Rare Concurrence of Triple Primary Thyroid Cancer: A Patient of Papillary Carcinoma, Follicular Carcinoma, and Primary Lymphoma of the Thyroid

Abstract Introduction Health care statistics provides a solid evidence of increasing thyroid cancer prevalence in Latvia. However, in order to characterise the problem of thyroid cancer more completely, histological type and stage of carcinomas as well as demographic characteristics of the affected patients would be as important as the total burden of new cases. Aim of the study was to provide detailed characteristics of the spectrum of surgically treated primary thyroid carcinoma. Materials and methods. The study was designed as retrospective research. Archives of a single university hospital were searched for consecutive, surgically treated or histologically proved cases of primary thyroid carcinoma (2008 - 2012). Each case was characterised by histological type, local tumour spread, largest diameter of the carcinoma, patient’s age and sex as well as extent of surgical treatment. Descriptive statistics was carried out by CIA software. Results. Archive search yielded 323 primary thyroid carcinoma cases, including 255 cases (78.9%; 95% confidence interval (CI) = 74.2 - 83.0) of papillary carcinoma, 54 cases (16.7%; 95% CI = 13.1 - 21.2%) of follicular carcinoma and 7 cases (2.2%; 95% CI = 1.1 - 4.4%) of medullary and anaplastic carcinoma. Although the youngest cases (aged 18 and 20 years) were diagnosed with papillary and follicular carcinoma, respectively, the mean age did not show statistically significant differences between the groups. Strong female predominance was observed regardless of cancer type. Regarding local tumour spread, pT1a was significantly more frequent in papillary carcinoma: 50.2% (95% CI = 44.1 - 56.3) in contrast to 18.5% (95% CI = 10.4 - 28.9) in case of follicular carcinoma. Total thyroidectomy was the most frequent type of operation that was applied for 28.6 - 71.4% cases in relation to histological type. Conclusions. This is the first research work in Latvia that comprehends the overall review of the morphological spectrum of thyroid carcinoma in the surgical material. Papillary and follicular carcinomas are the most frequently identified types in accordance with the global data. Much less common morphological forms of thyroid tumours were also diagnosed - medullary carcinoma and anaplastic thyroid carcinoma. The large mean diameter of follicular carcinoma in the surgery material and the fact that more than half of follicular carcinomas are revealed as pT2-T3 tumours highlights the necessity for up-to-dated diagnostics and elaboration of reliable novel molecular tests.

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Preoperative thyroid stimulating hormone level as risk factor for differentiated thyroid cancer

International Surgery Journal ◽

10.18203/2349-2902.isj20191252 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1063

Author(s):

Asem Fayed Moustafa ◽

Mohammed Sabery Ammar ◽

Asmaa El-Hantour ◽

Ahmed Farag El-Kased

Keyword(s):

Thyroid Cancer ◽

Papillary Carcinoma ◽

Multinodular Goiter ◽

Differentiated Thyroid Cancer ◽

Follicular Carcinoma ◽

Thyroid Stimulating Hormone ◽

Group I ◽

Female Predominance ◽

Group Ii ◽

The Relationship

Background: The objective of the study was to explore the relationship between TSH and differentiated thyroid cancer.Methods: From September 2017-September 2018, two groups included 247 euthyroid patients with thyroid swelling who had thyroidectomy studied retrospectively and prospectively by observing preoperative TSH level. Euthyroid adult patients with differentiated thyroid cancer and benign thyroid conditions and euthyroid patients with any thyroid diseases who will going to have thyroidectomy were included otherwise other thyroid conditions were excluded. Patients were classified into 192 retrospective cases (Group I) and 55 prospective cases (Group II).Results: Increased age of malignant cases with a female predominance. All cases presented with a neck swelling. Clinically in group I nodular swelling in 156 cases (81.2%), diffuse swelling in 36 cases (18.8%) and in group II, nodular swelling in 47 cases (85.5%) and diffuse swelling in 8 cases (14.5%). Histopathology of group I thyroid adenoma in 5 cases (4.8%) and multinodular goiter in 100 cases (95.2%). In addition 80 cases (92%) were papillary carcinoma and follicular carcinoma in 7 cases (8%) while in group II; multinodular goiter in29 cases (100%) and papillary carcinoma in 21 cases (80.8%) as well as follicular carcinoma in 5 cases (19.2%) in malignant cases. Group I showed a significant increase in TSH in malignant cases with the same finding in group II.Conclusions: TSH is an indicator for thyroid malignancy and FNAC biopsy is recommended for thyroid swellings showed elevated TSH.

