Rare Cases of Differentiated Thyroid Cancer with Low-Risk Histology and Distant Metastases Have High Prevalence of RAS and TERT Mutations

2017 ◽  
Vol 29 (4) ◽  
pp. 143-145
Author(s):  
Masha J. Livhits ◽  
Michael W. Yeh
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Distant Metastases ◽  
Low Risk ◽  
High Prevalence

scholarly journals A Search for Causes of Rising Incidence of Differentiated Thyroid Cancer in Children and Adolescents after Chernobyl and Fukushima: Comparison of the Clinical Features and Their Relevance for Treatment and Prognosis

2021 ◽  
Vol 18 (7) ◽  
pp. 3444
Author(s):  
Valentina Drozd ◽  
Vladimir Saenko ◽  
Daniel I. Branovan ◽  
Kate Brown ◽  
Shunichi Yamashita ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Children And Adolescents ◽  
Differentiated Thyroid Cancer ◽  
Age Groups ◽  
Distant Metastases ◽  
Lifestyle Changes ◽  
Radiation Doses ◽  
Related Factors ◽  
Fukushima Accident ◽  
Tumor Stages

The incidence of differentiated thyroid cancer (DTC) is steadily increasing globally. Epidemiologists usually explain this global upsurge as the result of new diagnostic modalities, screening and overdiagnosis as well as results of lifestyle changes including obesity and comorbidity. However, there is evidence that there is a real increase of DTC incidence worldwide in all age groups. Here, we review studies on pediatric DTC after nuclear accidents in Belarus after Chernobyl and Japan after Fukushima as compared to cohorts without radiation exposure of those two countries. According to the Chernobyl data, radiation-induced DTC may be characterized by a lag time of 4–5 years until detection, a higher incidence in boys, in children of youngest age, extrathyroidal extension and distant metastases. Radiation doses to the thyroid were considerably lower by appr. two orders of magnitude in children and adolescents exposed to Fukushima as compared to Chernobyl. In DTC patients detected after Fukushima by population-based screening, most of those characteristics were not reported, which can be taken as proof against the hypothesis, that radiation is the (main) cause of those tumors. However, roughly 80% of the Fukushima cases presented with tumor stages higher than microcarcinomas pT1a and 80% with lymph node metastases pN1. Mortality rates in pediatric DTC patients are generally very low, even at higher tumor stages. However, those cases considered to be clinically relevant should be followed-up carefully after treatment because of the risk of recurrencies which is expected to be not negligible. Considering that thyroid doses from the Fukushima accident were quite small, it makes sense to assess the role of other environmental and lifestyle-related factors in thyroid carcinogenesis. Well-designed studies with assessment of radiation doses from medical procedures and exposure to confounders/modifiers from the environment as e.g., nitrate are required to quantify their combined effect on thyroid cancer risk.

scholarly journals Low-Dose Radioiodine Ablation in Patients with Low-Risk Differentiated Thyroid Cancer

2018 ◽  
Vol 7 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Germán A. Jimenez Londoño ◽  
Ana Maria Garcia Vicente ◽  
Julia Sastre Marcos ◽  
Francisco Jose Pena Pardo ◽  
Mariano Amo-Salas ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Low Dose ◽  
Low Risk ◽  
Radioiodine Ablation

scholarly journals Preoperative Serum Thyroglobulin and Its Correlation with the Burden and Extent of Differentiated Thyroid Cancer

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 625
Author(s):  
Hosu Kim ◽  
So Young Park ◽  
Jun-Ho Choe ◽  
Jee Soo Kim ◽  
Soo Yeon Hahn ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Primary Tumor ◽  
Differentiated Thyroid Cancer ◽  
Medical Center ◽  
Distant Metastases ◽  
Predictive Biomarker ◽  
Tumor Burden ◽  
Serum Thyroglobulin ◽  
Preoperative Serum ◽  
Clinical Records

Lymph node metastasis (LNM) in differentiated thyroid cancer (DTC) is usually detected with preoperative ultrasonography; however, this has limited sensitivity for small metastases, and there is currently no predictive biomarker that can help to inform the extent of surgery required. We evaluated whether preoperative serum thyroglobulin levels can predict tumor burden and extent. We retrospectively reviewed the clinical records of 4029 DTC cases diagnosed and treated at a Samsung Medical Center between 1994 and 2016. We reviewed primary tumor size, number and location of LNM, and presence of distant metastases to reveal relationships between tumor burden and extent and preoperative serum thyroglobulin levels. We found a linear association between increasing preoperative thyroglobulin levels, the size of the primary tumor, and the number of LNM (r = 0.34, p < 0.001, r = 0.20, p < 0.001, respectively). Tumor extent also increased with each decile of increasing preoperative thyroglobulin level (r = 0.18, p < 0.001). Preoperative thyroglobulin levels of 13.15 ng/mL, 30.05 ng/mL, and 62.9 ng/mL were associated with the presence of ipsilateral lateral LNM, contralateral lateral LNM, and distant metastasis, respectively. Our results suggest that preoperative measurement of serum thyroglobulin may help to predict LNM and help to tailor surgery.

scholarly journals Late-onset distant metastases confer poor prognosis in patients with well-differentiated thyroid cancer

Gland Surgery ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 1857-1866
Author(s):  
Chan Kwon Jung ◽  
Sohee Lee ◽  
Ja Seong Bae ◽  
Dong-Jun Lim
Keyword(s):  
Thyroid Cancer ◽  
Poor Prognosis ◽  
Differentiated Thyroid Cancer ◽  
Late Onset ◽  
Distant Metastases ◽  
Well Differentiated

scholarly journals Current controversies in the initial post-surgical radioactive iodine therapy for thyroid cancer: a narrative review

2014 ◽  
Vol 21 (6) ◽  
pp. R473-R484 ◽  
Author(s):  
Ralph Blumhardt ◽  
Ely A Wolin ◽  
William T Phillips ◽  
Umber A Salman ◽  
Ronald C Walker ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Radioactive Iodine ◽  
Distant Metastases ◽  
Operative Management ◽  
Low Risk ◽  
Nodal Disease ◽  
Dose Selection ◽  
Remnant Ablation ◽  
Risks And Benefits ◽  
Definition Of

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy and the fifth most common cancer in women. DTC therapy requires a multimodal approach, including surgery, which is beyond the scope of this paper. However, for over 50 years, the post-operative management of the DTC post-thyroidectomy patient has included radioactive iodine (RAI) ablation and/or therapy. Before 2000, a typical RAI post-operative dose recommendation was 100 mCi for remnant ablation, 150 mCi for locoregional nodal disease, and 175–200 mCi for distant metastases. Recent recommendations have been made to decrease the dose in order to limit the perceived adverse effects of RAI including salivary gland dysfunction and inducing secondary primary malignancies. A significant controversy has thus arisen regarding the use of RAI, particularly in the management of the low-risk DTC patient. This debate includes the definition of the low-risk patient, RAI dose selection, and whether or not RAI is needed in all patients. To allow the reader to form an opinion regarding post-operative RAI therapy in DTC, a literature review of the risks and benefits is presented.

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