scholarly journals Ablation therapy using a low dose of radioiodine may be sufficient in low- to intermediate-risk patients with follicular variant papillary thyroid carcinoma

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096649
Author(s):  
Fuxin Li ◽  
Wei Li ◽  
Katherine D. Gray ◽  
Rasa Zarnegar ◽  
Dan Wang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Local Recurrence ◽  
Thyroid Carcinoma ◽  
Low Dose ◽  
High Dose ◽  
Intermediate Risk ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Remnant Ablation

Objectives Follicular variant papillary thyroid carcinoma (FVPTC) is treated similarly to classical variant papillary thyroid carcinoma (cPTC). However, FVPTC has unique tumour features and behaviours. We investigated whether a low dose of radioiodine was as effective as a high dose for remnant ablation in patients with FVPTC and evaluated the recurrence of low-intermediate risk FVPTC. Methods Data from cPTC and FVPTC patients treated with I-131 from 2004 to 2014 were reviewed. Demographics, tumour behaviour, lymph node metastasis, and local recurrence data were compared between FVPTC and cPTC patients. Then, low-intermediate risk FVPTC patients were divided into low, intermediate, and high I-131 dose groups, and postoperative I-131 activities were analysed to evaluate the effectiveness of I-131 therapy for thyroid remnant ablation. Results In total, 799 cases of FVPTC (n = 168) and cPTC (n = 631) treated with I-131 were identified. Patients with FVPTC had a larger primary nodule size than cPTC, but lymph node metastases and local recurrence were more prevalent in cPTC than in FVPTC. For the low-, intermediate-, and high-dose groups, success rates of ablation did not differ (82.0%, 80%, and 81.3%, respectively). Conclusion FVPTC differs from cPTC in behaviour. Low-dose ablation may be sufficient in FVPTC patients with low-intermediate disease risk.

scholarly journals Clinical outcomes of low-dose and high-dose postoperative radioiodine therapy in intermediate-risk papillary thyroid carcinoma patients with low postoperative stimulated thyroglobulin (1-20 ng/ml) and non-structural or functional metastasis: study protocol for a randomized-controlled trial

2021 ◽  
Author(s):  
Pan Chen ◽  
Jia-Xin Luo ◽  
Wei Ouyang ◽  
Hui-Juan Feng ◽  
Ju-Qing Wu ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Dose Group ◽  
Low Dose ◽  
Disease Free Survival ◽  
High Dose Group ◽  
High Dose ◽  
Intermediate Risk ◽  
Papillary Thyroid ◽  
Free Survival

Abstract Background: For some intermediate risk papillary thyroid carcinoma patients, if there are structural metastases, reoperation is preferred. If there are functional metastases (131I avidity), they can be treated with high-dose radioactive iodine (131I). However, it is still controversial whether 131I ablation should be used and the determination of 131I dosage for another part of intermediate risk patients with non-structural or functional metastases, especially those with postoperative stimulated thyroglobulin (ps-Tg) 1-20 ng/ml. The aim of the present study is mainly to compare the 3-years disease-free survival between low-dose group (1.1 GBq) and high-dose group (3.7 GBq) in intermediate risk papillary thyroid carcinoma patients with non-structural or functional metastases and ps-Tg 1-20 ng/ml.Methods: A single-center, randomized, double-blind parallel controlled study is designed at the Zhujiang Hospital of Southern Medical University. Participants will be randomized to low-dose group (1.1 GBq) or high-dose group (3.7 GBq) in a 1:1 ratio. After orally receiving different dosage of 131I once on an empty stomach, all patients will return to our hospital every 3-12 months to be performed related inspection items. Discussion: We believe that the 3-year disease-free survival of low-dose group (1.1 GBq) may not be lower than that of high-dose group (3.7 GBq) in intermediate-risk thyroid papillary carcinoma patients with no structural or functional metastases and ps-Tg 1-20 ng/ml. Besides we expect to clarify whether there are apparent differences in successful remnant ablation, efficacy, progression-free survival, safety, and health economics evaluation between the two groups.Trial registration: ClinicalTrials.gov (https://clinicaltrials.gov/), ID: NCT04354324. Registered on 16 April, 2020.

scholarly journals Aberrant intrathyroidal lymph node metastasis in classical papillary thyroid carcinoma

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Wan Mohd Nazlee Wan Zainon ◽  
Wan Faiziah Wan Abdul Rahman ◽  
Maya Mazuwin Yahya ◽  
Nor Azwani Mat Nawi ◽  
Nurul Shamimi Suhaimi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Differentiated Thyroid Carcinoma ◽  
High Dose ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Node Metastases

Abstract Background In cases of papillary thyroid carcinoma (PTC), lymph nodes are a typical site of metastasis. Extrathyroidal tissue involvement in differentiated thyroid carcinoma causes the disease to progress and affects the patients’ treatment options. Papillary thyroid carcinoma (PTC) is the common type in differentiated thyroid carcinoma (DTC), the other type is follicular thyroid carcinoma (FTC). Ectopic sites, such as intrathyroidal lymph node invasion in classical papillary thyroid malignancy, are extremely uncommon. It can be difficult to detect an intrathyroidal lymph node (ITLN) during a histopathological test, but it is important to do so since it affects the stage of the disease and subsequent treatment. Case presentation We present the case of a 63-year-old woman who presented with multinodular goitre and underwent total thyroidectomy. She was diagnosed with aberrant intrathyroidal lymph node metastases during pathological testing, resulting in an upgrade in treatment. Owing to the exceptionally unusual ectopic position of lymph node metastasis, in this case, there is a risk of diagnostic and therapeutic misinterpretation. This patient was treated with high-dose radioactive iodine in view of lymph node metastases. Conclusions Identification of ITLN by imaging characteristics is sometimes difficult, being often an intraoperative discovery and histopathological correlation that lead to upstage the disease and alter the final management.

