scholarly journals Prevalence and pattern of thyroid malignancy in thyroid nodule in Aseer Central Hospital in KSA

2017 ◽  
Vol 3 (4) ◽  
pp. 908 ◽  
Author(s):  
Jibril Yahya Hudise ◽  
Khalid Ali Alshehri ◽  
Saad Nasser Alqarni ◽  
Yara Assiri ◽  
Ashwaq Asiri ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Cell Carcinoma ◽  
Thyroid Nodules ◽  
Follicular Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Thyroid Malignancy ◽  
Central Hospital ◽  
Medullary Thyroid

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Thyroid nodules are common in the general population, especially in women. Non palpable nodules are often found when patients undergo diagnostic imaging such as ultrasonogra­phy and computed tomography of the chest and neck. This retrospective study to assess the Prevalence of thyroid malignancy in thyroid nodule related to gender, age, and pathology, in Aseer Central Hospital KSA. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">During a 5-year period (2011–2016), the medical records of 319 patients with thyroid nodules were collected from the department of pathology at Aseer Central Hospital KSA. The cases were reviewed for data on gender, age, and the pathological result. All patients underwent hemi or total thyroidectomy. Comparisons between genders, age groups, and tissue origins were performed. All statistical tests were performed with SPSS software.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Over a period of 5 years, a total of 319 patients: male 17.2% and female 82.8% Underwent for hemi or total thyroidectomy. The age of presentation was ranging from 14 to 80 years. Among the 319 cases of thyroid nodules 73.7% were benign nodules and 26.3% malignant nodules. Papillary thyroid carcinoma in 72.6%, follicular thyroid carcinoma 10.6%, Hurthle cell carcinoma 4.8%, anaplastic carcinoma 4.8%, thyroid lymphoma 4.8% and medullary thyroid carcinoma in 2.4%. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Thyroid nodule is a common clinical problem and the proportion of such nodules that prove to be malignant is not small, investigations are of immense help to corroborate with the clinical and morphological finding. Papillary thyroid carcinoma most common malignant thyroid carcinoma followed by follicular thyroid carcinoma, hurthel cell carcinoma, anaplastic thyroid carcinoma, lymphoma and finally medullary thyroid Carcinoma. No significant different between male and female as risk factors for malignancy.</span></p>

scholarly journals Papillary Thyroid Carcinoma With Cystic Changes in a Patient With Prior History of Toxic Nodule

2020 ◽  
Vol 8 ◽  
pp. 232470962094267
Author(s):  
Gliceida Maria Galarza Fortuna ◽  
Paola Rios ◽  
Ailyn Rivero ◽  
Gabriela Zuniga ◽  
Kathrin Dvir ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Molecular Testing ◽  
Papillary Thyroid ◽  
Thyroid Lobectomy ◽  
Cystic Changes ◽  
History Of

Thyroid nodules are palpable on up to 7% of asymptomatic patients. Cancer is present in 8% to 16% of those patients with previously identified thyroid nodules. Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, accounting for approximately 85% of thyroid cancers. Although most appear as solid nodules on ultrasound imaging, a subset of 2.5% to 6% has cystic components. The presence of cystic changes within thyroid nodules decreases the accuracy of fine needle aspiration (FNA) in the diagnosis of thyroid cancer, given the difficulty of obtaining appropriate cellular content. This becomes a diagnostic and therapeutic challenge. We present a case of a 31-year-old female with a 1-month history of palpitations, fatigue, and night sweats, who underwent evaluation, and was diagnosed with subclinical hyperthyroidism. She presented 4 years later with compressive symptoms leading to repeat FNA, showing Bethesda III-atypia of undetermined significance and negative molecular testing. Thyroid lobectomy revealed PTC with cystic changes. This case is a reminder that patients with hyperfunctioning thyroid nodule should have closer follow-up. It poses the diagnostic dilemma of how much is good enough in the evaluation and management of a thyroid nodule. Early detection and action should be the standard of care.

scholarly journals SAT-072 A Case of Solitary Hyperfunctioning Thyroid Nodule Harboring Papillary Thyroid Carcinoma in a Pediatric Patient

