scholarly journals A prospective observational study on thyroid malignancy

2021 ◽  
Vol 8 (4) ◽  
pp. 1155
Author(s):  
Bharath S. V. ◽  
Badareesh Lakshminarayana ◽  
Rishabh Mehta

Background: Thyroid cancers are a complex group of tumours with wide variety of histological presentation and biological behaviour, and prognosis range. In their early stages, they behave like other benign conditions of the thyroid. The success of treatment lies upon early diagnosis and proper management. The aim of the present study is to evaluate the modes of presentation, the incidence of various pathological types, and assess their clinical, behaviour and surgical management.Methods: The present study is observational, time-bound, consists of patients prospectively and consecutively diagnosed and histologically confirmed thyroid malignancy.Results: This study showed females 80.66% are commonly affected than males 19.44%. The most frequent malignancy is papillary 86.11%, followed by follicular carcinoma 11.11%, medullary carcinoma 2.78%. Cervical lymph nodes are involved in four 13.88% of patients. In patients undergone iodine ablation, 5.56% of them had a recurrence. Mortality at two years was 2.7%. In this study, Thyroid cancer is commonly seen between twenty-one to thirty years.Conclusions: The incidence of thyroid malignancies is more common among women (80.66%) than men. Papillary carcinoma (86.11%) is the common differentiated thyroid cancer. The prevalence of distant metastasis is 2.78% to the vertebral body. In our study, 41.66% of patients belongs to less than 30 years of age; this may be due to the trend of overdiagnosis due to the introduction of ultrasonography guided Fine needle aspiration study.

2021 ◽  
Vol 8 (8) ◽  
pp. 2345
Author(s):  
Balaji Chittipotula ◽  
Rajat Kumar Patra

Background: Large proportion of thyroid cancers arose from a pre-existing adenoma or from multinodular goiters. Surgical practice of removing thyroid nodule or multiple nodules of thyroid gland has been challenged for surgeons to prevent cancer. Aim of this study is to find out the prevalence of malignancy in solitary thyroid nodule and multi-nodular goitre in relation to age and sex. The aim of the study was to determine the incidence of malignancy in patients who underwent thyroidectomies.Methods: Study of 100 cases of nodular thyroid swelling has been done during the period from November 2017 to November 2019 on inpatients admitted to GEMS Hospital, Srikakulam, and Andhra Pradesh, India. Detail clinical examination, relevant investigations, surgical management and histopathological reports were collected and analyzed using software package for statistical analysis (SPSS 20).Results: Out of 100 patients with thyroid swellings, thyroid malignancies constitute 4%. The occurrence of thyroid cancer was maximum in the 4th decade of life. Female patients outnumbered males with a ratio of 4:0. Relative frequency of malignancy in solitary thyroid nodule was 4.76% and in multi-nodular goitre was 3.03%. Most common histopathological type was papillary carcinoma thyroid (50%); followed by follicular carcinoma thyroid (25%) and medullary carcinoma (25%).Conclusions: The prevalence of thyroid malignancy in the present study is at an earlier age group due to early diagnosis and treatment. The prevalence of thyroid cancer is higher in female when compared to those reported in the literature.  The proportion of medullary cancer is more in present study. 


2010 ◽  
Vol 54 (6) ◽  
pp. 550-554 ◽  
Author(s):  
André B. Zanella ◽  
Erika L. Souza Meyer ◽  
Letícia Balzan ◽  
Antônio C. Silva ◽  
Joíza Camargo ◽  
...  

OBJECTIVE: The aim of this study was to evaluate the accuracy of the measurement of thyroglobulin in washout needle aspiration biopsy (FNAB-Tg) to detect papillary thyroid cancer (PTC) metastases. SUBJECTS AND METHODS: Forty-three patients (51.4 ± 14.6 years) with PTC diagnosis and evidence of enlarged cervical lymph nodes (LN) were included. An ultrasound-guided fine-needle aspiration of suspicious LN was performed, for both cytological examination and measurement of FNAB-Tg. RESULTS: The median values of FNAB-Tg in patients with metastatic LN (n = 5) was 3,419 ng/mL (11.1-25,538), while patients without LN metastasis (n = 38) showed levels of 3.7 ng/mL (0.8-7.4). Considering a 10 ng/mL cutoff value for FNAB-Tg, the sensitivity and specificity was 100%. There were no differences on the median of FNAB-Tg measurements between those on (TSH 0.07 mUI/mL) or off levothyroxine (TSH 97.4 mUI/mL) therapy (3.3 vs. 3.8 ng/mL, respectively; P = 0.2). CONCLUSION: The results show that evaluation of FNAB-Tg in cervical LN is a valuable diagnostic tool for PTC metastases that can be used independent of the thyroid status.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Cortney Y. Lee ◽  
Samuel K. Snyder ◽  
Terry C. Lairmore ◽  
Sean C. Dupont ◽  
Daniel C. Jupiter

