scholarly journals Increased thyroid malignancy in patients with primary hyperparathyroidism

2021 ◽  
Author(s):  
Luchuan Li ◽  
Baoyuan Li ◽  
Bin Lv ◽  
Weili Liang ◽  
Binbin Zhang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Thyroid Nodules ◽  
Biological Data ◽  
Chinese Patients ◽  
Papillary Thyroid ◽  
Hormone Levels ◽  
Preoperative Ultrasound ◽  
Increased Risk

Background: Multiple studies have reported increased incidence of thyroid cancer in patients with primary hyperparathyroidism (PHPT). However, the underlying risk factors of concomitant thyroid cancer in patients with PHPT remain unknown. The primary aim of this study was to examine the records of patients with PHPT to identify characteristics that correlated with the presence of coexisting thyroid nodules, and which may have an implication for the prediction of thyroid cancer. Methods: Medical records of consecutive patients with PHPT (n=318) were reviewed from Jan 2010 to Sep 2020 in two tertiary medical centers in China. Patient clinicopathological and biological data were collected and analyzed. Results: Of a total of 318 patients with PHPT, 105 (33.0%) patients had thyroid nodules and 26 (8.2%) patients were concomitant with thyroid cancer. A total of 38 thyroid nodules taken from 26 patients were pathologically assessed to be well-differentiated papillary thyroid carcinoma (PTC), with 81% being papillary thyroid microcarcinoma (PTMC). In 79% (30/38) of these cancers, thyroid nodules were considered suspicious following preoperative ultrasound. Multinomial logistic regression analysis revealed that female gender was associated with increased risk of thyroid nodules (OR=2.13, 95%CI: 1.13-3.99, p = 0.019), while lower log-transformed parathyroid hormone levels were an independent predictor of thyroid cancer in patients with PHPT (OR=0.50, 95%CI: 0.26-0.93, p = 0.028). Conclusion: In conclusion, we observed a relatively high prevalence of thyroid cancer in our cohort of Chinese patients with PHPT. Evaluation of thyroid nodules by preoperative ultrasound may be advisable in patients with PHPT, particularly for females and patients with modestly elevated serum parathyroid hormone levels.

Konversion eines postoperativen Hypoparathyreoidismus in einen Hyperparathyreoidismus bei ektopem Nebenschilddrüsenadenom

2019 ◽  
Vol 58 (04) ◽  
pp. 333-336
Author(s):  
K. H. Davis ◽  
C. Happel ◽  
R. du Mesnil de Rochemont ◽  
T. J. Vogl ◽  
F. Grünwald
Keyword(s):  
Thyroid Cancer ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Imaging Modalities ◽  
Hormone Levels ◽  
History Of ◽  
Childhood Medulloblastoma ◽  
Vein Catheterization

AbstractWe present a patient with a history of thyroid cancer, presumably following radiochemotherapy of a childhood medulloblastoma, who developed a primary hyperparathyroidism 10 years after long-term postsurgical hypoparathyroidism. All established imaging modalities failed to detect the origin and only selective neck sampling could identify the suspected parathyroid adenoma causing hyperparathyroidism. This encourages the use of selective neck vein catheterization, particularly in patients with only slightly elevated parathyroid hormone-levels or suspected small ectopic adenoma.

scholarly journals Rs4911154 of circ-ITCH aggravated tumor malignancy of thyroid nodules via the circ-ITCH/miR-22-3p/CBL axis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yiqing Guo ◽  
Hua Zheng ◽  
Jie Yin ◽  
Huaming Wang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Thyroid Cancer ◽  
Thyroid Nodule ◽  
Doubling Time ◽  
Thyroid Nodules ◽  
Inhibitory Effect ◽  
Thyroid Tumor ◽  
Papillary Thyroid ◽  
Increased Risk ◽  
Ultrasound Testing

AbstractRecent evidence revealed an inhibitory effect of circ-ITCH on the progression of papillary thyroid cancer via affecting the circ-ITCH/miR-22-3p/CBL axis. Rs4911154, an SNP located in circ-ITHC, was previously reported to be significantly associated with an increased risk of hepatocellular carcinoma. Ultrasound testing was used to evaluate the doubling time of thyroid nodules. 202 patients diagnosed with thyroid nodule disorders were divided into three groups according to their genotypes at rs4911154. We found that the A allele was correlated with a shortening doubling time of thyroid nodules. Moreover, the A allele contributed to reduced expression of circ-ITCH/CBL and increased expression of miR-22-3p. Besides, decreased tissue apoptosis was linked to the A allele. Luciferase assays indicated that miR-22-3p could effectively suppress the luciferase activities of CBL and circ-ITCH. Furthermore, manual up-regulation of miR-22-3p effectively suppressed the expression of CBL, while CBL siRNA apparently abolished circ-ITCH induced CBL upregulation, reduced proliferation and increased apoptosis of K1 and TPC-1 cells. A signaling pathway of circ-ITCH/miR-22-3p/CBL axis was established to explain the effect of SNP of circ-ITCH in thyroid tumor malignancy. Compared with the G allele, the A allele in rs4911154 contributed to the malignancy of thyroid nodules with decreased doubling time and down-regulated CBL expression.

