Characteristics and Difficulties in the Management of Thyroid Microcarcinoma in Algeri

Abstract Introduction: Thyroid cancer prevalence has increased significantly in recent years, including in Algeria, which primarily concerned microcarcinoma making 30 to 50% of new diagnosed cases. Despite its good prognosis, its management remains highly controversial and debated. We aim to describe characteristics of thyroid microcarcinoma in a series from eastern Algeria monitored in the endocrinology department of Constantine University Hospital and to report the difficulties pertaining to its management. Patients and Methods: A descriptive retrospective study including patients followed and monitored in the thyroid cancer register in the endocrinology department of Constantine University Hospital during the period between January 2015 and December 2018. Results: Of 70 cases of thyroid microcarcinomas, mean age was 44 years [17-84 years] and 94% were women. 94% of the cases were papillary micro carcinomas; the two most frequent variants were the classic papillary and the vesicular variant of papillary carcinoma in 80% of cases. The diagnosis was made following a multi-nodular goiter exploration in 60% and thyroid function was normal in 50%. Moltifocality and bilaterality were reported in 27% and 5.71% of cases respectively. The most common surgical procedure was total thyroidectomy (96%), without lymph node dissection (86%). Classification of the initial risk was impossible due to the insufficient data in 28% of cases. 52% of patients received RAI therapy and 81% were in complete remission. Conclusion: Thyroid micro carcinoma has a good prognosis; however, its management faces several issues, mainly the stratification of risk which would be a source of overtreatment.

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Collision tumor of the thyroid – a challenge during the COVID-19 pandemic

Archive of Clinical Cases ◽

10.22551/2021.33.0804.10189 ◽

2021 ◽

Vol 8 (4) ◽

pp. 64-71

Author(s):

Mihaela Vlad ◽

◽

Ana Corlan ◽

Melania Balas ◽

◽

...

Keyword(s):

Thyroid Cancer ◽

Multinodular Goiter ◽

Nodular Goiter ◽

Anaplastic Thyroid Cancer ◽

Collision Tumor ◽

Left Lobe ◽

Thyroid Microcarcinoma ◽

Neoplastic Lesion ◽

Cervical Swelling ◽

The Right

Some of the patients with anaplastic thyroid carcinomas have a coexistent differentiated thyroid cancer, sustaining the hypothesis that this cancer may develop from more differentiated tumors. We describe a case with a collision tumor of the thyroid, defined as a neoplastic lesion composed of two distinct cell populations, with distinct borders. The patient presented during the COVID-19 pandemic with dysphonia, dyspnea, multinodular goiter and a painless, rapidly enlarging, left cervical swelling. She had been first time diagnosed with left nodular goiter in 2007, with an indication for surgery, which she declined. After partial excision of the left latero-cervical adenopathy, the pathological analysis showed massive lymph node metastasis from anaplastic thyroid cancer. A total thyroidectomy was done; the postoperative pathological exam identified a papillary thyroid microcarcinoma in the right lobe and an anaplastic thyroid cancer in the left lobe. Postoperatively, levothyroxine treatment was started and the patient was referred to radiotherapy. This case highlights the importance of urgent management of some cases with compressive multinodular goiter, even during the COVID-19 pandemic.

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Differentiated thyroid microcarcinoma − current perspective

Perspectives in Surgery ◽

10.33699/pis.2020.99.11.497-501 ◽

2020 ◽

Vol 99 (11) ◽

Keyword(s):

Overall Survival ◽

Thyroid Cancer ◽

Thyroid Gland ◽

Retrospective Analysis ◽

Differentiated Thyroid Cancer ◽

Good Prognosis ◽

Wilcoxon Test ◽

Nodal Involvement ◽

Thyroid Microcarcinoma ◽

Current Perspective

Introduction: Differentiated thyroid cancer (DTC) has a good prognosis and low mortality despite its growing incidence, which is particularly the case of microcarcinomas (T1a – up to 10 mm). Methods: Retrospective analysis of overall survival of patients in the group of thyroid gland surgeries for differentiated forms of microcarcinoma in the period of 2006–2015 up to the present. An overview of contemporary therapeutic methods is included. Results: Thyroid cancer was detected in 144 cases out of the total of 1820 patients with thyreopathy undergoing surgery (8%); DTC microcarcinoma was detected in 65 cases (45.1%) of all carcinomas. The papillary form was diagnosed in 59 cases (51.8% of all papillary cases), and the follicular form was found in 6 cases (37.5% of all follicular cases). Two cases of Hürthle cells cancer were found, both in a stage higher than T1. Overall 10-year survival of carcinomas >T1 was 86%, reaching 90% in the microcarcinoma group (Gehan Wilcoxon test: p=0.10675). Conclusion: Differentiated microcarcinoma shows a very good overall survival. Provided that other criteria are satisfied, particularly unifocal occurrence without spreading through the gland casing and without any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.

