) of radioiodine was received by all 138 patients. Among the unablated patients 62 received double doses totalling 9.25 GBq (250 mCi), 44 received three doses 12.95 GBq (350 mCi) and one patient received 8 doses 33.3 GBq (900 mCi). Out of 138 patients single dose ablated 76 cases and 62 remain unablated. Multiple doses ablated 28 patients and 34 still remain unablated and is under follow up. The success and failure in management of patients with differentiated thyroid cancer over 8 years period have been discussed here revealing a satisfactory outcome. (author)

  11. Thyroid-Specific Genes Expression Uncovered Age-Related Differences in Pediatric Thyroid Carcinomas

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    Maria Isabel Cunha Vieira Cordioli

    2016-01-01

    Full Text Available Despite a more advanced stage of disease at presentation, a better response to radioiodine (RAI therapy and a reduced overall mortality have been reported in pediatric differentiated thyroid cancer (DTC in comparison to adult DTC. Few studies suggested that the better response to RAI therapy in pediatric patients might be associated with an increased expression of NIS. However, a marked heterogeneity within the pediatric group has been recognized. Children (<10 years old usually present a more aggressive disease than adolescents (≥10–18 years old. By analyzing the expression of thyroid-specific genes in 38 sporadic pediatric tumors, we show that the expression of NIS, PDS, and TSHR was lower in children than adolescents (P<0.05. A linear regression confirmed the association between NIS expression and age. Most significantly, NIS was expressed at similar levels in DTC from children and adults, whereas PDS and TSHR expression was even lower in DTC from children, compared to adolescents and adults. Our data suggest that biological behaviors of DTC in adolescents might differ from those in children and adults. Therefore, the premise that the expression of thyroid-specific genes is higher in tumors from pediatric patients than in adults is not entirely true and might be too oversimplified.

  12. The Next Generation of Orthotopic Thyroid Cancer Models: Immunocompetent Orthotopic Mouse Models of BRAFV600E-Positive Papillary and Anaplastic Thyroid Carcinoma

    Science.gov (United States)

    Vanden Borre, Pierre; McFadden, David G.; Gunda, Viswanath; Sadow, Peter M.; Varmeh, Shohreh; Bernasconi, Maria; Jacks, Tyler

    2014-01-01

    Background: While the development of new treatments for aggressive thyroid cancer has advanced in the last 10 years, progress has trailed headways made with other malignancies. A lack of reliable authenticated human cell lines and reproducible animal models is one major roadblock to preclinical testing of novel therapeutics. Existing xenograft and orthotopic mouse models of aggressive thyroid cancer rely on the implantation of highly passaged human thyroid carcinoma lines in immunodeficient mice. Genetically engineered models of papillary and undifferentiated (anaplastic) thyroid carcinoma (PTC and ATC) are immunocompetent; however, slow and stochastic tumor development hinders high-throughput testing. Novel models of PTC and ATC in which tumors arise rapidly and synchronously in immunocompetent mice would facilitate the investigation of novel therapeutics and approaches. Methods: We characterized and utilized mouse cell lines derived from PTC and ATC tumors arising in genetically engineered mice with thyroid-specific expression of endogenous BrafV600E/WT and deletion of either Trp53 (p53) or Pten. These murine thyroid cancer cells were transduced with luciferase- and GFP-expressing lentivirus and implanted into the thyroid glands of immunocompetent syngeneic B6129SF1/J mice in which the growth characteristics were assessed. Results: Large locally aggressive thyroid tumors form within one week of implantation. Tumors recapitulate their histologic subtype, including well-differentiated PTC and ATC, and exhibit CD3+, CD8+, B220+, and CD163+ immune cell infiltration. Tumor progression can be followed in vivo using luciferase and ex vivo using GFP. Metastatic spread is not detected at early time points. Conclusions: We describe the development of the next generation of murine orthotopic thyroid cancer models. The implantation of genetically defined murine BRAF-mutated PTC and ATC cell lines into syngeneic mice results in rapid and synchronous tumor formation. This

  13. Value of preoperative serum LC3 and MMPs combined with TSH detection in diagnosis of papillary thyroid carcinoma

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    Yan-Fei Lu

    2016-03-01

    Full Text Available Objective: To study the value of preoperative serum LC3 and MMPs combined with TSH detection in diagnosis of papillary thyroid carcinoma and provide reference for clinical diagnosis and treatment. Methods: A total of 80 cases of patients with papillary thyroid carcinoma treated in our hospital from March 2010 to March 2014 were analyzed, and serum TSH, MMP2/9, TIMP1/2 and LC3 levels of patients before operation were detected by ELISA. Healthy subjects and patients with benign neoplasm of thyroid during the same period were taken as control. Results: Serum TSH, MMP2, MMP9 and LC3 levels in patients with papillary thyroid carcinoma significantly increased, TIMP1 and TIMP2 levels significantly decreased, and compared with healthy subjects and patients with benign neoplasm of thyroid, there were significant statistical differences; at the same time, above parameters in serum were not related to gender, but closely related to age, clinical stage and diameter of tumor as well as lymph node. Conclusion: Preoperative detection of serum LC3 and MMPs combined with TSH levels has important reference significance in diagnosis of papillary thyroid carcinoma.

  14. Survival after renal cell carcinoma metastasis to the thyroid: single center experience and systematic review of the literature.

    Science.gov (United States)

    Beutner, Ulrich; Leowardi, Christine; Bork, Ulrich; Lüthi, Cornelia; Tarantino, Ignazio; Pahernik, Sascha; Wente, Moritz N; Büchler, Markus W; Schmied, Bruno M; Müller, Sascha A

    2015-03-01

    Renal cell carcinoma can metastasize to uncommon sites, for example, the thyroid gland where metastases are rarely found. To determine the patient survival and the time between cancer diagnosis and thyroid metastasis, we analyzed a large patient cohort from our hospital records and performed a systematic review. Patients diagnosed between 1978 and 2007 with thyroid metastases from renal cell carcinoma were retrospectively identified from the hospital database. A systematic literature search was performed for publications describing at least three cases of thyroid metastasis from renal cell carcinoma. Case data from the identified studies were collected and used to determine the survival data. We identified 34 patients (19 females) from our hospital records with a mean age of 67 years (range, 33-79) when thyroid metastasis was diagnosed. Median time to primary metastasis after resection of renal cell carcinoma was 6.5 years (range, 0-25) with a single case of synchronous metastasis. Median survival after primary metastasis was 4.7 years (95% confidence interval [CI]: 1.8-7.6). The systematic review included 32 studies with 285 patients. Case data could be extracted for 202 patients. Median time to thyroid metastasis (without synchronous cases) was 8.8 years (95% CI: 7.5-10.1). Median actuarial survival after thyroid metastasis was 3.4 years (95% CI: 2.2-4.6). Total thyroidectomy was not associated with a better survival compared to partial thyroidectomies. Time to thyroid metastasis of renal cell carcinoma can be very long, and survival after thyroidectomy is favorable compared to metastasis to other sites.

  15. [Mandibular metastasis disclosing a papillary carcinoma of the thyroid gland].

    Science.gov (United States)

    Essakalli, L; Jazouli, N; Kzadri, M

    1994-01-01

    The thyroïd well differentiated carcinoma could be originate of the osseous metastasis and/or pulmonary or others. Sometimes, the cancer of the thyroïd stay latent, discovered by the occasion of secondary osseous localisations. We bring back a personally observation of papillary cancer of the thyroïd discovered by the occasion of mandibular metastasis. Helping ourselves by literary datum, we will comment on essentially the diagnostic and therapeutic problems breeded by this kind of metastasis.

  16. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Kim, Eui Young; Kim, Won Gu; Kim, Won Bae; Kim, Tae Yong; Kim, Jung Min; Ryu, Jin-Sook; Hong, Suck Joon; Gong, Gyungyub; Shong, Young Kee

    2009-10-01

    The effect of coexistent chronic lymphocytic thyroiditis (CLT) on prognosis in papillary thyroid carcinoma (PTC) patients remains controversial. We evaluated the influence of coexistent CLT on prognostic outcome and the association of coexistent CLT with clinicopathological parameters. A retrospective study with a median follow-up of 70 months. Patients with PTC who underwent total thyroidectomy followed by (131)I remnant ablation between 1995 and 2003 at Asan Medical Center, Seoul, Korea were enrolled. CLT was diagnosed histopathologically. Among 1441 patients, 214 (14.9%) had coexistent CLT. A greater female preponderance was noted in the patients with CLT compared with those without CLT (P CLT was smaller than that in patients without CLT (2.0 +/- 1.2 vs. 2.2 +/- 1.4 cm; P = 0.02). One hundred and fifty-one (12.3%) patients without CLT had recurrence, whereas 14 (7.1%) patients with CLT had recurrence during the follow-up period (P = 0.016). In patients with cervical lymph node metastases, those with coexistent CLT showed a significantly lower recurrence rate than those without CLT (P = 0.012). However, this association was lost on multivariate analysis adjusting for other clinicopathological predictors for recurrence. In this study, CLT was commonly associated with PTC and was associated with smaller size of the primary tumour at presentation. CLT was also associated with a reduced risk of recurrence during follow-up, although this was not significant after adjustment for other prognostic factors.

  17. The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in North American patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Jara, Sebastian M; Carson, Kathryn A; Pai, Sara I; Agrawal, Nishant; Richmon, Jeremy D; Prescott, Jason D; Dackiw, Alan; Zeiger, Martha A; Bishop, Justin A; Tufano, Ralph P

    2013-12-01

    Several studies have reported that concurrent chronic lymphocytic thyroiditis (CLT) with papillary thyroid carcinoma (PTC) is associated with improved prognosis of the PTC, including decreased lymph node metastasis. We sought to assess the incidence of central nodal metastasis (CNM) in patients with PTC and concurrent CLT. We studied 495 consecutive patients who underwent thyroidectomy with nodal excision for PTC. Pathology reports identified the presence of CLT and the extent of CNM. There were 226 patients (46%) with CLT and 220 (44%) with CNM. Patients with CLT were more often female (88% vs. 71%; P CLT was associated with a 39% decreased odds of CNM after adjusting for age, gender, tumor size, PTC histopathologic subtype, and presence of lymphovascular invasion (odds ratio, 0.61; 95% confidence interval, 0.38-0.99; P = .046). Predicted probability modeling showed that all females with CLT and no suspicious nodal findings on ultrasonography had a 9-11% risk of CNM with pT1a tumors. Female patients of all ages with CLT and small PTCs have the least incidence of CNM. Copyright © 2013 Mosby, Inc. All rights reserved.

  18. Benefit of measuring basal serum calcitonin to detect medullary thyroid carcinoma in a Danish population with a high prevalence of thyroid nodules

    DEFF Research Database (Denmark)

    Hasselgren, Martin; Hegedüs, Laszlo; Godballe, Christian

    2009-01-01

    BACKGROUND: Routine measurement of serum calcitonin to detect medullary thyroid carcinoma (MTC) continues to be fiercely debated, although less attention has been paid to the positive predictive value (PPV) of this method. METHODS: We collected data from 959 patients with nontoxic nodular goiter...

  19. 131I treatment for brain metastases from differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Yu Yongli; Lu Hankui; Zhu Reisen; Ma Jixiao

    2004-01-01

    To assess the clinical value of treatment with 131 I for brain metastases from differentiated thyroid cancer (DTC), the authors have observed 8 cases of brain metastases from DTC who received follow-up after 131 I therapy (2 male, 6 female, aged 12-65 years). The results of 131 I therapy were evaluated with clinical presentation, imaging scan and survival analysis. The main results are as follows. (1) All cases had been survival for 2-35 years in follow-up. (2) A space-occupying lesion in right cerebellum was reduced after taking 20.65 GBq and disappeared after 23.61 GBq, demonstrated by computed tomography. (3) The sequences and doses of 131 I therapy were clearly decreased for the cases with total thyroidectomy in comparison with those with semithyroidectomy (p 131 I for brain metastases from DTC after undergoing thyroidectomy may improve clinical symptoms and lift quality, reduce lesions, and prolong survival. (authors)

  20. Follicular Thyroid Carcinoma in a Country of Endemic Iodine Deficiency (1994–2013

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    Edmund Muonir Der

    2018-01-01

    Full Text Available Background. Follicular thyroid cancer (FTC has historically been linked to iodine deficiency. Although Ghana is among the iodine deficient regions of the world, the proportions, trends, and the clinical features of FTCs have not been studied as a single disease entity. The aim of this study was to determine the relative frequencies, trends, and the clinicopathological characteristics of FTCs among all thyroid malignancies in our institution. Materials and Methods. This was a retrospective study from January 1994 to December 2013. Data were analysed using SPSS software version 23 (Chicago and Graph pad prism version 5.00. Results. Follicular thyroid cancer was the second thyroid malignancy (35.0% and showed a gradual rise in relative proportions over the period. The male-female ratio was 1 : 1.5. The mean ages were 46.9 (SD ±17.3 for males and 46.4 (SD ±13.3 years for females. Enlarged palpable anterior neck swelling was the commonest symptom in males (86.7% and females (91.3% (P=0.730. Hurthle cell carcinoma was the commonest variant of FTC, with 26.7% males and 10.6% females (P=0.116. Distant spread was found in 23.3% of males compared to 19.1% of females (P=0.633. The common sites of distant spread were bones (57.2% in males and cervical lymph nodes (44.4% in females (P=0.106. Conclusion. Follicular thyroid cancer was the second common thyroid malignancy (35.0% with a gradual rise in trend over the study period and male-female ratio of 1.5 : 1. Large anterior neck swelling was the commonest clinical presentation of FTC.

  1. The impact of 131I therapy on the recurrence of differentiated thyroid carcinoma after thyroidectomy

    International Nuclear Information System (INIS)

    Yu Yongli; Luo Quanyong; Chen Libo; Lu Haikui; Zhu Ruisen; Ma Jixiao

    2004-01-01

    Objective: To investigate the effects of some factors on recurrence after thyroidectomy of differentiated thyroid carcinoma (DTC). Methods: Three groups of DTC cases were studied during follow-up. All cases (n=298) of group 1 with diagnosed recurrence were analyzed statistically on age, gender, thyroid-operating mode and pathologic nature at first diagnosis. One hundred and eight cases of group 2 had received thyroid hormone-replaced therapy and 124 cases of group 3 had received thyroid hormone-replaced plus 131 I ablating therapy after thyroidectomy, and were analyzed and compared statistically by their therapeutic outcomes. Results: 1) From group 1, the ratios of male/female (1:1.5) and follicular/papillary (1:4) were higher than primary cases reported in literatures (1:2-3 and 1:8). The recurrence rates in the cases had primary lesion excised, unilateral thyroid or bilateral thyroid excised were decreased 47.3%, 34.2% and 18.5%, respectively. Recurrence mainly occurred at first 5 years after thyroidectomy (65.1%). 2) From group 2, recurrence rates were 4.63%, 8.33% and 12.04%, respectively at 1, 5 and 10 years, and 53.84% and 30.77%, respectively as local recurrence and distant metastases. From group 3, recurrence rates were 0.81%, 4.03% and 7.26%, respectively in 1, 5 and 10 years, and 5/9 and 2/9 as local recurrence and distant metastases, respectively. The statistic difference was significant (P 131 I ablating therapy after thyroidectomy may improve the prognosis of DTC (prolonging recurrence-free time, reducing recurrence rate and decreasing distant metastases). (authors)

  2. Tuberculous Lymphadenitis Mimicking Nodal Metastasis in Follicular Variant Papillary Thyroid Carcinoma

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    Marc Gregory Yu

    2016-01-01

    Full Text Available Tuberculous (TB lymphadenitis can mimic cervical node metastasis from papillary thyroid carcinoma (PTC since the distribution and appearance of affected lymph nodes are similar. We present the case of an asymptomatic 50-year-old Filipino who sought consult for a gradually enlarging anterior neck mass and a single palpable cervical lymph node. Preoperative workup suggested a thyroid malignancy with nodal metastasis. He underwent total thyroidectomy with node dissection where histopathology confirmed follicular variant- (FV- PTC. Lymph node examination, however, revealed TB lymphadenitis, and the patient was given standard antimycobacterial therapy. This is the first documented case in Southeast Asia, a high TB burden region. This is also the first report involving FV-PTC, which has features between those of conventional PTC and follicular thyroid carcinoma. The case suggests that, in endemic areas, TB should be a differential in the etiology of cervical lymphadenopathy in PTC patients. In developed countries, this differential diagnosis is also valuable because of the increasing incidence of HIV and TB coinfection. Proper preoperative evaluation is important and needs to be highlighted in the formulation of local guidelines.

  3. Comparison of clinicopathological features in incidental and nonincidental papillary thyroid carcinomas in 308 patients

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    Nuray Can

    2017-11-01

    Full Text Available Incidental papillary thyroid carcinomas (IPTCs consist of a significant portion of increasing incidence in papillary thyroid carcinomas. This study investigated the clinicopathological features of IPTCs from different perspectives and by comparing nonincidental PTCs (NIPTCs in patients who underwent total thyroidectomy and lymph node dissection. Basic results were as follows. IPTC was present in 27.9% of 308 patients. IPTCs were significantly accompanied by lymphocytic thyroiditis (LT, particularly, multinodular hyperplasia (MNH. IPTCs were more common in older patients (51.3 years vs. 47.2 years and in female patients. IPTCs significantly differed from NIPTCs in terms of smaller tumour size, lymphatic vessel invasion (2.6% vs. 97.4%, extrathyroidal extension (4.3% vs. 95.7%, lymph node metastasis (3.6% vs. 96.4%, multifocality (21.2% vs. 78.8%, bilaterality (5.3% vs. 94.7%, and BRAFV600 mutation (6.7% vs. 93.3%. Older age, bilaterality, encapsulation, and radioactive iodine (RAI were significantly more common in IPTCs > 5 mm than in those ≤ 5 mm. In conclusion, IPTCs are more commonly associated with LT and MNH. IPTCs may have a more favourable prognosis than NIPTCs, and tumour size > 5 mm may predict bilaterality and need for RAI. Nevertheless, the patient-based clinical approach in IPTCs may have benefits in the management of IPTCs.

  4. Identification of novel therapeutic targets in anaplastic thyroid carcinoma using functional genomic mRNA-profiling : Paving the way for new avenues?

    NARCIS (Netherlands)

    Jonker, Pascal K. C.; van Dam, Gooitzen M.; Oosting, Sjoukje E.; Kruijff, Schelto; Fehrmann, Rudolf S. N.

    Background. Currently, anaplastic thyroid carcinoma has a very poor prognosis and there is an unmet need for new therapeutic options. Therefore, this study aims to identify upregulated genes in anaplastic thyroid carcinoma with known drug interactions that could serve as new therapeutic targets.

  5. Multicenter papillary thyroid carcinoma, general aspects and management at Hospital Calderon Guardia

    International Nuclear Information System (INIS)

    Madden Hernandez, Manfred

    2014-01-01

    Over 80% of all thyroid cancers are diagnosed in the United States of papillary carcinoma type and have been more common in women than in men. Thyroids can be in childhood, but is almost always seen in adults between the ages of 30 and 50 years. The cause of this cancer is unknown. The intervention of a genetic defect may occur. Differentiated thyroid tumors (both papillary and follicular) are susceptible curable. A total of 13 criteria systems are managed, among which the most frequent are: - Age, degree, tumor extension, size; -Age, metastasis, tumor size and size; - Metastasis, age for presentation, degree of surgical resection, extrathyroidal invasion and size. The survival rate for papillary thyroid cancer has been excellent; more than 95% of adults with this type of cancer have survived at least 10 years. The prognosis is best for patients younger than 40 years and for those with smaller tumors. Some methods of diagnosis before the appearance of a suspicious nodule have included an ultrasound, BAAF, gammagraphy, among others. The best way to choose which has been the best surgical method at the time of definitive treatment was determined in this review. (author) [es

  6. VDR mRNA overexpression is associated with worse prognostic factors in papillary thyroid carcinoma

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    June Young Choi

    2017-03-01

    Full Text Available The purpose of this study was to assess the relationship between vitamin D receptor gene (VDR expression and prognostic factors in papillary thyroid cancer (PTC. mRNA sequencing and somatic mutation data from The Cancer Genome Atlas (TCGA were analyzed. VDR mRNA expression was compared to clinicopathologic variables by linear regression. Tree-based classification was applied to find cutoff and patients were split into low and high VDR group. Logistic regression, Kaplan–Meier analysis, differentially expressed gene (DEG test and pathway analysis were performed to assess the differences between two VDR groups. VDR mRNA expression was elevated in PTC than that in normal thyroid tissue. VDR expressions were high in classic and tall-cell variant PTC and lateral neck node metastasis was present. High VDR group was also associated with classic and tall cell subtype, AJCC stage IV and lower recurrence-free survival. DEG test reveals that 545 genes were upregulated in high VDR group. Thyroid cancer-related pathways were enriched in high VDR group in pathway analyses. VDR mRNA overexpression was correlated with worse prognostic factors such as subtypes of papillary thyroid carcinoma that are known to be worse prognosis, lateral neck node metastasis, advanced stage and recurrence-free survival.

  7. Thyroid Carcinoma Showing Thymic-Like Differentiation Causing Fracture of the Trachea

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    Aikaterini Marini

    2016-01-01

    Full Text Available Thyroid carcinoma showing thymic-like differentiation (CASTLE comprises a rare neoplasm of the thyroid gland which arises from ectopic thymic tissue or remnants of brachial pouches. CASTLE is regarded as an indolent neoplasm with a favorable prognosis, irrespective of its metastatic potential. Diagnosis is difficult as clinicopathological features have not been yet well-defined. Radiological findings are not specific and only immunohistochemical positivity for CD5 and CD117 staining is highly suggestive of CASTLE. Despite lack of universally accepted treatment recommendations, the mainstay treatment includes thyroidectomy and systematic lymph node dissection. We report a case of CASTLE tumour with very uncommon characteristics developed in a 76-year-old man, who presented with rapidly deteriorating dyspnea and severe cough, resulting in respiratory failure. At surgery, a suspicious looking tumour arising from the upper pole of the right lobe of the thyroid gland, surrounding the trachea and displacing the right common carotid artery, was identified. The patient underwent en bloc resection of the tumour with the thyroid gland and regional lymph node dissection. This is the first reported case of CASTLE causing tracheal ring fracture.

