Surgery for Anaplastic Carcinoma and the Rare Thyroid Tumors

Abstract Activating point mutations of the BRAF gene have been recently reported in papillary thyroid carcinomas. In this study, we analyzed 320 thyroid tumors and six anaplastic carcinoma cell lines and detected BRAF mutations in 45 (38%) papillary carcinomas, two (13%) poorly-differentiated carcinomas, three (10%) anaplastic carcinomas, and five (83%) thyroid anaplastic carcinoma cell lines but not in follicular, Hürthle cell, and medullary carcinomas, follicular and Hürthle cell adenomas, or benign hyperplastic nodules. All mutations involved a T→A transversion at nucleotide 1796. In papillary carcinomas, BRAF mutations were associated with older age, classic papillary carcinoma or tall cell variant histology, extrathyroidal extension, and more frequent presentation at stages III and IV. All BRAF-positive poorly differentiated and anaplastic carcinomas contained areas of preexisting papillary carcinoma, and mutation was present in both the well-differentiated and dedifferentiated components. These data indicate that BRAF mutations are restricted to papillary carcinomas and poorly differentiated and anaplastic carcinomas arising from papillary carcinomas. They are associated with distinct phenotypical and biological properties of papillary carcinomas and may participate in progression to poorly differentiated and anaplastic carcinomas.

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Low frequency of p53 mutations in human thyroid tumors; p53 and Ras mutation in two out of fifty-six thyroid tumours

Acta Endocrinologica ◽

10.1530/eje.0.1340177 ◽

1996 ◽

Vol 134 (2) ◽

pp. 177-183 ◽

Cited By ~ 25

Author(s):

Domenico Salvatore ◽

Angela Celetti ◽

Nicole Fabien ◽

Christian Paulin ◽

Maria Luisa Martelli ◽

...

Keyword(s):

Papillary Carcinoma ◽

Tumour Progression ◽

Low Frequency ◽

Gene Mutations ◽

Genetic Alterations ◽

Anaplastic Carcinoma ◽

Human Thyroid ◽

Thyroid Tumors ◽

Ras Mutation ◽

Original Tumour

Salvatore D, Celetti A, Fabien N, Paulin C, Martelli ML, Battaglia C, Califano D, Monaco C, Viglietto G, Santoro M, Fusco A. Low frequency of p53 mutations in human thyroid tumors; p53 and Ras mutation in two out of fifty-six thyroid tumours. Eur J Endocrinol 1996;134:177–83. ISSN 0804–4643 Objective: p53 is a well-known nuclear phosphoprotein encoded by a suppressor gene known to be mutated in various kinds of human tumours. A relationship between p53 gene mutation and tumour progression seems to be a common feature of several neoplasias. Desing: In order to investigate the role of p53 mutations in human thyroid tumours, DNA samples derived from fifty-six neoplastic tissues, ranging from benign adenomas to undifferentiated carcinomas, were examined for the presence of p53 gene mutations. Methods: The analysis has been conducted using polymerase chain reaction (PCR) amplification of the exons 5–9 of the p53 gene followed by single strand conformation polymorphism (SSCP) and sequence analyses. Results: One anaplastic carcinoma and one papillary carcinoma showed p53 gene mutations in exons 5 and 8, respectively. A cell line established from the papillary carcinoma showed the same mutation present in the original tumour. Both p53 mutations were heterozygous. The p53 positive samples were analysed for other genetic alterations frequently detected in human thyroid carcinomas (mutations of the RET, TRK, and ras oncogenes): both p53-mutated samples proved to be mutated at level of codon 13 of the c-Ki-ras gene. Conclusions: Our data confirm that p53 gene alterations are rare in well-differentiated thyroid tumours, that they are an important requirement for the establishment in culture of human thyroid carcinoma cell lines, and that they can be associated with other genetic alterations, namely ras mutations, in the malignant progression of thyroid tumours. Alfredo Fusco, Dipartimento di Biologia e Patologia Cellulare e Molecolare, Facoltà di Medicina e Chirurgia, via S. Pansini 5, 80131, Napoli, Italy