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ENDOCRINE TUMOURS: Genetic predictors of thyroid cancer outcome

Acta Endocrinologica ◽

10.1530/eje-15-0605 ◽

2016 ◽

Vol 174 (4) ◽

pp. R117-R126 ◽

Cited By ~ 36

Author(s):

Catarina Tavares ◽

Miguel Melo ◽

José Manuel Cameselle-Teijeiro ◽

Paula Soares ◽

Manuel Sobrinho-Simões

Keyword(s):

Thyroid Cancer ◽

Papillary Carcinoma ◽

Follicular Carcinoma ◽

Distant Metastases ◽

Genetic Alterations ◽

Undifferentiated Carcinoma ◽

Genetic Predictors ◽

Patient’S Outcome ◽

Well Differentiated ◽

Cancer Outcome

Genetic predictors of outcome are reviewed in the context of a disease – cancer – that can be (too) simplistically described as a ‘successful, invasive clone of our own tissues’. Context has many faces that determine a thyroid cancer patient's outcome beyond the influence of genetic markers. There is also plenty of evidence on the prognostic meaning of the interplay between genetics and context/microenvironment factors (encapsulation, degree of invasion, staging, etc.). This review addresses only genetic alterations detected by molecular methods in surgically resected specimens, thus ruling out immunohistochemistry and (F)ISH, despite their crucial relevance as topographically oriented methods. For the sake of the discussion, well-differentiated carcinomas were divided into two main morphologic types: papillary carcinoma (classic and most variants) displaying BRAFV600E mutations and RET/papillary thyroid carcinoma rearrangements and the group of follicular patterned carcinomas that encompasses follicular carcinoma and the encapsulated form of follicular variant of papillary carcinoma, displaying RAS mutations and PAX8/PPARγ rearrangement. TERT promoter mutations have been recently described (and associated with distant metastases and reduced survival) in papillary and follicular carcinomas, as well as in poorly differentiated and undifferentiated carcinoma. TP53 mutations, previously thought to be restricted to less differentiated carcinomas, were also detected in papillary and follicular carcinoma and found to carry a guarded prognosis. Besides their putative importance for targeted therapies, the prognostic meaning of such mutations is discussed per se and in the setting of concurrent BRAF mutation.

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Pattern of Primary Thyroid Malignancy in a Tertiary Care Hospital

Journal of Dhaka Medical College ◽

10.3329/jdmc.v27i2.45829 ◽

2020 ◽

Vol 27 (2) ◽

pp. 161-174

Author(s):

Mohammad Asraful Islam ◽

Rashedul Islam ◽

Debnath Talukder ◽

AHM Noor E As Sayeed ◽

SK Nurul Fattah Rumi ◽

...

Keyword(s):

Thyroid Cancer ◽

Papillary Carcinoma ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Follicular Carcinoma ◽

