scholarly journals SUN-LB76 Euthyroid Ophthalmopathy in Coexistence With Differential Thyroid Carcinoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Dioni Garate ◽  
Adriana Villarreal ◽  
Gisella Alfaro ◽  
Elizabeth Salsavilca ◽  
Erika Chiu
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Thyroid Function ◽  
Autoimmune Disorder ◽  
Differentiated Thyroid Carcinoma ◽  
Upper Eyelid ◽  
Normal Thyroid Function ◽  
Normal Ranges ◽  
Relationship Of ◽  
Orbital Fibroblasts

Abstract Introduction: Thyroid ophthalmopathy (TAO) is a rare autoimmune disorder in euthyroid patients; less frequent in those with negative autoantibodies and thyroid cancer. TSH-R stimulating antibodies bind to said receptor in orbital fibroblasts, producing the secretion of cytokines, hyaluronic acid and adipogenesis that contribute to TAO1. Clinical case: 54-year-old woman has had orbital alterations compatible with TAO for four years, CAS score 2/7-Eugogo Mild, studies of thyroid function and TSI/AbTPO/AbTg antibodies in normal ranges; therefore, she received oral corticotherapy and subtenonial corticosteroid injections. She was subsequently evaluated in Endocrinology, where goiter was found. Thyroid ultrasound showed hypoechogenic left thyroid nodule (14 mm), FNA: Bethesda VI and Pathological anatomy: Papillary thyroid carcinoma. She received ablative therapy with I-131 (30 mCi). Currently with excellent response. During follow-up, ophthalmologic evaluation showed: CAS score 0/10 and VISA score 0/10. Presents palpebral retraction, corneal erosions and PIO elevation. In Tomography: increase in volume of the lacrimal glands and extraocular muscles predominantly in the upper and medial rectum, as well as a thickening of the upper eyelid lift muscle, with greater involvement in the left orbit. These findings are compatible with inactive TAO with an expansive “white eye” phenotype, generally with a lower risk of compressive neuropathy.Discussion: In addition to normal thyroid function and mild TAO, the patient has the characteristic of presenting negative antibodies. Associated with TSH-R, factors such as IGF-1 can be found in the pathogenesis of TAO, which can generate a similar effect1. Likewise, IGF-1 stimulates cell proliferation, and is related to neoplasms such as thyroid carcinoma2. Conclusions Differentiated thyroid carcinoma should be ruled out in all patients with TAO, whether euthyroid or not. Studies confirming the relationship of IGF-1, TAO and thyroid carcinoma are necessary. References: 1. Yu et al. Thyroid-associated orbitopathy in patients with thyroid carcinoma A case report of 5 case. Medicine (2017) 2. Manzella et al Activation of the IGF Axis in Thyroid Cancer: Implications for Tumorigenesis and Treatment. International Journal of Molecular Sciences, (2019). 20 (13), 3258.

scholarly journals Research on Clinical, Subclinical Characteristic of Incidental Thyroid Nodules

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A870-A870
Author(s):  
Bay Quang Nguyen
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Thyroid Function Tests ◽  
Cross Sectional ◽  
Normal Thyroid ◽  
Normal Thyroid Function

Abstract Background: Incidental thyroid nodules has become more prevalent in recent years due to applying diagnostic imaging tests. Many studies show that the rate of thyroid cancer in this group of patients is relatively high. Objective: To assess patients with incidentally detected thyroid nodules, including those who were diagnosed with thyroid cancer. Materials and Methods: A cross-sectional study, which involved 208 patients with 389 thyroid nodules detected by thyroid ultrasound. All patients have thyroid function tests. 272 nodules were performed fine-needle aspiration. Patients with thyroid cancer were assessed histopathology after removal. Results: The participants’ mean age was 47.22 ± 12.02. The female / male ratio is 6.7/1. No patients had history of head and neck irradiation or living in epidemiological areas with high prevalence of goiter. TSH level: 96.2% normal, 2.4% low, 1.4% high. In thyroid cancer group: 100% of patients had normal thyroid function. Nodule characteristics on ultrasound: Majority of thyroid nodules had diameters less than 1.5 cm (85.6%), multi-nodularity(52.9%). The largest carcinoma nodule was 2.35 cm, 22.2% of patients with thyroid cancer had ≥ 3 nodules. The malignancy rate of TIRADS 5 was 70.6%. FNA results of 272 thyroid nodules: the majority were Bethesda II (74,2%); the incidence of carcinoma (Bethesda V, VI) is 17.4%. 36 patients account for 17,3%, with 42 nodules were performed surgery, the results of histopathology were 100% of papillary thyroid carcinoma, which was consistent with cytological results. Conclusion: Thyroid nodules are common in women patients at the age of 31-60 with normal thyroid function. Most of them are <1.5 cm in size. There are 17.3% of patients were thyroid carcinoma.

