Regrowth of Thyroid Gland: Is This Possible????

Abstract Introduction: Adult Thyroid gland which derived from primitive pharynx and neural crest is considered a non-regenerative organ. In this nature, partial or total thyroidectomy is considered a curative treatment for compressive non-malignant goiter. While there is a potential regrowth from stimulating by pituitary thyroid stimulating hormone (TSH), such growth is rarely significant and suppressive TSH therapy is currently indicated only for thyroid malignancy. We present an unusual case of rapid regrowth of normal thyroid tissue that expanded both of the lobes from a single unilateral remnant. Case: 58-year-old male with prior history of multinodular goiter status post subtotal thyroidectomy due to compressive symptoms in 2006 present to our clinic for follow up. Post-operatively, case was complicated with Iatrogenic Hypoparathyroidism thus on replacement of calcium and calcitriol. Follow up neck ultrasound (US), showed no thyroid gland with minimal residual tissue in the right fossa and pathology was benign. In 2011, patient complained of new onset globus sensation, and voice changes which initially concern for gastroenterology issue as the etiology. A neck US unexpectedly revealed normal right thyroid lobe of 5.7 cm without any tissue on the left and no nodule. FNA subsequently performed which was benign tissue. Due to high risk of complication for repeat surgery, annual US was planned for monitoring. In 2013 there was a significant new growth of left thyroid of 1.7 cm in size, no nodules. A repeat US six months later revealed an increase in size in the right from 5.7 to 6.1 cm as well as 1.7 to 2.1cm on the left. Patient denied any compressive symptoms, so we continue with neck US surveillance. By 2020, the right lobe was 6.4 cm and left lobe at 2.4 cm. Within both lobes, now multiple nodules start appearing. FNA were performed on several of those nodules with a benign cytopathology in all of them. Of note, other than regrowth of his thyroid, it is also physiologically functional as patient is euthyroid without levothyroxine replacement since 2013. Discussion: When patient underwent thyroidectomy for benign multinodular goiter, thyroid function test is the only routine test for follow up without additional further images. While it is considered a curative treatment, some regeneration or recurrence is still a possibility which is shown in our case. This is one of the few cases in the literature that we could found about normal thyroid tissue regrowth. It is still unclear how the mechanism for this phenomenon occurs. Further studies may need to be pursued with regards to suppressive TSH therapy or even radioactive iodine ablation for benign goiter that have regrowth potential. It is crucial that physicians become aware of such occurrence may happen since new thyroid nodules can also develop in the new thyroid tissue and fine needle aspiration should be performed accordingly.

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Certain peculiarities of parenchymal-stromal correlations in the thyroid gland with nodular forms of goiter with its rucurrent and non-recurrent course

Clinical anatomy and operative surgery ◽

10.24061/1727-0847.19.1.2020.9 ◽

2020 ◽

Vol 19 (1) ◽

pp. 53-60

Author(s):

N. P. Tkachuk ◽

I. S. Davydenko

Keyword(s):

Thyroid Gland ◽

Slow Growth ◽

Thyroid Tissue ◽

Nodular Goiter ◽

Specific Weight ◽

Pathological Changes ◽

Normal Thyroid Tissue ◽

Normal Thyroid ◽

Stromal Component ◽

Correlation Parameters

In spite of a considerable efficacy of conservative treatment of goiter, surgery remains the main method of treatment of such patients. Though, on the one hand, total thyroidectomy inevitably results in the development of postsurgical hypothyroidism, on the other hand – in case organ-saving surgery is performed the risk of postsurgical relapse arises. Modern morphological methods are directed to detection of oncological risk of nodular formations, and recommendations concerning an adequate volume of surgery taking into account probability of relapse are practically lacking. Therefore, the objective of the study was finding criteria of a relapsing risk by means of investigation of morphological peculiarities of the parenchymal-stromal correlations in the thyroid gland with recurrent nodular and primary nodular (multinodular) goiter without signs of functional disorders. In the course of the research according to the examined correlation parameters of the parenchyma and stroma various forms of nodular goiter were found to differ from the thyroid tissue without pathological changes by a number of parameters. In particular, specific weight of the parenchyma on an average increases reliably in the tissue of nodular goiter with its various variants in comparison with the thyroid gland without pathological changes. Together with the increase of the parenchymal specific weight in nodular goiter the amount of colloid on an average decreases, and a specific dependence on the kind of goiter is observed – colloid volume decreases from goiter with slow growth to goiter with quick growth, and it is the smallest with goiter relapse. Quantitative analysis of the goiter tissue stromal component demonstrates a considerable increase of its specific volume in comparison with normal thyroid tissue. Evaluation of changes of the morphometric parameters in the thyroid follicles found that in case of nodular goiter with slow growth the percentage of follicles with colloid is close to 100%. On an average it does not differ from that of the normal thyroid tissue. At the same time, in case of nodular goiter with quick growth the percentage of follicles with colloid decreases sharply, and in case of relapse it appears to be still less than that in nodular goiter with quick growth. Besides, with nodular goiter the diameter of follicles on an average increases in comparison with the normal thyroid tissue. In a number of cases it can be estimated as macrofollicular goiter. At the same time, the diameter of follicles is smaller in nodular goiter with quick growth. It is still less in case of goiter relapse. The size of follicles becomes sharply diverse in case of nodular goiter with slow growth, but it decreases in case of nodular goiter with quick growth and relapse. Consequently, recurrent nodular goiter is mostly similar to that of primary nodular goiter with a quick growth, though certain differences between them exist. The peculiarities found enable to suggest that nodular goiter with a quick growth possesses more chances for relapse.