Medullary Carcinoma ◽

Anaplastic Carcinoma ◽

Care Hospital ◽

Thyroid Malignancy ◽

Follicular Variant

Background: Among the endocrine malignancies thyroid cancer is the most common. It constitutes a heterogeneous group of malignancies ranking it as the fifth most common cancer worldwide. On health as well as health system it has severe implication. Thyroid cancer incidence is rising most rapidly worldwide. Different thyroid malignancy requires different management strategy. Proper addressing and prompt management of different thyroid malignancies can lessen the suffering. Objective: The study aimed to evaluate the pattern of primary thyroid malignancy in a tertiary care hospital. Methods: The study was a hospital based descriptive cross sectional study and was conducted in Dhaka Medical College Hospital, Dhaka for one-year period following approval of this protocol. Patients suffering from primary thyroid carcinoma admitted in or attending the outpatient department (OPD) in the department of Otolaryngology and Head-Neck Surgery was approached for inclusion in the study. Written informed consent was taken from the subject and ethical issues were ensured. A total of 50 individual suffering from primary thyroid carcinoma calculated by sample size formula was selected by inclusion and exclusion criteria and data was collected by interview using a semi-structured questionnaire and by personal document analysis. Collected data was analyzed by the SPSS 20 for windows. This study reflects the pattern of primary thyroid malignancy in a tertiary care hospital in Bangladesh. Results: Mean age of the participants was 32.7 years with SD ± 13.8 years, Minimum age was 17 years and maximum age was 70 years. Majority of the patients (46%) were in the age group of 31- 40 years. Among the participants, 70% were female and 30% were male. The majority of the patients belong to Dhaka and Rangpur divisions (26% & 22% respectively) of which maximum patients were from rural area (70%). By occupation, maximum (22%) of the study subjects were businessman, maximum study subjects were below SSC (24%) and maximum patients (42%) had relatively low income per month. Half of the participants had habit of tobacco. All patients (100%) had presented with palpable thyroid swelling. Among the total participants 54% had lymphadenopathy, 10% had dysphagia, 4% had hoarseness of voice and 4% had lumpiness in throat. Only 2% of patients had the symptom of dyspnoea. No palpable lymph nodes were found in 46% followed by Single node lymphadenopathy 26%, multiple nodules in one side in 18%, bilateral lymphadenopathy 8% and 20% participants had Central compartment lymphadenopathy. USG findings of thyroid revealed Single solid nodule in 22.0%, Single cystic nodule in 16.0%, multiple mixed (solid + cystic) nodules in 62.0% cases. FNAC findings revealed Anaplastic carcinoma in 2.0%, Follicular neoplasm in 16.0% and Follicular variant of papillary carcinoma in 8.0%. Papillary carcinoma found in maximum 70.0% cases. No lymphoma found whereas medullary carcinoma found in 4.0% cases. Histopathological findings confirmed Anaplastic carcinoma in 4.0%, Follicular carcinoma in 16.0%, Follicular variant of papillary carcinoma in 8.0% and Papillary carcinoma 68.0% cases. By histopathological examination no lymphoma found whereas medullary carcinoma found in 4.0% cases. Only 24% participants had hypertension and 76% had DM as co-morbid diseases. Distant metastasis of carcinoma was not present in any of the participants. Conclusion: In this study, middle age group and female sex prevalent thyroid cancer. Geographical distribution also has an important role. Business, low educational level, low socioeconomic status and tobacco smoking are found the most important risk factors. Histopathologically papillary carcinoma was predominant followed by follicular carcinoma, follicular variant of papillary carcinoma, anaplastic carcinoma and medullary carcinoma. No lymphoma found. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 161-174

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Pola kanker tiroid periode Juli 2013 – Juni 2016 di RSUP Prof. Dr. R. D Kandou Manado

e-CliniC ◽

10.35790/ecl.4.2.2016.14475 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Yolanda Parura ◽

Victor Pontoh ◽

Marselus Werung

Keyword(s):

Thyroid Cancer ◽

Papillary Carcinoma ◽

Malignant Disease ◽

Endocrine System ◽

Follicular Carcinoma ◽

Female Gender ◽

Medullary Carcinoma ◽

Mountainous Areas ◽

Thyroid Carcinomas ◽

Histopathological Type

Abstract: Thyroid cancer is a common malignant disease found in endocrine system and is increasing in incidence every year, in Indonesia found around 9 from 10 malignancy. Based on histopathological types, thyroid carcinomas are divided into papillary carcinoma, follicular carcinoma, medullary carcinoma, and anaplastic carcinomas. The most common are papillary carcinoma and then follicular carcinoma. Factors that can influence the histopathological type of thyroid carcinomas is geographical factor, which most commonly found in mountainous areas. Thyroid cancer is rare in men, most often in women with a ratio of 1: 3.Conclusion: Female gender, mountainous terrain and adulthood to older people who suffered most thyroid cancer. Keywords: thyroid cancer Abstrak: Kanker tiroid penyakit keganasan tersering ditemukan pada sistim endokrin dan insidennya meningkat setiap tahun, di Indonesia menempati urutan 9 dari 10 keganasan yang sering ditemukan. Berdasarkan gambaran histopatologinya, karsinoma tiroid dibagi menjadi tipe papiler, folikuler, meduler, dan anaplastik. Kasus terbanyak adalah karsinoma tiroid papiler dan terbanyak kedua adalah karsinoma tiroid folikular. Salah satu faktor yang mempengaruhi gambaran histopatologi karsinoma tiroid adalah keadaan geografis, dimana paling banyak ditemukan pada daerah pegunungan. Kanker tiroid jarang terjadi pada laki-laki, paling sering pada perempuan dengan perbandingan 1:3. Simpulan: Jenis kelamin perempuan, daerah pegunungan dan usia dewasa sampai lanjut usia yang paling banyak menderita kanker tiroid. Kata kunci: kanker tiroid

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AN ANALYTICAL, STATISTICAL STUDY OF THYROID CANCER INCIDENCE IN SUDAN DURING 2005-2015

Global Journal of Public Health Medicine ◽

10.37557/gjphm.v1i2.8 ◽

2019 ◽

Vol 1 (2) ◽

pp. 96-106

Keyword(s):

