Papillary thyroid carcinoma in a 7-year-old boy presenting with a goitre without microcalcifications and enlarged cervical lymph nodes

2021 ◽  
Vol 14 (7) ◽  
pp. e242278
Author(s):  
Maria Cecilia Schultze ◽  
Cintia Castro-Correia ◽  
Maria Bom-Sucesso ◽  
Marianne Becker

The most frequent type of thyroid malignancy in children is papillary thyroid carcinoma (PTC), which usually presents as a thyroid nodule, but may also present as a diffuse infiltration with microcalcifications. Herein, we report the case of an uncommon presentation of a PTC in a 7-year-old boy. The child was referred for a goiter with cervical lymphadenopathies. Ultrasonography showed a hypervascularised goiter without microcalcifications but with numerous bilateral cervical nodular formations. A lymph node biopsy revealed metastatic thyroid cancer, hence a total thyroidectomy and complete neck dissection were performed. Histopathology confirmed a PTC. Ablative 131I, 30 mCi was performed 4 months postsurgery. At the end of this treatment, a metastatic lung nodule was identified. Since then, another three ablative 131I treatments have been administered. Thyroid cancers presenting as a diffuse infiltration without microcalcifications are rare. In the presence of lymphadenopathies, thyroid cancer needs to be suspected, even without microcalcifications.

2013 ◽  
Vol 5 (2) ◽  
pp. 55-58
Author(s):  
Geeta Lal ◽  
Anuradha R Bhama

ABSTRACT Autoimmune rheumatic diseases, such as polymyositis and dermatomyositis, have been demonstrated to carry a risk of the development of malignancy. Thyroid cancer is a rare occurrence in this setting; however, multiple cases have been reported. We present two cases of papillary thyroid carcinoma associated with dermatomyositis and polymyositis. The first patient is a 64-year-old female found to have papillary thyroid cancer after the diagnosis of polymyositis who underwent thyroid resection. The second patient is a 51-year-old male who was found to have synchronous papillary thyroid cancer and small cell carcinoma of the lung. He did not undergo thyroid resection due to widely metastatic lung cancer. We describe two cases of papillary thyroid cancer associated with autoimmune rheumatic disease. Though it is rare, thyroid cancer should remain in the differential diagnosis of a patient with new onset autoimmune rheumatic disease, as this may alter the eventual management of these patients. How to cite this article Lal G, Bhama AR. Autoimmune Rheumatic Disease (Polymyositis and Dermatomyositis) associated with Papillary Thyroid Carcinoma: Report of Two Cases and Review of the Literature. World J Endoc Surg 2013;5(2):55-58.


2019 ◽  
Vol 1 (2) ◽  
pp. 34-37
Author(s):  
Lubna Riaz Dar ◽  
Shaherzad Sohail ◽  
Afreen Farid

Background: Pregnancy after papillary thyroid carcinoma (PTC) is rarely seen. Monitoring of such pregnancy is very challenging as normal thyroxin levels are essential for satisfactory perinatal outcomes. Beside the effect of carcinoma, its surgery, radioactive iodine therapy and psychosocial factors need to be considered. Case Presentation: A 28 years old lady presented to Obstetrics/Gynecology outpatients department at 30 weeks for antenatal check-up of her first pregnancy in December 2018. Patients had papillary thyroid cancer in 2008, it was staged T2N1M1. She also had metastasis in cervical lymph nodes and lungs. It was treated by total thyroidectomy and para- thyroidectomy with bilateral neck dissection followed by two doses of radioactive iodine till 2011. She was followed up by her oncologist and they allowed her to conceive and continue pregnancy. Our patients had an uneventful pregnancy. She was delivered by caesarean section and the baby had to stay in neonatal unit for one day. Multidisciplinary approach, special attention in antenatal and perinatal period can result in successful outcomes of pregenancy in post treatment patients of papillary thyroid carcinoma. Conclusion: Reports of pregnancies after papillary thyroid carcinoma are rare and its management is challenging. Multidisciplinary approach and attention to their special needs can lead to satisfactory pregnancy outcome.


2017 ◽  
Vol 24 (5) ◽  
pp. 423 ◽  
Author(s):  
M. Flader ◽  
P. Kurzawa ◽  
J. Maldyk ◽  
J. Sygut ◽  
J. Harasymczuk ◽  
...  

Tuberous sclerosis complex (tsc), a phacomatosis, is a rare genetic disease (autosomal dominant; incidence: 1 in 6,800–17,300) associated with mutations in the TSC1 and TSC2 genes, 70% of which are sporadic. The disease causes benign tumours in the brain, kidneys, heart, lungs, skin, and eyes; thyroid lesions are extremely rare.A 13-year-old euthyroid boy with a hereditary form of tsc (del 4730G in TSC2, also seen in 2 sisters and the father) was admitted to hospital with a thyroid nodule. Physical examination revealed a nodular left lobe with increased consistency. Thyroid ultrasonography revealed a heterogeneous left lobe, predominantly hypoechoic with multiple microcalcifications and the presence of suspicious cervical lymph nodes on the left side. A macrocalcification was observed on the right lobe. Fine-needle biopsy results showed a few groups of cells with discrete atypical characteristics, including abundant cytoplasm, nuclei with conspicuous nucleoli, intra-nuclear inclusions, and nuclear grooves. The patient underwent total thyroidectomy with lymphadenectomy. Histopathology examination confirmed papillary thyroid carcinoma.The coincidence of endocrine neoplasia including thyroid cancer and tsc is rare, and tsc with papillary thyroid carcinoma has never been described in a child. Studies of mutations in the tumour suppressor genes TSC1, TSC2, and STK11, activating the mtor (mammalian target of rapamycin) pathway, might support their role in the pathogenesis of thyroid cancer.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Khawla S Al-Kuraya ◽  
Abdul K Siraj ◽  
Pratheeshkumar Poyil ◽  
Divya Padmaja ◽  
Sandeep Kumar Parvathareddy ◽  
...  