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The Accuracy of ACR TI-RADS Classification of Neck Ultrasound as a First-Line Diagnostic Approach for Thyroid Neoplasms in Pediatric Patients: A Retrospective Study

Oncopediatrics ◽

10.15690/onco.v5i1.1862 ◽

2018 ◽

Vol 5 (1) ◽

pp. 13-23

Author(s):

Nikolai S. Grachev ◽

Elena V. Feoktistova ◽

Igor N. Vorozhtsov ◽

Natalia V. Babaskina ◽

Ekaterina Yu. Iaremenko ◽

...

Keyword(s):

Thyroid Cancer ◽

Predictive Value ◽

Thyroid Nodules ◽

Pediatric Patients ◽

Thyroid Neoplasms ◽

Diagnostic Methods ◽

Diagnostic Approach ◽

First Line ◽

Neck Ultrasound

Background.Ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) is the gold standard in diagnosing the pathological nature of undetermined thyroid nodules. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis.Objective.Our aim was to evaluate the effectiveness of ACR TI-RADS classification of neck ultrasound as a first-line diagnostic approach for thyroid neoplasms in pediatric patients.Methods.A retrospective analysis was made of FNA and US protocols in 70 patients who underwent the examination and treatment at Dmitry Rogachev National Research Center between January 2012 and August 2017. In the retrospective series 70% (49/70) of patients undergone FNA and 43% (30/70) of them undergone repeated FNA. All US protocols were interpreted according to ACR TI-RADS system by the two independent experts. The clinical judgment was assessed using the concordance test and the reliability of preoperative diagnostic methods was analized.Results.According to histologic examination protocols, benign nodules reported greater multimorbidity 29% (20/70), compared with thyroid cancer 17% (12/70), complicating FNA procedure. A statistically significant predictor of thyroid cancer with a tumor size ACR TI-RADS showed a significant advantage of ACR TI-RADS due to higher sensitivity (97.6 vs 60%), specificity (78.6 vs 53.8%), positive predictive value (87.2 vs 71.4%), and negative predictive value (95.7 vs 41.2%). Concordance on the interpreted US protocols according to ACR TI-RADS classification between two experts was high, excluding accidental coincidence.Conclusion.The data support the feasibility of US corresponding to the ACR TI-RADS classification as a first-line diagnostic approach for thyroid neoplasm reducing the number of unnecessary biopsies for thyroid nodules.

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On the Classification of TI-RADS and Stratification of Signs of Thyroid Cancer According to Ultrasound Data

Medical Visualization ◽

10.24835/1607-0763-2017-5-29-38 ◽

2017 ◽

pp. 29-38 ◽

Cited By ~ 1

Author(s):

E. P. Fisenko ◽

J. P. Sich ◽

N. N. Vetsheva

Keyword(s):

Thyroid Cancer ◽

Retrospective Analysis ◽

Thyroid Nodules ◽

Thyroid Ultrasound ◽

High Reproducibility ◽

System 1

Objective:a comparative “blind” assessment of the thyroid nodules identified by ultrasound, according to the TI-RADS scale in various modifications.Materials and methods.Retrospective analysis of 149 echograms of thyroid nodules by three independent experts was performed (the experience of ultrasound of thyroid ultrasound for more than 7 years).Results. In solid nodules, high-specific large (more than 94%) and small (more than 90%) ultrasound signs of thyroid cancer have been identified. The nodes are stratified according to the TI-RADS system: 1 – in the modification J.Y. Kwak et al. (2011), 2 – according to the proposed system, taking into account small ultrasound signs of thyroid cancer. High reproducibility of both systems are obtained. In the first system 13.7% of cancer nodes fell into the category of TI- RADS 3 (benign formations), in the second system only 5% of cancers fell into the category of TI-RADS 3, which is important for biopsy selection. The sensitivity of the first system was TI-RADS 82.05%, of the second system – 94.87%.Conclusions.Classification of TI-RADS can be used to interpret the ultrasound results of thyroid nodules, taking into account both the main large and small ultrasound signs of cancer. For its validation in our country, it is necessary to further broad discussion of the proposed TI-RADS system.

