Arterial Embolization for Thyroid Goiter, Graves’ Disease, and Thyroid Malignancy

Objective3,5,3′-Triiodothyronine (T3)-predominant Graves' disease is characterized by the increasing volume of thyroid goiter resulting in poor prognosis. Although type 1 and type 2 iodothyronine deiodinases (DIO1 and DIO2 respectively) are known to be overexpressed in the thyroid tissues of T3-predominant Graves' disease, the pathogenesis of this disease is still unclear. The aim of our study is to identify genes that characterize T3-predominant Graves' disease tissue in order to clarify the molecular mechanism of this disease.Design and methodsmRNAs from two thyroid tissues of both typical T3-predominant and common-type Graves' disease were analyzed with DNA microarrays with probes for 28 869 genes. Genes identified to be differentially expressed between the two groups were further analyzed in the second and third screenings using 70 Graves' thyroid tissues by real-time quantitative RT-PCR.ResultsTwenty-three candidate genes were selected as being differentially expressed in the first screening with microarrays. Among these, seven genes, leucine-rich repeat neuronal 1 (LRRN1), bone morphogenetic protein 8a (BMP8A), N-cadherin (CDH2), phosphodiesterase 1A (PDE1A), creatine kinase mitochondrial 2 (CKMT2), integrin beta-3 (ITGB3), and protein tyrosine phosphatase non-receptor type 4 (PTPN4), were confirmed to be differentially expressed in DIO1 or DIO2 over- and underexpressing Graves' tissues.ConclusionsThese genes are related to the characteristics of T3-predominant Graves' disease, such as high titer level of serum anti-TSH receptor antibody, high free T3 to free thyroxine ratio, and a large goiter size. They might play a role in the pathogenesis of T3-predominant Graves' disease.

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Angiogenic study in Graves’ disease treated with thyroid arterial embolization

Clinical & Investigative Medicine ◽

10.25011/cim.v32i5.6921 ◽

2009 ◽

Vol 32 (5) ◽

pp. 335 ◽

Cited By ~ 2

Author(s):

Wei Zhao ◽

Bu-Lang Gao ◽

Zhi-Yong Liu ◽

Gen-Fa Yi ◽

Li-Juan Shen ◽

...

Keyword(s):

Growth Factor ◽

Immunohistochemical Staining ◽

Arterial Embolization ◽

Graves Disease ◽

Vascular Endothelial ◽

Vegf Expression ◽

And Function ◽

Endothelial Growth Factor

Purpose: To investigate angiogenesis in the thyroid of Graves’ disease (GD) treated with thyroid arterial embolization through analysis of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and microvessel density (MVD). Materials and methods: Forty-two GD patients were treated with thyroid arterial embolization and followed up for 1-68 months after embolization. Before embolization and at 7 days, 3, 6, 12, 36 and 48 months following embolization, TT3, TT4, FT3, FT4, TSH and thyroid stimulating antibody (TSAb) were tested respectively. Thyroid biopsy was performed under the guidance of computed tomography for immunohistochemical staining of VEGF and bFGF, and MVD within the thyroid gland was marked by CD34. Results: VEGF and bFGF were mostly expressed in the cytoplasm and on the cell membrane. The expression of VEGF was increased (P < 0.05) at ?6 months compared with before embolization and decreased (P < 0.05) at ?1 year compared with either at ?6 months or before embolization. The expression of bFGF was not statistically different at ?6 months compared with before embolization but was decreased (P < 0.05) at ?1 year compared with either at ?6 months or before embolization. Thyroid MVD marked by CD34 had similar changes to those of the VEGF expression after embolization. There was a positive correlation between VEGF and bFGF (P < 0.05) and between VEGF or bFGF and MVD (P < 0.05). Thyroid hormones mostly returned to normal and TSAb was decreased in longer follow-up. Conclusion: Thyroid arterial embolization can decrease the expression of VEGF, bFGF and MVD. Consequently, angiogenesis within the GD thyroid will be decreased in the long term after embolization and may serve as the basis for reduced thyroid size and function.