  8. Significance of CK19, TPO, and HBME-1 expression for diagnosis of papillary thyroid carcinoma.

    Science.gov (United States)

    Liu, Zeming; Yu, Pan; Xiong, Yiquan; Zeng, Wen; Li, Xiaoyu; Maiaiti, Yusufu; Wang, Shuntao; Song, Haiping; Shi, Lan; Liu, Chunping; Cheng, Bo; Zhang, Bo; Ming, Jie; Dong, Fang; Ge, Hui; Nie, Xiu; Huang, Tao

    2015-01-01

    To evaluate the expression and significance of CK19, TPO, and HBME-1 in the differential diagnosis of papillary thyroid carcinoma (PTC) and nonmalignant nodules. Tissue samples were obtained from 257 patients with PTC and 149 patients with nonmalignant thyroid specimens, and immunohistochemical staining for CK-19, TPO, and HBME-1 was performed. The expression of CK-19, TPO, and HBME-1 was 96.3%, 12.0%, and 85.3%, respectively, for the PTC group. For nonmalignant thyroid lesions group, the expression of these markers was 40.4%, 86.2%, and 37.2%, respectively. Further, the expression of CK-19 and HBME-1 in PTCs was much higher than that in the benign thyroid lesions (P TPO in PTC specimens was much lower than that in the nonmalignant specimens (P TPO had the highest sensitivity (98.50%), while that of the positive expression of HBME-1 and negative expression of TPO had the highest specificity (92.90%). The combination of positive expression of CK-19 or HBME-1 or negative expression of TPO can improve the specificity of the diagnosis of PTC.

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

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    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.

  10. Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Mello, Maria Eduarda; Flamini, Rodrigo C.; Corbo, Rossana; Mamede, Marcelo [Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear], e-mail: mamede@inca.gov.br

    2009-10-15

    The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy. (author)

  11. Smoldering medullary thyroid carcinoma liver metastasis 37 years after resection of an organ-confined tumor.

    Science.gov (United States)

    Waters, Kevin M; Ali, Syed Z; Erozan, Yener S; Olson, Matthew T

    2015-01-01

    Medullary thyroid carcinoma (MTC) is an uncommon thyroid tumor that usually behaves aggressively. After resection, serological surveillance for calcitonin and carcinoembryonic antigen (CEA) is used to prompt a radiographic search for metastatic disease. We report a case of a 65-year-old woman who presented with a large liver metastasis 37 years after she underwent thyroidectomy for organ-confined MTC. Her clinical course over that time showed a smoldering pattern in which she was symptom free until presentation even though her serum calcitonin and CEA concentrations were elevated for 17 years, and a small equivocal radiographic lesion in the liver was detected 10 years prior to presentation. Cytopathology from an ultrasound guided fine needle aspiration of the hepatic lesion was diagnostic for metastatic MTC. This case highlights the ability for smoldering residual MTC to suddenly transform to aggressive biological behavior after a long period of clinical remission. © 2014 Wiley Periodicals, Inc.

  12. RET mutations in a large indian family with medullary thyroid carcinoma

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    D M Mahesh

    2014-01-01

    Full Text Available Background: Medullary thyroid carcinoma (MTC is a tumor arising from the para follicular (C cells of the thyroid gland and can occur either sporadically or as part of an inherited syndrome. A proportion of these cases carry an autosomal dominant mutation in the RET (REarranged during Transfection proto-oncogene. Screening for these mutations in the affected patients and the carriers ′′at risk′′ which includes the first-degree relatives is of utmost importance for early detection and prompt treatment including prophylactic thyroidectomy in cases that harbor these mutations. Results: This report presents details of screening and subsequent follow-up of a large Indian family, where the index case was found to carry p.Cys634Ser mutation involving exon 11 of the RET gene. These data are of value considering the paucity of information within the region in context of screening large families affected by these mutations.

  13. Concurrent intrathyroidal thymus and parathyroid in a patient with papillary thyroid carcinoma: a challenging diagnosis

    Directory of Open Access Journals (Sweden)

    Georgios Velimezis

    2017-06-01

    Full Text Available During embryogenesis, the thymus and inferior parathyroid glands develop from the third pharyngeal pouch and migrate to their definite position. During this process, several anatomic variations may arise, with the thyroid being one of the most common sites of ectopic implantation for both organs. Here, we report the case of a young female patient, who underwent total thyroidectomy for papillary carcinoma of the thyroid. The patient’s history was remarkable for disorders of the genitourinary system. Histologic examination revealed the presence of well-differentiated intrathyroidal thymic tissue, containing an inferior parathyroid gland. While each individual entity has been well documented, this is one of the few reports in which concurrent presentation is reported. Given the fact that both the thymus and the inferior parathyroid are derivatives of the same embryonic structure (i.e. the third pharyngeal pouch, it is speculated that the present condition resulted from a failure in separation and migration during organogenesis.

  14. Thyroid, Renal, and Breast Carcinomas, Chondrosarcoma, Colon Adenomas, and Ganglioneuroma: A New Cancer Syndrome, FAP, or Just Coincidence

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    Ihab Shafek Atta

    2016-01-01

    Full Text Available We are presenting a case associated with papillary thyroid carcinoma, renal cell carcinoma, invasive mammary carcinoma, chondrosarcoma, benign ganglioneuroma, and numerous colon adenomas. The patient had a family history of colon cancer, kidney and bladder cancers, lung cancer, thyroid cancer, leukemia, and throat and mouth cancers. She was diagnosed with colonic villous adenoma at the age of 41 followed by thyroid, renal, and breast cancers and chondrosarcoma at the ages of 48, 64, 71, and 74, respectively. Additionally, we included a table with the most common familial cancer syndromes with one or more benign or malignant tumors diagnosed in our case, namely, FAP, HNPCC, Cowden, Peutz-Jeghers, renal cancer, tuberous sclerosis, VHL, breast/other, breast/ovarian, Carney, Werner’s, Bloom, Li-Fraumeni, xeroderma pigmentosum, ataxia-telangiectasia, osteochondromatosis, retinoblastoma, and MEN2A.

  15. Thyroid, Renal, and Breast Carcinomas, Chondrosarcoma, Colon Adenomas, and Ganglioneuroma: A New Cancer Syndrome, FAP, or Just Coincidence

    Science.gov (United States)

    Atta, Ihab Shafek; AlQahtani, Fahd Nasser

    2016-01-01

    We are presenting a case associated with papillary thyroid carcinoma, renal cell carcinoma, invasive mammary carcinoma, chondrosarcoma, benign ganglioneuroma, and numerous colon adenomas. The patient had a family history of colon cancer, kidney and bladder cancers, lung cancer, thyroid cancer, leukemia, and throat and mouth cancers. She was diagnosed with colonic villous adenoma at the age of 41 followed by thyroid, renal, and breast cancers and chondrosarcoma at the ages of 48, 64, 71, and 74, respectively. Additionally, we included a table with the most common familial cancer syndromes with one or more benign or malignant tumors diagnosed in our case, namely, FAP, HNPCC, Cowden, Peutz-Jeghers, renal cancer, tuberous sclerosis, VHL, breast/other, breast/ovarian, Carney, Werner's, Bloom, Li-Fraumeni, xeroderma pigmentosum, ataxia-telangiectasia, osteochondromatosis, retinoblastoma, and MEN2A. PMID:27087812

  16. Papillary carcinoma of thyroid with an unusual coexistence of metastatic deposits and tuberculosis in the cervical lymph nodes

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    Nagarajan Swathanthra

    2014-01-01

    Full Text Available Papillary carcinoma of the thyroid with clinically significant cervical lymphadenopathy is a common presentation (particularly in young patients, and it may be the first manifestation of disease. Occasionally, besides metastatic deposits, the cervical lymph nodes may harbor other diseases, and determining the etiology in such a case becomes critical for the institution of proper treatment and complete cure of the patient. Detection of tuberculous lymphadenitis and metastatic deposits by radiological and/or fine needle aspiration cytology methods may not be always easy and may be missed due to inherent defects of the techniques hence, histopathological examination still remains the final resort. We report a case of papillary carcinoma of the thyroid and its rare association with both metastatic deposits and tuberculosis of the contiguous cervical lymph node groups. We suggest that tuberculosis must always be borne in mind besides metastases while evaluating the enlarged neck nodes in papillary carcinoma of the thyroid.

  17. Focal Bronchiectasis Causing Abnormal Pulmonary Radioiodine Uptake in a Patient with Well-Differentiated Papillary Thyroid Carcinoma

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    Ash Gargya

    2012-01-01

    Full Text Available Background. False-positive pulmonary radioactive iodine uptake in the followup of differentiated thyroid carcinoma has been reported in patients with certain respiratory conditions. Patient Findings. We describe a case of well-differentiated papillary thyroid carcinoma treated by total thyroidectomy and radioiodine ablation therapy. Postablation radioiodine whole body scan and subsequent diagnostic radioiodine whole body scans have shown persistent uptake in the left hemithorax despite an undetectable stimulated serum thyroglobulin in the absence of interfering thyroglobulin antibodies. Contrast-enhanced chest computed tomography has confirmed that the abnormal pulmonary radioiodine uptake correlates with focal bronchiectasis. Summary. Bronchiectasis can cause abnormal chest radioactive iodine uptake in the followup of differentiated thyroid carcinoma. Conclusions. Recognition of potential false-positive chest radioactive iodine uptake, simulating pulmonary metastases, is needed to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine.

  18. Combined analysis of circulating epithelial cells and serum thyroglobulin for distinguishing disease status of the patients with papillary thyroid carcinoma

    OpenAIRE

    Lin, Hung-Chih; Liou, Miaw-Jene; Hsu, Hsung-Ling; Hsieh, Jason Chia-Hsun; Chen, Yi-An; Tseng, Ching-Ping; Lin, Jen-Der

    2015-01-01

    Papillary thyroid carcinoma (PTC) accounts for about 80% of the cases in thyroid cancer. Routine surveillance by serum thyroglobulin (Tg) and medical imaging is the current practice to monitor disease progression of the patients. Whether enumeration of circulating epithelial cells (CECs) helps to define disease status of PTC patients was investigated. CECs were enriched from the peripheral blood of the healthy control subjects (G1, n = 17) and the patients at disease-free status (G2, n = 26) ...

  19. Thyroid papillary carcinoma of columnar cell type: a clinicopathologic study of 16 cases.

    Science.gov (United States)

    Wenig, B M; Thompson, L D; Adair, C F; Shmookler, B; Heffess, C S

    1998-02-15

    Thyroid papillary carcinoma of columnar cell type is considered an uncommon histologic subtype of papillary carcinoma characterized by its morphologic features and purportedly aggressive biologic course. Sixteen cases of thyroid papillary carcinoma of columnar cell type were identified from the Endocrine Tumor Registry at the Armed Forces Institute of Pathology and the Washington Hospital Center. Clinical records and follow-up were available in all cases. Paraffin blocks were available for histochemical and immunohistochemical studies in 15 of the 16 cases. Of the 16 cases reported, 13 patients were female and 3 were male. The ages ranged from 16-76 years (average, 47 years; median, 40 years). An asymptomatic neck mass was the most common clinical presenting symptom. Macroscopically, the tumors varied from circumscribed or encapsulated to infiltrative, ranging in size from 1.5-6.5 cm. Histologically, the tumors had diverse growth patterns, including papillary, solid, microfollicular, and cribriform. A common pattern was the presence of markedly elongated follicles arranged in parallel cords. Colloid-filled follicles could be found, at least focally, in all cases. The characteristic histologic appearance included the presence of elongated cells showing nuclear stratification. Other features included the presence of vacuolated-appearing cells, spindle-shaped cells, and squamoid nests. Limited areas in the tumors showed morphologic features typical of thyroid papillary carcinoma. In 14 of the cases, the tumor was encapsulated, showed limited invasive growth, or was a microscopic tumor. In two of the cases, there was extrathyroidal invasion. Immunohistochemical studies showed consistent reactivity with cytokeratin and vimentin; varied reactivity with thyroglobulin, epithelial membrane antigen, carcinoembryonic antigen, and LeuM1; and no reactivity with calcitonin or chromogranin. Treatment was by surgical resection; supplemental radioactive iodine therapy was

  20. Optimization of the therapeutic dose of 131I for thyroid differentiated carcinoma

    International Nuclear Information System (INIS)

    Lima, Fabiana Farias de

    2002-09-01

    organs, such as the narrow and gonads, of up to 78.4%.Possible benefits to the institution also include the use of less radioactive material and a reduction in radiation exposures to the staff during the manipulation and administration of the 131 I. To facilitate the calculations of the optimum therapeutic activity of 131 I for individual patients, a simple and fast dose planning program was created (PlanDose). The program has been set up to evaluate thryroid remant ablation, but it can also be used for the calculation of the activity to be administered for treatment of hyperthyroidism. This protocol of calculated optimal patient-specific 131 I. activities allows a better determination of the necessary ablative dose for patients with differentiated carcinoma of the thyroid, and is an example of optimizing the practice of radiation protection. (author)

  1. Thyroid papillary carcinoma and histologic variants linked to Hashimoto disease

    OpenAIRE

    Neves Junior, Murilo Pedreira; Camandaroba, Marcos Pedro Guedes; Almeida, Marco Antônio Cardoso de; Miranda, Julia Souto

    2009-01-01

    INTRODUÇÃO E OBJETIVO: A associação entre o carcinoma papilífero da tireoide e suas variantes e a tireoidite de Hashimoto (TH) é bastante questionada no meio científico, pois compartilham diversos aspectos morfológicos, imuno-histoquímicos e biomoleculares. Os tumores da tireoide representam mais de 90% de todos os cânceres endócrinos e são caracterizados por alterações genéticas, entre as quais envolvem RET (rearranjos) e BRAS, RAS, P53 (mutações). Já a TH é uma doença autoimune, caracteriza...

  2. Correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion

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    Jing Wan

    2017-04-01

    Full Text Available Objective: To study the correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion. Methods: A total of 128 patients with thyroid papillary carcinoma who received surgical treatment in the hospital between May 2013 and May 2016 were collected, CEUS was used to make clear the peak intensity (PI and area under the curve (AUC of tumor tissue and surrounding normal tissue, and the median of PI and AUC was referred to further divide the patients into high PI group and low PI group as well as high AUC group and low AUC group, 64 cases in each group. Fluorescent quantitative PCR was used to determine proliferation and invasion gene mRNA expression in tumor tissues. Results: PI and AUC levels in tumor tissue were lower than those in surrounding normal tissue; proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low PI group were higher than those of high PI group, and invasion gene Ki-67 mRNA expression was higher than that of high PI group while P53 and MRP-1 mRNA expression were lower than those of high PI group; proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low AUC group were higher than those of high AUC group, and invasion gene Ki-67 mRNA expression was higher than that of high AUC group while P53 and MRP-1 mRNA expression were lower than those of high AUC group. Conclusion: Thyroid papillary carcinoma CEUS parameters PI and AUC levels can quantifiably reflect the cancer cell proliferation and invasion activity.

  3. Novel tumorigenic rearrangement, {delta}rfp/ret, in a papillary thyroid carcinoma from externally irradiated patient

    Energy Technology Data Exchange (ETDEWEB)

    Saenko, Vladimir; Rogounovitch, Tatiana; Shimizu-Yoshida, Yuki; Abrosimov, Aleksandr; Lushnikov, Eugeny; Roumiantsev, Pavel; Matsumoto, Naomichi; Nakashima, Masahiro; Meirmanov, Serik; Ohtsuru, Akira; Namba, Hiroyuki; Tsyb, Anatoly; Yamashita, Shunichi

    2003-06-19

    Molecular analysis of cDNA derived from a papillary thyroid carcinoma (PTC) (follicular variant of papillary thyroid carcinoma on histology) which developed in an externally irradiated patient 4 years after exposure identified a portion of the 5' region, exons 1-3, of the rfp gene juxtaposed upstream of the fragment encoding the tyrosine kinase (TK) domain of the ret gene. The fusion gene, termed {delta}rfp/ret, was the result of a balanced chromosomal translocation t(6;10) (p21.3;q11.2) confirmed by interphase FISH painting, with breakpoints occurring in introns 3 and 11 of the rfp and ret genes, respectively. Both {delta}rfp/ret and reciprocal ret/rfp chimeric introns had small deletions around breakpoints consistent with presumed misrepair of a radiation-induced double-strand DNA break underlying the rearrangement. No extensive sequence homology was found between the fragments flanking the breakpoints. The fusion protein retained the propensity to form oligomers likely to be mediated by a coiled-coil of the RFP polypeptide as assessed by a yeast two-hybrid system. NIH 3T3 fibroblasts stably transfected with a mammalian expression vector encoding full-length {delta}RFP/RET readily gave rise to the tumors in athymic mice suggestive of high transforming potential of the fusion protein. Thus, the {delta}rfp/ret rearrangement may be causatively involved in cancerogenesis and provides additional evidence of the role of activated ret oncogene in the development of a subset of papillary thyroid carcinoma.

  4. Metastatic Renal Cell Carcinoma to the Thyroid Gland: A Case Report and Brief Review of the Literature

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    Georgios Kyriakos

    2014-06-01

    Full Text Available Thyroid metastases are rarely seen in clinical practice but should be considered particularly in patients with a history of non-thyroidal malignancies. Renal cell carcinoma (RCC is the most common tumor to metastasize to the thyroid gland and may present many years after a nephrectomy. Thus, patients require a long-term follow-up and, physicians should have a high index of suspicion particularly in patients with benign disorders of the thyroid gland. Fine needle aspiration cytology (FNAC and thyroglobulin immunohistochemical staining are considered the most effective methods for diagnosis. Surgical treatment of solitary thyroid metastases is recommended and prolongs survival. Adjuvant medical treatment may also be useful in specific situations. We present the unusual case of a relative young patient with goiter who presented with an intrathyroidal metastasis of RCC. Turk Jem 2014; 2: 58-60

  5. A comparison of physical and cytogenetic estimates of radiation dose in patients treated with iodine-131 for thyroid carcinoma

    International Nuclear Information System (INIS)

    Lloyd, D.C.; Purrott, R.J.; Dolphin, G.W.; Horton, P.W.; Halnan, K.E.; Scott, J.S.; Mair, G.

    1976-01-01

    Physical and cytogenetic estimates of the whole-body radiation doses have been compared in 11 patients receiving large doses of iodine-131 for the treatment of thyroid carcinoma. The physical estimate was based on the measurement of thyroid uptake, of the plasma activity variation, and of urinary activity. The cytogenetic estimate was obtained from the analysis of chromosome aberrations in peripheral blood lymphocytes. Good agreement between the estimates was observed in patients whose thyroid glands had previously be ablated by radioiodine. In patients who had varying degrees of thyroid function, there were considerable differences between the estimates with the cytogenetic value always being higher. It is suggested that these differences might be due in part to non-uniform irradiation of lymphocytes by local sources of activity in the thyroid and in the liver. (author)

  6. Survival improvement in patients with disseminated medullary thyroid carcinoma treated with 131I-MIBG therapy

    International Nuclear Information System (INIS)

    Mihaljevic, I.; Topuzovi, N.; Snajder, D.

    2015-01-01

    Full text of publication follows. Introduction and aim: The aim of this paper is to present our experience of 131 I-MIBG therapy in the cases of aggressive form of medullary thyroid carcinoma (MTC) with local and distant metastases. MTC is an uncommon thyroid tumor, accounting from 3-5% of all thyroid malignancies, and arises from para-follicular C cells which produce calcitonin (CT). Prognosis of MTC is related to tumor extension at disease detection, but long-term survival in patients with disseminated MTC is still unsatisfactory. Methods: 4 female patients with metastatic MTC (63, 69 and 2 patients aged 73 years), which already underwent total thyroidectomy and selective neck dissection, received therapy with 100 mCi 131 I-MIBG in our Institute. Patients had widespread disease with neck recurrences (all 4 cases), liver and bone metastases (2 cases) and lung metastases (1 case). All those patients received the therapy twice, second one 3 months up to 1 year after the first cycle. After therapy, whole body scintigraphy was performed; tumor marker levels (CT, carcinoembryonic antigen - CEA, neuron specific enolase - NSE, chromogranin A - CgA and pro-gastrin releasing peptide - pro-GRP) were measured before and after therapy. Results: in one patient we observed a slight decrease in CT level after first MIBG therapy, in another one a slight decrease in CEA serum level, and no lung metastases were visible on whole body scan after second 131 I-MIBG therapy. In one of the two remaining cases there was a significant decrease in CT serum level only after neck dissection. In all cases the patients reported an improvement in subjective symptom reduction. Conclusion: 131 I-MIBG therapy could provide additional benefit to patients with MTC and could improve overall survival, but more patient should be treated in order to define the true potential of the therapy. The aim of this paper is to present our experience of 131 I-MIBG therapy in the cases of aggressive form of

  7. Papillary thyroid carcinoma metastasis to the lumbar spine masquerading as a schmorl's node

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    Daignault, Cory P.; Palmer, Edwin L.; Scott, James A.; Swan, John S. [Dept. of Radiology, Massachusetts General Hospital, Boston (United States); Daniels, Gilbert H. [Dept. of Radiology, Division of Nuclear Medicine, UMass Memorial Medical Center, Worcester (United States)

    2015-09-15

    A Schmorl's node is a common incidental finding encountered during radiologic imaging. Despite the vertebral body being a common site of metastatic disease, a lytic lesion adjacent to an endplate with typical imaging features can often confidently be called a Schmorl's node. This is a case report of a patient with a single well-defined FDG-avid papillary thyroid carcinoma metastasis to the spine that had imaging findings characteristic of a Schmorl's node on CT and MRI. This case is important to consider as it demonstrates that the imaging characteristics of metastatic disease and Schmorl's nodes can overlap.

  8. Myelopathy associated with cervical epidural spinal metastasis of follicular-compact thyroid carcinoma in two dogs

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    Camila Tochetto

    2015-08-01

    Full Text Available This case report describes the clinical, histopathological and immunohistochemical findings in two dogs with myelopathy associated with metastasis of follicular-compact thyroid carcinoma. Microscopically, both primary neoplasms were characterized by polygonal cells arranged in follicles (occasionally filled with eosinophilic colloid-like material or in sheets. The neoplastic cells had a moderately eosinophilic cytoplasm and there was moderate anisokaryosis and anisocytosis. Additionally, the neoplastic cells were positive for thyroglobulin on immunohistochemistry, confirming the follicular origin of both tumors. This is a very uncommon presentation of this pathological condition.

