Follow-Up Strategy in Papillary Thyroid Cancer

2016 ◽  
pp. 419-425
Author(s):  
Merica Shrestha ◽  
Henry B. Burch
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid

Abstract 730: Annual hazard rate of recurrence in Middle-Eastern papillary thyroid cancer over a long-term follow-up

2021 ◽  
Author(s):  
Abdul K. Siraj ◽  
Sandeep K. Parvathareddy ◽  
Zeeshan Qadri ◽  
Saud Azam ◽  
Felisa De Vera ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Hazard Rate ◽  
Middle Eastern ◽  
Papillary Thyroid ◽  
Long Term Follow Up

scholarly journals MON-533 Diffuse Sclerosing Variant Papillary Thyroid Cancer: Clinical and Histopathological Features, Mutational Profile, Management and Outcome

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Abeer Abdulhadi Aljomaiah ◽  
Yosra Moria ◽  
Nora Aldaej ◽  
Meshael Alswailem ◽  
Ali Saeed Alzahrani
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Molecular Genetics ◽  
Papillary Thyroid Cancer ◽  
Distant Metastases ◽  
The Other ◽  
Papillary Thyroid ◽  
Histopathological Features ◽  
Diffuse Sclerosing Variant

Abstract Diffuse sclerosing variant (DSV) is a rare subtype of papillary thyroid cancer (PTC). Whether it represents a higher grade subtype than conventional PTC is not quite clear. Furthermore, there are limited data on its long-term outcome and its molecular genetics. In this report, we studied all cases of DSV PTC seen at our center during the last 20 years. Out of more than 6000 patients (pts) with differentiated thyroid cancer, only 37 were DSV. We reviewed the clinical and histopathological features, management and outcome of these cases. In addition, molecular genetics is partially achieved; 17 out of these 37 cases have been genotyped for BRAFV600E, TERT promotor mutations, NRAS, HRAS and KRAS mutations. The molecular profiling of the other 20 cases is being done. A total of 37 pts were studied {(12 Males:25 Females, median age 21 years (8-89)}. One pt had lobectomy and the other 36 pts (97.3%) had a total thyroidectomy. Central only (4 pts) or central/lateral lymph node dissection (29 pts) were performed. The median tumor size was 4.5 cm (1.5-8.1). The tumor was multifocal in 27 cases (73%), with extrathyroidal invasion in 27 (73%) and lymphovascular invasion in 24 pts (64.8%). A background lymphocytic thyroiditis was present in 12 pts (32.4%). Lymph node metastases were present in 34 pts (92%) and distant metastases in 13 pts (35%). The sites of metastasis are lungs in 12 pts (32.4%) and lungs and bone in 1 pt. Twenty pts (54.1%) were in TNM8 stage 1, 10 pts (27%) in stage 2, 1 (2.7%) in stage 4a, 3 (8.1%) in stage 4b and 3 unstageable. The ATA risk classification for these pts was 4 pts (10.8%) in low, 12 (32.4%) in intermediate, 19 (51.4%) in high-risk groups and 2 could not be assessed. I-131 was administered to 33 pts (89.2%). The median administered activity was 136 mCi (46-218). Fifteen pts (40.5%) received additional therapies (3 surgeries, 7 RAI, 5 surgeries, and RAI). In 17 pts (46%) which were genotyped, only 3 tumors (8.1%) had BRAFV600E mutation, 1 (2.7%) had TERT promotor C228T mutation and none had RAS mutations. At the last follow up, 15 pts (40.5%) achieved an excellent response, 9 (24%) an indeterminate response, 6 (16.2%) with a structural disease, and 7 (19%) were lost for follow up. Conclusion: DSV PTC is a rare variant, occurs mostly in adolescent and young pts, characterized by aggressive histopathological features and high rates of lymph node and distant metastases but the commonly reported mutations in PTC are rare in DSV and mortality is absent.