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Sodium/iodide symporter (NIS) and pendrin are expressed differently in hot and cold nodules of thyroid toxic multinodular goiter

Acta Endocrinologica ◽

10.1530/eje.0.1450591 ◽

2001 ◽

pp. 591-597 ◽

Cited By ~ 25

Author(s):

D Russo ◽

S Bulotta ◽

R Bruno ◽

F Arturi ◽

P Giannasio ◽

...

Keyword(s):

Multinodular Goiter ◽

Normal Tissue ◽

Sodium Iodide ◽

Thyroid Tissue ◽

Sodium Iodide Symporter ◽

Normal Thyroid Tissue ◽

Tissue Samples ◽

Normal Thyroid ◽

Toxic Multinodular Goiter

OBJECTIVE: The expression of two iodide transporters, the sodium/iodide symporter (NIS) and pendrin, was analyzed in thyroid tissues of patients with toxic multinodular goiter (TMNG) and non-toxic multinodular goiter (MNG). METHODS: The levels of NIS and pendrin proteins were analyzed in total protein extracts from nodular and non-nodular tissues by Western blot. RESULTS: In tissue samples from TMNG, we found an increased expression of NIS (2.5-fold) in the hot nodules, and similar levels between cold nodules and non-nodular tissues. In contrast, the levels of pendrin were slightly increased in both hot and cold nodules from TMNG, and decreased (about twofold) in cold nodules from MNG. We also noticed that there was no relationship between NIS and pendrin expression. CONCLUSIONS: Our data demonstrate that hot nodules from TMNG express a higher number of iodide transporters (mainly NIS), whereas cold nodules from TMNG, but not from MNG, show levels of the two proteins comparable with normal tissue, suggesting a role in vivo of TSH in maintaining the expression of NIS and pendrin protein in normal thyroid tissue. Finally, different mechanisms are involved in the regulation of NIS and pendrin expression.

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Lateral aberrant thyroid having papillary carcinoma: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20211853 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1658

Author(s):

Saurabh Subhash Parab ◽

Mansing N. Ghatage ◽

Sharang S. Kulkarni ◽

Aniket P. Patil ◽

Pallavi S. Phatak ◽

...

Keyword(s):

Case Report ◽

Thyroid Gland ◽

Thyroid Carcinoma ◽

Papillary Carcinoma ◽

Thyroid Tissue ◽

Ectopic Thyroid ◽

Normal Thyroid ◽

Ectopic Tissue ◽

Well Differentiated ◽

The Right

Aberrant thyroid is a mass of tissue having the structure of a pathological thyroid gland situated at some definite distance from the normal thyroid gland. In all the variants of carcinoma of thyroid the papillary variant is the most common. Predominantly seen in females ranging in the age group of 25-45 years. It is often well differentiated, slow growing and localised. Here we report a case of a 35-year-old lady with a swelling in the right anterior triangle of the neck with normal thyroid gland. Histopathological report was suggestive of papillary carcinoma of thyroid. The origin of lateral ectopic thyroid tissue is not fully understood and controversial. The lateral localisation is a rare entity and debated extensively in the literature. Though rare, the possibility of an ectopic thyroid carcinoma must always be considered by the surgeon in cases of a pathological mass in the neck. This case report demonstrates that a normal thyroid gland on clinical examination does not exclude the presence of thyroid carcinoma in an ectopic tissue.

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Proteomic Profiling of Thyroid Papillary Carcinoma

Journal of Thyroid Research ◽

10.1155/2012/815079 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Yoshiyuki Ban ◽

Gou Yamamoto ◽

Michiya Takada ◽

Shigeo Hayashi ◽

Yoshio Ban ◽

...