Ultrasound is the recommended staging modality for papillary thyroid cancer. Surgeons proficient in US assessment of the neck and experienced in the management of papillary thyroid cancer (PTC) appear uniquely qualified to assess the lateral cervical lymph nodes for metastatic disease. Of 310 patients treated for PTC between 2000 and 2008, 109 underwent surgeon-performed ultrasound (SUS) of the lateral neck preoperatively. Fine needle aspiration was performed on suspicious lateral lymph nodes. SUS findings were compared with FNA cytology and results of postoperative imaging studies. The sensitivity and negative predictive value of SUS were 88% and 97%, respectively. Four patients were found to have missed metastatic disease within 6 months. No patient underwent a nontherapeutic neck dissection. SUS combined with US-guided FNA of suspicious lymph nodes can accurately stage PTC to reliably direct surgical management.


2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Luca Giovanella ◽  
Luca Ceriani ◽  
Sergio Suriano

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.


1994 ◽  
Vol 80 (4) ◽  
pp. 257-262 ◽  
Author(s):  
Ambrogio S. Fassina ◽  
Maurizio Rupolo ◽  
Maria Rosa Pelizzo ◽  
Dario Casara

Aims and background It was the aim of this paper to report clinical and pathologic characteristics and outcome of treatment in terms of relapse-free and overall survival in 36 patients under 20 years of age and treated for thyroid cancer at Padua University Hospital from January 1968 to December 1988 and followed until December 1992. Methods The median follow-up was 112 months (range 3 to 228 months). Age at diagnosis ranged from 4 to 20 years with a mean age of 15 years and a male/female ratio of 1:2.9. A thyroid nodule or a laterocervical mass was the most frequent sign of presentation. The routine diagnosis schedule included thyroid scintigram, neck echotomography and in the last decade fine needle aspiration biopsy. Results Sixteen (28%) patients had a family history of thyroid disease. Histology revealed that papillary carcinoma was present in 43 patients (76.8%), follicular carcinoma in 9 (16%), medullary carcinoma in 2 (3.6%) and lymphoma in 2 (3.6%). Fifty-four patients were treated with total thyroidectomy, of these 34 had bilateral neck dissection and 20 unilateral nodal dissection; 2 patients underwent simple lobectomy with unilateral dissection. Nodal involvement was present in 41 (73%) cases, and synchronous visceral metastases were detected with scan and/or chest X-ray in 10 (18%) cases. In the case of differentiated thyroid carcinoma, patients with residual disease or thyroid remnants were treated with 131I metabolic therapy. All patients were put on suppressive hormone therapy. At this writing, 52 (93%) patients were in complete remission and 4 (7%) had persistent disease. Recurrences developed in 2 (3.5%) patients: one presented lung metachronus metastases and one local recurrence; no deaths have occurred. Conclusions From this experience, total thyroidectomy appears to be the appropriate approach for differentiated tumors in children and adolescents because the disease is often diffuse, secondary deposits may be easily detected, and the value of thyroglobulin measurement can be improved. Following this strategy, overall recurrence risk was low and 131I therapy was curative in patients with nodal and lung metastases.


1997 ◽  
Vol 4 (1) ◽  
pp. 25-29
Author(s):  
Michael G. Franz

Background Medullary thyroid cancer, a tumor of the parafollicular C cells, accounts for approximately 10% of all thyroid malignancies. An estimated 75% of cases are sporadic, and the remaining 25% are familial. Methods The author reviews the clinical features and diagnostic tests for this entity, as well as the surgical treatment of recurrent or persistent medullary carcinoma. Results Sporadic medullary thyroid cancer typically presents as an isolated unilateral mass. Familial tumors tend to be multifocal and bilateral. In patients with multiple endocrine neoplasia type 2A, pheochromocytomas and parathyroid hyperplasia also may develop. Care is taken to avoid operating on a patient with occult pheochromocytoma. Total thyroidectomy and central lymph node dissection are the keys for successful surgical treatment. Conclusions Surgery is the cornerstone of treatment for medullary carcinoma of the thyroid. Genetic testing using the ret oncogene allows identification of individuals who are at risk for the disease or those with early-stage disease.