Abstract Thyroid cancer is the second most common malignancy among females in Saudi Arabia, with Papillary thyroid carcinoma (PTC) accounting for 80-90%. The Kruppel-like factor 5 (Klf5) is a transcription factor that play a critical role in cell transformation, proliferation and oncogenesis. Immunohistochemical analysis of KLF5 was performed in 1219 PTC cases. KLF5 over-expression was noted in 65.1% (793/1219) of PTCs, and was significantly associated with tall-cell variant (p <0.0001), extrathyroidal extension (p = 0.0003), lymph node metastasis (p < 0.0001) and stage IV tumors (p < 0.0001). Significant association was also noted with HIF-1α over-expression (p = 0.0492). Interestingly, KLF5 over-expressing tumors showed poor disease-free survival (p = 0.0066). Functional studies in PTC cell lines showed that KLF5 co-immunoprecipitated with HIF-1α. Knockdown of KLF5 decreased the expression of HIF-1α while KLF5 was not affected by HIF-1α inhibition, suggesting that KLF5 is a functional upstream of HIF-1α. Down-regulation of KLF5 using specific inhibitor, ML264 or siRNA inhibited cell invasion and migration. In addition, treatment of PTC cell lines with ML264 resulted in inhibition of proliferation and induction of apoptosis in a dose-dependent manner. Furthermore, silencing of KLF5 significantly decreased the self-renewal ability of spheroids generated from PTC cells. Our findings confer that KLF5 may be a potential therapeutic target for the treatment of papillary thyroid cancer.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Maki Yukari

Abstract BACKGROUND Fatigue among thyroid cancer survivors is an important issue that needs to be appreciated and managed appropriately. Although several studies have reported potential factors that might be related to postoperative fatigue, the associations have yet to be inconclusive. The purpose of the present study was to estimate the prevalence of clinical fatigue in patients with papillary thyroid carcinoma and to reveal predictive factors, including their quality of life. METHODS A cross-sectional survey was conducted on patients with papillary thyroid carcinoma. Patients who underwent non-curative surgery, or those with recurrent or metastatic PTC, or those with other malignancies were excluded. The primary outcome was fatigue measured by the Cancer Fatigue Scale (CFS), and the secondary outcome was quality of life (QoL) quantified using the SF-36 v2. The following explanatory variables were collected; gender, age, employment status, marital status, co-morbidities, time since initial surgery, types of surgery, replacement of thyroid hormone, use of radioactive iodine, and the level of thyrotropin. The prevalence of clinical fatigue was estimated with the cut-off value of 18/19 of the CFS score. Correlations between the CFS score and the explanatory variables were examined using uni-variable analyses as well as multi-variable analysis. RESULTS Three hundred twenty-one patients participated in the survey. Of them, 258 respondents (80%) were female. The median age was 58 years, and the median time from initial surgery was 6.4 years. The mean and the standard deviation of the CFS score were 17.9 and 9.3, respectively (range: 0-48). The prevalence of clinical fatigue was 42% [95%CI: 36-47%]. Among the variables explored, having a job and scores of the mental component summary, the physical component summary, and the role/social component summary of the SF-36 were inversely associated with the CFS score in both uni- and multivariable analyses. CONCLUSION Postoperative fatigue was common in thyroid cancer survivors. Patients with a job and better QoL, in particular, those with good mental health, maybe at low-risk of developing the burden.


Author(s):  
Dumitru A Iacobas

Publically available (own) transcriptomic data were re-analyzed to quantify the alteration of functional pathways in the thyroid cancer, establish the gene hierarchy, identify potential gene targets and predict the effects of their manipulation. The expression data were generated from one case of papillary thyroid carcinoma (PTC) and from genetically manipulated BCPAP (papillary) and 8505C (anaplastic) human thyroid cancer cell lines. The study used the genomic fabric perspective that considers the transcriptome as a multi-dimensional mathematical object based on the three independent characteristics that can be derived for each gene from the expression data. We found remarkable remodeling of the thyroid hormone synthesis, cell cycle, oxidative phosphorylation and apoptosis pathways. Serine peptidase inhibitor, Kunitz type, 2 (SPINT2) was identified as the Gene Master Regulator of the investigated PTC. The substantial increase of the expression synergism of SPINT2 with apoptosis genes in the cancer nodule with respect to the surrounding normal tissue (NOR) suggests that its experimental overexpression may force the PTC cells into apoptosis with negligible effect on the NOR cells. The predictive value of the expression coordination for the expression regulation was validated with data from 8505C and BCPAP cells before and after lentiviral transfection with DDX19B.


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