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

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    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.

  10. Investigation of the results of therapy of anaplastic thyroid gland carcinomas

    International Nuclear Information System (INIS)

    Ooijen, M. van.

    1979-01-01

    The results of the treatment of 28 patients with an anaplastic thyroid gland carcinoma are investigated, to see whether an optimal therapy is indicated. The execution of an operation before radiotherapy does not appear to improve the prognosis (statistically this conclusion is not wholly justified). The presence of metastases at the beginning of the therapy gave rise to a worse prognosis than the absence of metastases. The combination treatment of chemotherapy and either surgery or radiotherapy was only applied to two patients so no conclusions can be made about its benefit. (C.F.)

  11. In vitro studies of the cellular response to boron neutron capture therapy (BNCT) in thyroid carcinoma

    International Nuclear Information System (INIS)

    Rodriguez, C; Carpano, M; Perona, M; Thorp, S; Curotto, P; Pozzi, E; Casal, M; Juvenal, G; Pisarev, M; Dagrosa, A

    2012-01-01

    Background: Previously, we have started to study the mechanisms of DNA damage and repair induced by BNCT in thyroid carcinoma some years ago. We have shown different genotoxic patterns for tumor cells irradiated with gamma rays, neutrons alone or neutrons plus different compounds, boronophenylalanine (BPA) or α, β - dihydroxyethyl)-deutero-porphyrin IX (BOPP). In the present study we analyzed the expression of Ku70, Rad51 and Rad54 components of non homologous end-joing (NHEJ) and homologous recombination repair (HRR) pathways, respectively, induced by BNCT in human cells of thyroid carcinoma. Methods: A human cell line of follicular thyroid carcinoma (WRO) in exponential growth phase was distributed into the following groups: 1) Gamma Radiation, 2) Radiation with neutrons beam (NCT), 3) Radiation with n th in presence of BPA (BNCT). A control group for each treatment was added. The cells were irradiated in the thermal column facility of the RA-3 reactor (flux= 1.10 10 n/cm 2 sec) or with a source of 60 Co. The irradiations were performed during different lapses in order to obtain a total physical dose of 3 Gy (±10%). The mRNA expressions of Ku70, Rad 51 and Rad 54 were analysed by reverse transcription-polymerase chain reaction (RT-PCR) at different times post irradiation (2, 4, 6, 24 and 48 h). DNA damage was evaluated by immunofluorescence using an antibody against the phosphorylation of histone H2AX, which indicates double strand breaks in the DNA. Results: The expression of Rad51 increased at 2 h post-irradiation and it lasted until 6 h only in the neutron and neutron + BPA groups (p<0.05). Rad54 showed an up-regulation from 2 to 24 h in both groups irradiated with the neutron beam (with and without BPA) (p<0.05). On the other hand, Ku70 mRNA did not show a modification of its expression in the irradiated groups respect to the control group. Conclusion: these results would indicate an activation of the HRR pathway in the thyroid carcinoma cells treated by

  12. Abnormal number cell division of human thyroid anaplastic carcinoma cell line, SW 1736

    Directory of Open Access Journals (Sweden)

    Keiichi Ikeda

    2015-12-01

    Full Text Available Cell division, during which a mother cell usually divides into two daughter cells during one cell cycle, is the most important physiological event of cell biology. We observed one-to-four cell division during imaging of live SW1736 human thyroid anaplastic carcinoma cells transfected with a plasmid expressing the hybrid protein of green fluorescent protein and histone 2B (plasmid eGFP-H2B. Analysis of the images revealed a mother cell divided into four daughter cells. And one of the abnormally divided daughter cells subsequently formed a dinucleate cell.

  13. Impaired DNA repair as assessed by the ``comet`` assay in patients developing thyroid carcinoma after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Leprat, F.; Sarasin, A.; Suarez, H.G. [Institut de Recherches sur le Cancer, 94 - Villesuif (France); Leprat, F.; Alapetite, C.; Rosselli, F.; Ridet, A.; Moustacch, E.; Alapetite, C. [Institut Curie, 75 - Paris (France); Schlumberger, M. [Institut Gustave Roussy, 94 - Villejuif (France)

    1997-03-01

    A defective cellular response to DNA lesions induced be genotoxic agents may be associated to an increased cancer proneness. This has been clearly identified in some rare but extensively studied genetic diseases such as xeroderma pigmentosum (XP), ataxia telangiectasia (AT) and Fanconi anemia (FA). In practical oncology, most patients receive genotoxic therapeutic agents and the presence of so far unidentified sensitive genotypes could account for an increased susceptibility to cancer in a subgroup of exposed patients. The thyroid gland of children is especially sensitive to the carcinogenic effect of ionizing radiation. Evidence for risk is reported even at doses as low as 0.1 Gy, and the excess relative risk to develop a thyroid tumor following a radiation dose of 1 Gy in childhood is of 7.7 [l]. In order to determine if a defect in repair of DNA strand breaks could be involved, as an early step, in the development of secondary thyroid tumors after radiotherapy, we examined, using the alkaline single cell gel electrophoresis assay (SCGE or `comet`), the response to in vitro {gamma}-rays exposure of lymphocytes of a small group of patients who developed thyroid carcinoma after radiotherapy for a primary tumor. Because of its practical advantages, the alkaline comet assay offers the opportunity to question the role of DNA strand beaks rejoining capacity of the individual in the radiation induced carcinogenesis of thyroid tumors. This preliminary study of a small group of patients with therapeutic irradiation at childhood for a primary tumor indicates that, at the time of blood sampling, lymphocytes of some of these patients demonstrated reduced rejoining capacity. These results suggest that the comet assay might help to distinguish a subgroup of individuals at risk for radiation induced genomic instability and encourage further investigation. (authors)

  14. Thyroid size change by CT monitoring after sorafenib or sunitinib treatment in patients with renal cell carcinoma: Comparison with thyroid function

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro, E-mail: kitajima@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan); Takahashi, Satoru; Maeda, Tetsuo; Yoshikawa, Takeshi; Ohno, Yoshiharu; Fujii, Masahiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan); Miyake, Hideaki; Fujisawa, Masato [Department of Urology, Kobe University Graduate School of Medicine, Kobe (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan)

    2012-09-15

    Objective: Hypothyroidism is a common complication in patients receiving tyrosine kinase inhibitors. We evaluated the relationship between thyroid size evident on CT and thyroid function in patients with advanced renal cell carcinoma (RCC) receiving tyrosine kinase inhibitors. Materials and methods: Forty-two patients with metastatic RCC receiving tyrosine kinase inhibitors (sorafenib n = 25; sunitinib n = 17) and, followed-up for ≥12 months were eligible. Patients who had ever shown an elevated thyroid-stimulating hormone (TSH) level of >10 mU/l were defined as having “hypothyroidism”. CT scans were performed before, and 3, 6, 9, and 12 months after the start of treatment. The area of the thyroid in the maximum section at each examination was measured and compared with that before treatment. Using repeated-measures ANOVA, differences in thyroid size were compared over time between patients with and without “hypothyroidism”, in relation to the type of drug employed. Results: Twenty-one patients (sorafenib 9, sunitinib 12) developed “hypothyroidism” 95 ± 88 days (range 12–315 days) after the start of treatment. In such patients, the thyroid was reduced in size to 89 ± 16% after 3 months, 81 ± 21% after 6 months, 71 ± 21% after 9 months and 68 ± 21% after 12 months, whereas the patients without “hypothyroidism” maintained a thyroid size of 90 ± 12% even after 12 months (p = 0.0030). Among the patients with “hypothyroidism”, those treated with sunitinib tended to show greater thyroid size reduction than those with sorafenib (59 ± 23% vs. 79 ± 13%, after 12 months). Conclusion: Tyrosine kinase inhibitors cause an apparent thyroid size reduction in patients with “hypothyroidism”.

  15. A longitudinal study on the radiation-induced thyroid gland changes after external beam radiotherapy of nasopharyngeal carcinoma.

    Science.gov (United States)

    Lin, Zhixiong; Wu, Vincent Wing-Cheung; Lin, Jing; Feng, Huiting; Chen, Longhua

    2011-01-01

    Radiation-induced thyroid disorders have been reported in radiotherapy of head and neck cancers. This study evaluated the radiation-induced damages to thyroid gland in patients with nasopharyngeal carcinoma (NPC). Forty-five patients with NPC treated by radiotherapy underwent baseline thyroid hormones (free triiodothyronine, free thyroxine [fT4], and thyrotropin [TSH]) examination and CT scan before radiotherapy. The volume of the thyroid gland was calculated by delineating the structure in the corresponding CT slices using the radiotherapy treatment planning system. The thyroid doses were estimated using the treatment planning system. Subsequent CT scans were conducted at 6, 12, and 18 months after radiotherapy, whereas the hormone levels were assessed at 3, 6, 12, and 18 months after radiotherapy. Trend lines of the volume and hormone level changes against time were plotted. The relationship between the dose and the change of thyroid volume and hormone levels were evaluated using the Pearson correlation test. An average of 20% thyroid volume reduction in the first 6 months and a further 8% shrinkage at 12 months after radiotherapy were observed. The volume reduction was dependent on the mean thyroid doses at 6, 12, and 18 months after radiotherapy (r = -0.399, -0.472, and -0.417, respectively). Serum free triiodothyronine and fT4 levels showed mild changes of thyroid doses between patients with hypothyroidism and normal thyroid function. Radiotherapy for patients with NPC caused radiation-induced changes of the thyroid gland. The shrinkage of the gland was greatest in the first 6 months after radiotherapy, whereas the serum fT4 and TSH levels changed at 12 months. Radiation-induced changes were dependent on the mean dose to the gland. Therefore, measures to reduce the thyroid dose in radiotherapy should be considered.

  16. Importance of thyroglobulin measurement at radioiodine thyroid remnant ablation stimulated by recombinant TSH in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Paz-Filho, Gilberto; Carvalho, Gisah; Graf, Hans

    2005-01-01

    Full text: Radioiodine remnant ablation (RRA) after total or near-total thyroidectomy for differentiated thyroid carcinoma (DTC) is adopted routinely by our department. Recombinant TSH (rh TSH) is an alternative for patient preparation for RRA, as effective as RRA after thyroid hormone withdrawal. Thyroglobulin (Tg) dosage at RRA may be important for the follow-up of DCT. To evaluate the predictive value of serum Tg for metastatic disease in patients submitted to rh TSH before RRA, 29 consecutive patients (25 female, 4 male; mean age 38 ± 13 years) with DCT (28 papillary and 1 follicular) were submitted to RRA with 100 to 150 mCi after receiving rh TSH (2 x 0.9 mg). Serum values of TSH, Tg and anti-thyroglobulin (TgAb) were measured before and 24 hours after rh TSH, and 48 hours after RRA. Whole-body radioiodine scan (RxWBS) was performed 4 to 7 days after RRA. Conclusion: RxWBS revealed thyroid remnants (TR) in 75.9% (n=22, Group 1), lymph node metastasis in 17.2% (n=5, Group 2) and pulmonary metastasis in 6.9% (n=2, Group 3). Positive TgAb prevalence was found in 31% of all patients (n=9). Considering TgAb-negative subjects, basal median Tg levels were 0.2 ng/ml (0.08-3.89) in Group 1, 2.86 ng/ml (0.01-12.24) in Group 2 and 5.27 ng/ml in Group 3 (only one patient in Group 3 had pulmonary metastasis and negative TgAb). Median peak Tg levels after rh TSH at 131 I RRA were significantly lower in Group 1 (1.6 ng/ml) than in Group 2 (18.7 ng/ml) and in Group 3 (90.8 ng/ml) and between Group 2 and 3 combined (19.8 ng/ml). In conclusion, elevated Tg levels before rh TSH and at RRA could suggest the presence and the extension of metastatic disease observed at the RxWBS, in patients with DTC. Further studies should be designed to fully examine this relationship. (author)

  17. Rare metastasis of nasopharyngeal carcinoma to the thyroid gland with subsequent metastatic abdominal lymph nodes: A case report and literature review.

    Science.gov (United States)

    Cai, Changjing; Shen, Hong; Liu, Wenqiang; Ma, Junli; Zhang, Yan; Yin, Ling; Li, Jindong; Shen, Liangfang; Zeng, Shan

    2017-11-01

    Thyroid metastasis from nasopharyngeal carcinoma is rare. Metastasis of nasopharyngeal carcinoma to the thyroid gland with subsequent metastatic abdominal lymph nodes hasn't been reported before. We want to share our experience about the treatment choice. A 27-year-old man was diagnosed with nasopharyngeal nonkeratinizing carcinoma in August 2004. In March 2013 he underwent a thyroid carcinoma radical operation, and histological examination revealed metastasis to the thyroid gland from nasopharyngeal carcinoma. An 18F-FDG-PET/CT scan and biopsy showed metastatic abdominal lymph nodes of nasopharyngeal carcinoma in April 2015. A 27-year-old man was diagnosed with metastasis of nasopharyngeal carcinoma to the thyroid gland with subsequent metastatic abdominal lymph nodes. The patient was treated with concurrent chemotherapy and radiotherapy for nasopharyngeal carcinoma and metastasis to the thyroid gland. The metastases to the abdominal lymph nodes received chemotherapy. After 6 cycles of chemotherapy with gemcitabine, cisplatin, and 5-fluorouracil for metastasis to the abdominal lymph nodes, the patient is currently asymptomatic with stable disease and improved quality of life. The treatment choice for metastasis of nasopharyngeal carcinoma depends on the clinical disease extent, and surgery and/or chemo-radiation therapy must be drafted to the individual patient in order to improve the prognosis and quality of life.

  18. The role of selenium, vitamin C, and zinc in benign thyroid diseases and of selenium in malignant thyroid diseases: Low selenium levels are found in subacute and silent thyroiditis and in papillary and follicular carcinoma

    Directory of Open Access Journals (Sweden)

    Starzinger Matthias

    2008-01-01

    follicular and papillary thyroid carcinoma. The mean Se level in the control group was 90.5 ± 20.8 μg/l. Conclusion The H0 can be accepted for vitamin C and zinc levels whereas it has to be rejected for Se. Patients with benign or malignant thyroid diseases can present low Se levels as compared to controls. Low levels of vitamin C were found in all subgroups of patients.

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

    Directory of Open Access Journals (Sweden)

    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. Sporadic minute medullary thyroid carcinoma with a double RET mutation: A case report.

    Science.gov (United States)

    Yamamoto, Hiroyuki; Ishii, Jun; Chiba, Tomohiro; Nakazato, Yoko; Hirano, Kouichi; Kamma, Hiroshi

    2017-11-01

    We describe a 74-year-old man with a nodular goiter accompanied by an incidental sporadic minute medullary thyroid carcinoma (MTC). Histopathologically, the MTC was a well-defined 1.7 mm tumor in the upper one-third right lobe, with solid cell nests (SCNs) adjacent to the MTC. C-cells were scattered mainly around the SCNs, but C-cell hyperplasia was not evident in the background thyroid. The MTC cell phenotype was immunohistochemically identical to background C-cells, but was completely different from the SCN main cells. Direct DNA analyses of isolated MTC paraffin-embedded specimens revealed two RET proto-oncogene missense point mutations in exon 11 (i.e., C630R and C634W). The non-tumor thyroid tissue did not reveal any mutations. This study reports the smallest case of sporadic MTC with a double RET somatic mutation, substantiating that RET mutations can occur during a very early stage of carcinogenesis. The combined presence of C630R and C634W represent a novel somatic mutation in sporadic MTC. The present case indicates that the sporadic MTC originated from the surrounding C-cells of the SCNs without C-cell hyperplasia and that the SCN main cells may not be able to develop into an MTC. © 2017 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

  1. Biodistribution of p-borophenylalanine (BPA) in dogs with spontaneous undifferentiated thyroid carcinoma (UTC)

    International Nuclear Information System (INIS)

    Dagrosa, M.A.; Viaggi, M.; Rebagliati, R. Jimenez; Castillo, V.A.; Batistoni, D.; Cabrini, R.L.; Castiglia, S.; Juvenal, G.J.; Pisarev, M.A.

    2004-01-01

    Human undifferentiated thyroid carcinoma (UTC) is a very aggressive tumor which lacks an adequate treatment. The UTC human cell line ARO has a selective uptake of BPA in vitro and after transplanting into nude mice. Applications of boron neutron capture therapy (BNCT) to mice showed a 100% control of growth and a 50% histological cure of tumors with an initial volume of 50 mm 3 or less. As a further step towards the potential application in humans we have performed the present studies. Four dogs with diagnosis of spontaneous UTC were studied. A BPA-fructose solution was infused during 60 min and dogs were submitted to thyroidectomy. Samples of blood and from different areas of the tumors (and in one dog from normal thyroid) were obtained and the boron was determined by ICP-OES. Selective BPA uptake by the tumor was found in all animals, the tumor/blood ratios ranged between 2.02 and 3.76, while the tumor/normal thyroid ratio was 6.78. Individual samples had tumor/blood ratios between 8.36 and 0.33. These ratios were related to the two histological patterns observed: homogeneous and heterogeneous tumors. We confirm the selective uptake of BPA by spontaneous UTC in dogs and plan to apply BNCT in the future

  2. Correlation between serum thyroglobulin levels and whole body scans in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Hristova, N.; Piperkova, E.; Sergieva, S.; Tsingilev, D.; Fanariotov, D.; Kirilova, B.; Dimitrova, M.

    1999-01-01

    Postoperative follow-up study of patients with differentiated thyroid carcinoma (DTC) is currently based on periodic whole body scan (WBS) and serum thyroglobulin (Tg) assessment. The correlation between Tg levels measured and WB scans of 84 DTC patients is investigated. WBS are performed on a rotation gamma camera DIACAM (Siemens) at 48 and 72 hours after per os administration of 185-222 MBq 131 I. The levels of Tg are determined by IRMA method and kits of BYK, Germany. Normal Tg values are obtained at a control group of 27 patients free of thyroid disease. Increased Tg levels are found at 2 cases (4%) of the group of 50 patients with total thyroidectomy given 131 I without any evidence of recurrences or metastases. At the third group consisting of 18 patients with total thyroidectomy, following 131 I therapy and recurrences and/or metastases, increased Tg values were obtained in 8 cases or 44.4%. Also increased Tg levels were obtained at 4 from 16 patients (25%) subjected to total thyroidectomy but with a residual thyroid tissue proved by scintigraphy. In conclusion, a combination of both methods should be applied for improving the diagnostic and therapeutic results at the postoperative control of DTC patients

  3. miR-199a-3p displays tumor suppressor functions in papillary thyroid carcinoma.

    Science.gov (United States)

    Minna, Emanuela; Romeo, Paola; De Cecco, Loris; Dugo, Matteo; Cassinelli, Giuliana; Pilotti, Silvana; Degl'Innocenti, Debora; Lanzi, Cinzia; Casalini, Patrizia; Pierotti, Marco A; Greco, Angela; Borrello, Maria Grazia

    2014-05-15

    Thyroid cancer incidence is rapidly increasing. Papillary Thyroid Carcinoma (PTC), the most frequent hystotype, usually displays good prognosis, but no effective therapeutic options are available for the fraction of progressive PTC patients. BRAF and RET/PTC are the most frequent driving genetic lesions identified in PTC. We developed two complementary in vitro models based on RET/PTC1 oncogene, starting from the hypothesis that miRNAs modulated by a driving PTC-oncogene are likely to have a role in thyroid neoplastic processes. Through this strategy, we identified a panel of deregulated miRNAs. Among these we focused on miR-199a-3p and showed its under-expression in PTC specimens and cell lines. We demonstrated that miR-199a-3p restoration in PTC cells reduces MET and mTOR protein levels, impairs migration and proliferation and, more interesting, induces lethality through an unusual form of cell death similar to methuosis, caused by macropinocytosis dysregulation. Silencing MET or mTOR, both involved in survival pathways, does not recapitulate miR-199a-3p-induced cell lethality, thus suggesting that the cooperative regulation of multiple gene targets is necessary. Integrated analysis of miR-199a-3p targets unveils interesting networks including HGF and macropinocytosis pathways. Overall our results indicate miR-199a-3p as a tumor suppressor miRNA in PTC.

  4. Use of 177Lu-dotatate in the treatment of iodine refractory thyroid carcinomas.

    Science.gov (United States)

    Oliván-Sasot, P; Falgás-Lacueva, M; García-Sánchez, J; Vera-Pinto, V; Olivas-Arroyo, C; Bello-Arques, P

    In a patient with a differentiated thyroid cancer the standard treatment protocol to be followed is surgery, ablation of thyroid remnants with 131 Iodine ( 131 I), and TSH suppression. However, the treatment with 131 I is not effective in some cases, and it no longer becomes a therapeutic option due to cell de-differentiation with loss of 131 I uptake. Systemic treatment can be used as other options, although patients are not always responsive; thus, the disease may progress and therapeutic options may run out. Endocrine tumours may express somatostatin receptors,and this characteristic has been used, not only for diagnosis, but also for their treatment through somatostatin analogue labelling with radioactive isotopes. This was the case of a patient suffering from iodine-refractory follicular thyroid carcinoma, with somatostatin receptors expression, treated with 177 Lu-DOTATATE, showing an excellent clinical and analytical response. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  5. Assessment of female fertility and carconogenesis after iodine-131 therapy for differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Dottorini, M.E.; Lomuscio, G.; Mazzucchelli, L. [U.O. Medicina Nucleare, Buto Arsizio (Italy)] [and others

    1995-01-01

    The aim of this study was to evaluate female fertility, carcinogenic, and genetic effects after treatment with {sup 131}I of differentiated thyroid carcinoma. A total of 814 females of child-bearing age were studied. The fertility of 627 females who received {sup 131}I therapy was compared to 187 untreated females. Birth histories of the children born from these women were registered. The carcinogenic effect was evaluated by comparing the incidence of tumors in 730 patients treated with {sup 131}I with an internal control group, as well as with local population incidence. There was no significant difference in the fertility rate, birth weight and prematurity between the two groups. Only one case of a ventricular septal defect was observed in a child born to a woman treated with {sup 131}I. The overall standardized incidence ratio (SIR) of second tumors was 1.19 (95% CI: 0.76-1.77) in patients treated with {sup 131}I. An elevated SIR was registered for salivary gland tumors and melanoma. No case of leukemia was registered. The risk of long-term effects of {sup 131}I treatment of differentiated thyroid carcinoma is quite low. Iodine-131 may be safely used in treating cases with a high risk of recurrence. 35 refs., 7 tabs.

