“Not Just Any Thyroid Follicular Tumor”

The most recent revision of the World Health Organization (WHO) Classification of Tumours of Endocrine Organs introduced a new variant of follicular thyroid carcinoma (FTC). It is characterized by a “glomeruloid” architectural pattern of growth. We present a case of follicular tumor with glomeruloid features, with Alcian Blue positive mucinous stromal degeneration in foci of questionable capsular microinvasion. At our knowledge, this the second case of glomeruloid follicular tumor in the literature and the first case in which Alcian Blue staining was used to investigate capsular invasion. Moreover, RAS mutation further supports that this is a variant of follicular tumor with uncertain malignant potential.

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Iritable bowel syndrome as the first manifestation of Hashimoto's tireoiditis

PONS - medicinski casopis ◽

10.5937/pomc17-25787 ◽

2020 ◽

Vol 17 (2) ◽

pp. 89-92

Author(s):

Marijana Jandrić-Kočić

Keyword(s):

Neuromuscular Disorders ◽

Intestinal Wall ◽

Aspiration Biopsy ◽

American Thyroid Association ◽

Laboratory Findings ◽

Dietary Regimen ◽

The Past ◽

Follicular Tumor ◽

One Year ◽

The Right

Introduction. Hashimoto's thyreoiditis has a complex effect on the gastrointestinal tract, which includes hormone receptor alteration, neuromuscular disorders, myopathies caused by intestinal wall infiltration. Case report. A 44-year-old patient appears in the family medicine clinic due to moderate pain in the lower part of the abdomen present for the past three months, which intensifies before defecation and stops immediately after defecation. He has two to four liquid stools daily in which he has not noticed the presence of mucus or blood for the past two months. He negates earlier illnesses as well as diseases relevant to heredity. Physical examination provides a neat finding. Ultrasound examination of the abdomen is within the age range. Thyroid ultrasound identifies the right flap of a 48x24x10 mm diametre with hypoechogenic calcified nodus 14x12 mm in diameter (meets the criteria of the American Thyroid Association for aspiration biopsy), left flap of 44x20x14 mm diameter. The following are the laboratory findings: TSH 7.66 mIU/l, FT4 6.42 pmol/l, TG 5080 ng/ml, calcitonin 8.94 pg/ml, TG-At 24.99 IU/ ml, TPO-At 500 IU/ml. The patient is instructed on a hygienic dietary regimen and includes spasmolytic and antidiarrheal, and referred to a nuclear medicine specialist who performs an aspiration biopsy (TBSRTC IV follicular tumor). The Oncology Consilium indicates surgery (right-sided lobectomy) with extempore verification and further follow-up. Pathohistological examination of the removed right lobe excludes the presence of malignant disease (struma coloides multinodosa glandulae thyroideae). Antidiarrheal therapy is discontinued and replacement therapy is administered (levothyroxine sodium tablets 50 mcg, qd). Subsequent proctosigmoidoscopy shows a neat finding. One year after surgery the patient is in remission of the disease. Conclusion. Diagnostic evaluation of the thyroid gland in patients with irritable colon syndrome significantly improves quality of life, reduces occupational absenteeism and health care costs.

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Long-term results of surgical treatment of thyroid adenomas

Kazan medical journal ◽

10.17816/kmj2019-892 ◽

2019 ◽

Vol 100 (6) ◽

pp. 892-897

Author(s):

Stanislav Olegovich Artyukhin ◽

Vladimir Georgievich Aristarhov ◽

Denis Anatolyevich Puzin

Keyword(s):

Surgical Treatment ◽

Needle Aspiration ◽

Long Term Results ◽

Fine Needle ◽

Thyroid Adenomas ◽

Follicular Tumor ◽

Group 3 ◽

Group 2 ◽

Group 1

Aim. To study the long-term results of surgical treatment of patients with thyroid adenomas. Methods. From 2004 to 2006, 667 patients with follicular adenomas of the thyroid gland, including 134 (20.1%) men and 533 (79.9%) women, were operated on in the surgical department №2 of city clinical hospital №11 of Ryazan. 3 groups of patients were defined: group 1 operated on for solitary adenomas of the thyroid gland, 103 patients, hemithyreoidectomy performed; group 2 operated on for multiple adenomas of the thyroid in both lobes, 101 patients, thyroidectomy performed; group 3 32 patients operated on for multiple adenomas of the thyroid in the same lobe, hemithyreoidectomy performed. Patients were examined 14 years after the surgery. Results. Hypothyroidism was diagnosed in: group 1 18 (17.5%) patients, group 2 101 (100%), group 3 0. All patients with hypothyroidism were compensated with hormone replacement therapy. Permanent hypoparathyroidism was diagnosed only in group 2 8 (4.8%) patients. Unilateral laryngeal paralysis was found in group 1 in 1 (0.9%) patient, group 2 in 2 (1.9%) patients, group 3 contained no such patients. Recurrence (node more than 1 cm according to ultrasound) was observed in group 1 in 12 (11.7%) patients; fine-needle aspiration found colloidal nodes in 8 (7.8%) patients (Bethesda II), in 4 (3.9%) follicular tumor (IV). Group 2 had no recurrences. In group 3 11 (34.3%) patients had recurrence; fine-needle aspiration found colloidal nodes in 1 (3.1%) patient (Bethesda II), in 10 (31.3%) follicular tumor (Bethesda IV). Conclusion. In solitary adenomas it is possible to perform organ-saving operations, which reduces the percentage of postoperative complications; in multiple adenomas, the optimal volume of surgery is thyroidectomy; when multiple adenomas are localized in one lobe, the chance of recurrence of the disease (31.3%) is high leading to re-surgery.

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Oxyphilic Follicular Tumor Arising in Struma Ovarii

Tumori Journal ◽

10.1177/030089169408000615 ◽

1994 ◽

Vol 80 (6) ◽

pp. 482-484 ◽

Cited By ~ 2

Author(s):

Simonetta Piana ◽

Stefania Damiani ◽

Donatella Santini

Keyword(s):

Mitotic Activity ◽

Aggressive Behaviour ◽

Vascular Invasion ◽

Present Report ◽

Thyroid Tumor ◽

Struma Ovarii ◽

Nuclear Pleomorphism ◽

High Mitotic Activity ◽

Proliferative Lesion ◽

Follicular Tumor

The present report describes a case of a proliferative lesion developed in a struma ovarii of a 26-year-old woman who presented with asymptomatic bilateral mature ovarian teratomas. The tumor immunohistochemically and ultrastructurally proved to be an oxyphilic follicular thyroid tumor. Although it showed some histologic features which could raise a suspicion of malignancy (solid, trabecular pattern and nuclear pleomorphism), no unequivocable signs of aggressive behaviour (high mitotic activity and vascular invasion) were evident. The patient was alive and well 1 year after a bilateral subtotal ovariectomy.

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Extending the Impact of RAC1b Overexpression to Follicular Thyroid Carcinomas

International Journal of Endocrinology ◽

10.1155/2016/1972367 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Márcia Faria ◽

Liliana Capinha ◽

Joana Simões-Pereira ◽

Maria João Bugalho ◽

Ana Luísa Silva

Keyword(s):

Differential Diagnosis ◽

Distant Metastases ◽

Small Gtpase ◽

Papillary Thyroid ◽

Thyroid Carcinomas ◽

Follicular Lesions ◽

Thyroid Adenomas ◽

Follicular Tumor ◽

Clinical Correlations ◽

The Impact

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.

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