scholarly journals Splenectomy for Solitary Splenic Metastasis in Recurrent Papillary Thyroid Cancer. A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Antonio Maffuz-Aziz ◽  
Gabriel Garnica ◽  
Silvia López-Hernández ◽  
Janet Pineda-Diaz ◽  
Javier Baquera-Heredia ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Lung Metastases ◽  
The United States ◽  
Central Neck Dissection ◽  
Splenic Metastasis ◽  
Papillary Thyroid ◽  
Rare Manifestation ◽  
Tall Cell

Thyroid cancer is the most common endocrine malignancy, presenting with 23 500 new cases per year in the United States. About 7-23% of the patients will present recurrent metastases disease during follow-up. The classic variant of papillary carcinoma is less aggressive compared to its other variants like diffuse sclerosing, tall cell or columnar cell, and insular variants, and the sites to which this metastasizes is already well identified. Metastasis to the spleen is an extremely rare manifestation of papillary thyroid cancer. To date, only 3 cases have been reported in the literature. Herein, we present a 52-year-old male, who developed spleen metastases, 2.4 years after total thyroidectomy and central neck dissection followed by radioactive iodine ablation and seven months after treatment with sorafenib for lung metastases. The splenic lesion was detected in surveillance studies. This case highlights that splenic metastasis, although rare, may occur even in a patient with a locoregional and systemic controlled thyroid cancer and that it can be treated safely with surgical resection.

Predictors for papillary thyroid cancer persistence and recurrence: a retrospective analysis with a 10-year follow-up cohort study

2016 ◽  
Vol 85 (3) ◽  
pp. 466-474 ◽  
Author(s):  
Taciana Padilha de Castro ◽  
William Waissmann ◽  
Taynãna César Simões ◽  
Rossana Corbo R. de Mello ◽  
Denise P. Carvalho
Keyword(s):  
Cohort Study ◽  
Thyroid Cancer ◽  
Retrospective Analysis ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid

scholarly journals Decision aid on radioactive iodine treatment for early stage papillary thyroid cancer: update to study protocol with follow-up extension

Trials ◽  
2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Anna M. Sawka ◽  
Sharon Straus ◽  
Gary Rodin ◽  
Kevin E. Thorpe ◽  
Shereen Ezzat ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Study Protocol ◽  
Decision Aid ◽  
Radioactive Iodine ◽  
Early Stage ◽  
Papillary Thyroid ◽  
Iodine Treatment

scholarly journals Surgical Treatment of Low- and Intermediate-Risk Papillary Thyroid Cancer with Minimally Invasive Video-Assisted Thyroidectomy

2009 ◽  
Vol 94 (5) ◽  
pp. 1618-1622 ◽  
Author(s):  
Paolo Miccoli ◽  
Aldo Pinchera ◽  
Gabriele Materazzi ◽  
Agnese Biagini ◽  
Piero Berti ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Minimally Invasive ◽  
Papillary Thyroid Cancer ◽  
Intermediate Risk ◽  
Papillary Thyroid ◽  
Conventional Thyroidectomy ◽  
Video Assisted ◽  
Group A ◽  
Group B

Abstract Background: Minimally invasive video-assisted thyroidectomy (MIVAT) was introduced in the clinical practice to treat small benign thyroid nodules. This method has recently been demonstrated to produce the same completeness as a conventional thyroidectomy in patients with papillary thyroid cancer (PTC). The low number of treated cases and the limited follow-up of these patients represent the major limitations of these studies. Objective: The aim of the study was to compare the outcome of two groups of PTC patients, one treated with MIVAT and the other with conventional thyroidectomy, after a median follow-up of 5 yr. Study Group: A total of 221 PTC patients were enrolled in this study according to the following criteria: 171 were treated with MIVAT (group A), and 50 were treated with conventional thyroidectomy (group B). Results: The outcome and the cumulative 131I activity administered to achieve curative status were compared. After a mean follow-up of 3.6 ± 1.5 yr (range, 1–8 yr; median, 5 yr), no differences were found between group A and group B. A similar rate of permanent hypoparathyroidism and/or nerve cord palsy was found in both groups. Conclusion: We demonstrated that PTC patients operated on with MIVAT had a good outcome after 5 yr. This was similar to the outcome of patients treated with conventional thyroidectomy and the same degree of exposure to 131I. These results, together with the evidence of a similar degree of completeness and rate of complications between the two surgical techniques, show that MIVAT is a valid option to treat low- and intermediate-risk PTC patients.