Keyword(s):

Thyroid Gland ◽

Thyroid Tissue ◽

Tandem Mass ◽

Papillary Thyroid ◽

Proteomic Profiling ◽

Rt Pcr ◽

Normal Thyroid Tissue ◽

Normal Thyroid ◽

Thyroid Papillary ◽

The One

Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. We performed shotgun liquid chromatography (LC)/tandem mass spectrometry (MS/MS) analysis on pooled protein extracts from patients with PTC and compared the results with those from normal thyroid tissue validated by real-time (RT) PCR and immunohistochemistry (IHC). We detected 524 types of protein in PTC and 432 in normal thyroid gland. Among these proteins, 145 were specific to PTC and 53 were specific to normal thyroid gland. We have also identified two important new markers, nephronectin (NPNT) and malectin (MLEC). Reproducibility was confirmed with several known markers, but the one of two new candidate markers such as MLEC did not show large variations in expression levels. Furthermore, IHC confirmed the overexpression of both those markers in PTCs compared with normal surrounding tissues. Our protein data suggest that NPNT and MLEC could be a characteristic marker for PTC.

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The CCK2-receptor is expressed in human medullary thyroid carcinomas as well as in normal thyroid tissue

Gastroenterology ◽

10.1016/s0016-5085(01)82515-4 ◽

2001 ◽

Vol 120 (5) ◽

pp. A507-A507

Author(s):

M BLAEKER ◽

A WEERTH ◽

L JONAS ◽

M TOMETTEN ◽

M SCHUTZ ◽

...

Keyword(s):

Thyroid Tissue ◽

Normal Thyroid Tissue ◽

Normal Thyroid ◽

Medullary Thyroid ◽

Thyroid Carcinomas ◽

Cck2 Receptor ◽

Medullary Thyroid Carcinomas

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Detection of parathyroid adenomas with 4DCT: Towards a true four-dimensional technique

10.21203/rs.3.rs-237831/v1 ◽

2021 ◽

Author(s):

Steven Raeymaeckers ◽

Yannick De Brucker ◽

Tim Vanderhasselt ◽

Nico Buls ◽

Johan De Mey

Keyword(s):

Primary Hyperparathyroidism ◽

Thyroid Tissue ◽

Motion Artifacts ◽

P Value ◽

Normal Thyroid Tissue ◽

Dose Length Product ◽

Normal Thyroid ◽

Parathyroid Adenomas ◽

Parathyroid Lesions ◽

Over Time

Abstract Background. 4DCT is a commonly performed examination in the management of primary hyperparathyroidism, combining three-dimensional imaging with enhancement over time as the fourth dimension. We propose a novel technique consisting of 16 different contrast phases, instead of three or four different phases. The main aim of this study was to see if this protocol allows for the detection of parathyroid adenomas within dose limits. Our secondary aim was examining the enhancement of parathyroid lesions over time.Methods. For this prospective study, we included 15 patients with primary hyperparathyroidism prior to surgery. We obtain a 4DCT with 16 different phases: an unenhanced phase followed by 11 consecutive arterial phases and 4 venous phases. Centered on the thyroid, continuous axial scanning is performed over a fixed 8cm or 16cm coverage volume after start of contrast administration.Results. In all patients an enlarged parathyroid can be demonstrated, mean lesion size is 13.6mm. Mean peak arterial peak enhancement for parathyroid lesions is 384 HU compared to 333 HU for the normal thyroid. No statistical difference could be found. Time to peak (TTP) is significantly earlier for parathyroid adenomas compared to normal thyroid tissue: 30.8s versus 32.3s (p value 0.008). Mean Slope of Increase (MSI) of the enhancement curve is significantly steeper compared to normal thyroid tissue: 29.8% versus 22.2% (p value 0.012). Mean dose length product was 890.7 mGy.cm with a calculated effective dose of 6.7 mSv.Conclusion. We propose a feasible 4DCT scanning-protocol for the detection of parathyroid adenomas. We manage to obtain a multitude of phases, allowing for a dynamic evaluation within an acceptable exposure range when compared to classic helical 4DCT. Our 4DCT protocol may allow for a better visualization of the pattern of enhancement of parathyroid lesions, as enhancement over time curves can be drawn. This way wash-in and wash-out of contrast in suspected lesions can be readily demonstrated. Motion artifacts are less problematic as multiple phases are available.