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STUDY ON CLINICAL CHARACTERISTICS AND RESULT OF TREATMENT BENIGN VOCAL CORD TUMOR WITH RIGID LARYNGEAL ENDOSCOPIC SURGERY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.2.8 ◽

2012 ◽

pp. 58-65

Author(s):

Duy Thai Truong ◽

Van Dung Phan ◽

Tu The Nguyen

Keyword(s):

Vocal Cord ◽

Endoscopic Surgery ◽

Clinical Characteristics ◽

University Hospital ◽

High Rate ◽

Treatment Rate ◽

Reinke’S Edema ◽

Vocal Nodules ◽

A Prospective Study

Objective: Study on clinical characteristics and result of treatment benign vocal cord tumor with suspensive laryngeal endoscopic surgery. Materials and Methods: A prospective study was undertaken in 43 patients who had benign vocal cord tumor and performed a suspensive laryngeal endoscopic surgery at ENT Dept. of Hue University Hospital, from 3/2010 to 5/2011. Results: The most common was group was 31 - 45 (44.2%). There was no difference of gender. Moderate hoarness was 67.4%. Classification of benign laryngeal tumor: vocal nodules (13 cases), vocal cyst (18 cases), vocal polyp (10 cases) and Reinke’s edema (2 cases). The successful treatment rate of vocal benign tumor was 88.4%. Conclusions: Suspensive laryngeal endoscopic surgery was the best method to cure benign vocal cord tumor. The surgeon had a clear operative field, easy manoeuver, high rate of cure and less complication.

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CLINICAL AND PARA-CLINICAL CHARACTERISTICS OF SICK NEWBORN BABIES TREATED AT PEDIATRIC DEPARTMENT OF HUE UNIVERSITY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.2.15 ◽

2011 ◽

pp. 112-117

Author(s):

Thi Kieu Nhi Nguyen

Keyword(s):

Respiratory Distress ◽

Congenital Malformation ◽

Clinical Characteristics ◽

Descriptive Study ◽

Neonatal Unit ◽

University Hospital ◽

Pediatric Department ◽

Sick Newborn ◽

Observational Descriptive Study

Objectives: 1. Describe neonatal classification of WHO. 2. Identify some principal clinical and paraclinical signs of term, preterm, post term babies. Patients and method: an observational descriptive study of 233 newborns hospitalized in neonatal unit at Hue university‘ s hospital was done during 12 months from 01/01/2009 to 31/12/2009 for describing neonatal classification and identifying principal clinical and paraclinical signs. Results: Premature (16.74%); Term babies (45.5%); Post term (37.76%); Premature: asphyxia (43.59%), hypothermia (25.64%), vomit (30.77%), jaundice (61.54%), congenital malformation (17.95%); CRP > 10mg/l (53.85%); anemia Hb < 15g/dl (12.82%). Term babies: poor feeding (21.7%); fever (24.53%); CRP > 10mg/l (53.77%); Hyperleucocytes/ Leucopenia (35.85%). Post term: respiratory distress (34%); lethargy (29.55%); vomit (26.14%); polycuthemia (1.14%); hypoglycemia (22.73%). Conclusion: each of neonatal type classified by WHO presente different clinical and paraclinical. Signs. The purpose of this research is to help to treat neonatal pathology more effectively.

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STUDY OF HISTOPATHOLOGY IN PATIENTS WITH HODGKIN AND NON - HODGKIN LYMPHOMA

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.3.9 ◽

2016 ◽

pp. 59-65 ◽

Cited By ~ 1

Author(s):

Van Mao Nguyen

Keyword(s):

Lymph Node ◽

Hodgkin Lymphoma ◽

Cross Sectional Study ◽

University Hospital ◽

Cross Sectional ◽

Histopathological Classification ◽

Non Hodgkin Lymphoma ◽

Key Words Lymphoma ◽

Malignant Grade

Background: Lymphoma is one of the most ten common cancers in the world as well as in Vietnam which has been ever increasing. It was divided into 2 main groups Hodgkin and non – Hodgkin lymphoma in which non-Hodgkin lymphoma appeared more frequency, worse prognosis and different therapy. Objectives: - To describe some common characteristics in patients with non – Hodgkin lymphoma; - To determine the proportion between Hodgkin and non- Hodgkin lymphoma, histopathological classification of classical Hodgkin by modified Rye 1966 and non-Hodgkin lymphoma by Working Formulation (WF) of US national oncology institute 1982. Materials and Method: This cross-sectional study was conducted on 65 patients with Hodgkin and non- Hodgkin lymphoma diagnosed definitely by histopathology at Hue Central Hospital and Hue University Hospital. Results:. The ratio of male/female for the non-Hodgkin lymphoma was 1.14/1, the most frequent range of age was 51-60 accounting for 35%, not common under 40 years. Non - Hodgkin lymphoma appeared at lymph node was the most common (51.7%), at the extranodal site was rather high 48.3%. The non - Hodgkin lymphoma proportion was predominant 92.3% comparing to the Hodgkin lymphoma only 7.7%; The most WF type was WF7 (53.3%), following the WF6 18,3% and WF5 11,7%; The intermediate malignancy grade of non- Hodgkin lymphoma was the highest proportion accouting for 85%, then the low and the high one 8.3% and 6.7% respectively. Conclusion: The histopathological classification and the malignant grade of lymphoma for Hodgkin and non - Hodgkin lymphoma played a practical role for the prognosis and the treatment orientation, also a fundamental one for the modern classification of non - Hodgkin lymphoma nowadays. Key words: lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, classication, grade, histopathology, lymph node