  6. Guidelines on radioiodine therapy for differentiated thyroid carcinoma. Impact on clinical practice

    International Nuclear Information System (INIS)

    Biermann, M.; Pixberg, M.K.; Schober, O.; Doerr, U.; Dietlein, M.; Schlemmer, H.; Grimm, J.; Zajic, T.; Nestle, U.; Ladner, S.; Sepehr-Rezai, S.; Rosenbaum, S.; Puskas, C.; Fostitsch, P.; Heinecke, A.; Schuck, A.; Willich, N.; Schmid, K.W.; Dralle, H.

    2005-01-01

    Aim: For the examination of the impact on clinical practice of the guidelines for differentiated thyroid carcinoma (DTC), treatment data from the ongoing multicenter study differentiated thyroid carcinoma (MSDS) were analyzed. Patients, methods: patients were randomized to adjuvant external beam radiotherapy (RTx) or no RTx in addition to standard therapy in TNM stages pT4 pNO/1/x MO/x (UICC, 5 th ed. 1997). All patients were to receive the same treatment regimen consisting of thyroidectomy, ablative radioiodine therapy (RIT), and a diagnostic 131 I whole-body scintigraphy (WBS) 3-4 months after RIT. Results: Of 339 eligible patients enrolled between January 2000 and March 2004, 273 could be analyzed. Guideline recommendations by the German Society for Nuclear Medicine from 1999 and 1992 were complied with within 28% and 82% with regard to the interval between surgery and RIT (4 vs. 4-6 weeks), in 33% and 84% with regard to 131 I activity for RIT (1-3 vs. 1-4 GBq; ±10%), and in 16% and 60% with regard to 131 I activity for WBS (100-300 vs. 100-400 MBq; ±10%). Conclusions: the 1999 guideline revision appears to have had little impact on clinical practice. Further follow-up will reveal if guideline compliance had an effect on outcomes. (orig.)

  7. Review of survival rates 20-years after conservative surgery for papillary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Abrão Rapoport

    2015-08-01

    Full Text Available INTRODUCTION: A less extensive thyroidectomy could be used for patients in the low risk group.OBJECTIVE: To perform a critical follow-up after lobectomy with isthmusectomy for the treatment of papillary thyroid carcinoma in patients with a single nodule limited to the periphery of the lobe.METHODS: Thirty-one patients with thyroid papillary carcinoma operated on till 1993 were selected. They had undergone lobectomy with isthmusectomy. This is a retrospective cohort study in which the oncological outcome (contralateral and regional recurrence and the reoperation complications (recurrent nerve paralysis/paresis and hypoparathyroidism were evaluated. Descriptive analysis was employed.RESULTS: In the last decade (2003-2013, 6 (20% contralateral recurrences were observed in the remaining lobe and in 1 of these cases (3%, contralateral lymph node metastases were noted. A completion thyroidectomy plus lymphadenectomy was performed, without modification of global survival.CONCLUSION: Because of the rate of 20% of contralateral recurrence after a 20-year follow-up, we suggest modification of the surgical paradigm for total thyroidectomy as an initial therapy.

  8. False-positive I-131 scan by contaminated muffler in a patient with thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Han Kyung; Kim, Min Woo; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Hospital, Chonju (Korea, Republic of)

    2006-02-15

    A 39-year-old female patient who had undergone a total thyroidectomy for a papillary thyroid carcinoma underwent a whole body scan with I-131. The I-131 scan was performed 72 hours after administering 185 MBq (5 mGi) of an I-131 solution. The anterior image of head, neck, and upper chest showed multiple areas of increased uptake in the mediastinal area considering of functional metastasis. However, radioactivity was not evident in the image taken after removing her clothes and muffler. The image obtained after placing the muffler on the pallet showed that the radioactivity was still present. It is well known that artifacts on an I-131 scan can be produced by styling hair sputum, drooling during sleep, chewing gum, and paper or a cloth handkerchief that is contaminated with the radioactive iodine from either perspiration or saliva. This activity might be mistaken for a functional metastasis. Therefore, it is essential that an image be obtained after removing the patient's clothes. In this study, artifacts due to a contaminated muffler on the I-131 scan were found. These mimicked a functional metastasis of the mediastinal area in a patient with a papillary thyroid carcinoma.

  9. [Postoperative radioiodine ablation in patients with low risk differentiated thyroid carcinoma].

    Science.gov (United States)

    Díez, Juan J; Grande, Enrique; Iglesias, Pedro

    2015-01-06

    Most patients with newly diagnosed differentiated thyroid carcinoma have tumors with low risk of mortality and recurrence. Standard therapy has been total or near total thyroidectomy followed by postoperative radioiodine remnant ablation (RRA). Although RRA provides benefits, current clinical guidelines do not recommend it universally, since an increase in disease-free survival or a decrease in mortality in low risk patients has not been demonstrated so far. Advancements in our understanding of the biological behavior of thyroid cancer have been translated into the clinic in a personalized approach to the patients based on their individual risk of recurrence and mortality. Current evidence suggests that RRA is not indicated in most low-risk patients, especially those with papillary carcinomas smaller than 1cm, without extrathyroidal extension, unfavorable histology, lymph node involvement or distant metastases. Follow-up of these patients with serial measurements of serum thyroglobulin and neck ultrasound is adequate. Careful evaluation of all risk factors of clinical relevance will allow a more realistic assessment of each individual patient. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  10. The cellular localization of autotaxin impacts on its biological functions in human thyroid carcinoma cells.

    Science.gov (United States)

    Seifert, Anja; Klonisch, Thomas; Wulfaenger, Jens; Haag, Friedrich; Dralle, Henning; Langner, Jürgen; Hoang-Vu, Cuong; Kehlen, Astrid

    2008-06-01

    Autotaxin (ATX/NPP2) shows a nucleotide pyrophosphatase/phosphodiesterase and lysophospholipase D (lysoPLD) activity and is a member of a family of structurally-related mammalian ecto-nucleotide pyrophosphate/phosphodiesterases (E-NPP1-3). ATX is unique among E-NPP as it is secreted and not membrane-bound as are NPP1 and -3. The ATX gene activity is significantly higher in undifferentiated anaplastic (UTC) as compared to follicular (FTC) and papillary thyroid carcinomas (PTC) or goiter tissues. ATX also enhances the motility of thyroid tumor cells. We bio-engineered stable transfectants of the human thyroid carcinoma cell line FTC-238 expressing either bioactively-secreted (sATX) or membrane-anchored ATX (mATX) to identify the biological functions of ATX which critically depend on the E-NPP member being secreted and provide insight into the effects of high local ATX concentrations and cellular responses. An increased cell motility was exclusively observed with FTC-238 sATX transfectants, whereas membrane-anchored ATX appeared to impair motility. We identified IL-1beta as an upstream suppressor of ATX expression in FTC-238, ATX-mediated motility in FTC-238 and stable transfectants, with IL-1beta having the strongest motility-suppressive effect on FTC-238 sATX clones. sATX and mATX strongly increased the anchorage-independent colony formation of FTC-238 but the size and number of colonies formed in the soft agar were significantly smaller in FTC-238 mATX versus the FTC-238 sATX clones. The cancer-testis antigen BAGE was identified as a novel target gene of ATX in FTC-238. Transcript levels for BAGE were 6-fold higher in FTC-238 mATX versus sATX clones. Increased BAGE transcript levels were also detected in tissues of patients with UTC versus FTC, PTC or goiter tissues. In summary, enhanced tumor cell motility and tumorigenic capacity critically depended on sATX in thyroid carcinoma cells. Irrespective of its compartmentalization, the cancer-testis antigen BAGE was

  11. Multilevel 3D Printing Implant for Reconstructing Cervical Spine With Metastatic Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Li, Xiucan; Wang, Yiguo; Zhao, Yongfei; Liu, Jianheng; Xiao, Songhua; Mao, Keya

    2017-11-15

    MINI: A 3D printing technology is proposed for reconstructing multilevel cervical spine (C2-C4) after resection of metastatic papillary thyroid carcinoma. The personalized porous implant printed in Ti6AL4V provided excellent physicochemical properties and biological performance, including biocompatibility, osteogenic activity, and bone ingrowth effect. A unique case report. A three-dimensional (3D) printing technology is proposed for reconstructing multilevel cervical spine (C2-C4) after resection of metastatic papillary thyroid carcinoma in a middle-age female patient. Papillary thyroid carcinoma is a malignant neoplasm with a relatively favorable prognosis. A metastatic lesion in multilevel cervical spine (C2-C4) destroys neurological functions and causes local instability. Radical excision of the metastasis and reconstruction of the cervical vertebrae sequence conforms with therapeutic principles, whereas the special-shaped multilevel upper-cervical spine requires personalized implants. 3D printing is an additive manufacturing technology that produces personalized products by accurately layering material under digital model control via a computer. Reporting of this recent technology for reconstructing multilevel cervical spine (C2-C4) is rare in the literature. Anterior-posterior surgery was performed in one stage. Radical resection of the metastatic lesion (C2-C4) and thyroid gland, along with insertion of a personalized implant manufactured by 3D printing technology, were performed to rebuild the cervical spine sequences. The porous implant was printed in Ti6AL4V with perfect physicochemical properties and biological performance, such as biocompatibility and osteogenic activity. Finally, lateral mass screw fixation was performed via a posterior approach. Patient neurological function gradually improved after the surgery. The patient received 11/17 on the Japanese Orthopedic Association scale and ambulated with a personalized skull-neck-thorax orthosis on

  12. Toxoplasmic Lymphadenitis Mimicking a Metastatic Thyroid Carcinoma at {sup 18}F-FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio; Bongiovanni, Massimo; Ceriani, Luca; Paone, Gaetano; Giovanella, Luca [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2013-12-15

    A 28-year-old woman underwent total thyroidectomy for a papillary thyroid carcinoma in the right thyroid lobe (pTx, pN1b). Subsequently a {sup 131}I-ablation (4.4 GBq) was performed. Four years later the patient presented increased thyroglobulin (Tg) serum levels (8.4 μg/l) during thyroxine treatment. Furthermore, enlarged hypoechoic and round-shaped bilateral cervical lymph nodes were detected at cervical ultrasonography (US). Based on laboratory and US findings suspicious for lymph nodal recurrence of thyroid carcinoma, the patient underwent an {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG-PET/CT) to check for distant metastases (Fig. 1). The patient underwent a US-guided fine-needle aspiration cytology on an {sup 18}F-FDG-avid cervical lymph-node. The smears were hypercellulated and consisted of numerous small- to medium-sized lymphocytes, macrophages, dendritic cells and tingible body macrophages. The cytological diagnosis was consistent with that of reactive lymphadenitis. Serological test revealed elevated IgM and IgG anti-Toxoplasma antibodies with a very low IgG-avidity, indicating an acute toxoplasmosis. Serum Tg was then measured by using heterophilic antibody blocking tubes, as previously reported, and serum value dropped to <0.2 μg/l. It is well known that antibody interference may falsely increase serum Tg; in particular, increased anti-Toxoplasma antibodies likely interfered to the Tg measurement in our case. Additionally, activated granulocytes and macrophages may display significantly increased glucose consumption, giving false-positive results at {sup 18}F-FDG-PET/CT in oncological patients. Few reports have described toxoplasmic infection mimicking malignancy at {sup 18}F-FDG-PET/CT; these findings were found mainly in immunodepressive patients or with history of lymphoma. Conversely, we described here a case of toxoplasmosis inducing false-positive Tg measurement, neck US and {sup 18}F

  13. Multicenter study differentiated thyroid carcinoma (MSDS). Diminished acceptance of adjuvant external beam radiotherapy

    International Nuclear Information System (INIS)

    Biermann, M.; Pixberg, M.K.; Schober, O.; Schuck, A.; Willich, N.; Heinecke, A.; Koepke, W.; Schmid, K.W.; Dralle, H.

    2003-01-01

    Aim: The Multicenter Study Differentiated Thyroid Carcinoma (MSDS) is an ongoing study in Germany, Austria, and Switzerland on the clinical benefit of adjuvant external beam radiotherapy (RTx) for locally invasive differentiated thyroid carcinoma (DTC) in TNM stages pT4 pNO/1/xMO/x (5th ed. 1997). Methods: MSDS was designed as a prospective randomized trial. Patients receive thyroidectomy, radioiodine therapy (RIT) to ablate the thyroid remnant, and TSH-suppressive L-thyroxine therapy with or without RTx after documented elimination of cervical iodine-131 uptake (http://msds-studie.uni-muenster.de). Results: 311 patients were enrolled between January 2000 and March 2003. 279 patients met the trial's inclusion criteria. 45 consented to randomization, of whom 17 were randomized into treatment arm A (RTx) and 18 into arm B (no RTx). Advised by the trial's independent Data Monitoring and Safety Committee, the MSDS steering committee decided to terminate randomization in April 2003 and continue MSDS as a prospective cohort study. 23 of the 234 patients in the observation arm of the trial were prescribed RTx by their physicians. Thus, 14% of the trial cohort were randomized or assigned to receive RTx (intention-to-treat analysis). In contrast, at least 44% of all patients with pT4 papillary DTC in Germany in the nationwide PCES study underwent RTx in 1996 (p 2 -test). Conclusions: Acceptance of external beam RTx as a treatment modality for DTC has receded to a degree that accrual of a sufficient number of patients for a randomized trial has been impossible. Observation of the trial cohort is continued in order to assess clinical event rates with and without RTx and chronic RTx toxicity. (orig.) [de

  14. Sporadic ret-rearranged papillary carcinoma of the thyroid: a subset of slow growing, less aggressive thyroid neoplasms?

    Science.gov (United States)

    Soares, P; Fonseca, E; Wynford-Thomas, D; Sobrinho-Simões, M

    1998-05-01

    Despite the large amount of information accumulated on the role played by ret activation in the oncogenesis of papillary thyroid carcinoma (PTC), the biological and clinical significance of such activation 'in vivo' remains controversial. The aim of this study was to address some of the existing controversies by comparing two groups of unselected PTCs, one with and the other without ret rearrangement, with regard to several clinicopathological and biological features. Thirty-three PTCs were selected at random. ret rearrangement was found in eight cases (24.2 per cent) using Southern blot analysis. The mean age of the patients with tumours displaying ret rearrangement (28 +/- 3.1 years) was significantly lower than that of the patients harbouring cases that did not present rearrangement (45 +/- 2.9 years). The large majority of the tumours with ret rearrangement displayed a papillary or mixed follicular-papillary pattern and very low proliferative activity. ret rearrangement correlated significantly with decreased cytoplasmic expression of E-cadherin. No significant differences were found regarding the gender of the patients, tumour size, multicentricity, extrathyroidal growth, vascular invasion, lymphocytic infiltration, lymph node involvement or the expression of E-cadherin (membrane), c-erb-B2, c-met, Bcl-2, and vimentin. It is proposed that sporadic PTCs harbouring a ret rearrangement occur frequently as slow growing, papillary, or predominantly papillary tumours that do not usually progress towards less differentiated neoplasms representing what might be described as a Bonsai phenotype.

  15. [Anaplastic carcinoma of the thyroid at the Instituto Nacional de la Nutrición Salvador Zubirán].

    Science.gov (United States)

    Sierra, M; Gamboa-Domínguez, A; Herrera, M F; Barredo-Prieto, B; Alvarado de la Barrera, C; Llorente, L; Pérez-Enriquez, B; Rivera, R; González, O; Rull, J A

    1997-01-01

    Anaplastic thyroid carcinoma (ATC) is a highly aggressive tumor with a median survival rate of 6 months. To analyze presentation, treatment, morphology, immunohistochemistry, and nuclear DNA analysis of a cohort of patients with ATC. Twelve patients with ATC (11 female) with a mean age of 65 years were seen at our hospital from 1970-1995. The data were obtained from the clinical records and the morphology, immunohistochemic studies and DNA pattern were performed in slides obtained from archival specimens. Previous or coexisting thyroide disease was documented in 10 patients (9 multinodular goiters and one Grave's). The most frequent presentation was a rapidly growing tumor associated with dysphagia, cervical pain, hoarseness and dyspnea. A cold thyroid nodule was detected by thyroid scan in 10 patients. The most frequent subtype was the spindle cell variety. Papillary thyroid carcinoma coexisted in eight cases, two of them corresponded to the tall cell variant. Reactivity for S-100 protein and vimentin was studied in six patients: all were positive for S-100 protein and vimentin, 5/6 for epithelial membrane antigen, half for carcinoembriogenic antigen, 2/6 for thyroglobulin and calcitonin, and one for neuronal specific enolase. These six tumors showed a diploid DNA pattern. Tumor resection was achieved in 2/11 and none survived six years after diagnosis. ATC is a highly aggressive tumor coexisting with thyroid pathologies. Spindle cell variant is the most frequent with positive reactivity for S-100 protein, vimentin and epithelial membrane antigen. Most tumors have a diploid DNA content.

  16. Calcitonin and carcinoembryonic antigen doubling times as prognostic factors in medullary thyroid carcinoma: a structured meta-analysis

    NARCIS (Netherlands)

    Meijer, Johannes A. A.; le Cessie, Saskia; van den Hout, Wilbert B.; Kievit, Job; Schoones, Johannes W.; Romijn, Johannes A.; Smit, Johannes W. A.

    2010-01-01

    In the management of patients with medullary thyroid carcinoma (MTC), calcitonin doubling time (dt) has gained interest as an independent predictor of recurrence and survival. To perform a structured meta-analysis of the diagnostic value of calcitonin dt, carcinoembryonic antigen (CEA) dt and the

  17. METASTASIS OF RENAL CARCINOMA TO THE THYROID, SPECIFIC FEATURES OF DIAGNOSIS AND TREATMENT (DESCRIPTION OF A CASE

    Directory of Open Access Journals (Sweden)

    L. P. Yakovleva

    2014-08-01

    Full Text Available The paper describes a case of metastatic involvement of the thyroid by renal carcinoma. The specific features of this observation are diagnostic difficulties in assessing the pattern and extent of a process and in choosing surgical treatment tactics.

  18. Somatostatin receptor scintigraphy using (99m)Tc-EDDA/HYNIC-TOC in patients with medullary thyroid carcinoma

    NARCIS (Netherlands)

    Czepczynski, Rafal; Parisella, Maria Gemma; Kosowicz, Jerzy; Mikolajczak, Renata; Ziemnicka, Katarzyna; Gryczynska, Maria; Sowinski, Jerzy; Signore, Alberto

    2007-01-01

    Purpose Several new somatostatin analogues have been developed for the diagnosis and therapy of different tumours. Since somatostatin receptors are often over-expressed in medullary thyroid carcinoma (MTC), the aim of our study was to evaluate the utility of scintigraphy with the somatostatin

  19. CHROMOSOMAL-ABERRATIONS IN FOLLICULAR THYROID-CARCINOMA - CASE-REPORT OF A PRIMARY TUMOR AND ITS METASTASIS

    NARCIS (Netherlands)

    VANDENBERG, E; VANDOORMAAL, JJ; OOSTERHUIS, JW; DEJONG, B; WIERSEMA, J; VOS, A; VERMEIJ, A; Dam, A.

    We present the result of a cytogenetic study of a case of follicular carcinoma of the thyroid and its metastasis. Both tumors have a low number of chromosomes. The primary tumor is characterized by a idic(22;22)(p11;p11). The skeletal metastasis has also structural abnormalities of chromosome 22.

  20. Low plasminogen activator inhibitor-1 levels in thyroid carcinoma: uPA/PAI-1 paradox in cancer proggression

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    Bekir Ucan

    2017-06-01

    Conclusions: Serum PAI-1 levels were lower in patients with papillary thyroid carcinoma. Our results might support the thesis of PAI-1 is expected to suppress cancer progression due to its ability to inhibit urokinase plasminogen activator activity. [J Contemp Med 2017; 7(2.000: 121-125

  1. Usefulness of recombinant human TSH aided radioiodine doses administered in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Pitoia, Fabian; El Tamer, Elias; Schere, Daniel B.; Passerieu, Mariano; Bruno, Oscar D.; Niepominiszcze, Hugo

    2006-01-01

    The published studies confirming the safety and efficacy of rh TSH for diagnostic purposes have led to an increased interest in its use for preparation for radioiodine (RI) dose administration in patients with recurrent or persistent differentiated thyroid carcinoma (DTC). In order to establish the efficacy of RI therapy after rh TSH, we have reviewed 39 rh TSH-aided radioiodine treatments in a series of 28 DTC patients. Patients were divided into two groups: GI (n=17), with previous thyroid bed uptake and undetectable thyroglobulin (Tg) levels under levothyroxine treatment and GII (n=11), with proven metastatic local or distant disease. Median follow-up after the first rh TSH-aided radioiodine treatment was 32 ± 13 months (range 8 to 54 months). Sixteen patients (94%) in GI were rendered disease free and one patient was shown to have persistent disease. In GII, the post therapy whole body scan showed pathological uptakes in all cases: in four patients in lungs, in four in mediastinum and in three in lateral neck. In two patients with mediastinum uptake, Tg levels were undetectable after rh TSH. In the follow-up, two patients with lateral neck uptake were rendered disease free, four patients died (three due to thyroid cancer) and five out of the remaining patients have persistent disease. In conclusion, rh TSH aided therapy was helpful to eliminate normal thyroid bed remnants in 16/17 (94%) patients (GI). rh TSH stimulated Tg was undetectable in two patients with mediastinal metastasis. We believe that rh TSH is a good alternative to levothyroxine withdrawal for the treatment of DTC with radioactive iodine, increasing the quality of life in these patients. Caution should be recommended in the follow-up of unselected DTC patients only with stimulated Tg levels. (author) [es

  2. Lean body mass-based levothyroxine replacement in young athyrotic patients with differentiated carcinoma of thyroid

    Directory of Open Access Journals (Sweden)

    Fatima Begum

    2013-01-01

    Full Text Available Objective: The objective of this study was to optimize dose of levothyroxine (LT4 based on lean body mass (LBM in young athyrotic patients with differentiated carcinoma of thyroid (DCT which has not been properly addressed in Bangladesh before. Materials and Methods: Sixty patients with DCT (age, range: 20-39 years having total thyroidectomy followed by radioiodine ablative therapy (RIT and 23 euthyroid volunteers were recruited. Clinical, biochemical parameters were obtained from all patients after 2 months of RIT and on LT4 replacement at a dose of 200 μg/day as first follow up visit and also from control subjects. Then 60 patients were divided into two groups consisting of 30 patients each. Patients of Group-I received LT4 replacement based on LBM measured by dual energy X-ray absorptiometry (DXA and Group-II continued LT4 replacement in conventional dose. Patients of both groups were assessed again for same parameters at 6 to 12 months at the second visit. Results: Optimized dose of LT4 based on LBM by DXA (131 ±23 μg/day significantly reduced thyroid hormones and kept thyroid stimulating hormone (TSH in expected levels in patients of Group-I at the second visit compared to patients of Group-II who continued conventional LT4 dose (200 μg/day. Hyperthyroid symptom scale (HSS was significantly reduced to 2 ± 1 in patients of Group-I but not in patients of Group-II, HSS, 8 ±1 ( P < 0.001. Conclusion: Optimization of LT4 dose based on LBM can avoid chronic exposure of mild excess of thyroid hormone in young patients with low risk DCT.