scholarly journals Zebra Case of Papillary Thyroid Cancer in MEN-2 Syndrome

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A905-A906
Author(s):  
Salem Gaballa
Keyword(s):  
Thyroid Cancer ◽  
Genetic Testing ◽  
Papillary Thyroid Cancer ◽  
Normal Serum ◽  
Papillary Thyroid ◽  
Prophylactic Thyroidectomy ◽  
Cervical Lymph Nodes ◽  
Serum Calcitonin ◽  
Ret Oncogene

Abstract Introduction: The occurrence of papillary thyroid cancer in patients with familial medullary thyroid cancer (FMTC) is extremely rare and underreported. Case Presentation: A 51-year-old caucasian female with no past medical history who presented to primary care physician for her annual visit. She denied any complaints. Vital signs were unremarkable. Physical examination was remarkable for large left thyroid nodule without cervical lymph nodes enlargements. Family history was significant for metastatic MTC of her two sisters (at the age of 55, 60) and her niece at age of 21. She previously declined genetic testing. Labs were unremarkable including serum calcium of 8.3 mg/dL. Thyroid function panel revealed a TSH of 2.1 μU/mL, Free T4 of 1.4 ng/dL, Thyroid peroxidase (TPO) antibody of <6 IU/mL. Neck ultrasonography revealed a mid-left thyroid hypoechoic nodule of 1.8 ×1.5 cm, without cervical lymph nodes enlargements. Fine needle biopsy revealed a papillary thyroid cancer, follicular variant. The diagnosis confirmed by two university pathologists, without any evidence of MTC. Genetic testing revealed a germline mutation in RET oncogene exons 13. Further labs revealed normal metanephrines of 12 pg/mL and normal normetanephrine of 31 pg/mL, normal serum calcitonin was less than 2 pg/mL (0-5), normal serum CEA was 2.5 ng/mL (0-5), elevated anti- thyroglobulin (anti-TG) antibodies of 1234 iu/mL (0-0.9), and elevated thyroglobulin of 50 ng/mL (1.5-38.5). The patient was referred to ENT for total thyroidectomy. Further, she was treated with radioactive iodine ablation by 155 mCi of iodine 131. Follow up whole body thyroid scan revealed no evidence of residual or recurrence. The patient was treated with 112 mcg levothyroxine with a target of TSH less than 0.1. On six months follow up, repeated neck ultrasonography revealed no remnant of thyroid tissue. Follow up Thyroglobulin (TG) was less than 0.1 ng/mL, TSH 0.05 μU/mL, FT4 of 1.98 ng/dL, and calcitonin was still less than 2 pg/ml. Genetic testing of her daughters (24, 31) revealed germline mutations in RET-oncogene exons 13 and was referred for prophylactic thyroidectomy. Discussion: FMTC is an inherited syndrome characterized by the presence of only MTC without hyperparathyroidism or pheochromocytoma and is considered a variant of MEN2A. Most cases of MEN2A have been attributed to mutations in the intracellular portion of RET, and somatic mutations in RET have been identified in 50% of cases of sporadic FMTC. We recommend in patients with germline RET mutations and a family history of MTC, the diagnosis of papillary thyroid cancer should be confirmed by two pathologists, and patients should be tested for serum calcitonin, serum calcium, and metanephrines/normetanephrine levels. Genetic testing of first-degree relatives of FMTC at an early age is essential in guiding major management decisions such as the timing of prophylactic thyroidectomy.