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Giant thyroid tumours - therapeutic difficulties

ORL ro ◽

10.26416/orl.33.4.2016.154 ◽

2016 ◽

Vol 4 (1) ◽

pp. 14-20

Author(s):

Daniela Vrînceanu ◽

V. Axinte ◽

Bogdan Bănică

Keyword(s):

Single Case ◽

Balance Sheet ◽

Thyroid Tumor ◽

Anaplastic Carcinoma ◽

Team Work ◽

Postoperative Treatment ◽

Preoperative Embolization ◽

Thyroid Tumors ◽

Therapeutic Result ◽

Oncological Treatment

Introduction. Thyroid tumors are a borderline pathology approached equally by endocrine surgeons, ENT surgeons, thorax surgeons or general surgeons. The cooperation with the endocrinologist is mandatory in preoperative balance sheet, but also in postoperative treatment. The large size of a thyroid tumor (over 10 cm) causes a big surgical risk and a special preoperative preparation. Material and method. We present two cases of giant thyroid tumors: an anaplastic carcinoma developed on a papillary carcinoma and a medullar carcinoma. We present our therapeutic options for every single case, including the surgical treatment in mixed team with thorax surgeon‚ “long time hard surgery”. In one case we performed intubation on bronchoscope to avoid tracheotomy, and in the other case we made preoperative embolization. Results. The immediate therapeutic result depends on team work with thoracic surgeon, with the endocrinologist and intensive care specialist. The final therapeutic result depends on complex oncological treatment, but also on clinical and endocrine supervision. Discussions. The decision to operate a giant thyroid tumor had to put in balance risks and benefits maybe more than in other types of head and neck tumors because of the major intraoperative risk of bleeding and of bilateral injury of recurrent nerves. Conclusions. The surgical indication must be assessed judiciously. Preoperative (endocrine and general) complete clinical balance is indispensable. The surgical intervention has to be well prepared by both patient and surgeon. Effective therapeutic result depends on the interdisciplinary collaboration and on patient compliance to treatment.

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Immunophenotyping of thyroid tumors identifies molecular markers altered during transformation of differentiated into anaplastic carcinoma

The American Journal of Surgery ◽

10.1016/j.amjsurg.2011.01.010 ◽

2011 ◽

Vol 201 (5) ◽

pp. 580-586 ◽

Cited By ~ 11

Author(s):

Sam M. Wiseman ◽

Obi L. Griffith ◽

Allen Gown ◽

Blair Walker ◽

Steven J.M. Jones

Keyword(s):

Molecular Markers ◽

Anaplastic Carcinoma ◽

Thyroid Tumors

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Complications of Advanced Stage of Various Types of Thyroid Tumors at Tertiary Care Hospital

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i29b31594 ◽

2021 ◽

pp. 105-109

Author(s):

Ahsan Ali Laghari ◽

Ghulam Akbar Khaskheli ◽

Amjad Ali Bhurt ◽

...

Keyword(s):