  3. Metabolic changes associated with papillary thyroid carcinoma: A nuclear magnetic resonance-based metabolomics study.

    Science.gov (United States)

    Li, Yanyun; Chen, Minjian; Liu, Cuiping; Xia, Yankai; Xu, Bo; Hu, Yanhui; Chen, Ting; Shen, Meiping; Tang, Wei

    2018-05-01

    Papillary thyroid carcinoma (PTC) is the most common thyroid cancer. Nuclear magnetic resonance (NMR)‑based metabolomic technique is the gold standard in metabolite structural elucidation, and can provide different coverage of information compared with other metabolomic techniques. Here, we firstly conducted NMR based metabolomics study regarding detailed metabolic changes especially metabolic pathway changes related to PTC pathogenesis. 1H NMR-based metabolomic technique was adopted in conju-nction with multivariate analysis to analyze matched tumor and normal thyroid tissues obtained from 16 patients. The results were further annotated with Kyoto Encyclopedia of Genes and Genomes (KEGG), and Human Metabolome Database, and then were analyzed using modules of pathway analysis and enrichment analysis of MetaboAnalyst 3.0. Based on the analytical techniques, we established the models of principal component analysis (PCA), partial least squares-discriminant analysis (PLS-DA), and orthogonal partial least-squares discriminant analysis (OPLS‑DA) which could discriminate PTC from normal thyroid tissue, and found 15 robust differentiated metabolites from two OPLS-DA models. We identified 8 KEGG pathways and 3 pathways of small molecular pathway database which were significantly related to PTC by using pathway analysis and enrichment analysis, respectively, through which we identified metabolisms related to PTC including branched chain amino acid metabolism (leucine and valine), other amino acid metabolism (glycine and taurine), glycolysis (lactate), tricarboxylic acid cycle (citrate), choline metabolism (choline, ethanolamine and glycerolphosphocholine) and lipid metabolism (very-low‑density lipoprotein and low-density lipoprotein). In conclusion, the PTC was characterized with increased glycolysis and inhibited tricarboxylic acid cycle, increased oncogenic amino acids as well as abnormal choline and lipid metabolism. The findings in this study provide new

  4. Clinicopathologic risk factors for right paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Yu, Q A; Ma, D K; Liu, K P; Wang, P; Xie, C M; Wu, Y H; Dai, W J; Jiang, H C

    2018-03-17

    To investigate risk factors associated with right paraesophageal lymph node (RPELN) metastasis in patients with papillary thyroid carcinoma (PTC) and to determine the indications for right lymph node dissection. Clinicopathologic data from 829 patients (104 men and 725 women) with PTC, operated on by the same thyroid surgery team at the First Affiliated Hospital of Harbin Medical University from January 2013 to May 2017, were analyzed. Overall, 309 patients underwent total thyroidectomy with bilateral lymph node dissection, 488 underwent right thyroid lobe and isthmic resection with right central compartment lymph node dissection, and 32 underwent near-total thyroidectomy (ipsilateral thyroid lobectomy with contralateral near-total lobectomy) with bilateral lymph node dissection. The overall rate of central compartment lymph node metastasis was 43.5% (361/829), with right central compartment lymph node and RPELN metastasis rates of 35.5% (294/829) and 19.1% (158/829), respectively. Tumor size, number, invasion, and location, lymph node metastasis, right central compartment lymph node metastasis, and right lateral compartment lymph node metastasis were associated with RPELN in the univariate analysis, whereas age and sex were not. Multivariate analysis identified tumors with a diameter ≥ 1 cm, multiple tumors, tumors located in the right lobe, right central compartment lymph node metastasis, and right lateral compartment lymph node metastasis as independent risk factors for RPELN metastasis. Lymph node dissection, including RPELN dissection, should be performed for patients with PTC with a tumor diameter ≥ 1 cm, multiple tumors, right-lobe tumors, right central compartment lymph node metastasis, or suspected lateral compartment lymph node metastasis.

  5. Lean body mass-based levothyroxine replacement in young athyrotic patients with differentiated carcinoma of thyroid

    Science.gov (United States)

    Begum, Fatima; Ahmed, Chaudhury M.; Afroz, Shahana; Kabir, Enamul; Alam, Faridul; Banerjee, Sajal; Zaman, Nazma

    2013-01-01

    Objective: The objective of this study was to optimize dose of levothyroxine (LT4) based on lean body mass (LBM) in young athyrotic patients with differentiated carcinoma of thyroid (DCT) which has not been properly addressed in Bangladesh before. Materials and Methods: Sixty patients with DCT (age, range: 20-39 years) having total thyroidectomy followed by radioiodine ablative therapy (RIT) and 23 euthyroid volunteers were recruited. Clinical, biochemical parameters were obtained from all patients after 2 months of RIT and on LT4 replacement at a dose of 200 μg/day as first follow up visit and also from control subjects. Then 60 patients were divided into two groups consisting of 30 patients each. Patients of Group-I received LT4 replacement based on LBM measured by dual energy X-ray absorptiometry (DXA) and Group-II continued LT4 replacement in conventional dose. Patients of both groups were assessed again for same parameters at 6 to 12 months at the second visit. Results: Optimized dose of LT4 based on LBM by DXA (131 ±23 μg/day) significantly reduced thyroid hormones and kept thyroid stimulating hormone (TSH) in expected levels in patients of Group-I at the second visit compared to patients of Group-II who continued conventional LT4 dose (200 μg/day). Hyperthyroid symptom scale (HSS) was significantly reduced to 2 ± 1 in patients of Group-I but not in patients of Group-II, HSS, 8 ±1 (P > 0.001). Conclusion: Optimization of LT4 dose based on LBM can avoid chronic exposure of mild excess of thyroid hormone in young patients with low risk DCT. PMID:23776898

  6. Prognostic indicators in well-differentiated thyroid carcinoma when controlling for stage and treatment.

    Science.gov (United States)

    Krook, Kaelyn A; Fedewa, Stacey A; Chen, Amy Y

    2015-04-01

    The incidence of thyroid carcinoma is rising. Few studies have examined patient characteristics that influence survival when adjusting for treatment and tumor stage/extent. Retrospective analysis was performed using the Surveillance Epidemiology and End Results registry data among patients diagnosed with well-differentiated thyroid (WDT) carcinoma during 1988-2009. Kaplan-Meir survival curves were used to estimate 5- and 10-year cause-specific and overall survival differences by sociodemographics, clinical characteristics, and treatment. Multivariate Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 83,985 patients were identified with WDT carcinoma. Blacks had higher hazard of death at 5 years (HR, 1.67; 95% CI, 1.42-1.96) and 10 years (HR, 1.57; 95% CI, 1.37-1.80) when compared to Caucasians, but there were no significant differences in cause-specific deaths. Hispanics had higher overall and cause-specific 5-year and 10-year hazard of death (5-year cause-specific: HR, 1.56; 95% CI, 1.23-1.99). Age was the most significant predictor of cause-specific and overall survival, with risk increasing in a nonlinear fashion. After age 45 years, the HR for 5- and 10-year cause-specific survival rose drastically, reaching an HR of 153 for individuals aged 85 years and older (HR, 153.45; 95% CI, 97.84-240.67). Age was the strongest factor associated with WDT cancer in our study. African Americans had worse overall survival, although only Hispanics had a significantly worse cause-specific survival. These factors should be taken into account in counseling patients and treatment planning. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Follicular Thyroid Carcinoma: How Have Histologic Diagnoses Changed in the Last Half-Century and What Are the Prognostic Implications?

    Science.gov (United States)

    Cipriani, Nicole A; Nagar, Sapna; Kaplan, Sharone P; White, Michael G; Antic, Tatjana; Sadow, Peter M; Aschebrook-Kilfoy, Briseis; Angelos, Peter; Kaplan, Edwin L; Grogan, Raymon H

    2015-11-01

    Follicular thyroid carcinoma (FTC) comprises 10% of differentiated thyroid cancers. Diagnostic controversy and interobserver variability render the practical diagnosis of FTC difficult. Overall survival rates vary (46-97%). The aims of this study were to review FTC histologically at the authors' tertiary care institution and to evaluate long-term survival and recurrence. Diagnostic slides from 66 FTC cases (1965-2007) were reviewed by three pathologists from two institutions (blinded to clinical outcomes), and consensus was obtained. Patient demographics, tumor characteristics, and treatment, survival, and recurrence data were collected. Thyroid cancer-specific and recurrence-free survival were calculated by original and reclassified diagnoses. Forty-seven cases (71%) were reclassified: 24 (36%) to papillary thyroid carcinoma (PTC), 18 (27%) to follicular adenoma (FA), and five (8%) to poorly differentiated carcinoma (PDC). Nineteen (29%) maintained a diagnosis of FTC. The extent of surgical resection and rates of radioiodine treatment did not differ by reclassification diagnosis. Pre-review FTC-specific survival was 83.5% and 75.1% at 10 and 20 years, respectively. Following contemporary reclassification, FTC-specific survival was 77% and 33.7% at 10 and 20 years, respectively. There were no cancer-specific deaths in the FA or PTC groups. Over the past 50 years, changes in our understanding of the pathogenesis, histology, and behavior of thyroid carcinoma may partially account for the changes in histologic diagnosis. Elimination of PTC and FA "contaminants" led to decrease in survival following reclassification. Variability in histologic interpretation contributes to diagnostic challenges in follicular lesions. Histologic review of thyroid tumors for research studies is crucial, especially given the ever-changing diagnostic criteria.

  8. Follow-up and prognosis of thyroid carcinoma; Nachsorge und Prognose der Schilddruesenkarzinome

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    Sandrock, D.; Munz, D.L. [Humboldt-Universitaet, Berlin (Germany). Medizinische Fakultaet Charite

    2000-03-01

    The follow-up of patients with differentiated thyroid carcinoma is based on guidelines of the appropriate scientific societies like the German Society of Nuclear Medicine (DGN). After (successfull) radioiodine treatment there are follow-up investigations in intervalls (every [half] year, life-long) including ultrasound, serum level of thyroglobulin, TSH, (f)T3, and (f)T4. If recurrent/metastatic disease is suspected further special methods will follow (radioiodine scan, CT, MRI..). 5- and 10-year overall survival rates of paillary carcinoma are in the range of 90% and 80%, of follicular carcinoma in the range of 80% and 70%, respectively. Individual prognosis can be assessed by different scoring systems including factors like age, sex, size, grading, and extent of the disease. The medullary carcinoma has a mediocre prognosis and similar follow-up intervals focusing on the tumor markers calcitonin and CEA and, if necessary, a variety of imaging methods. The anaplastic carcinoma with its bad prognosis needs individual (palliative) symptomatic follow-up. (orig.) [German] Die Nachsorge des differenzierten Schilddruesenkarzinoms orientiert sich an Empfehlungen und Leitlinien der DGN sowie weiterer Fachgesellschaften. Nach (erfolgreicher) Therapie sind in Intervallen (1/2jaehrlich, jaehrlich, lebenslang) ambulante Nachsorgeuntersuchungen mit Sonographie, Thyreoglobulin- und TSH-, [f]T3-, [f]T4-Bestimmung erforderlich. Je nach Rezidiv-/Metastasenverdacht sind gezielte weitere Untersuchungen durchzufuehren (Radiojoddiagnostik, CT, MRT...). Die 5- und 10-Jahres-Ueberlebensraten des papillaeren Karzinoms liegen um 90% bzw. 80%, die des follikulaeren um 80% bzw. 70%. Die Prognose kann mittels diverser Scores bestimmt werden, die u.a. Alter, Geschlecht, Grading, und Ausdehnung der Erkrankung beruecksichtigen. Das medullaere Karzinom hat bei mittlerer Prognose aehnliche Nachsorgeintervalle, orientiert sich an den Tumormarkern Kalzitonin und CEA und gegebenenfalls komplexer

  9. Laryngeal chondrosarcoma mimicking medullary thyroid carcinoma on fine-needle aspiration cytology: A case report of a diagnostic pitfall.

    Science.gov (United States)

    Vahidi, Shifteh; Amin, Khalid; Stewart, Jimmie

    2017-11-01

    Chondrosarcoma (CS) of larynx is a rare laryngeal tumor accounting about 1% of laryngeal malignancies. When CS arises from thyroid cartilage, it may clinically present as a thyroid nodule. Here we report a rare case of CS of thyroid cartilage misinterpreted as medullary thyroid carcinoma. The main aim of this case report is to emphasize the important role of accurate clinical history, appropriate physical examination, and proper localization of the tumor and clear definitive imaging in conjunction with interpretation of cytologic smears. When any of these roles are unclear, it may result in misinterpretation of the cytologic smears. In these unusual circumstances, when cytomorphologic features does not completely fit an entity, communication with the physician and the consideration of a broad differential diagnoses in the head and neck pathology may lead to correct diagnosis and avoid diagnostic pitfalls. Also in certain conditions, ancillary studies including laboratory tests are necessary for definitive classification. © 2017 Wiley Periodicals, Inc.

  10. Late simultaneous metastasis of renal cell carcinoma to the submandibular and thyroid glands seven years after radical nephrectomy.

    Science.gov (United States)

    Miah, Mohammed S; White, Sharon J; Oommen, George; Birney, Esther; Majumdar, Samit

    2010-01-01

    Background. Renal cell carcinoma (RCC) metastasis to the salivary glands is extremely rare. Most cases reported previously have involved the parotid gland and only six cases involving the submandibular gland exist in the current literature. Metastasis of RCC to thyroid gland is also rare but appears to be more common than to salivary glands. Methods and Results. We present the first case of simultaneous metastasis to the submandibular and thyroid glands from clear cell RCC in a 61-year-old woman who presented seven years after the primary treatment. The submandibular and thyroid glands were excised completely with preservation of the marginal mandibular and recurrent laryngeal nerves, respectively. Conclusion. Metastatic disease should always be considered in the differential diagnosis for patients who present with painless salivary or thyroid gland swelling with a previous history of RCC. If metastatic disease is confined only to these glands, prompt surgical excision can be curative.

  11. Anaplastic thyroid cancer

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000352.htm Anaplastic thyroid cancer To use the sharing features on this page, ... carcinoma is a rare and aggressive form of cancer of the thyroid gland. Causes Anaplastic thyroid cancer is an invasive ...

  12. Significance of TNF-α and the Adhesion Molecules: L-Selectin and VCAM-1 in Papillary Thyroid Carcinoma

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    Toral P. Kobawala

    2016-01-01

    Full Text Available Circulating levels of TNF-α and the adhesion molecules L-Selectin and VCAM-1 as well as their expression in the primary tumors of patients with benign thyroid diseases and papillary thyroid carcinoma (PTC have been determined in this study. The serum levels of TNF-α, L-Selectin, and VCAM-1 were significantly higher in patients with both benign thyroid diseases and PTC as compared to the healthy individuals. However, the levels of only TNF-α and L-Selectin, and not VCAM-1, were significantly higher in patients with PTC in comparison to those observed in patients with benign thyroid diseases. Further the expression of TNF-α and L-Selectin was also significantly higher in the primary tumors of PTC patients, relative to the benign thyroid diseases. The expression of L-Selectin and VCAM-1 significantly correlated with aggressive tumor behavior. In PTC patients, the circulating TNF-α levels significantly positively correlated with the levels of L-Selectin, while TNF-α immunoreactivity was significantly associated with VCAM-1 expression. Serum TNF-α was found to be a significant prognosticator for OS in PTC patients. Overall the results signify that the interaction between TNF-α and the adhesion molecules may have a role in thyroid carcinogenesis and understanding this complexity may offer potential therapeutic targets for better management of thyroid cancer.

  13. Thyroid Hormone Activates Brown Adipose Tissue and Increases Non-Shivering Thermogenesis--A Cohort Study in a Group of Thyroid Carcinoma Patients.

    Directory of Open Access Journals (Sweden)

    Evie P M Broeders

    Full Text Available Thyroid hormone receptors are present on brown adipose tissue (BAT, indicating a role for thyroid hormone in the regulation of BAT activation. The objective of this study was to examine the effect of thyroid hormone withdrawal followed by thyroid hormone in TSH-suppressive dosages, on energy expenditure and brown adipose tissue activity.This study was a longitudinal study in an academic center, with a follow-up period of 6 months. Ten patients with well-differentiated thyroid carcinoma eligible for surgical treatment and subsequent radioactive iodine ablation therapy were studied in a hypothyroid state after thyroidectomy and in a subclinical hyperthyroid state (TSH-suppression according to treatment protocol. Paired two-tailed t-tests and linear regression analyses were used.Basal metabolic rate (BMR was significantly higher after treatment with synthetic thyroid hormone (levothyroxine than in the hypothyroid state (BMR 3.8 ± 0.5 kJ/min versus 4.4 ± 0.6 kJ/min, P = 0.012, and non-shivering thermogenesis (NST significantly increased from 15 ± 10% to 25 ± 6% (P = 0.009. Mean BAT activity was significantly higher in the subclinical hyperthyroid state than in the hypothyroid state (BAT standard uptake value (SUVMean 4.0 ± 2.9 versus 2.4 ± 1.8, P = 0.039.Our study shows that higher levels of thyroid hormone are associated with a higher level of cold-activated BAT.ClinicalTrials.gov NCT02499471.

  14. Taponamiento cardíaco secundario a carcinoma papilar esclerosante difuso de tiroides Metastatic cardiac tamponade as initial manifestation of papillary thyroid carcinoma

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    Verónica Riva

    2011-12-01

    Full Text Available El carcinoma papilar, variante esclerosante difusa, corresponde al 2% de todos los carcinomas papilares de la tiroides. Se caracteriza por comprometer de manera difusa y bilateral a la glándula tiroides. Clínicamente se manifiesta con metástasis ganglionares y pulmonares, afectando predominantemente a mujeres jóvenes. Se describe un caso de taponamiento cardíaco como presentación inicial de un carcinoma papilar de tiroides variante esclerosante difusa. Una mujer de 32 años concurrió al servicio de emergencias médicas refiriendo epigastralgia y tos seca. Durante el examen físico se constató hipotensión arterial, taquicardia y ruidos cardíacos disminuidos. Se realizó un ecocardiograma, observándose derrame pericárdico. Por medio de una pericardiocentesis se obtuvo líquido pericárdico, cuyo análisis mostró células neoplásicas. Durante la evolución la paciente presentó recurrencia del derrame pericárdico por lo que se realizó una ventana pleuropericárdica, detectándose durante la cirugía una lesión nodular subpleural, la cual fue biopsiada e informada posteriormente como una metástasis de carcinoma papilar vinculable a origen tiroideo. Se realizó una tiroidectomía total con linfadenectomía cervical bilateral. El diagnóstico final fue carcinoma papilar, variante esclerosante difusa. Esta variante infiltra el tejido conectivo de los espacios interfoliculares, simulando una tiroiditis y se caracteriza por una permeación vascular temprana. En oposición a la variante clásica, la esclerosante difusa presenta mayor agresividad y mayor tasa de recurrencia. El carcinoma papilar de tiroides debe tenerse presente como diagnóstico diferencial en nuestro medio, en todas aquellas lesiones neoplásicas papilares metastásicas, más aún si se trata de mujeres jóvenes.Papillary carcinoma, diffuse sclerosing variant corresponds to 2% of all papillary thyroid carcinomas. It is usually diffuse and bilateral, affecting the entire

  15. Galectins and Carcinogenesis: Their Role in Head and Neck Carcinomas and Thyroid Carcinomas

    Directory of Open Access Journals (Sweden)

    Nadège Kindt

    2017-12-01

    Full Text Available Head and neck cancers are among the most frequently occurring cancers worldwide. Of the molecular drivers described for these tumors, galectins play an important role via their interaction with several intracellular pathways. In this review, we will detail and discuss this role with specific reference to galectins-1, -3, and -7 in angiogenesis, cell proliferation, and invasion as well as in cell transformation and cancer progression. Furthermore, we will evaluate the prognostic value of galectin expression in head and neck cancers including those with oral cavity, salivary gland, and nasopharyngeal pathologies. In addition, we will discuss the involvement of these galectins in thyroid cancers where their altered expression is proposed as a new diagnostic biomarker.