scholarly journals MON-489 Comorbidity of Primary Hyperparathyroidism and Papillary Thyroid Cancer. A Single Center Outcomes

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Nektaria Papadopoulou ◽  
Eleni Papanikolaou ◽  
George P Chrousos ◽  
Evangelos Karvounis
Keyword(s):  
Thyroid Cancer ◽  
Primary Hyperparathyroidism ◽  
Papillary Thyroid Cancer ◽  
Thyroid Nodules ◽  
Age Groups ◽  
Case Series ◽  
Distant Metastases ◽  
Endocrine Surgery ◽  
Papillary Thyroid ◽  
Papillary Cancer

Abstract Introduction Concurrence of primary hyperparathyroidism in patients with thyroid disease has been previously reported by several studies. However, comorbidity between primary hyperparathyroidism (PHPT) and papillary thyroid cancer (PTC) has been sparsely described by previous, mostly case-series studies, and is considered rare. Since pathophysiological mechanisms behind the two diseases are supposed to be different, any link between these diseases has not been explained as yet. Hypothesis: Aim of the study was to investigate the possible concurrence for the two diseases in people who underwent thyroidectomy for suspected thyroid nodules. Methodology Retrospective observational study that included 2913 patients (24% men with mean age 49.82 yrs, 76% women mean aged 47.73 yrs), who underwent total thyroidectomy during the last 13 years (2005-2018) at the Department of Endocrine Surgery, Euroclinic Hospital, in Greece. The patient-groups were categorised according to histopathology criteria of the thyroid and/ or parathyroid glands (in case of comorbidity of primary hyperparathyroidism (PHPT) diagnosed prior to surgery). Results: Statistical analysis revealed benign histopathology findings in 1945 patients (64%), while papillary cancer was found in 978 (32%). Among patients with non-malignancy, 16 (11 women/5 men) had PHPT, but in those with papillary cancer, PHPT was diagnosed in 38 (33 women/5 men) individuals. The relative risk for the concurrence of PHPT and PTC was 2.033 (95%CI 1.69 to 2.43, P<0.0001). Age groups between 30 and 60 yrs were associated with the highest relative frequency of comorbidity (82%). A significant positive correlation was observed between less aggressive PTC histopathology findings and PHPT concurrence (P<0.0001). Interestingly, no patient with PTC and PHPT had either capsular invasion or regional/distant metastases. Moreover, most patients with comorbidity (92%) had a tumour diameter smaller (mean 6.3 mm) than those with PTC alone (mean 18 mm). Conclusions: Our study found that the comorbidity between primary hyperparathyroidism and PTC may be considered as possible. Endocrinologist’s diagnostic approach may add serum calcium and parathormone levels in patients who undergo evaluation for suspected thyroid nodules. Patients with PHPT and PTC had mostly microcarcinomas, and histopathology findings showed a less aggressive PTC pattern. Further large cohorts as well as genetic studies, are needed to duplicate our results and further highlight possible common pathogenetic pathways behind PHPT and PTC concurrence.

Male Patients With Papillary Thyroid Cancer Have a Higher Risk of Extranodal Extension

2021 ◽  
Author(s):  
Hu Hei ◽  
Bin Zhou ◽  
Wenbo Gong ◽  
Chen Zheng ◽  
Jianwu Qin
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Multivariable Analysis ◽  
Underlying Mechanism ◽  
Clinicopathological Factors ◽  
Papillary Thyroid ◽  
Extranodal Extension ◽  
Increased Risk ◽  
Male Patients ◽  
Male Sex

Abstract Purpose: There is a sex disparity in papillary thyroid cancer (PTC). Male sex is associated with a higher likelihood of advanced stage disease. This study aimed to examine the significance of sex for extranodal extension (ENE) in PTC. Patients and Methods: We reviewed the data of PTC patients who had undergone initial surgical resection from July 2012 to December 2014 (N = 1531). The effects of sex and other clinicopathological factors on ENE were investigated.Results: Of 1531 patients identified, 377 (24.6%) were male, 816 (53.3%) had positive nodes, and 256 (16.7%) had ENE. Compared with female patients, male patients had a higher risk of ENE (P < 0.001). Multivariable analysis of clinicopathological factors revealed that male sex (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.37 - 2.87; P < 0.001), age older than 60 years (OR, 1.93; 95% CI, 1.08 - 3.35; P = 0.023), extrathyroidal extension (OR, 3.52; 95% CI, 2.42 - 5.14; P < 0.001), bilateral multifocality (OR, 2.18; 95% CI, 1.53 - 3.13; P < 0.001), and more positive nodes were significantly associated with increased risk of ENE. Patients with 6-10 positive nodes were 16.45-fold higher to have ENE than patients with 5 positive nodes or less (95% CI, 11.07 - 24.68; P < 0.001).Conclusion: Male PTC patients had a higher risk of ENE than female. Sex was an independent predictor of ENE. The underlying mechanism needs to be investigated further.