scholarly journals Coexisting Thyroglossal Duct Cyst with Papillary Thyroid Cancer: A Case Report and Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Abdullah A. Alarfaj ◽  
Ahmed Zekri ◽  
Ibrahim Alyaeesh ◽  
Ahmed Alomairin ◽  
Abdulrahman Al Naim
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Needle Aspiration ◽  
Central Neck Dissection ◽  
Papillary Thyroid ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
History Of ◽  
Detection And Diagnosis

Thyroglossal duct cysts (TGDCs) are common developmental anomalies in which the thyroglossal duct is not obliterated. Coexisting papillary thyroid cancer and TGDC are uncommon and should be investigated thoroughly to rule out TGDC carcinoma. We report a rare case of coexisting papillary thyroid cancer and TGDC in a 48-year-old man, who presented with a history of recurrent mild painful midline neck swelling, and ultrasound (US) revealed a TGDC that was subsequently managed conservatively. On follow-up after 1.6 years, a thyroid US and a fine-needle aspiration (FNA) biopsy were performed, which showed malignant papillary thyroid carcinoma. Total thyroidectomy, the Sistrunk procedure, and central neck dissection were implemented. After three days, the patient was discharged on 150 mg of levothyroxine. Follow-up was unremarkable with no complications. The authors would like to stress the importance of regular TGDC and thyroid gland follow-ups for early detection and diagnosis of thyroid malignancy via clinical examination and US.

scholarly journals Long-Term Efficacy of Lymph Node Reoperation for Persistent Papillary Thyroid Cancer

2010 ◽  
Vol 95 (5) ◽  
pp. 2187-2194 ◽  
Author(s):  
Osama Al-Saif ◽  
William B. Farrar ◽  
Mark Bloomston ◽  
Kyle Porter ◽  
Matthew D. Ringel ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Surgical Resection ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Initial Surgery ◽  
Retrospective Clinical Study

Abstract Objective: The objective of the study was to determine the outcome of surgical resection of metastatic papillary thyroid cancer (PTC) in cervical lymph nodes after failure of initial surgery and I131 therapy. Design: This was a retrospective clinical study. Setting: The study was conducted at a university-based tertiary cancer hospital. Patients: A cohort of 95 consecutive patients with recurrent/persistent PTC in the neck underwent initial reoperation during 1999–2005. All had previous thyroidectomy (±nodal dissection) and I131 therapy. Twenty-five patients with antithyroglobulin (Tg) antibodies were subsequently excluded. Main Outcome Measures: Biochemical complete remission (BCR) was stringently defined as undetectable TSH-stimulated serum Tg. Results: A total of 107 lymphadenectomies were undertaken in these 70 patients through January 2010. BCR was initially achieved in 12 patients (17%). Of the 58 patients with detectable postoperative Tg, 28 had a second reoperation and BCR was achieved in five (18%), seven had a third reoperation, and none achieved BCR. No patient achieving BCR had a subsequent recurrence after a mean follow-up of 60 months (range 4–116 months). In addition, two more patients achieved BCR during long-term follow-up without further intervention. In total, 19 patients (27%) achieved BCR and 32 patients (46%) achieved a TSH-stimulated Tg less than 2.0 ng/ml. Patients who did not achieve BCR had significant reduction in Tg after the first (P < 0.001) and second (P = 0.008) operations. No patient developed detectable distant metastases or died from PTC. Conclusions: Surgical resection of persistent PTC in cervical lymph nodes achieves BCR, when most stringently defined, in 27% of patients, sometimes requiring several surgeries. No biochemical or clinical recurrences occurred during follow-up. In patients who do not achieve BCR, Tg levels were significantly reduced. The long-term durability and impact of this intervention will require further investigation.

Sign in / Sign up

Export Citation Format

Share Document