  16. Metronomic chemotherapy in anaplastic thyroid carcinoma: A potentially feasible alternative to therapeutic nihilism

    Directory of Open Access Journals (Sweden)

    Swaroop Revannasiddaiah

    2015-01-01

    Full Text Available Anaplastic thyroid carcinoma (ATC is one of the most aggressive malignancies and prognostic outlook remains very dismal. Treatment most often is palliative in intent attempting to relieve the patients from local compressive symptoms in the neck. Radical surgery, radiotherapy (RT, and chemotherapy have not been tested in large prospective trials, and current evidence from retrospective series and small trials indicate only marginal survival benefits. Given the poor prognostic and therapeutic outlook, patients must be encouraged to be actively involved in the decision making process. We report the case of an elderly patient who had no response to palliative RT, and was treated with oral metronomic chemotherapy. The response to oral metronomic chemotherapy was dramatic, and the patient has enjoyed complete freedom from symptoms as well as radiologically exhibits a complete regression. Thus, we document the first ever use of a simple, cost-effective, and convenient oral metronomic chemotherapeutic regimen delivering a remarkable response in an elderly patient with ATC.

  17. A role for radiotherapy in the management of advanced medullary thyroid carcinoma: the Mayo Clinic experience

    Directory of Open Access Journals (Sweden)

    Jason A. Call

    2013-07-01

    Full Text Available Outcomes of external beam radiotherapy (EBRT in advanced medullary thyroid carcinoma\t(MTC\tare\tlargely\tunknown. Retrospective review of data from patients with MTC, diagnosed from June 1, 1970, through December 31, 2007. Overall survival and locoregional tumor control rates were calculated. Seventeen patients had adjuvant or palliative EBRT delivered to 41 sites. Six patients initially had adjuvant EBRT (median, 60.80 Gy; none had relapse in the treated area. Five patients with locoregional recurrence after surgery were treated (median, 59.40 Gy, and durable disease control was achieved in 3. Twelve patients received palliative EBRT to 29 sites of metastatic disease (median, 30.00 Gy, which provided sustained symptom relief at 45% of sites. Five- and ten- year overall survival rates were 44% and 19%, respectively. Adjuvant EBRT may be most effective for prevention of locoregional recurrence. EBRT may provide sustained control of advanced, metastatic disease in select patients.

  18. Sudden hemorrhage in metastatic thyroid carcinoma of the brain during treatment with 131I

    International Nuclear Information System (INIS)

    Holmquest, D.L.; Lake, P.

    1976-01-01

    A patient with papillary--follicular carcinoma of the thyroid, with metastases to the lungs, skeleton, and brain, was treated 5 weeks after thyroidectomy with 135 mCi of 131 I. Although preliminary studies with 1 mCi had not shown any iodine uptake by the brain metastasis, this lesion showed intense concentration at the time of the larger therapeutic dose. Four days later, acute hemorrhage of the tumor occurred, requiring surgical removal. Although 131 I therapy would seem an unlikely cause of acute necrosis and hemorrhage in these lesions, the association of therapeutic radioiodine and hemorrhage is interesting. Since recent reports suggest that brain metastasis may be somewhat more common than previously suspected, we suggest that brain imaging be included in the workup prior to radioiodine therapy of patients with advanced metastatic disease or neurologic symptoms

  19. Metronomic chemotherapy in anaplastic thyroid carcinoma: a potentially feasible alternative to therapeutic nihilism.

    Science.gov (United States)

    Revannasiddaiah, Swaroop; Madabhavi, Irappa; Bodh, Anita; Thakur, Priyanka; Sharma, Mukesh

    2015-01-01

    Anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies and prognostic outlook remains very dismal. Treatment most often is palliative in intent attempting to relieve the patients from local compressive symptoms in the neck. Radical surgery, radiotherapy (RT), and chemotherapy have not been tested in large prospective trials, and current evidence from retrospective series and small trials indicate only marginal survival benefits. Given the poor prognostic and therapeutic outlook, patients must be encouraged to be actively involved in the decision making process. We report the case of an elderly patient who had no response to palliative RT, and was treated with oral metronomic chemotherapy. The response to oral metronomic chemotherapy was dramatic, and the patient has enjoyed complete freedom from symptoms as well as radiologically exhibits a complete regression. Thus, we document the first ever use of a simple, cost-effective, and convenient oral metronomic chemotherapeutic regimen delivering a remarkable response in an elderly patient with ATC.

  20. Testicular impact of the treatment with I-131 in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Chebel, G.; Gutierrez, S.; Fadel, A.; Suarez, S.; Levalle, O.

    2007-01-01

    Young patients carriers differentiated thyroid carcinoma (DTC) are treated with high doses of I-131 for much of his life with very good prognosis and projects with paternity. However, there is scarce information on the effect of radioiodine on the male gonad and their future fertility. This therapy may compromise on a temporary and / or definitively the role of the germinal cells. The testicular irradiation depends on the blood flow, the dose of I-131 administered and of the presence or absence of metastasis pelvic near to the gonads. A single dose of 100 mCi of I-131 throws an absorbed dose at gonadal level of 50-150 cGy. It has been reported that absorbed doses of 50 cGy can produce transitory decrease spermatogenesis and higher doses can also affect the function of the Leydig cells [es

  1. The scope of false-positive iodine-131 images for thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Greenler, D.P.; Klein, H.A.

    1989-02-01

    Iodine-131 is used to detect and treat functioning lesions of papillary and follicular carcinoma of the thyroid. False-positive images although rare, do occur, with major categories being (1) body secretions, (2) pathologic transudates and inflammation, (3) nonspecific mediastinal uptake, and (4) neoplasms of nonthyroidal origin. The authors present eight cases that fall into the first three categories, including three types not previously reported--a lymphoepithelial cyst, a scrotal hydrocele, and a skin burn. The classification of mediastinal uptake as false positive is tentative. High-dose images and those exploiting therapeutic doses have an increased detection rate for both true and spurious lesions. Appropriate caution is advised in the interpretation of I-131 images.

  2. The follicular variant of papillary thyroid carcinoma: Characteristics of preoperative ultrasonography and cytology

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jung Hyun; Kwon, Hyeong Ju; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-01-15

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

  3. Ret/PTC activation does not influence clinical and pathological features of adult papillary thyroid carcinomas.

    Science.gov (United States)

    Puxeddu, Efisio; Moretti, Sonia; Giannico, Angela; Martinelli, Marco; Marino, Cecilia; Avenia, Nicola; Cristofani, Roberto; Farabi, Raffaele; Reboldi, Gianpaolo; Ribacchi, Rodolfo; Pontecorvi, Alfredo; Santeusanio, Fausto

    2003-05-01

    RET proto-oncogene rearrangements (ret/PTCs) represent the most common genetic alterations found in papillary thyroid carcinomas (PTCs). Correlation of ret/PTC expression with clinical outcome is controversial. The aim of the present study was to analyze the frequency of RET rearrangements in adult PTCs, and to investigate if ret/PTCs influence biological behavior and clinical features of the cancers. Ret/PTC rearrangements were looked for in tIssue samples of 48 PTCs collected at our institution. Data about clinical and pathological features of the tumors were also reviewed. Three separate association analyses were carried out on the cohort evaluating the effects of, respectively, ret/PTC positivity, preferential RET tyrosine kinase domain (RET-TK) expression, and ret/PTC plus RET-TK positivity, on age, sex, tumor size, staging, number of neoplastic foci, and histological subtype. The genetic study was conducted with the RT-PCR-Southern blot technique. Standard Student's t-test and Fisher exact test were applied for the association analyses. The molecular genetic study demonstrated the positivity of ret/PTC1 and ret/PTC3 in 13 of 48 tumors (27.1%), and an exclusive or preferential RET-TK expression in 17 cases (35.4%). None of the three genetico-clinical analyses showed any significant association between ret/PTC expression and the clinical and pathological features of the cancers. These data indicate that RET rearrangements may not play any distinctive role in driving histotype development and cancer progression in these neoplasms. Moreover, they weaken the possibility of using ret/PTC as a prognostic marker for papillary thyroid carcinomas.

  4. Primary squamous cell carcinomas in the thyroid gland: an individual participant data meta-analysis

    International Nuclear Information System (INIS)

    Cho, Jae Keun; Woo, Seung-Hoon; Park, Junoh; Kim, Min-Ji; Jeong, Han-Sin

    2014-01-01

    Primary squamous cell carcinomas arising from the thyroid gland (SCCTh) is extremely rare diseases, which have never been fully studied. Thus, we performed a systematic review and individual participant data meta-analysis of published SCCTh cases, to understand the clinical characteristics and to identify the prognostic factors of primary SCCTh. A literature search was conducted within Medline, EMBASE, Cochrane library databases and KoreaMed using the following Medical Subject Headings (MeSH) keywords: “primary,” “squamous,” “carcinoma,” “cancer,” and “thyroid.” Eighty-four patients' individual data from 39 articles and five patients' data in our institute were selected for analysis (N = 89). The mean age at diagnosis was 63.0 years (range, 24–90) and female preponderance (M:F = 1:2) was noted. The commonest complaint was the anterior neck mass, followed by dyspnea or dysphagia, and extension to the adjacent structure was found in 72%. The median survival was 9.0 months (95% CI, 6.0–23.0) and 3-year survival rate (3YSR) was 37.6% by Kaplan–Meier method, but only 20.1% by a shared frailty model for adjusting heterogeneity. Complete resection (R0) of tumors was the only significant prognostic factor in multivariable analysis, and the benefit of adjuvant treatment was not proved. The prognosis of patients with SCCTh is very poor (20% in 3YSR), but complete resection of disease is correlated with improved survival. To achieve complete surgical eradication of tumors, early detection and accurate diagnosis should be emphasized

  5. Relationship between lymphovascular invasion and clinicopathological features of papillary thyroid carcinoma

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    Atakan Sezer

    2017-05-01

    Full Text Available Lymphovascular invasion (LVI is an important prognostic factor in various solid tumors, however, data on the association between LVI and thyroid carcinomas are limited. In this study, we evaluated the relationship between LVI and clinicopathological features of papillary thyroid carcinoma (PTC. Six hundred seventy-eight patients diagnosed with PTC between 2012 and 2015 were included into the study. Patients were classified based on the presence or absence of LVI. Gender, age, ultrasonography (US, tumor size and multifocality, BRAFV600E mutation, perineural and capsular invasion, extrathyroid extension (ETE, nodal metastasis, and recurrences were evaluated, and risk analysis was performed for each parameter. The number of patients with LVI [LVI (+] was 63, while the number of patients without LVI [LVI (-] was 615. The female/male ratio was 564/114. LVI was present in 18.4% of male patients and in 7.4 % of female patients. In the age group between 17-25 years LVI was detected in 6/13 patients, and this result was statistically significant compared to other age groups (p = 0.004. Suspicious lymph nodes upon US, perineural or capsular invasion, ETE, tumor size, and nodal metastasis were significantly more frequent in LVI (+ group (p < 0.001. The frequency of BRAFV600E mutation was also significantly higher in LVI (+ group (p < 0.001. Overall, the presence of LVI was associated with gender, tumor size, age, lymph node metastasis, pathological lymph nodes, perineural and capsular invasion, ETE, and BRAFV600E mutation. These results suggest that in PTC patients undergoing thyroidectomy, the presence of LVI should be considered as an indicator of aggressive clinicopathological features and those patients should be followed up carefully for recurrences and metastasis.

  6. Papillary Thyroid Carcinoma: Analysis of the Central Compartmentʼs Lymph Nodes Metastases

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    Ján Sojak

    2017-06-01

    Full Text Available Background: Papillary thyroid carcinoma is typical by regional lymph nodes metastases. Therefore we decided to analyse associated risk factors. Objective: In this retrospective study we focused on the incidence of metastatic involvement of the central compartment’s lymph nodes correlated with age, size of the primary tumour, infiltration of thyroid gland capsule, positive lymphangioinvasion in order to assess risk factors. Method: We analysed group of 156 patients with papillary carcinoma, who have undergone total thyroidectomy and bilateral elective central compartment neck dissection. We evaluated the occurrence of metastases, size, infiltration and lymphangioinvasion based on definitive histology of the whole group and separately for subgroups of patients under and over 45 years. Result: We found metastatic involvement in 88 (56.4% patients. When comparing the subgroups of patients under (73 patients and over 45 years (83 patients, we found metastases in 56 vs. 32 (76.7% vs. 38.6% patients. In the subgroup of younger patients we found significant higher incidence of metastases compared with the group of over 45 years, P < 0.001 (P = 0.000027. We found significant higher incidence of metastases in patients with positive capsule infiltration in the whole group, P < 0.001 (P = 0.00049; in the subgroup of under 45 years, P < 0.001 (P = 0.00091 and in patients with positive lymphangioinvasion in the whole group, P < 0.01 (P = 0.00177; in the subgroup of over 45 years, P < 0.001 (P = 0.0002. In patients with metastases we found tumour size ≥1cm more frequently in all groups. Conclusion: We recorded higher incidence of regional metastases in patients under 45 years, positive capsule infiltration, lymphangioinvasion. Age under 45 years itself does not correlate with less aggressive disease, to the contrary some of other analysed risk factors correlate with more aggressive disease.

  7. Biological dosimetry in patients with differenced thyroid carcinoma treated with Iodine-131

    International Nuclear Information System (INIS)

    Vallerga, M.; Taja, Maria R.; Radl, A.; Rojo, Ana M.; Deluca, G.; Di Giogio, Marina; Fadel, A.; Chebel, G.; Oneto, A.; Cabrejas, Mariana

    2007-01-01

    The differentiated thyroid carcinoma (DTC), constitutes the 90 % of the thyroid gland cancers. 80% of patients are cured after the initial therapy and 12% remained disease-free after successive treatments. The 24 patients included in this study represent a sample of the aforementioned 12% and 8%, with recurrence in the first decade post-treatment (local disease and/or recurrence at distance). The internal radiotherapy with 131 I in patients with DTC is used within the therapeutic schema as a step post-thyroidectomy. The success of the therapy is to get a lethal dose in the tumor tissue, which depends on the therapeutic activity and the retention of 131 I, without exceeding the dose of tolerance in healthy tissues. The most widespread way of administration is the empirical prescription which considers the clinical and laboratory parameters for its determination. In this work, the treatment protocol applied incorporates assessment by biological (DB) and internal (DI) dosimetry for estimating absorbed dose to the whole body and bone marrow to manage a personalized therapeutic dose for each patient. The biological dose estimation is based on the quantification of chromosomal aberrations, which is often referred to a dose-response curve in which lymphocytes are irradiated in vitro with 131 I, allowing to determine the dose in vivo of circulating lymphocytes patients [es

  8. Special role of JUN in papillary thyroid carcinoma based on bioinformatics analysis.

    Science.gov (United States)

    Chen, Wenzheng; Liu, Qingfeng; Lv, Yunxia; Xu, Debin; Chen, Wanzhi; Yu, Jichun

    2017-07-03

    Papillary thyroid carcinoma (PTC) is the most common malignancy in thyroid tissue, and the number of patients with PTC has been increasing in recent years. Discovering the mechanism of PTC genesis and progression and finding new potential diagnostic biomarkers/therapeutic target genes of PTC are of great significance. In this work, the datasets GSE3467 and GSE3678 were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified with the limma package in R. GO function and KEGG pathway enrichment were conducted with DAVID tool. The interaction network of the DEGs and other genes was performed with Cytoscape plugin BisoGenet, while clustering analysis was performed with Cytoscape plugin ClusterOne. A total of 1800 overlapped DEGs were detected in two datasets. Enrichment analysis of the DEGs found that the top three enriched GO terms in three ontologies and four significantly enriched KEGG pathways were mainly concerned with intercellular junction and extracellular matrix components. Interaction network analysis found that transcription factor hepatocyte nuclear factor 4, alpha (HNF4A) and DEG JUN had higher connection degrees. Clustering analysis indicated that two function modules, in which JUN was playing a central role, were highly relevant to PTC genesis and progression. JUN may be used as a specific diagnostic biomarker/therapeutic molecular target of PTC. However, further experiments are still needed to confirm our results.

  9. Recombinant TSH in follow-up and therapy of differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Luster, M.; Reiners, C.

    2000-01-01

    I-131-scintigraphy and serum thyroglobulin testing - if possible under stimulation of thyrotropin - are besides physical examination and ultrasonography crucial for the optimal follow-up of patients with well-differentiated thyroid carcinoma. This required physicians to withdraw patients from thyroid hormone suppression therapy (THST) for several weeks in order to raise endogenous TSH-levels. Clinical hypothyroidism often results in substantial patient discomfort, with sometimes major psychic alterations; the subsequent disability to work is occasionally an unpleasant consequence from an economical point of view. The temporary use of bovine, and for a short period of time human TSH is obsolete today because of a high risk of allergic reactions or the potential transmission of the Creutzfeldt-Jakob disease, respectively. Lately recombinant human TSH (rhTSH, Thyrogen trademark ), a hormone that was developed with the help of genetic engineering techniques, is available; its pharmacological safety has been demonstrated in previous phase-I/II-studies. The results of a phase-III-study showed in the majority of patients a marked rise in thyroglobulin levels after rhTSH. In all cases an adequate TSH level (>100 mU/l) was achieved after i.m. injection of recombinant TSH. Wholebody-scans showed a high level of accordance (>90%) in addition to a substantially lower background-activity. A tumour-background-ratio corresponding to conventional imaging could be demonstrated. (orig.) [de

  10. MicroRNA-mediated networks underlie immune response regulation in papillary thyroid carcinoma

    Science.gov (United States)

    Huang, Chen-Tsung; Oyang, Yen-Jen; Huang, Hsuan-Cheng; Juan, Hsueh-Fen

    2014-09-01

    Papillary thyroid carcinoma (PTC) is a common endocrine malignancy with low death rate but increased incidence and recurrence in recent years. MicroRNAs (miRNAs) are small non-coding RNAs with diverse regulatory capacities in eukaryotes and have been frequently implied in human cancer. Despite current progress, however, a panoramic overview concerning miRNA regulatory networks in PTC is still lacking. Here, we analyzed the expression datasets of PTC from The Cancer Genome Atlas (TCGA) Data Portal and demonstrate for the first time that immune responses are significantly enriched and under specific regulation in the direct miRNA-target network among distinctive PTC variants to different extents. Additionally, considering the unconventional properties of miRNAs, we explore the protein-coding competing endogenous RNA (ceRNA) and the modulatory networks in PTC and unexpectedly disclose concerted regulation of immune responses from these networks. Interestingly, miRNAs from these conventional and unconventional networks share general similarities and differences but tend to be disparate as regulatory activities increase, coordinately tuning the immune responses that in part account for PTC tumor biology. Together, our systematic results uncover the intensive regulation of immune responses underlain by miRNA-mediated networks in PTC, opening up new avenues in the management of thyroid cancer.

  11. Conventional papillary thyroid carcinoma: effects of cystic changes visible on ultrasonography on disease prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Kim, Eun Kyung; Kwak, Jin Young [Dept. of Radiology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Lee, Hye Sun [Dept. of Biostatistics, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    To investigate the characteristics of papillary thyroid carcinoma (PTC) with cystic changes visible on ultrasonography (US). This study included 553 PTCs in 553 patients between January 2003 and August 2004. One radiologist with 10 years of experience in thyroid imaging retrospectively reviewed the preoperative US images. Two different groups were formed according to two different reference points (group 1, 25%; group 2, 50%) of the cystic component. Patients between the groups were compared according to their clinicopathologic characteristics. Disease-free survival (DFS) was estimated. Cox's multivariate proportional hazards regression model was used to identify the effect of variable factors on the recurrence risk. Fifty-six patients (10.1%) were confirmed to have tumor recurrence within the follow-up period. Thirty-five patients had regional metastasis, one had distant metastasis, eight had multiple site metastases, and 12 had biochemical recurrence. PTC patients with a ≤ 50% or PTC patients with a ≤ 25% cystic component did not have a statistically significant longer DFS than those with a >50% (hazard ratio [HR], 1.118; 95% confidence interval [CI], 0.255 to 4.910; P=0.883) or those with a >25% cystic component (HR, 0.569; 95% CI, 0.164 to 1.976; P=0.375), respectively. Moreover, independent predictors of recurrence were pathologic size, male gender, and lymph node metastasis, not a >50% or >25% cystic component. The proportion of the cystic component in PTCs did not affect DFS.

  12. Antiproliferative and pro-apoptotic effects of Uncaria tomentosa in human medullary thyroid carcinoma cells.

    Science.gov (United States)

    Rinner, Beate; Li, Zeng Xia; Haas, Helga; Siegl, Veronika; Sturm, Sonja; Stuppner, Hermann; Pfragner, Roswitha

    2009-11-01

    Medullary thyroid carcinoma (MTC), a rare calcitonin-producing tumor, is derived from parafollicular C-cells of the thyroid and is characterized by constitutive Bcl-2 overexpression. The tumor is relatively insensitive to radiation therapy as well as conventional chemotherapy. To date, the only curative treatment is the early and complete surgical removal of all neoplastic tissue. In this study, the antiproliferative and pro-apoptotic effects of fractions obtained from Uncaria tomentosa (Willd.) DC, commonly known as uña de gato or cat's claw were investigated. Cell growth of MTC cells as well as enzymatic activity of mitochondrial dehydrogenase was markedly inhibited after treatment with different fractions of the plant. Furthermore, there was an increase in the expressions of caspase-3 and -7 and poly(ADP-ribose) polymerase (PARP) fraction, while bcl-2 overexpression remained constant. In particular, the alkaloids isopterpodine and pteropodine of U. tomentosa exhibited a significant pro-apoptotic effect on MTC cells, whereas the alkaloid-poor fraction inhibited cell proliferation but did not show any pro-apoptotic effects. These promising results indicate the growth-restraining and apoptotic potential of plant extracts against neuroendocrine tumors, which may add to existing therapies for cancer.

  13. Discrepancies between the ultrasonographic and gross pathological size of papillary thyroid carcinomas

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    Hahm, Soo Yeon; Shin, Jung Hee; Oh, Young Lyun; Son, Young Ik [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The goal of this study was to investigate the level of agreement between tumor sizes measured on ultrasonography (US) and in pathological specimens of papillary thyroid carcinomas (PTCs) and to identify the US characteristics contributing to discrepancies in these measurements. We retrospectively reviewed the US findings and pathological reports of 490 tumors in 431 patients who underwent surgery for PTC. Agreement was defined as a difference of <20% between the US and pathological tumor size measurements. Tumors were divided by size into groups of 0.5-1 cm, 1-2 cm, 2-3 cm, and ≥3 cm. We compared tumors in which the US and pathological tumor size measurements agreed and those in which they disagreed with regard to the following parameters: taller-than-wide shape, infiltrative margin, echogenicity, microcalcifications, cystic changes in tumors, and the US diagnosis. The rate of agreement between US and the pathological tumor size measurements was 64.1% (314/490). Statistical analysis indicated that the US and pathological measurements significantly differed in tumors <1.0 cm in size (P=0.033), with US significantly overestimating the tumor size by 0.2 cm in such tumors (P<0.001). Cystic changes were significantly more frequent in the tumors where US and pathological tumor size measurements disagreed (P<0.001). Thyroid US may overestimate the size of PTCs, particularly for tumors <1.0 cm in size. This information may be helpful in guiding decision making regarding surgical extent.