Thyroid Cancer ◽

Papillary Carcinoma ◽

Old Age ◽

Age Groups ◽

Follicular Carcinoma ◽

Epidemiological Data ◽

Medullary Carcinoma ◽

Epidemiological Studies ◽

University Hospital ◽

Epidemiological Characteristics

Introduction: Sudan, the most diverse country in the African continent, is experiencing growing cancers problems. However, little is known about thyroid cancer epidemiology and patterns. the study aimed to analyse and describe the epidemiological characteristics and trends of thyroid cancer in, in the period1st January 2005 and 31st December 2015. Methods: This is retrospective population and hospital-based study. We analysed epidemiological data for digital medical records at both Radiation and Isotope Centre Khartoum (RICK), and Soba University Hospital, Khartoum, Sudan were reviewed. Results: In total, 1,062 cases were reported during 1st January 2005 and 31st December 2015. Of these, (360; 33.9%) were male and (702; 66.1%) were female. The highest number of cases was in the 25-54-year-old age group (451; 42.5%), and more than 65-year-old age (331; 31.2%). The most predominant type of thyroid cancer among the Sudanese population was Papillary carcinoma (734; 69.1%) followed by Follicular carcinoma 178(16.8%) and Medullary carcinoma (150; 14.1%). There were significant differences in gender, age groups and types of thyroid cancer (P=0.001). Based on geographical distribution thyroid cancer showed high prevalence in Khartoum, North Kurdufan, River Nile, Kassala, North Darfur, Northern, and south Kurdufan. Whereas, low distribution is seen in Red sea, West Darfur, West Kurdufan, East Darfur, Al Gadarif, and the Blue Nile. Conclusion: our results suggest that thyroid cancer continuous presenting alarming challenge with an increasing the prevalence in females. Papillary carcinoma is the most common type among Sudanese populations. Further epidemiological studies are required in policy strategies for control and prevention strategies of thyroid cancer in Sudan.

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Socio-demographic and Clinical Characteristics of Patient with Thyroid Cancer

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v11i1.45668 ◽

2020 ◽

Vol 11 (1) ◽

pp. 54-58

Author(s):

AKM Farhad Hossain ◽

Md Mahmudur Rahman Siddiqui ◽

Sayada Fatema Khatun

Keyword(s):

Public Health ◽

Thyroid Cancer ◽

Clinical Characteristics ◽

Family Income ◽

Ethical Issues ◽

Endocrine System ◽

Public Health Problem ◽

Follicular Carcinoma ◽

Public Health Issue ◽

Cross Sectional

Background: Thyroid cancer is the most common malignant disease in endocrine system. It is an emerging public health issue associated with burden on the family, community and the nation. The aim of this study is to determine the socio-demographic and clinical characteristics of patient with thyroid cancer attending in tertiary hospital. Methods: This cross sectional study was conducted among 246 thyroid cancer patients in two tertiary hospitals of Dhaka city from 01 July 2018 to 30 June 2019. The subjects were selected purposively following specific selection criteria and maintaining ethical issues. Data were collected by face to face interview using a semi-structured questionnaire and checklist. Data were analyzed by the statistical package for the social science (SPSS) version 23. Results: This study revealed that majority (74.4%) of respondents was female, married (72%), housewife (61.4%), rural respondent (41.1%) and had primary education (69%). Mean (± SD) age of the respondent was 37.85(±12.20) years (Range 14-70 years) and mean (± SD) monthly family income was Tk. 17681(±10602). Out of 246 cases, 204 (82.9%) was papillary and 42 (17.1%) was follicular carcinoma. Various clinical presentations included visible neck swelling in 225 (91.5%), swollen lymph node in 103 (41.9%), pain 90 (36.6%), Difficulties in swallowing 87 (35.4%), Hoarseness of voice in 141 (57.3%), cough along with swelling 47(19.1%), Difficulties in breathing due to swelling in 13(5.3%) of the patients. Conclusion: Incidence of thyroid cancer has increased worldwide specially in female patients in 3rd and 4th decades of life. As thyroid cancer is a growing public health problem in Bangladesh, proper screening and early diagnostic facilities at all level should be available to measure its actual burden in the country. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 54-58

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Lymphocytic Infiltration in Pediatric Thyroid Carcinomas

Pediatric and Developmental Pathology ◽

10.1007/s10024-003-3028-3 ◽

2004 ◽

Vol 7 (5) ◽

pp. 487-492 ◽

Cited By ~ 10

Author(s):