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Intrathyroidal Parathyroid Carcinoma: Report of an Unusual Case and Review of the Literature

Case Reports in Pathology ◽

10.1155/2013/198643 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Lizette Vila Duckworth ◽

William E. Winter ◽

Mikhail Vaysberg ◽

César A. Moran ◽

Samer Z. Al-Quran

Keyword(s):

Thyroid Gland ◽

Parathyroid Carcinoma ◽

Unusual Case ◽

Thyroid Tissue ◽

Parathyroid Tissue ◽

African American Female ◽

Thyroid Lobe ◽

Local Infiltration ◽

Sestamibi Scan ◽

The Right

Intrathyroidal parathyroid carcinoma is an exceedingly rare cause of primary hyperparathyroidism. A 51-year-old African American female presented with goiter, hyperparathyroidism, and symptomatic hypercalcemia. Sestamibi scan revealed diffuse activity within an enlarged thyroid gland with uptake in the right thyroid lobe suggestive of hyperfunctioning parathyroid tissue. The patient underwent thyroidectomy and parathyroidectomy. At exploration, a 2.0 cm nodule in the usual location of the right inferior parathyroid was sent for intraoperative frozen consultation, which revealed only ectopic thyroid tissue. No parathyroid glands were identified grossly on the external aspect of the thyroid. Interestingly, postoperative parathyroid hormone levels normalized after removal of the thyroid gland. Examination of the thyroidectomy specimen revealed a 1.4 cm parathyroid nodule located within the parenchyma of the right superior thyroid, with capsular and vascular invasion and local infiltration into surrounding thyroid tissue. We present only the eighth reported case of intrathyroidal parathyroid carcinoma and review the literature.

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Rectal carcinoma metastatic to the thyroid gland

The Journal of Laryngology & Otology ◽

10.1017/s0022215100133158 ◽

1996 ◽

Vol 110 (2) ◽

pp. 192-195 ◽

Cited By ~ 7

Author(s):

Thomas W. Mesko ◽

Julie Friedman ◽

Harry Sendzischew ◽

Daniel D. Nixon

Keyword(s):

Thyroid Gland ◽

Rectal Carcinoma ◽

Secondary Malignancy ◽

Prior History ◽

Low Back ◽

Metastatic Adenocarcinoma ◽

History Of ◽

Right Lobe ◽

The Right ◽

History Of Cancer

AbstractClinically evident metastases to the thyroid gland are rarely found antemortem. A case of a 59-year-old woman with a history of rectal carcinoma, who presented with low back pain and a mass in the right lobe of her thyroid gland, is presented. The tumour of the thyroid was found to be metastatic adenocarcinoma from her previous rectal cancer. Other synchronous metastases were noted in her lumbar spine and kidneys.The clinical finding of metastases to the thyroid gland is rare, particularly from a colorectal primary. One must consider, however, the possibility of a tumour of the thyroid gland representing a secondary malignancy in any patient with a prior history of cancer.

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Steroid receptor coactivator-1 interacts with NF-κB to increase VEGFC levels in human thyroid cancer

Bioscience Reports ◽

10.1042/bsr20180394 ◽

2018 ◽

Vol 38 (3) ◽

Cited By ~ 3

Author(s):

Bo Gao ◽

Lingji Guo ◽

Donglin Luo ◽

Yan Jiang ◽

Jianjie Zhao ◽

...

Keyword(s):

Thyroid Cancer ◽

Thyroid Tissue ◽

Lymphatic Vessels ◽

Steroid Receptor ◽

Human Thyroid ◽

Normal Thyroid Tissue ◽

Normal Thyroid ◽

Steroid Receptor Coactivator ◽

Lymphatic Metastases ◽

Factor C

Thyroid cancer is the most common endocrine cancer, and has a high incidence of lymphatic metastasis. Vascular endothelial growth factor C (VEGFC) is essential for development of lymphatic vessels and lymphatic metastases during carcinogenesis. Steroid receptor coactivator-1 (SRC-1) interacts with nuclear receptors and transcription factors to promote tumor proliferation and metastasis. However, the correlation between SRC-1 and VEGFC levels in the lymphatic metastases of thyroid cancer remains unclear. We analyzed 20-paired specimens of thyroid cancer tissue and normal thyroid tissue and found increased levels of SRC-1 and VEGFC proteins in 13/20 and 15/20 thyroid cancer specimens, respectively, when compared with those levels in specimens of normal thyroid tissue. A high level of SRC-1 expression was positively correlated with VEGFC and lymphatic endothelial cell marker LYVE-1 expression. Papillary thyroid carcinoma cell line TPC-1 displayed high levels of SRC-1 and VEGFC expression and was selected for stable knockdown of SRC-1 in vitro. Inhibition of SRC-1 significantly reduced the VEGFC levels in TPC-1 cells. We found that SRC-1 binds to transcription factor NF-kB (p50/p65), and that this coactivation complex directly promoted VEGFC transcription, which could be abrogated by SRC-1 knockdown. Up-regulated NF-kB signaling was also confirmed in thyroid cancer tissues. In vivo studies showed that SRC-1 knockdown restricted tumor growth, reduced the numbers of LYVE-1-positive lymphatic vessels, and decreased the levels of VEGFC in tumor tissues. These results suggest a tumorigenic role for SRC-1 in thyroid cancer via its ability to regulate VEGFC expression.

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