scholarly journals Brain Metastases From Differentiated Thyroid Carcinoma: Prevalence, Current Therapies, and Outcomes

2018 ◽  
Vol 3 (2) ◽  
pp. 359-371 ◽  
Author(s):  
Cristiane J Gomes-Lima ◽  
Di Wu ◽  
Sarika N Rao ◽  
Sree Punukollu ◽  
Rama Hritani ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Brain Metastases ◽  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Differentiated Thyroid Carcinoma ◽  
Unusual Site ◽  
Current Therapies ◽  
The Brain

Abstract Background and Objective The brain is an unusual site for distant metastases of differentiated thyroid carcinoma (DTC). The aim of this study was to document the prevalence of brain metastases from DTC at our institutions and to analyze the current therapies and the outcomes of these patients. Methods We performed a retrospective chart review of patients with DTC and secondary neoplasia of the brain. Results From 2002 to 2016, 9514 cases of thyroid cancer were evaluated across our institutions and 24 patients met our inclusion criteria, corresponding to a prevalence of 0.3% of patients with DTC. Fourteen (58.3%) were female and 10 (41.7%) were male. Fifteen patients had papillary thyroid cancer (PTC) (62.5%). Brain metastases were diagnosed 0 to 37 years (mean ± SD, 10.6 ± 10.4 years) after the initial diagnosis of thyroid cancer. Patients undergoing surgery had a median survival time longer than those that did not undergo surgery (27.3 months vs 6.8 months; P = 0.15). Patients who underwent stereotactic radiosurgery (SRS) had a median survival time longer than those that did not receive SRS (52.5 months vs 6.7 months; P = 0.11). Twelve patients (50%) were treated with tyrosine kinase inhibitors (TKIs), and they had a better survival than those who have not used a TKI (median survival time, 27.2 months vs 4.7 months; P < 0.05). Conclusion The prevalence of brain metastases of DTC in our institutions was 0.3% over 15 years. The median survival time after diagnosis of brain metastases was 19 months. In our study population, the use of TKI improved the survival rates.

scholarly journals Lenvatinib Administered via Nasogastric Tube in Poorly Differentiated Thyroid Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Eleonora Molinaro ◽  
David Viola ◽  
Nicola Viola ◽  
Pierpaolo Falcetta ◽  
Francesca Orsolini ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Gastric Tube ◽  
Kinase Inhibitors ◽  
Locally Advanced ◽  
Differentiated Thyroid Carcinoma ◽  
Cervical Esophagus ◽  
Extrinsic Compression ◽  
Poorly Differentiated ◽  
Iodine 131

Background. The tyrosine kinase inhibitors (TKIs) are indicated for the treatment of locally advanced or metastatic progressive thyroid carcinoma (CDT), refractory to radioactive iodine. The following report describes the efficacy of lenvatinib administered through a nose-gastric tube (SNG) in a patient affected with a poorly differentiated thyroid carcinoma (PDTC) which determined a stenosis of the esophagus. Material and Methods. A patient was followed up for papillary thyroid carcinoma follicular variant (T3NxMx), subjected to total thyroidectomy and treated with iodine-131 radio metabolic therapy. Two years after surgery, following the onset of dysphonia and dysphagia, patient was submitted to a computed tomography (CT) scan of the neck that showed the presence of a lesion of 6 × 2.5 × 3.5 cm, which determined trachea deviation and cervical esophagus compression. The biopsy indicated the presence of PDTC, triggering tracheal lumen reduction and sub-stenosis of the cervical esophagus for an ab-extrinsic compression. A nose-gastric tube (SNG) was placed and lenvatinib was started at a dose of 20 mg/day, administered via this probe after opening the capsules and diluting the drug in 10 ml of saline solution. Results. One month later, CT showed a significant cervical lesion reduction. Bronchoscopy confirmed tracheal infiltration, but the residual caliber was improved from 50% to 75%. At the esophagogastroduodenoscopy (EGDS), the sub stenosis of the cervical esophagus was no longer appreciated; however, a double perforation of the esophagus was found, without fistula. Conclusion. Lenvatinib therapy is effective also when administered via SNG. Our result is of particular relevance in the management of thyroid cancer patients, especially in the presence of subjects unable to swallow. Further studies are needed to validate the administration of lenvatinib by SNG, in order to extend the indications to this alternative administration way, beside the oral one.