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Thyroid arterial embolization for the treatment of hyperthyroidism in a patient with thyrotoxic crisis

Clinical & Investigative Medicine ◽

10.25011/cim.v32i1.5091 ◽

2009 ◽

Vol 32 (1) ◽

pp. 78 ◽

Cited By ~ 6

Author(s):

Wei Zhao ◽

Bu-Lang Gao ◽

Gen-Fa Yi ◽

Hui-Ying Yang ◽

Hong Li

Keyword(s):

Thyroid Hormone ◽

Thyroid Gland ◽

Thyroid Hormones ◽

Young Woman ◽

Effective Means ◽

Arterial Embolization ◽

Graves Disease ◽

Thyrotoxic Crisis ◽

History Of ◽

Serum Thyroid Hormones

Purpose: We report a case of hyperthyroidism in a young woman caused by Graves’ disease that was successfully treated with thyroid arterial embolization. Clinical details: A 35 year-old woman with a history of thyrotoxic crises was admitted after the last thyroid crisis. Thyroid arterial embolization was used to treat the hyperthyroidism after it had been controlled. Immediately after embolization, the enlarged thyroid gland shrank and vascular murmurs disappeared. Serum thyroid hormones increased on day 3 following embolization but decreased gradually. Thyroid hormone returned to normal 2 months after embolization and remained normal at three years. Conclusion: Thyroid arterial embolization is an effective means to treat refractory hyperthyroidism.

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Arterial Embolization: A Novel Approach to Thyroid Ablative Therapy for Graves' Disease

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.87.8.3583 ◽

2002 ◽

Vol 87 (8) ◽

pp. 3583-3589 ◽

Cited By ~ 6

Author(s):

H. Xiao

Keyword(s):

Arterial Embolization ◽

Graves Disease ◽

Ablative Therapy ◽

Novel Approach

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Abstract No. 177: Featured Abstract—Thyroid Arterial Embolization to Treat Graves' Disease: 9-Year Experience

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2008.12.165 ◽

2009 ◽

Vol 20 (2) ◽

pp. S68-S69

Author(s):

J. Yang

Keyword(s):

Arterial Embolization ◽

Graves Disease

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Thyroid Cancer in Patients with Hyperthyroidism

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1162 ◽

2015 ◽

Vol 7 (2) ◽

pp. 29-32 ◽

Cited By ~ 1

Author(s):

Baki Tastan ◽

Alper Dogu ◽

Yusuf Sevim

Keyword(s):

Differential Diagnosis ◽

Thyroid Cancer ◽

Multinodular Goiter ◽

Malignant Tumors ◽

Graves Disease ◽

Thyroid Malignancy ◽

Toxic Adenoma ◽

Endocrine Organs ◽

Toxic Multinodular Goiter ◽

Hyperthyroid Patients

ABSTRACT Background and objective Malignant tumors of the thyroid gland are the most common of the endocrine malignancies. Although, patients with thyroid cancer have high 5 years survival rate, thyroid cancer is the most seen cause of mortality among cancers of the endocrine organs. The incidence of thyroid cancer in hyperthyroid patients varies from 0.1 to 21% in the literature. We aimed in this study to analyze the frequency of coexisting thyroid cancer and hyperthyroidism in our experience. Results Total 230 patients, who were operated for hyperthyroidism without the suspicion of thyroid malignancy between January 2005 and September 2010 were included in our study. Toxic multinodular goiter, toxic adenoma and Graves’ disease were diagnosed preoperatively in 187, 16 and 27 patients respectively. Histopathological thyroid malignancy was detected in 13 patients (5.7%). Conclusion Thyroid cancer with variable incidence up to 21% should be remembered in differential diagnosis of hyperthyroid patients. How to cite this article Tastan B, Dogu A, Sevim Y. Thyroid Cancer in Patients with Hyperthyroidism. World J Endoc Surg 2015;7(2):29-32.

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