Van H. Savell ◽

Stephen M. Hughes ◽

Charles Bower ◽

David M. Parham

Keyword(s):

Papillary Carcinoma ◽

Follicular Carcinoma ◽

Thyroid Neoplasms ◽

Lymphocytic Infiltration ◽

Lymphocytic Infiltrate ◽

Low Grade ◽

Lymphoid Infiltrate ◽

Thyroid Carcinomas ◽

Thyroid Papillary ◽

Adults And Children

Lymphocytic thyroiditis has been associated with an increase in the incidence of thyroid papillary carcinoma in some reports, mostly series of both adults and children. Relatively little is written about thyroiditis and follicular carcinomas. We have seen several cases of pediatric follicular thyroid carcinomas, that had an associated lymphocytic infiltrate, which led us to examine all primary malignant thyroid neoplasms in our surgical files from 1984 through 2000 to examine this relationship. We also investigated the nature of the lymphocytic infiltrate with routine immunohistochemistry. Ten patients (five male, five female, ages 4.5–21 years of age) had a thyroid carcinoma resection, six (three males and three females) with papillary carcinoma and four patients (two males and two females) with low-grade follicular carcinoma. Seven samples (one male had two cases with tumor) from patients who had a papillary carcinoma resection with tissue blocks available were identified (one patient had slides but no blocks), as were all four patients with a follicular carcinoma. The thyroid of all patients with a follicular carcinoma contained a lymphocytic infiltrate; only four of the seven papillary carcinoma samples had an associated lymphoid infiltrate. In all cases with a lymphoid infiltrate, the infiltrate was present in both lobes (both adjacent and separate from the tumor). B lymphocytes were present in the lymphoid infiltrate of three of four patients with follicular carcinomas and in 1 of 3 cases of papillary carcinomas. T cells were dispersed throughout all the tumors with lymphoid infiltrates. We conclude that pediatric follicular carcinomas have an associated lymphocytic infiltrate in the tumor and/or adjacent thyroid, more commonly than papillary carcinomas.

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DNA repair proteins may differentiate papillary thyroid cancer from chronic lymphocytic thyroiditis and nodular colloidal goiter

Scientific Reports ◽

10.1038/s41598-021-89403-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bahri Evren ◽

Sami Yılmaz ◽

Neşe Karadağ ◽

Ayşe Çıkım Sertkaya ◽

Ömercan Topaloğlu ◽

...

Keyword(s):

Dna Repair ◽

Thyroid Cancer ◽

Papillary Carcinoma ◽

Staining Intensity ◽

Follicular Cell ◽

Papillary Thyroid ◽

Chronic Thyroiditis ◽

Dna Repair Proteins ◽

The Difference ◽

Repair Genes

AbstractMalignant thyroid lesions are the most common malignancy of the endocrine glands with increasing rates in the last two decades. Papillary thyroid cancer is the most common thyroid malignancy. In our study, we aimed to quantitatively evaluate the levels of DNA repair proteins MSH2, MLH1, MGMT, which are representative blocks of patients diagnosed with papillary carcinoma, chronic thyroiditis, or colloidal goiter. Total or subtotal thyroidectomy material of 90 patients diagnosed with papillary carcinoma, nodular colloidal goiter, or chronic thyroiditis between 2009 and 2012 were retrospectively evaluated. Tissue samples obtained from paraffin blocks were stained with MGMT, MSH2, MLH1 proteins and their immunohistochemistry was evaluated. Prepared sections were examined qualitatively by an impartial pathologist and a clinician, taking into account the staining method under the trinocular light microscope. Although there was no statistically significant difference in MGMT, MSH2, MLH1, follicular cell positivity, staining intensity, and immunoreactivity values, papillary carcinoma cases showed a higher rate of follicular cell positivity, and this difference was more pronounced between papillary carcinoma and colloidal goiter. In the MSH2 follicular cell positivity evaluation, the difference between chronic thyroiditis and colloidal goiter was significant (p = 0.023). The difference between chronic thyroiditis and colloidal goiter was significant in the MSH2 staining intensity evaluation (p = 0.001). The difference between chronic thyroiditis and colloidal goiter was significant in MLH1 immunoreactivity evaluation (p = 0.012). Papillary carcinoma cases were demonstrated by nuclear staining only for MSH2 and MLH1 proteins as opposed to hyperplastic nodules. The higher levels of expression of DNA repair genes in malignant tumors compared to benign tumors are attributed to the functional activation of DNA repair genes. Further studies are needed for DNA repair proteins to be a potential test in the development and progression of thyroid cancer.

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