Intact parathyroid hormone levels and primary hyperparathyroidism

2017 ◽  
pp. 1-5 ◽  
Author(s):  
Haidar Al-Hraishawi ◽  
Peter J. Dellatore ◽  
Xinjiang Cai ◽  
Xiangbing Wang
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Intact Parathyroid Hormone ◽  
Hormone Levels

NO BENEFIT OF DEDICATED THYROID NODULE SCREENING IN PATIENTS WITH ACROMEGALY

2020 ◽  
Vol 26 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Ngan Betty Lai ◽  
Dave Garg ◽  
Anthony P. Heaney ◽  
Marvin Bergsneider ◽  
Angela M. Leung
Keyword(s):  
United States ◽  
Growth Hormone ◽  
Thyroid Cancer ◽  
Growth Factor ◽  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle

Objective: Acromegaly results from the excessive production of growth hormone and insulin-like growth factor-1. While there is up to a 2-fold increased prevalence of thyroid nodules in patients with acromegaly, the incidence of thyroid cancer in this population varies from 1.6 to 10.6% in several European studies. The goal of our study was to determine the prevalence of thyroid nodules and thyroid cancer among patients with acromegaly at a large urban academic medical center in the United States (U.S.). Methods: A retrospective chart review was performed of all patients with acromegaly between 2006–2015 within the University of California, Los Angeles health system. Data were collected regarding patient demographics, thyroid ultrasounds, thyroid nodule fine needle aspiration (FNA) biopsy cytology, and thyroid surgical pathology. Results: In this cohort (n = 221, 49.3% women, mean age 53.8 ± 15.2 [SD] years, 55.2% Caucasian), 102 patients (46.2%) underwent a thyroid ultrasound, from which 71 patients (52.1% women, mean age 52.9 ± 15.2 [SD] years, 56.3% Caucasian) were found to have a thyroid nodule. Seventeen patients underwent a thyroid nodule FNA biopsy and the results revealed 12 benign biopsies, 1 follicular neoplasm, 3 suspicious for malignancy, and 1 papillary thyroid cancer (PTC), from which 6 underwent thyroidectomy; PTC was confirmed by surgical pathology for all cases (8.5% of all nodules observed). Conclusion: In this sample, the prevalence of thyroid cancer in patients with acromegaly and coexisting thyroid nodules is similar to that reported in the general U.S. population with thyroid nodules (7 to 15%). These findings suggest that there is no benefit of dedicated thyroid nodule screening in patients newly diagnosed with acromegaly. Abbreviations: AACE = American Association of Clinical Endocrinologists; ATA = American Thyroid Association; DTC = differentiated thyroid cancer; FNA = fine needle aspiration; GH = growth hormone; IGF-1 = insulin-like growth factor-1; PTC = papillary thyroid cancer; U.S. = United States

scholarly journals A novel CASR variant in a family with familial hypocalciuric hypercalcaemia and primary hyperparathyroidism

2020 ◽  
Vol 2020 ◽  
Author(s):  
Satyanarayana V Sagi ◽  
Hareesh Joshi ◽  
Jamie Trotman ◽  
Terence Elsey ◽  
Ashwini Swamy ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Organ Damage ◽  
Urinary Calcium ◽  
Interesting Case ◽  
List Type ◽  
Loss Of Function ◽  
Clearance Ratio ◽  
Hormone Levels ◽  
Severe Hypercalcaemia