scholarly journals Tuberculous Lymphadenitis Mimicking Nodal Metastasis in Follicular Variant Papillary Thyroid Carcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Marc Gregory Yu ◽  
Jenny Maureen Atun
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Preoperative Evaluation ◽  
Cervical Lymphadenopathy ◽  
Developed Countries ◽  
Nodal Metastasis ◽  
Tuberculous Lymphadenitis ◽  
Papillary Thyroid ◽  
Follicular Variant

Tuberculous (TB) lymphadenitis can mimic cervical node metastasis from papillary thyroid carcinoma (PTC) since the distribution and appearance of affected lymph nodes are similar. We present the case of an asymptomatic 50-year-old Filipino who sought consult for a gradually enlarging anterior neck mass and a single palpable cervical lymph node. Preoperative workup suggested a thyroid malignancy with nodal metastasis. He underwent total thyroidectomy with node dissection where histopathology confirmed follicular variant- (FV-) PTC. Lymph node examination, however, revealed TB lymphadenitis, and the patient was given standard antimycobacterial therapy. This is the first documented case in Southeast Asia, a high TB burden region. This is also the first report involving FV-PTC, which has features between those of conventional PTC and follicular thyroid carcinoma. The case suggests that, in endemic areas, TB should be a differential in the etiology of cervical lymphadenopathy in PTC patients. In developed countries, this differential diagnosis is also valuable because of the increasing incidence of HIV and TB coinfection. Proper preoperative evaluation is important and needs to be highlighted in the formulation of local guidelines.

Factors predictive of lymph node metastasis in the follicular variant of papillary thyroid carcinoma

2013 ◽  
Vol 100 (10) ◽  
pp. 1312-1317 ◽  
Author(s):  
C. Blanchard ◽  
C. Brient ◽  
C. Volteau ◽  
F. Sebag ◽  
M. Roy ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Node Metastasis

Predictive Factors of Lymph Node Metastasis in Follicular Variant of Papillary Thyroid Carcinoma

2017 ◽  
Vol 24 (9) ◽  
pp. 2617-2623 ◽  
Author(s):  
Seo Ki Kim ◽  
Ah-Young Kwon ◽  
Kyorim Back ◽  
Inhye Park ◽  
Nayoon Hur ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Predictive Factors ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Node Metastasis

Risk factors for central neck lymph node metastases in follicular variant vs. classic papillary thyroid carcinoma

Endocrine ◽  
2018 ◽  
Vol 62 (1) ◽  
pp. 64-70 ◽  
Author(s):  
Marco Raffaelli ◽  
Carmela De Crea ◽  
Luca Sessa ◽  
Guido Fadda ◽  
Celestino Pio Lombardi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Central Neck ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Neck Lymph Node ◽  
Node Metastases ◽  
Neck Lymph Node Metastases

scholarly journals Radioactive iodine ablation may not decrease the risk of recurrence in intermediate-risk papillary thyroid carcinoma

2016 ◽  
Vol 23 (5) ◽  
pp. 367-376 ◽  
Author(s):  
Seo Ki Kim ◽  
Jung-Woo Woo ◽  
Jun Ho Lee ◽  
Inhye Park ◽  
Jun-Ho Choe ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Regional Lymph Node ◽  
Medical Center ◽  
Clinicopathological Characteristics ◽  
Cancer Center ◽  
High Dose ◽  
Intermediate Risk ◽  
Papillary Thyroid

The use of radioactive iodine (RAI) ablation in patients with intermediate-risk papillary thyroid carcinoma (PTC) who show microscopic extrathyroidal extension (ETE), regional lymph node (LN) metastasis, tumors with aggressive histology, or vascular invasion has been debated due to the lack of data regarding long-term prognosis in this risk group. Therefore, the purpose of this study was to resolve the controversy surrounding the prognostic benefit of RAI ablation, especially in intermediate-risk PTC patients. We retrospectively reviewed the medical records of 8297 intermediate-risk PTC patients who underwent primary total thyroidectomy with or without neck dissection at the Thyroid Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, between January 1997 and June 2015. Of these 8297 patients, 7483 (90.2%) received RAI ablation. After adjusting for clinicopathological characteristics, RAI ablation did not significantly decrease the risk of loco-regional recurrence (LRR) (adjusted hazard ratio (HR) 0.852, P 0.413). Moreover, RAI ablation did not decrease the risk of LRR even in intermediate-risk PTC patients with aggressive features such as BRAF positivity (adjusted HR 0.729, P 0.137), tumor size >1 cm (adjusted HR 0.762, P 0.228), multifocality (adjusted HR 1.032, P 0.926), ETE (adjusted HR 0.870, P 0.541), and regional LN metastasis (adjusted HR 0.804, P 0.349). Furthermore, high-dose RAI ablation (>100 mCi) did not significantly decrease the risk of LRR (adjusted HR 0.942, P 0.843). Therefore, RAI ablation in intermediate-risk PTC patients should be considered on the basis of tailored risk restratification.

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