  14. Cáncer de Tiroides: Estudio descriptivo retrospectivo Thyroid carcinoma: A descriptive retrospective study

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    Carolina C. González

    2006-12-01

    Full Text Available Entre todos los tumores, el carcinoma tiroideo (CT es poco frecuente, se caracteriza por su lenta evolución y elevado porcentaje de curación. Nuestro objetivo es estudiar las características de los pacientes con CT. Analizamos retrospectivamente a 171 pacientes, edad media al diagnóstico 41.1( ± 14.6 años, que consultaron entre los años 2000-04 por CT. Se evaluaron datos de anamnesis, métodos de diagnóstico, anatomía patológica y evolución. Agrupamos a los tumores por el tamaño y según TNM (tumor-adenopatía-metástasis en estadios (E. La presencia de tiroglobulina estimulada (Tg > 2 ng/ml e imagen positiva (con 131I u otro radiotrazador fueron consideradas como positivas para CT residual. De la población total el 88% fue sexo femenino, el 62% menores de 45 años, y el 77.1% tuvo función tiroidea normal. La punción con aguja fina (PAAF fue diagnóstica en 78%. El 96% fue carcinoma papilar (CTP, 63% presentaban E I; 14% E II; 19% E III y 4% E IV. Se detectó CT residual en el 90% de los pacientes con Tg entre 2 y 10, y en el 100% con Tg > 10 ng/ml, mientras que con Tg The thyroid carcinoma (TC is not very frequent among all cancers. Its course is slow and is high potentially curable. Our aim was to analyse the characteristics in patients with TC. A retrospective analysis on 171 patients, with an average age of 41.1 (±14,6, who asked for TC to our service between the years 2000-04, was performed. From case histories it was evaluated: anamnesis, diagnostic image, histopathology and evolution. Tumours were grouped for size and TNM (tumour-nodule-metastasis in stages (S. A stimulated serum thyroglobulin level > 2 ng/ml and positive image with 131I or another nuclear marker were considered as positive for residual TC. In the totality of the analyzed patients 88% were female, 62% below 45 years old, and in 77% the thyroid function was normal. The fine needle aspiration (FNA was diagnostic in 78%. Papillary thyroid carcinoma (PTC in 96

  15. Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning

    International Nuclear Information System (INIS)

    Caballero-Calabuig, Elisa; Cano-Terol, Carmen; Sopena-Monforte, Ramon; Reyes-Ojeda, Dolores; Abreu-Sanchez, Pedro; Ferrer-Rebolleda, Jose; Sopena-Novales, Pablo; Plancha-Mansanet, Carmen; Felix-Fontestad, Jesus

    2008-01-01

    Stimulated thyroglobulin (Tg) and 131 I total-body scan (TBS) have been the mainstays of differentiated thyroid carcinoma (DTC), but now diagnostic TBS has been eliminated from some follow-up protocols. Nevertheless, Tg can be negative in the presence of thyroid tissue, and moderately elevated Tg poses management problems. The purpose of this study was to check how many patients have Tg negative but visible thyroid tissue and if diagnostic TBS could be clinically useful. Retrospective review of 317 exams (stimulated Tg and TBS) of 128 patients with DTC. Patients with high-grade criteria and/or positive autoantibodies are excluded. Tg is considered positive if higher than the sensitivity level of the technique. TBS is positive if thyroid remnant, lymphatic node or metastases are detected. Results are classified in Tg and TBS concordant or discordant. Discordant 131 I TBS and Tg were found in 74/317 studies (23.3%), 48 (65%) being TBS positive and Tg negative. None of 128 patients had a first post-surgery negative scan, but 13 (10%) were Tg negative, even two patients with lymph node uptake. One year after radioiodine treatment, 26 out of 115 patients (initially Tg and TBS concordant positive) showed Tg negative and TBS still positive due to cervical remnants (20 patients), lymph node uptake (one) and metastasis (five); 20 patients remained Tg and TBS positive, but 14 of them only showed thyroid remnants. We propose to perform periodic diagnostic TBS to improve Tg specificity, at least while neck thyroid activity is detected, even if Tg is negative. (orig.)

  16. Thyroid carcinoma after exposure to the atomic radiation of Hiroshima, 1958-1979

    International Nuclear Information System (INIS)

    Ezaki, Haruo; Yasuda, Katsuhiko; Takeichi, Nobuo

    1983-01-01

    Clinical thyroid carcinoma occurred in 125 (15 males and 110 females) of 75,493 subjects on the list of the life span study extended sample of the Radiation Effects Research Foundation. The crude annual incidence rate in a population of 100,000 was 2.7 for the males and 12.4 for the females, and the risk increased with increasing dosage for both sexes. This tendency was remarkable among young women. In view of the ratio of expected to observed numbers (O/E), the incidence increased with increasing dosage for the two sexes both separately and collectively. Test of linearity revealed dose effects among the females and in the sum of both groups. The younger a subject, the more definite was the dose effect. The relative risk of the group exposed to more than 50 rad against the control group was 4.2. According to the age group, the risk of the group aged below 20 yrs. was as high as 7.9 with statistical significance. Occult carcinoma was found in 155 of the 4,425 autopsied cases in the same period. The relative risk of the group exposed to more than 50 rad was significantly high, 1.9, and the O/E ratio was significant only for the females. (Chiba, N.)

  17. Trametinib in Increasing Tumoral Iodine Incorporation in Patients With Recurrent or Metastatic Thyroid Cancer

    Science.gov (United States)

    2018-03-22

    BRAF Gene Mutation; Poorly Differentiated Thyroid Gland Carcinoma; RAS Family Gene Mutation; Recurrent Thyroid Gland Carcinoma; Stage IV Thyroid Gland Follicular Carcinoma AJCC v7; Stage IV Thyroid Gland Papillary Carcinoma AJCC v7; Stage IVA Thyroid Gland Follicular Carcinoma AJCC v7; Stage IVA Thyroid Gland Papillary Carcinoma AJCC v7; Stage IVB Thyroid Gland Follicular Carcinoma AJCC v7; Stage IVB Thyroid Gland Papillary Carcinoma AJCC v7; Stage IVC Thyroid Gland Follicular Carcinoma AJCC v7; Stage IVC Thyroid Gland Papillary Carcinoma AJCC v7

  18. Prognosis factors of thyroid micro carcinomas and recurrences characteristics; Facteurs pronostiques des microcarcinomes thyroidiens et caracteristiques des recidives

    Energy Technology Data Exchange (ETDEWEB)

    Habbeche, M.; Oufriha, N.; Nezzar, A.; Othmane, S.; Khelifa, A.; Drahmoune, R.; Bellazoug, K.; Bouyoucef, S.E. [CHU Bab El Oued, Service de medecine nucleaire, Alger (Algeria)

    2010-07-01

    Purpose: The aim of this study is the presentation of compiled series including 142 cases of thyroid micro carcinomas observed between 1993 and 2008, the description of recurrences and the discussion of iodine 131 contribution in the therapy choices. Conclusions: Frequency of local recurrence is linked to age (under 45 years), to the size of the micro carcinoma and the presence or not of peripheral ipsilateral lymphadenectomy. In this series, all patients that had lymphadenectomy have not recurred. Bi laterality and capsular break are not causes of the recurrences. (N.C.)

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

    International Nuclear Information System (INIS)

    Bouges, S.; Daures, J.P.; Arthus, J.C.; Vidonne Sartre, O.

    1997-01-01

    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.)

  20. Impact of tall cell variant histology on predicting relapse and changing the management of papillary thyroid carcinoma patients.

    Science.gov (United States)

    Gunalp, Bengul; Okuyucu, Kursat; Ince, Semra; Ayan, Aslı; Alagoz, Engin

    2017-01-01

    There has been much discussion recently about the risk category of tall cell variant (TVC) histology and its effects on the management of papillary thyroid carcinoma (PTC). We, therefore, undertook a retrospective study to compare stage-matched risk factors and recurrence rates between classical PTC (cPTC) patients and patients with TCV histology. A total of 3128 well-differentiated thyroid carcinoma patients who were treated and followed-up for more than 5 years in our clinic from 1995 to 2016 were included in this study. There were 2783 PTC (89%) patients, 1113 (40%) of them were cPTC and 56 (2%) of them were TCV patients. In all stages, the stage-matched incidence of extrathyroidal extension (ETE), lymphovascular invasion and initial lymph node metastases were significantly higher in TCV patients than in cPTC patients (Papproach and closer follow-up than classical patients.

  1. A case of thyroid medullary carcinoma with multiple painful bone metastases successfully treated with strontium-89 chloride

    International Nuclear Information System (INIS)

    Oshiro, Chiya; Kamigaki, Shunji; Arai, Takashi; Nakamura, Yukio; Fukunaga, Mutsumi; Ichida, Wakako; Ikeda, Hiroshi

    2012-01-01

    A 70-year-old man was diagnosed as thyroid medullary carcinoma with multiple bone metastases. He underwent total thyroidectomy and cervical lymph node dissection. After one year, the pain from his bone lesions was becoming severe. To relieve the pain, he was administered opioids and external-beam radiation therapy. However, he continued to have substantial multiple bone pain. We used combination therapy of strontium-89 chloride for the treatment of widespread multiple bone pain and external-beam radiation therapy for localized pain. That combination therapy was effective and improved the quality of life (QOL) of the patient. We used strontium-89 chloride four times within one year, and no serious side effects occurred during therapy. Our thoroughly investigated case suggests that strontium-89 therapy is one of the effective and safe therapies for patients with painful bone metastases of thyroid medullary carcinoma. (author)

  2. Association of RET genetic polymorphisms and haplotypes with papillary thyroid carcinoma in the Portuguese population: a case-control study.

    Directory of Open Access Journals (Sweden)

    Marina Santos

    Full Text Available Thyroid cancer has a multifactorial aetiology resulting from the interaction of genetic and environmental factors. Several low penetrance susceptibility genes have been identified but their effects often vary between different populations. Somatic point mutations and translocations of the REarranged during Transfection (RET proto-oncogene are frequently found in thyroid cancer. The aim of this case-control study was to determine the effect of four well known RET single nucleotide polymorphisms (SNPs on the risk for differentiated thyroid carcinoma. A total of 545 Portuguese patients and 543 controls were genotyped by PCR and restriction enzyme analysis, for the following SNPs: G691S (exon 11, rs1799939 G/A, L769L (exon 13, rs1800861 T/G, S836S (exon 14, rs1800862 C/T, and S904S (exon 15, rs1800863 C/G. The minor allele of S836S was overrepresented in patients with papillary thyroid carcinoma (PTC when compared to controls (OR 1.57; 95% CI 1.05-2.35; p = 0.026. The GGTC haplotype was also overrepresented in PTC (OR 2.51; 95% CI 1.07-5.91; p = 0.029. No associations were found in follicular thyroid carcinoma (FTC. Multivariate logistic regression analysis showed no differences regarding gender, age at diagnosis, lymph node or distant metastasis. However, a near significant overrepresentation of the minor alleles of G691S and S904S was found in patients with tumours greater than 10 mm of diameter at diagnosis. These data suggest that the RET S836S polymorphism in exon 14 and the GGTC haplotype are risk factors for PTC, but not FTC, and that the G691S/S904S polymorphisms might be associated with tumour behaviour.

  3. Association of RET Genetic Polymorphisms and Haplotypes with Papillary Thyroid Carcinoma in the Portuguese Population: A Case-Control Study

    Science.gov (United States)

    Santos, Marina; Azevedo, Teresa; Martins, Teresa; Rodrigues, Fernando J.; Lemos, Manuel C.

    2014-01-01

    Thyroid cancer has a multifactorial aetiology resulting from the interaction of genetic and environmental factors. Several low penetrance susceptibility genes have been identified but their effects often vary between different populations. Somatic point mutations and translocations of the REarranged during Transfection (RET) proto-oncogene are frequently found in thyroid cancer. The aim of this case-control study was to determine the effect of four well known RET single nucleotide polymorphisms (SNPs) on the risk for differentiated thyroid carcinoma. A total of 545 Portuguese patients and 543 controls were genotyped by PCR and restriction enzyme analysis, for the following SNPs: G691S (exon 11, rs1799939 G/A), L769L (exon 13, rs1800861 T/G), S836S (exon 14, rs1800862 C/T), and S904S (exon 15, rs1800863 C/G). The minor allele of S836S was overrepresented in patients with papillary thyroid carcinoma (PTC) when compared to controls (OR 1.57; 95% CI 1.05–2.35; p = 0.026). The GGTC haplotype was also overrepresented in PTC (OR 2.51; 95% CI 1.07–5.91; p = 0.029). No associations were found in follicular thyroid carcinoma (FTC). Multivariate logistic regression analysis showed no differences regarding gender, age at diagnosis, lymph node or distant metastasis. However, a near significant overrepresentation of the minor alleles of G691S and S904S was found in patients with tumours greater than 10 mm of diameter at diagnosis. These data suggest that the RET S836S polymorphism in exon 14 and the GGTC haplotype are risk factors for PTC, but not FTC, and that the G691S/S904S polymorphisms might be associated with tumour behaviour. PMID:25330015

  4. Doxorubicin fails to eradicate cancer stem cells derived from anaplastic thyroid carcinoma cells: characterization of resistant cells.

    Science.gov (United States)

    Zheng, Xuqin; Cui, Dai; Xu, Shuhang; Brabant, Georg; Derwahl, Michael

    2010-08-01

    Current chemotherapy with doxorubicin fails to eradicate anaplastic thyroid cancer or even to stop tumor progress which may be due to the failure of these drugs to effectively target putative cancer stem cells. To test this hypothesis, anaplastic thyroid cell lines were characterized by FACS for their content of cancer stem cells, their in vitro sphere-forming capacity and their expression of multidrug resistance transporters of the ABC gene family which may confer drug resistance to the cells. Cells were treated with doxorubicin in short-term and long-term culture up to 6 months to establish a resistant cell line. The survival of cancer and cancer stem cells and the differential expression of transporters were analyzed. Anaplastic thyroid cancer cell lines that consisted of 0.4-0.8% side population cells, expressed ABCG2 and multi-drug-resistant 1 (MDR1) transporters. Treatment with doxorubicin gradually killed the non-side population of cancer cells derived from anaplastic thyroid carcinoma cells. This conferred a growth advantage to cancer stem cells which in turn overgrew the culture. Resistant cell line consisted of a 70% side population fraction enriched with Oct4-positive cancer stem cells. Inhibition of ABCG2 and/or MDR1 revealed that resistance of cancer stem cells to doxorubicin may be mainly due to the expression of these ABC transporters that were highly up-regulated in the resistant subline. The poor outcome of chemotherapy with doxorubicin in anaplastic thyroid carcinoma may be partly explained by up-regulation of ABCG2 and MDR1 transporters that confers resistance to cancer stem cells. Thus an effective treatment of anaplastic thyroid cancer has not only to destroy cancer cells that represent the bulk of tumor cell population but also cancer stem cells that may drive tumor progression.

  5. Maximal safe dose therapy of I-131 after failure of standard fixed dose therapy in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Lee, Jong Jin; Seok, Ju Won; Uh, Jae Sun

    2005-01-01

    In patients with recurrent or metastatic differentiated thyroid carcinoma, residual disease despite repetitive fixed dose I-131 therapy presents an awkward situation in terms of treatment decision making. Maximal safe dose (MSD) administration base on bone marrow radiation allows the delivery of a large amount I-131 to thyroid cancer tissue within the safety margin. We investigated the efficacy of MSD in differentiated thyroid cancers, which had persisted after conventional fixed dose therapy. Forty-six patients with differentiated thyroid carcinoma who had non-responsible residual disease despite repetitive fixed dose I-131 therapy were enrolled in this study. The postoperative pathology consisted of 43 papillary carcinomas and 3 follicular carcinomas. MSD was calculated according the Memorial Sloan Kettering Cancer Center protocol using blood samples. MSDs were administered at intervals of at least 6 months. Treatment responses were evaluated using I-131 whole body scan (WBS) and serum thyroglobulin measurements. Mean calculated MSD was 12.5±2.1 GBq. Of the 46 patients, 6 (13.0%) showed complete remission, 15 (32.6%) partial response, 19 (41.3%) stable disease, and 6 (13.0%) disease progression. Thus, about a half of the patients showed complete or partial remission, and of these patients, 14 (67%) showed response after a single MSD administration and 6 (29%) showed response after the second dose of MSD administrations. Twenty-nine patients (63%) experienced transient cytopenia after therapy, and recovered spontaneously with the exception of one. MSD administration is an effective method even in the patients who failed to be treated by conventional fixed dose therapy. MSD therapy of I-131 can be considered in the patients who failed by fixed dose therapy

  6. Detriments of radioactive Iodine 131 in managing thyroid carcinoma - a retrospective study with review of the current scenario

    International Nuclear Information System (INIS)

    Mohan, Shaweta; Agnihotri, Gaurav

    2016-01-01

    Radioactive iodine (RAI) ablation following thyroidectomy is recommended for most patients diagnosed with papillary and follicular thyroid carcinoma. We performed a literature search on MEDLlNE and EMBASE, using keywords, such as, differentiated thyroid carcinoma, radioiodine therapy, 131 I complications, adverse effects and side effects, and chose the most relevant studies till date to prepare this work on the side effects of RAIT (Radioactive Iodine Therapy) for thyroid cancer. We contacted authors of published studies where appropriate for further information. Also, the percentage incidence of the hazards was determined for North Indian population accessing data from Govt. Medical Colleges of Punjab, Haryana, and Postgraduate Institute of Medical Education and Research, Chandigarh. The most prominent side effect came out to be xerostomia with an incidence of 47%, followed by local neck pain and swelling (39%). The incidence of gastritis was also common (34%). Radioactive iodine therapy complications have been divided into early and late effects. Early complications include gastrointestinal symptoms, radiation thyroiditis, sialadenitis/xerostomia, bone marrow suppression, gonadal damage, dry eye, and nasolacrimal duct obstruction. Late complications include secondary cancers, pulmonary fibrosis, permanent bone marrow suppression, and genetic effects. As 131 I is an efficacious form of treatment that can significantly decrease the rate of mortality, recurrence and metastasis, and as the side effects are often minor and well-tolerated, radio iodine therapy remains the principal mode of treatment for patients. (author)

  7. Skeletal Muscle Metastasis as an Initial Presentation of Follicular Thyroid Carcinoma: A Case Report and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Mutahir A. Tunio

    2013-01-01

    Full Text Available Introduction. Follicular thyroid carcinoma (FTC frequently metastasizes to the lungs and bones. However, metastasis to the skeletal muscles is an extremely rare manifestation of FTC. To date, only seven cases of FTC have been reported in the literature. Skeletal muscle metastases from FTC usually remain asymptomatic or manifest as swelling and are associated with dismal prognosis. Case Presentation. A 45-year-old Saudi woman presented with right buttock swelling since 8 months. Physical examination revealed right gluteal mass of size  cm and right thyroid lobe nodule. The rest of examination was unremarkable. Magnetic resonance imaging (MRI showed  cm lobulated mass arising from the gluteus medius muscle, and tru-cut biopsy confirmed the metastatic papillary carcinoma of thyroid origin. The patient subsequently underwent palliative radiotherapy followed by total thyroidectomy and radioactive iodine ablation. At the time of publication, the patient was alive with partial response in gluteal mass. Conclusion. Skeletal muscles metastases are a rare manifestation of FTC, and searching for the primary focus in a patient with skeletal muscle metastasis, thyroid cancer should be considered as differential diagnosis.

  8. Pseudo-angiomatous liver metastasis of thyroid medullary carcinoma: multimodality diagnostic approach; Metastase hepatique pseudoangiomateuse d'un carcinome medullaire de la thyroide: approche diagnostique multimodalite

    Energy Technology Data Exchange (ETDEWEB)

    Imperiale, A.; Keomany, J.; Rust, E.; Constantinesco, A. [CHU de Strasbourg, Service de biophysique et medecine nucleaire, 67 (France); Greget, M. [CHU de Strasbourg, Service de radiologie 1, 67 (France); Chabrier, G.; Goichot, B. [CHU de Strasbourg, Service de medecine interne, endocrinologie et nutrition, 67 (France); Detour, J. [CHU de Strasbourg, Service de radiopharmacie, 67 (France); Pessaux, P. [CHU de Strasbourg, Service de chirurgie generale, hepatique et endocrinienne, 67 (France)

    2010-07-01

    Purpose: Illustrate the result of the diagnosis by multimodality imaging (MRI, scintigraphy {sup 123}I-Mibg, PET/CT{sup 18}F-F.D.G. and {sup 18}F-F DOPA) with liver metastasis looking like a single angioma in a patient with atypical medullary thyroid carcinoma. Conclusions: Angiomas must be taken into account in the differential diagnosis of liver metastasis of endocrine tumors, particularly in the case of small injuries where it may be difficult to differentiate a peripheral nodular contrast enhancement of a globular enhancement characteristics of angiomas. (N.C.)

  9. Changes in the function of the thyroid gland and the connection of the appearance of thyroid gland carcinoma after irradiation of the neck

    International Nuclear Information System (INIS)

    Vellinga, M.A.

    1979-06-01

    A programme of examinations has been carried out on adults to discover the connection between irradiation of the neck or head and the development of aberrations of the thyroid gland. Two patient groups were studied, 26 men between 41 and 79 and 8 men between 51 and 75 years of age who received radiation treatment for carcinoma of the larynx during 1967-1971 and 1972-1976 respectively. The examination included an E.C.G., and a technetium scan. In the former group two cases of hypothyroidism and one case of hyperthyroidism were found. In general it was found that the radiation treatment had a high curative effect. (C.F.)