Summary Familial hypocalciuric hypercalcaemia (FHH) is a dominantly inherited, lifelong benign disorder characterised by asymptomatic hypercalcaemia, relative hypocalciuria and variable parathyroid hormone levels. It is caused by loss-of-function pathogenic variants in the calcium-sensing receptor (CASR) gene. Primary hyperparathyroidism (PHPT) is characterised by variable hypercalcaemia in the context of non-suppressed parathyroid hormone levels. Unlike patients with FHH, patients with severe hypercalcaemia due to PHPT are usually symptomatic and are at risk of end-organ damage affecting the kidneys, bone, heart, gastrointestinal system and CNS. Surgical resection of the offending parathyroid gland(s) is the treatment of choice for PHPT, while dietary adjustment and reassurance is the mainstay of management for patients with FHH. The occurrence of both FHH and primary hyperparathyroidism (PHPT) in the same patient has been described. We report an interesting case of FHH due to a novel CASR variant confirmed in a mother and her two daughters and the possible coexistence of FHH and PHPT in the mother, highlighting the challenges involved in diagnosis and management. Learning points: Familial hypocalciuric hypercalcaemia (FHH) and primary hyperparathyroidism (PHPT) can coexist in the same patient. Urinary calcium creatinine clearance ratio can play a role in distinguishing between PHPT and FHH. Genetic testing should be considered in managing patients with PHPT and FHH where the benefit may extend to the wider family. Family segregation studies can play an important role in the reclassification of variants of uncertain significance. Parathyroidectomy has no benefit in patients with FHH and therefore, it is important to exclude FHH prior to considering surgery. For patients with coexisting FHH and PHPT, parathyroidectomy will reduce the risk of complications from the severe hypercalcaemia associated with PHPT.

scholarly journals Role of biomarkers in predicting the occurrence of thyroid neoplasms in radiation-exposed children

2018 ◽  
Vol 25 (4) ◽  
pp. 481-491
Author(s):  
Joseph M Shulan ◽  
Leonid Vydro ◽  
Arthur B Schneider ◽  
Dan V Mihailescu
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Subsequent Development ◽  
Thyroid Neoplasms ◽  
Childhood Cancer Survivors ◽  
Malignant Neoplasms ◽  
Increased Risk ◽  
Need To Evaluate

With increasing numbers of childhood cancer survivors who were treated with radiation, there is a need to evaluate potential biomarkers that could signal an increased risk of developing thyroid cancer. We aimed to examine the relationships between thyrotropin and thyroglobulin levels and the risk of developing thyroid nodules and cancer in a cohort of radiation-exposed children. 764 subjects who were irradiated in the neck area as children were examined and followed for up to 25 years. All subjects underwent a clinical examination, measurements of thyrotropin, thyroglobulin levels and thyroid imaging. At baseline, 216 subjects had thyroid nodules and 548 did not. Of those with nodules, 176 underwent surgery with 55 confirmed thyroid cancers. During the follow-up, 147 subjects developed thyroid nodules including 22 with thyroid cancer. Thyroglobulin levels were higher in subjects with prevalent thyroid nodules (26.1 ng/mL vs 9.37 ng/mL; P < 0.001) and in those who had an initial normal examination but later developed thyroid nodules (11.2 ng/mL vs 8.87 ng/mL; P = 0.017). There was no relationship between baseline thyrotropin levels and the prevalent presence or absence of thyroid nodules, whether a prevalent neoplasm was benign or malignant, subsequent development of thyroid nodules during follow-up or whether an incident nodule was benign or malignant. In conclusion, in radiation-exposed children, higher thyroglobulin levels indicated an increased risk of developing thyroid nodules but did not differentiate between benign and malignant neoplasms. There was no association between the baseline TSH level and the risk of developing thyroid nodules or cancer.

Serum osteopontin can improve papillary thyroid cancer risk assessment of Bethesda III thyroid nodules: a preliminary study

2021 ◽  
Author(s):  
Taha Ulutan Kars ◽  
Mustafa Kulaksizoglu ◽  
İbrahim Kılınç
Keyword(s):  
Thyroid Cancer ◽  
Cancer Risk ◽  
Papillary Thyroid Cancer ◽  
Thyroid Nodules ◽  
Cancer Risk Assessment ◽  
Papillary Thyroid ◽  
Operating Characteristics ◽  
Discriminative Performance ◽  
Thyroid Cancer Risk ◽  
Preliminary Study

Objective: Thyroid cancer can be detected in 5–10% of patients with thyroid nodules. Management may be a challenge if fine-needle aspiration biopsy yields Bethesda III findings. Most of these cases undergo surgery and are ultimately found benign. Our aim was to evaluate whether serum osteopontin can accurately estimate thyroid cancer risk in cases with cytologically Bethesda III thyroid nodules and, thereby, decrease the number of unnecessary surgical interventions. Design and Methods: We obtained blood samples of cases with repeated cytologically Bethesda III thyroid nodules before surgery, and followed up the pathology results after thyroidectomy. We evaluated serum osteopontin from 36 patients with papillary thyroid cancer and compared them with 40 benign cases. Results: Serum osteopontin levels in patients with papillary thyroid cancer are significantly higher than in benign cases (mean serum osteopontin: 10.48 ± 3.51 ng/mL vs 6.14 ± 2.29 ng/mL, p<0.001). The area under the receiver operating characteristics curve was 0.851, suggesting that serum osteopontin could have considerable discriminative performance. Conclusions: In our preliminary study, high serum osteopontin levels can predict the risk of papillary thyroid cancer in thyroid nodules with Bethesda III cytology. Further studies are necessary to confirm these findings.

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