scholarly journals Analysis of the efficacy and toxicity of sorafenib in thyroid cancer: a phase II study in a UK based population

2011 ◽  
Vol 165 (2) ◽  
pp. 315-322 ◽  
Author(s):  
Merina Ahmed ◽  
Yolanda Barbachano ◽  
Angela Riddell ◽  
Jen Hickey ◽  
Katie L Newbold ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Differentiated Thyroid Carcinoma ◽  
Free Survival ◽  
Hand Foot Syndrome ◽  
Secondary Endpoints ◽  
Radiological Response ◽  
Dose Reductions

AimTo evaluate the tolerability and efficacy of sorafenib in patients with thyroid carcinoma.MethodsPatients with progressive locally advanced/metastatic medullary thyroid carcinoma (MTC), or differentiated thyroid carcinoma (DTC) with non-radioiodine-avid disease, were treated with sorafenib 400 mg twice daily until disease progression. The primary endpoint was the radiological response rate (RR) at 6 months. Secondary endpoints were RR at 3, 9 and 12 months, biochemical responses, toxicity, biomarker analyses and progression free and overall survival (OS).ResultsA total of 34 patients were recruited to the study (15 medullary and 19 differentiated). After 6 months, the RR rate was 15% and a further 74% of patients achieved stable disease in the first 6 months. After 12 months of treatment, the RR was 21%. In the MTC patients, the RR at 12 months was 25% and OS was 100%. In DTC patients corresponding rates were 18 and 79% respectively. Median overall and progression-free survival points were not reached at 19 months. Commonest adverse events included hand–foot syndrome, other skin toxicities, diarrhoea and alopecia. Dose reduction was required in 79% patients. Median time on treatment was 16.5 months.ConclusionThis study demonstrates that sorafenib is tolerable at reduced doses over prolonged periods of time in patients with thyroid cancer. Sorafenib leads to radiological and biochemical stabilisation of disease in the majority of these patients despite dose reductions.

scholarly journals The relationship of thyroid cancer with dominant nodule in patients with nodular goiter who underwent total thyroidectomy and had thyroid carcinoma

2013 ◽  
Vol 28 (4) ◽  
pp. 182-185
Author(s):  
Koray Arisoy ◽  
Ferda Nihat Koksoy ◽  
Dogan Gonullu ◽  
Aysenur Ayyildiz Igdem ◽  
Bekir Kuru
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Nodular Goiter ◽  
Relationship Of ◽  
The Relationship

scholarly journals Chronic lymphocytic thyroiditis is associated with invasive characteristics of differentiated thyroid carcinoma in children and adolescents

2015 ◽  
Vol 173 (6) ◽  
pp. 827-833 ◽  
Author(s):  
Paschalia K Iliadou ◽  
Grigoris Effraimidis ◽  
Michalakis Konstantinos ◽  
Panagiotou Grigorios ◽  
Periklis Mitsakis ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Children And Adolescents ◽  
Differentiated Thyroid Carcinoma ◽  
Chronic Lymphocytic Thyroiditis ◽  
Long Term Outcome ◽  
Lymphocytic Thyroiditis ◽  
History Of ◽  
Histological Characteristics ◽  
Thyroid Parenchyma