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THE USE OF MEDICINES IN TREATING HYPERTENSION IN HUE UNIVERSITY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.2.11 ◽

2016 ◽

pp. 76-84

Author(s):

Khoa Bao Chau Thai ◽

Thi Hong Phuong Vo

Keyword(s):

Blood Pressure ◽

Channel Blocker ◽

Enzyme Inhibitor ◽

Antihypertensive Drugs ◽

Good Prognosis ◽

Target Blood Pressure ◽

University Hospital ◽

Key Words Hypertension ◽

Cross Sectional ◽

Positive Effects

Background: Hypertension is a common condition in the world as well as in Viet Nam. If hypertension isn’t treated well, it can cause many serious complications. Controlling target blood pressure will bring positive effects on reducing mortality rate and also disabilities caused by diseases related to hypertension. Objectives: (1) Analyzing the use of medicines in treating hypertension. (2) Evaluating the effects of medicine usage in treating hypertension at the hospital of Hue University of Medicine and Pharmacy. Materials and methods: 388 patients were diagnosed as having hypertension with inpatient care at the Cardiovascular Department of Hue University of Medicine and Pharmacy’s hospital, using cross-sectional descriptive study methods. Results: All antihypertensive drugs in the research were contained in the antihypertensive list recommended by Vietnamese Society of Cardiology. Angiotensin converting enzyme inhibitor and calcium channel blocker were the two most popular drug groups (96.6% and 71.4%, respectively). The rate of using multi-therapy regimens was higher than the rate of using uni-therapy regimens in both initial therapies (64.7%>35.3%) and final therapies (61.9%>38.1%). The rate of patients having interactions between antihypertensive drugs and the other kinds of drugs was 7.5%. The rate of patients having reasonable prescriptions was 84.3%. Evaluating the effects of medicine usage in treatments showed that the rate of patients reaching target blood pressure before leaving the hospital was 67.3%. Most patients were evaluated as having good prognosis after treatment, up to 81.7%. Conclusions: All antihypertensive drugs in the research were contained in the antihypertensive list recommended by Vietnamese Society of Cardiology. The rate of using multi-therapy regimens was higher than the rate of using uni-therapy regimens. The rate of drug interactions was quite low; most patients were evaluated as having good prognosis after treatment. Key words: hypertension, antihypertensive drugs.

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GCT-10. CAN HIGH LEVEL SERUM hCG-β BE CONSIDERED EQUIVALENT TO A DIAGNOSIS OF CHORIOCARCINOMA IN PRIMARY CENTRAL NERVOUS SYSTEM GERM-CELL TUMOR?

Neuro-Oncology ◽

10.1093/neuonc/noaa222.231 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii329-iii330

Author(s):

Hiroaki Motegi ◽

Shigeru Yamaguchi ◽

Yukitomo Ishi ◽

Michinari Okamoto ◽

Akihiro Iguchi ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Germ Cell ◽

Germ Cell Tumor ◽

Good Prognosis ◽

Cell Tumor ◽

University Hospital ◽

Kaplan Meier ◽

Beta Human Chorionic Gonadotropin ◽

High Level

Abstract BACKGROUND Primary central nervous system(CNS) choriocarcinoma(CC) is very rare and has the poorest prognosis among germ cell tumor (GCT). CC usually has extremely high level (HL) of serum beta-human chorionic gonadotropin (bhCG) over than 1,000 mIU/ml. Some studies assign HL bhCG cases to poor prognosis group even without biopsy. The purpose of this study was to find out if there was a good prognosis subset in the HL bh group. MATERIALS AND METHODS We analyzed 103 cases diagnosed with GCT from 1998 to 2019 in Hokkaido University Hospital and reviewed the literature of CNS CC and bhCG. Survival was assessed using Kaplan-Meier method and log-rank statistics between the group with CC component and that with no CC component but HL bhCG. RESULTS One out of 103 our cases was diagnosed as a mixed GCT with CC component and did not respond to treatment and died 9 months later. Two cases were treated as CC because of HL bhCG (1,226 and 2,739 mIU/ml) despite that the biopsy showed only germinomas and survived(105 and 37 months), that is, no CC component. Combining our cases with 69 cases in the literature, all 7 cases with no CC component but HL bhCG survived but the median survival of the other 65 cases with CC component was 38.2 months (P=0.02). CONCLUSION This study has a limitation of selection bias, however, it suggests that patients with no CC component but HL bhCG may have a better prognosis.

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