  10. Artificial neural network model to distinguish follicular adenoma from follicular carcinoma on fine needle aspiration of thyroid.

    Science.gov (United States)

    Savala, Rajiv; Dey, Pranab; Gupta, Nalini

    2018-03-01

    To distinguish follicular adenoma (FA) and follicular carcinoma (FC) of thyroid in fine needle aspiration cytology (FNAC) is a challenging problem. In this article, we attempted to build an artificial neural network (ANN) model from the cytological and morphometric features of the FNAC smears of thyroid to distinguish FA from FC. The cytological features and morphometric analysis were done on the FNAC smears of histology proven cases of FA (26) and FC (31). The cytological features were analysed semi-quantitatively by two independent observers (RS and PD). These data were used to make an ANN model to differentiate FA versus FC on FNAC material. The performance of this ANN model was assessed by analysing the confusion matrix and receiving operator curve. There were 39 cases in training set, 9 cases each in validation and test sets. In the test group, ANN model successfully distinguished all cases (9/9) of FA and FC. The area under receiver operating curve was 1. The present ANN model is efficient to diagnose follicular adenoma and carcinoma cases on cytology smears without any error. In future, this ANN model will be able to diagnose follicular adenoma and carcinoma cases on thyroid aspirate. This study has immense potential in future. This is an open ended ANN model and more parameters and more cases can be included to make the model much stronger. © 2017 Wiley Periodicals, Inc.

  11. Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical thyroid remnant of differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Bin Long

    2015-01-01

    Conclusion: Combined use of RAI therapy and radiofrequency ablation in treating excessive postsurgical thyroid remnant of DTC can be an effective approach and avoids re-operation. Long-term efficacy monitoring would further determine its feasibility.

  12. Iodine excretion during stimulation with rhTSH in differentiated thyroid carcinoma

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    Loeffler, M.; Weckesser, M.; Franzius, C.; Kies, P.; Schober, O. [Muenster Univ. (Germany). Dept. of Nuclear Medicine

    2003-12-01

    Aim: Elevated iodine intake is a serious problem in the diagnostic and therapeutic application of {sup 131}iodine in patients with differentiated thyroid cancer. Therefore, iodine avoidance is necessary 3 months in advance. Additionally, endogenous stimulation requires withdrawal of thyroid hormone substitution for 4 weeks. Exogenous stimulation using recombinant human TSH (rhTSH) enables the continuous substitution of levothyroxine, which contains 65.4% of its molecular weight in iodine. Thus, a substantial source of iodine intake is maintained during exogenous stimulation. Although this amount of stable iodine is comparable to the iodine intake in regions of normal iodine supply, it may reduce the accumulation of radioiodine in thyroid carcinoma tissue. The aim of this study was to assess the iodine excretion depending on different ways of stimulation. Methods: Iodine excretion was measured in 146 patients in the long term follow up after differentiated thyroid carcinoma. Patients were separated into 2 groups, those on hormone withdrawal (G I) and rhTSH-stimulated patients on hormone substitution (G II). Results: Iodine excretion was significantly lower in hypothyroid patients (G I, median 50 {mu}g/l, range: 25-600 {mu}g/l) than in those under levothyroxine medication (G II, median 75 {mu}g/l, 25-600 {mu}g/l, p<0.027). TSH in G I (median 57.0 {mu}U/ml, range: 14.4-183 {mu}U/ml) was significantly lower (p<0.001) than in G II (117 {mu}U/ml, 32.2-281 {mu}U/ml). Conclusion: Iodine excretion was higher in patients under rhTSH-stimulation than after hormone withdrawal. This may indicate an increased iodine pool in rhTSH-stimulated patients (deiodination of levothyroxine), thus limiting the sensitivity of radioiodine scanning to the level of endogenous stimulation despite significantly higher TSH levels during rhTSH-stimulation. (orig.) [German] Ziel: Eine erhoehte Iodzufuhr ist ein erhebliches Problem in der diagnostischen und therapeutischen Anwendung von {sup 131}Iod

  13. Nonanaplastic follicular cell-derived thyroid carcinoma: mitosis and necrosis in long-term follow-up.

    Science.gov (United States)

    Skansing, Daniel Bräuner; Londero, Stefano Christian; Asschenfeldt, Pia; Larsen, Stine Rosenkilde; Godballe, Christian

    2017-06-01

    Nonanaplastic follicular cell-derived thyroid carcinoma (NAFCTC) includes differentiated- (DTC) and poorly differentiated thyroid carcinoma (PDTC). DTC has an excellent prognosis, while PDTC is situated between DTC and anaplastic carcinomas. Short-term studies suggest that PDTC patients diagnosed only on tumor necrosis and/or mitosis have a prognosis similar to those diagnosed according to the TURIN proposal. The purpose of this study was to evaluate prognosis for NAFCTC based on long-term follow-up illuminating the significance of tumor necrosis and mitosis. A cohort of 225 patients with NAFCTC was followed more than 20 years. Age, sex, distant metastasis, histology, tumor size, extrathyroidal invasion, lymph node metastasis, tumor necrosis and mitosis were examined as possible prognostic factors. Median follow-up time for patients alive was 28 years (range 20-43 years). Age, distant metastasis, extrathyroidal invasion, tumor size, tumor necrosis and mitosis were independent prognostic factors in multivariate analysis for overall survival (OS). In disease specific survival (DSS) age was not significant. Using only necrosis and/or mitosis as criteria for PDTC the 5-, 10- and 20-year OS for DTC was 87, 79 and 69%, respectively. In DSS it was 95, 92 and 90%. For PDTC the 5-, 10- and 20-year OS was 57, 40 and 25%, respectively. In DSS it was 71, 55 and 48%. Tumor necrosis and mitosis are highly significant prognostic indicators in analysis of long time survival of nonanaplastic follicular cell-derived thyroid carcinoma indicating that a simplification of the actually used criteria for poorly differentiated carcinomas may be justified.

  14. The thyroid cancer policy model: A mathematical simulation model of papillary thyroid carcinoma in The U.S. population.

    Directory of Open Access Journals (Sweden)

    Carrie Lubitz

    Full Text Available Thyroid cancer affects over ½ million people in the U.S. and the incidence of thyroid cancer has increased worldwide at a rate higher than any other cancer, while survival has remained largely unchanged. The aim of this research was to develop, calibrate and verify a mathematical disease model to simulate the natural history of papillary thyroid cancer, which will serve as a platform to assess the effectiveness of clinical and cancer control interventions.Herein, we modeled the natural pre-clinical course of both benign and malignant thyroid nodules with biologically relevant health states from normal to detected nodule. Using established calibration techniques, optimal parameter sets for tumor growth characteristics, development rate, and detection rate were used to fit Surveillance Epidemiology and End Results (SEER incidence data and other calibration targets.Model outputs compared to calibration targets demonstrating sufficient calibration fit and model validation are presented including primary targets of SEER incidence data and size distribution at detection of malignancy. Additionally, we show the predicted underlying benign and malignant prevalence of nodules in the population, the probability of detection based on size of nodule, and estimates of growth over time in both benign and malignant nodules.This comprehensive model provides a dynamic platform employable for future comparative effectiveness research. Future model analyses will test and assess various clinical management strategies to improve patient outcomes related to thyroid cancer and optimize resource utilization for patients with thyroid nodules.

  15. Cyclin A1 is a transcriptional target of PITX2 and overexpressed in papillary thyroid carcinoma.

    Science.gov (United States)

    Liu, Yan; Huang, Yue; Zhu, Guo-Zhang

    2013-12-01

    Physiological expression of cyclin A1, a unique cell cycle regulator essential for spermatogenesis, is predominantly restricted in male germ cells. Outstandingly, previous studies have also demonstrated the abnormal expression of cyclin A1 in various human tumors. How male germ cell-specific cyclin A1 is transcriptionally activated in tumor cells, however, is elusive. To begin to understand the molecular mechanisms governing the ectopic expression of cyclin A1, we searched for transcription factors and cis-regulatory DNA elements. We found that overexpression of PITX2, a paired-like homeodomain transcription factor and a downstream effector of Wnt/β-catenin signaling, resulted in upregulation of cyclin A1 in HEK293 cells and TPC-1 thyroid cancer cells. On the other hand, PITX2 knockdown in TPC-1 cells caused reduced cyclin A1. Promoter reporter assays with a series of deletion constructs determined that the DNA element from -102 to -96 bp of the cyclin A1 promoter is responsible for PITX2-induced gene expression. The result of chromatin immunoprecipitation revealed the occupancy of PITX2 on the cyclin A1 promoter. Taken together, these findings demonstrate that cyclin A1 is a transcriptional target of PITX2. Consistently, our immunohistochemistry result showed up-regulation of cyclin A1 in human papillary thyroid carcinoma, where overexpressed PITX2 has been endorsed in our recent report. Thus, our study provides new evidence on the regulation of cyclin A1 gene expression and offers a PITX2-cycin A1 pathway for cell cycle regulation.

  16. Retrospective Analysis of 255 Papillary Thyroid Carcinomas ≤2 cm: Clinicohistological Features and Prognostic Factors

    Science.gov (United States)

    Marques, Pedro; Leite, Valeriano; Bugalho, Maria João

    2014-01-01

    Background Papillary thyroid carcinoma (PTC) is the most common thyroid cancer. The widespread use of neck ultrasound (US) and US-guided fine-needle aspiration cytology is triggering an overdiagnosis of PTC. Objective To evaluate clinical behavior and outcomes of patients with PTCs ≤2 cm, seeking for possible prognostic factors. Methods Clinical records of cases with histological diagnosis of PTC ≤2 cm followed at the Endocrine Department of Instituto Português de Oncologia, Lisbon between 2002 and 2006 were analyzed retrospectively. Results We identified 255 PTCs, 111 were microcarcinomas. Most patients underwent near-total thyroidectomy, with lymph node dissections in 55 cases (21.6%). Radioiodine therapy was administered in 184 patients. At the last evaluation, 38 (14.9%) had evidence of disease. Two deaths were attributed to PTC. Median (±SD) follow-up was 74 (±23) months. Multivariate analysis identified vascular invasion, lymph node and systemic metastases significantly associated with recurrence/persistence of disease. In addition, lymph node involvement was significantly associated with extrathyroidal extension and angioinvasion. Median (±SD) disease-free survival (DFS) was estimated as 106 (±3) months and the 5-year DFS rate was 87.5%. Univariate Cox analysis identified some relevant parameters for DFS, but multivariate regression only identified lymph node and systemic metastases as significant independent factors. The median DFS estimated for lymph node and systemic metastases was 75 and 0 months, respectively. Conclusions In the setting of small PTCs, vascular invasion, extrathyroidal extension and lymph node and/or systemic metastases may confer worse prognosis, perhaps justifying more aggressive therapeutic and follow-up approaches in such cases. PMID:25759803

  17. Differentiated thyroid carcinoma presentation may be more aggressive in children and adolescents than in young adults.

    Science.gov (United States)

    Zirilli, Giuseppina; Cannavò, Laura; Vermiglio, Francesco; Violi, Maria Antonia; Luca, Filippo De; Wasniewska, Malgorzata

    2018-01-17

    The available studies concerning the influence of age on the phenotypical expression of differentiated thyroid carcinoma (DTC) have hitherto compared DTC presentation either between pre-pubertal and pubertal children or between pediatric patients and aged adults; aim of this study was to ascertain for the first time whether presentation of DTC may significantly vary according to age, even within a peculiar study population covering only young patients aged less than 30 years. The main clinical, biochemical and pathologic data at DTC diagnosis were retrospectively recorded in 2 selected cohorts including, respectively, 18 children and adolescents aged less than 18 years (Group A) or 45 young adults aged between 20 and 29.8 years (Group B). The statistical distribution of DTC cases in the different age ranges was found to progressively increase with increasing age; furthermore, the patients of Group A exhibited at diagnosis a more severe clinical involvement and a higher rate of extra-regional metastases; finally, also the association with both autoimmune thyroid diseases (AITDs) and a biochemical hypothyroid pattern was more common in Group A patients. In a study population younger than 30 years: a) the risk of developing DTC increases with age, achieving its zenith during the 3rd decade of life; b) clinical presentation is more severe in children and adolescents younger than 18 years than in the patients aged between 20 and 30; c) in the cohort of children and adolescents DTC is more often associated with AITDs, which might play some role in conditioning the more aggressive phenotypical presentation of DTC in this patient group.

  18. Diagnostic assessment of intraoperative cytology for papillary thyroid carcinoma: using a decision tree analysis.

    Science.gov (United States)

    Pyo, J-S; Sohn, J H; Kang, G

    2017-03-01

    The aim of this study was to elucidate the cytological characteristics and the diagnostic usefulness of intraoperative cytology (IOC) for papillary thyroid carcinoma (PTC). In addition, using decision tree analysis, effective features for accurate cytological diagnosis were sought. We investigated cellularity, cytological features and diagnosis based on the Bethesda System for Reporting Thyroid Cytopathology in IOC of 240 conventional PTCs. The cytological features were evaluated in terms of nuclear score with nuclear features, and additional figures such as presence of swirling sheets, psammoma bodies, and multinucleated giant cells. The nuclear score (range 0-7) was made via seven nuclear features, including (1) enlarged, (2) oval or irregularly shaped nuclei, (3) longitudinal nuclear grooves, (4) intranuclear cytoplasmic pseudoinclusion, (5) pale nuclei with powdery chromatin, (6) nuclear membrane thickening, and (7) marginally placed micronucleoli. Nuclear scores in PTC, suspicious for malignancy, and atypia of undetermined significance cases were 6.18 ± 0.80, 4.48 ± 0.82, and 3.15 ± 0.67, respectively. Additional figures more frequent in PTC than in other diagnostic categories were identified. Cellularity of IOC significantly correlated with tumor size, nuclear score, and presence of additional figures. Also, IOCs with higher nuclear scores (4-7) significantly correlated with larger tumor size and presence of additional figures. In decision tree analysis, IOCs with nuclear score >5 and swirling sheets could be considered diagnostic for PTCs. Our study suggests that IOCs using nuclear features and additional figures could be useful with decreasing the likelihood of inconclusive results.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Mauri, Giovanni, E-mail: vanni.mauri@gmail.com [European Institute of Oncology, Division of Interventional Radiology (Italy); Cova, Luca [General Hospital of Busto Arsizio, Unit of Interventional Oncology (Italy); Ierace, Tiziana [IRCCS Istituto Clinico Humanitas, Unit of Interventional Radiology (Italy); Baroli, Alberto; Di Mauro, Enzo [General Hospital of Busto Arsizio, Department of Nuclear Medicine (Italy); Pacella, Claudio Maurizio [Regina Apostolorum Hospital, Department of Diagnostic Imaging (Italy); Goldberg, Shraga Nahum [Hadassah Hebrew University Medical Center, Image-guided Therapy and Interventional Oncology Unit (Israel); Solbiati, Luigi [IRCCS Istituto Clinico Humanitas, Unit of Interventional Radiology (Italy)

    2016-07-15

    PurposeTo assess the effectiveness of percutaneous laser ablation (PLA) of cervical lymph node metastases from papillary thyroid carcinoma.Materials and Methods24 patients (62.3 ± 13.2 year; range 32–80) previously treated with thyroidectomy, neck dissection, and radioiodine ablation underwent ultrasound-guided PLA of 46 {sup 18}FDG-PET/CT—positive metachronous nodal metastases. All patients were at high surgical risk or refused surgery and were unsuitable for additional radioiodine ablation. A 300 µm quartz fiber and a continuous-wave Nd-YAG laser operating at 1.064 mm were used. Technical success, rate of complications, rate of serological conversion, and local control at follow-up were derived. Fisher’s exact test and Mann–Whitney U test were used and Kaplan–Meier curve calculated.ResultsTechnical success was obtained in all 46 lymph nodes (100 %). There were no major complications. Thyroglobulin levels decreased from 8.40 ± 9.25 ng/ml before treatment to 2.73 ± 4.0 ng/ml after treatment (p = 0.011), with serological conversion in 11/24 (45.8 %) patients. Overall, local control was obtained in 40/46 (86.9 %) lymph nodes over 30 ± 11 month follow-up, with no residual disease seen at imaging in 19/24 (79.1 %) patients. Local control was achieved in 40/46 (86.9 %) lymph nodes at 1 year and in all of the 25 nodes (100 %) followed for 3 years. Estimated mean time to progression was 38.6 ± 2.7 m.ConclusionUltrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.

  1. Thyroid disease

    International Nuclear Information System (INIS)

    Falk, S.

    1990-01-01

    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

  2. RNA interference targeting CD147 inhibits the proliferation, invasiveness, and metastatic activity of thyroid carcinoma cells by down-regulating glycolysis.

    Science.gov (United States)

    Huang, Peng; Chang, Shi; Jiang, Xiaolin; Su, Juan; Dong, Chao; Liu, Xu; Yuan, Zhengtai; Zhang, Zhipeng; Liao, Huijun

    2015-01-01

    A high rate of glycolytic flux, even in the presence of oxygen, is a key metabolic hallmark of cancer cells. Lactate, the end product of glycolysis, decreases the extracellular pH and contributes to the proliferation, invasiveness and metastasis of tumor cells. CD147 play a crucial role in tumorigenicity, invasion and metastasis; and CD147 also interacts strongly and specifically with monocarboxylate transporter1 (MCT1) that mediates the transport of lactate. The objective of this study was to determine whether CD147 is involved, via its association with MCT1 to transport lactate, in glycolysis, contributing to the progression of thyroid carcinoma. The expression levels of CD147 in surgical specimens of normal thyroid, nodular goiter (NG), well-differentiated thyroid carcinoma (WDTC), and undifferentiated thyroid carcinoma (UDTC) were determined using immunohistochemical techniques. The effects of CD147 silencing on cell proliferation, invasiveness, metastasis, co-localization with MCT1, glycolysis rate and extracellular pH of thyroid cancer cells (WRO and FRO cell lines) were measured after CD147 was knocked-down using siRNA targeting CD147. Immunohistochemical analysis of thyroid carcinoma (TC) tissues revealed significant increases in signal for CD147 compared with normal tissue or NG, while UDTC expressed remarkably higher levels of CD147 compared with WDTC. Furthermore, silencing of CD147 in TC cells clearly abrogated the expression of MCT1 and its co-localization with CD147 and dramatically decreased both the glycolysis rate and extracellular pH. Thus, cell proliferation, invasiveness, and metastasis were all significantly decreased by siRNA. These results demonstrate in vitro that the expression of CD147 correlates with the degree of dedifferentiation of thyroid cancer, and show that CD147 interacts with MCT1 to regulate tumor cell glycolysis, resulting in the progression of thyroid carcinoma.

  3. BRAF mutation in progression and therapy of melanoma, papillary thyroid carcinoma and colorectal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Izabela Zaleśna

    2016-05-01

    Full Text Available BRAF is mutated at a high frequency in various malignancies, including melanoma, papillary thyroid carcinoma and colorectal adenocarcinoma. BRAF is an element of the RAS/RAF/MEK/ERK (MAPK pathway, which when constitutively active can lead to increased proliferation rate, enhanced survival, invasion and metastasis. The development of small molecule inhibitors of mutant BRAF kinase has changed the care of patients, especially with melanoma. Despite the success in treating melanoma with inhibitors of mutant BRAF and other elements of RAS/RAF/MEK/ERK (MAPK pathway, resistance limits the long-term responsiveness to these drugs. The resistance mechanisms to MAPK pathway inhibition are complex, occur at genomic and phenotypic levels, and frequently the same patient can simultaneously develop diverse mechanisms of resistance in different progressive metastases or even in the same lesion. In the current review, we summarize recent research on mutations in BRAF and their importance for the development of tumor. This review will also give an overview on the current knowledge concerning therapies for patients harboring mutation in BRAF and discusses the diverse mechanisms of resistance developed in response to these targeted therapies.

  4. Correlation of RET somatic mutations with clinicopathological features in sporadic medullary thyroid carcinomas

    Science.gov (United States)

    Moura, M M; Cavaco, B M; Pinto, A E; Domingues, R; Santos, J R; Cid, M O; Bugalho, M J; Leite, V

    2009-01-01

    Screening of REarranged during Transfection (RET) gene mutations has been carried out in different series of sporadic medullary thyroid carcinomas (MTC). RET-positive tumours seem to be associated to a worse clinical outcome. However, the correlation between the type of RET mutation and the patients' clinicopathological data has not been evaluated yet. We analysed RET exons 5, 8, 10–16 in fifty-one sporadic MTC, and found somatic mutations in thirty-three (64.7%) tumours. Among the RET-positive cases, exon 16 was the most frequently affected (60.6%). Two novel somatic mutations (Cys630Gly, c.1881del18) were identified. MTC patients were divided into three groups: group 1, with mutations in RET exons 15 and 16; group 2, with other RET mutations; group 3, having no RET mutations. Group 1 had higher prevalence (P=0.0051) and number of lymph node metastases (P=0.0017), and presented more often multifocal tumours (P=0.037) and persistent disease at last control (P=0.0242) than group 2. Detectable serum calcitonin levels at last screening (P=0.0119) and stage IV disease (P=0.0145) were more frequent in group 1, than in the other groups. Our results suggest that, among the sporadic MTC, cases with RET mutations in exons 15 and 16 are associated with the worst prognosis. Cases with other RET mutations have the most indolent course, and those with no RET mutations have an intermediate risk. PMID:19401695

  5. Side effects of rational dose iodine-131 therapy for metastatic well-differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Van Nostrand, D.; Neutze, J.; Atkins, F.

    1986-01-01

    Benua, Leeper, and others (BEL) have advocated the estimation of radiation exposure to the blood to select a more rational maximum safe dose of radioiodine (dosimetry) to treat metastatic functioning well-differentiated thyroid carcinoma. After adopting the BEL dosimetry approach, we reviewed the immediate (during hospitalization) and intermediate (from discharge up to 3 mo) side effects after our initial 15 therapies in ten patients. The doses ranged from 51 mCi (1887 MBq) to 450 mCi (16.65 GBq). Immediate side effects were observed in 12/15 (80%), are described in detail, and were as follows: gastrointestinal 10/15, salivary 9/15, nonsalivary neck pain, swelling, etc. 2/15, pulmonary 0/15. Intermediate side effects were