BackgroundThe association between chronic lymphocytic thyroiditis (CLT) and thyroid cancer is an interesting topic. The aim of the present study was to evaluate if demographic and histological characteristics as well as the long-term outcome of thyroid cancer was different in children and adolescents with and without CLT.MethodsThe medical records of children and adolescents (≤21 years old) were reviewed. The following data were recorded: gender, year and age at diagnosis, family history of thyroid cancer, history of external radiation therapy, histological type (papillary and variants, follicular and variants), tumour size, multifocality, infiltration of thyroid parenchyma or surrounding soft tissues, vascular invasion, presence of lymph node and distant metastases. Information about the presence of TgAb and TPOAb was also collected.ResultsOne hundred eight children and adolescents (median age 19.0, interquartile range 4.0 years) were diagnosed with differentiated thyroid carcinoma (DTC); 31 patients (28.7%) presented histological characteristics compatible with CLT. Infiltration of thyroid parenchyma was more frequent in patients with CLT compared to patients without (74.2% vs 48.1% respectively, P=0.024). Familial papillary thyroid carcinoma (PTC) was more frequent in patients with CLT compared to those without CLT (20.7% vs 2.8% respectively, P=0.009). There was no better outcome with respect to the presence of CLT or not.ConclusionsChildren and adolescents with CLT present more frequently familial PTC as well as thyroid cancer with invasive characteristics.

Conservative surgical management of invasive differentiated thyroid cancer

1985 ◽  
Vol 99 (12) ◽  
pp. 1255-1260 ◽  
Author(s):  
Y. Shvili ◽  
Y. Zohar ◽  
N. Buller ◽  
N. Laurian
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Surgical Management ◽  
Upper Airway ◽  
Differentiated Thyroid Carcinoma ◽  
Tracheal Resection ◽  
Low Grade ◽  
Tracheal Defect ◽  
Airway Invasion ◽  
Well Differentiated

AbstractThe majority of well differentiated thyroid carcinoma are tumours of low grade malignancy. Laryngotracheal invasion by well differentiated thyroid carcinoma is an uncommon occurrence. The surgical management of patients with thyroid cancer invading the upper airway has primarily been by total laryngectomy. Other surgeons recommend in selected cases partial laryngeal and/or tracheal resection.A total of 122 patients with thyroid carcinoma were treated in our department between 1967 and 1982. Only seven patients with well differentiated tumours had airway invasion. In these seven patients we used a partial laryngeal and/or tracheal resection. In three of the patients with tracheal invasion a myoperichondrial flap was used for closing the tracheal defect. A partial resection of the larynx and trachea, and end to end anastomosis between the trachea and the remaining part of the larynx was performed in another four patients.

scholarly journals Lymph Node Thyroglobulin Measurement in Diagnosis of Neck Metastases of Differentiated Thyroid Carcinoma

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Luca Giovanella ◽  
Luca Ceriani ◽  
Sergio Suriano
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Receiver Operating Curve ◽  
Cervical Lymph Nodes ◽  
Receiver Operating Curve Analysis ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Aim. Enlarged cervical lymph nodes (LNs) in patients with thyroid cancer are usually assessed by fine-needle aspiration cytology (FNAC). Thyroglobulin (Tg) is frequently elevated in malignant FNAC needle wash specimens (FNAC-Tg). The objectives of the study were to (1) determine an appropriate diagnostic cut-off for FNAC-Tg levels (2) compare FNAC and FNAC-Tg results in a group of 108 patients affected by differentiated thyroid carcinoma (DTC).Methods. A total of 126 consecutive FNACs were performed on enlarged LNs and the final diagnosis was confirmed by surgical pathology examination or clinical follow-up. The best FNAC-Tg cut-off level was selected by receiver operating curve analysis, and diagnostic performances of FNAC and FNAC-Tg were compared.Results. The rate of FNAC samples adequate for cytological examination was 77% in contrast FNAC-Tg available in 100% of aspirates (). The sensitivity, specificity, and accuracy of FNAC were 71%, 80%, 74%, 100%, 80%, and 94%, respectively. The most appropriate cut-off value for the diagnosis of thyroid cancer metastatic LN was 1.1 ng/mL (sensitivity 100%, specificity 100%).Conclusions. The diagnostic performance of needle washout FNAC-Tg measurement with a cut-off of 1.1 ng/mL compared favorably with cytology in detecting DTC node metastases.

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