Thyroid Disease ◽

Tertiary Care Hospital ◽

Frozen Section ◽

Tertiary Care ◽

Cervical Lymphadenopathy ◽

Anaplastic Carcinoma ◽

Care Hospital ◽

Advanced Stage ◽

Thyroid Tumors ◽

Thyroid Swelling

Objective: To determine the complications associated various types of tumors of advanced stage of thyroid disease at tertiary care hospital. Study Design: Descriptive study. Place and Duration: Two years study from April 2018 to March 2020 was conducted in Liaquat University of Medical and health sciences Jamshoro. Patients and Methods: All patients were admitted from Outpatient department (OPD) with advance stage of tumor of thyroid and either of gender were included. The patients were evaluated fully after history and clinical examinations berries sign and specific investigations of thyroid profile (T3,T4,TSH), ultrasound of thyroid, fine-needle aspiration cytology FNAC, image guided biopsy, frozen section biopsy for confirmation of diagnosis, indirect laryngoscopy, x - Ray neck and MRI. All the patients were assessed for pre-operative evaluation (complications) with advanced stage of thyroid tumors. All the data regarding developed complications was recorded via study proforma. Data was analyzed by using the SPSS version 20. Results: Most of the patients were found with age groups of 20 to 34 years and 35 to 55 years. Out of all, 25 patients were diagnosed papillary carcinoma, 12 patients were diagnosed as follicular carcinoma, 7 patients had Anaplastic carcinoma, 4 patients were diagnosed lymphoma and 2 patients were diagnosed as medullary carcinoma. As per complications of advanced disease 23 patients had thyroid swelling with cervical lymphadenopathy and pain, 13 patients had thyroid swelling with change of voice, 7 patients had thyroid swelling with dyspnea and dysphagia, 5 patients were presented with thyroid swelling with bony pain, weight loss and pathological fractures, 2 patients were presented with thyroid swelling with diarrhea. Conclusion: Various complications such as swelling, pain, hemorrhage, cervical lymphadenopathy, change in voice, weight loos, pathological fracture, dyspnea and dysphagia were frequently seen in patients presented with advanced stage of thyroid disease.

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Benign and malignant thyroid tumors are more frequent in the right thyroid lobe, presumably due to its larger size

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-2005-862909 ◽

2005 ◽

Vol 113 (S 1) ◽

Author(s):

A Hofmann ◽

A Staudenherz ◽

H Vierhapper ◽

A Gessl

Keyword(s):

Thyroid Tumors ◽

Thyroid Lobe ◽

The Right

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TO STUDY THE ETIOPATHOLOGICAL SPECTRUM OF ADULT PATIENTS WITH PANCYTOPENIA

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i10.1461 ◽

2020 ◽

Vol 4 (10) ◽

Author(s):

Harimohan Garg ◽

Haritej Anand Khirawari ◽

Sona Priyadarshi

Keyword(s):

Acute Leukemia ◽

Aplastic Anemia ◽

Indian Subcontinent ◽

Megaloblastic Anemia ◽

Anaplastic Carcinoma ◽

Adult Patients ◽

Research Centre ◽

New Delhi ◽

Nutritional Anemia ◽

Male Preponderance

Background: Pancytopenia is diagnosed when there is a reduction in all three hematopoietic cell lines. Till date there is limited number of studies on the frequency of various causes of pancytopenia. Of these some have been reported from the Indian subcontinent. There appears to be a changing spectrum of pancytopenia over the past two decades. The objective was to study the etiopathological spectrum of adult patients with pancytopenia over a period of one and half year. Methods: The Prospective and retrospective observational study was conducted in the Department of Family Medicine, Batra Hospital and Medical Research Centre, New Delhi. A total of 120 Patients were included in the study. All patients gave their consent to take part in the study and were subjected to a questionnaire regarding symptoms, past relevant history, lifestyle and detailed clinical examination and investigations as mentioned in materials and methods. Results: Six broad diagnostic groups could be identified in adults with pancytopenia. Megaloblastic anemia (D1) was the largest group comprising 57.5% of all patients. 11.7% of patients with pancytopenia were diagnosed as Aplastic anemia (D2).11.7% of patients with pancytopenia were diagnosed as leukemia/lymphoma (D3) such as lymphoma (1), metastatic anaplastic carcinoma (1), acute leukemia (11), and metastatic gastric carcinoma (1). 15% of patients with pancytopenia were diagnosed with infections (D4) such as complicated malaria cases (7), HIV (5), disseminated tuberculosis (4), viral (2). We also encountered (D5) 0.8% was Myelophthisis/Storage disorder as myelodysplastic syndrome (1) and 3.3% were other (D6) as reactive marrow (4). Conclusion: Pancytopenia is not a disease itself. It is a hematological feature of varying etiology with slight male preponderance. Megaloblastic anemia along with mixed nutritional anemia is leading cause of pancytopenia in India followed by infections being second and aplastic anemia and acute leukemia being third common causes. Keyword: Pancytopenia, Megaloblastic anemia, Nutritional anemia.

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