2018 ◽  
Vol 29 (2) ◽  
pp. 16-20
Author(s):  
MM Sarker ◽  
MK Sarker ◽  
NA Perveen

Non-Toxic multi-nodular goitre is one of the common presentations of various thyroid diseases. A sizable portion of multi-nodular goitre turns into malignancy over time. This cross-sectional study was conducted in RMCH and different clinics of Rajshahi City to determine the incidence and types of various thyroid malignancies in non-toxic multi-nodular goitres. Among the total cases, 43% of the patients were in the age group of 31-40 years and majority (81%) of whom were female. 52% of the patients had a history of thyroid swelling for 1-5 years and 55% of the patients had goitre size ≤ 15 cm2. Sub-total thyroidectomy was the commonest operation performed and all the resected specimens were sent for histopathological examinations, which demonstrates that 13% of the multi-nodular goitres had malignancies with papillary and follicular carcinoma ratio 5:1. This study did not reveal any significant association of malignancies with age and sex and goitre size also not influence the presence of malignancy. However, it was observed that the mean duration of thyroid swelling in patients who developed malignancy was significantly higher (8.6 years) than that of patients who did not experience any malignant change (5.7 years).TAJ 2016; 29(2): 16-20


2019 ◽  
Vol 6 (5) ◽  
pp. 1429
Author(s):  
Mohammed Hillu Surriah ◽  
Amine Mohammed Bakkour ◽  
Riad Rahman Jallod Al-Asadi ◽  
Laith Qauis Majeed

Background: The solitary thyroid nodule, defined as a palpable discrete swelling within an otherwise apparently normal gland, is usually a benign lesion. However, patients and physicians alike are typically concerned about the possibility of thyroid cancer. This study describes a strategy for the treatment of clinically euthyroid patients who have a solitary thyroid nodule that prevents unnecessary testing while identifying the few patients who require therapy.Methods: This is a prospective study of randomly selected patients with clinically palpable, solitary thyroid nodule diagnosed and treated at Al-Karama Teaching Hospital from September 2015 till December 2018. Initially 176 patients were diagnosed by clinical examination to have solitary thyroid nodule but after investigation and operative finding, 42 patients were found to have multinodular goiter and all excluded from the study.Results: All the 134 patients included in the study (21 males and 113 females) have been evaluated by clinical examination; thyroid scan and fine needle aspiration, ultrasound and the results of the evaluation have been correlated with operative histologic diagnosis. The study was undertaken to obtain information on the usefulness of the above measures for predicting or ruling out malignancy in solitary thyroid nodule.Conclusions: The incidence of malignancy seems to be higher among male, presented with hard nodule at palpation, those associated with hoarseness or palpable cervical lymph nodes. A cytological diagnosis of malignant tumor is reliable and provides sufficient basis of definitive surgery for thyroid cancer.


2012 ◽  
Vol 3 (3) ◽  
pp. 184-186
Author(s):  
S Kumar ◽  
Ambikavathy Mohan ◽  
Udaya Kumar

ABSTRACT Thyroid carcinoma comprises 1% of all malignancies. Follicular thyroid carcinoma is the second most common cancer of thyroid. Vascular invasion and hematogenous metastases to bone, lungs, brain, skin and adrenal glands has a reported incidence of 11 to 25%. The initial presentation of the patient with distant metastases is rare. Well-differentiated thyroid cancers with renal secondaries are reported in limited number of cases so far. W e report a case of an asymptomatic female patient who presented to us with soft tissue metastases to scalp, left sc apular regio n an d left k idn ey. On furth er evalu atin g, ultrasound of the neck showed a solitary nodule of 2 × 1 cm in the left lobe of thyroid. Fine needle aspiration cytology (FNAC) of thyroid reported as follicular carcinoma. FNAC of scalp, scapular swelling, and left kidney lesion was reported as metastatic lesions from follicular thyroid cancer. The patient refused any surgical intervention and she received three cycles of chemotherapy and suppressive treatment with L-thyroxine. She is on regular follow-up with the stable disease till date. We present this case for its rarity of renal metastases from follicular thyroid cancer. How to cite this article Mohan A, Kumar S, Kumar U. Atypical Presentation as Unilateral Renal and Soft Tissue Metastases from Follicular Carcinoma Thyroid. Int J Head and Neck Surg 2012;3(3):184-186.


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