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Liliana Burdea ◽  
Mary E Calabrese ◽  
Inha Jo ◽  
Stelios Mantis
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Pediatric Population ◽  
Hormone Replacement ◽  
Laboratory Evaluation ◽  
Papillary Thyroid ◽  
Solid Nodule ◽  
Difficulty Breathing

Abstract Introduction: Thyroid nodules are less common among children than adults but are more likely to be malignant. Among all the thyroid nodules, autonomous functioning thyroid nodules (AFTN) are generally considered to be a benign entity, with malignancy found in less than 1 %. AFTN are very rare in the pediatric population, and the optimal treatment is not well defined. We present a 14-year-old female patient with an AFTN treated with surgical resection and found to contain papillary thyroid carcinoma, despite a previous biopsy which did not demonstrate malignancy. Case presentation: A 14-year-old girl presented with left-sided palpable thyroid lesion for four months. The patient had no symptoms at that time, and the physical exam was notable for a palpable left thyroid nodule measuring 3x 2.2 cm. Thyroid studies were remarkable for a suppressed thyroid-stimulating hormone (TSH) of 0.056uIU/mL (0.350–4.94), normal free thyroxine (FT4): 1.1 ng/dL (0.7–1.5), and positive anti-thyroglobulin antibodies: 9.0 IU/ml (0.0 - 4.1) with negative anti peroxidase antibodies and negative thyroid-stimulating immunoglobulin. Initial ultrasound (US) showed a left complex cystic and solid nodule measuring 3.4 cm x 1.8 cm x 2.3 cm. Fine needle aspiration (FNA) of the nodule revealed a benign aspirate. An I-123 scan revealed a hyperfunctioning nodule with suppression of uptake in surrounding thyroid parenchyma. The patient was then lost to follow up, presenting to our clinic over a year later due to difficulty breathing when supine and increased nodule size. Thyroid studies were notable for a suppressed TSH of 0.005 and slightly elevated FT4:1.8. Thyroid US showed a mixed cystic and solid nodule measuring 4.7 x3 x 4cm, with no calcification. Given the increased size of the lesion, her age, and difficulty breathing when supine, a decision was made to proceed with left hemithyroidectomy for definitive diagnosis and treatment. Pathology of the specimen revealed an encapsulated papillary thyroid carcinoma with focal capsular invasion. Right hemithyroidectomy was performed three weeks later, followed by I-131 ablation one month after surgery. The patient is currently doing well and euthyroid on thyroid hormone replacement therapy, with no evidence of disease. She is undergoing surveillance with ultrasound imaging and laboratory evaluation. Conclusion: This is a rare case of AFTN harboring papillary thyroid carcinoma. Although the majority of cases of AFTN are benign, an FNA was performed and was negative for malignancy. Due to an increase in size, new symptoms and ultrasound changes, surgery was performed and revealed the final diagnosis. The behavior of thyroid nodules in pediatric patients can be different than adult patients. Even though the majority of AFTN are benign, we should still keep malignancy in our differential when the nodule has a growth pattern, new US findings or patient develops worsening symptoms.

scholarly journals A case of papillary thyroid carcinoma in toxic adenoma: are hyperfunctioning nodules truly innocent all the times?

2017 ◽  
Vol 4 (3) ◽  
pp. 1093
Author(s):  
Banu Sarer Yurekli ◽  
Hatice Ozisik ◽  
Nilufer Ozdemir Kutbay ◽  
Ozer Makay ◽  
Gokhan Ozgen ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Thyroid Tissue ◽  
Follicular Neoplasm ◽  
Pathology Report ◽  
Papillary Thyroid ◽  
Toxic Adenoma ◽  
Thyroid Lobectomy

Thyroid nodule is seen commonly in clinical practice. Thyroid scintigraphy should be performed for the evaluation of thyroid nodules in case of suppressed TSH. We would like to present a case of toxic adenoma with the diagnosis of papillary thyroid carcinoma. Forty-four-year-old female patient had applied to the hospital with the diagnosis of thyroid nodule. Thyroid fine needle aspiration biopsy (FNAB) was performed for the evaluation of thyroid nodule measured as 47x12 mm. This nodule was in mixed solid form bearing cystic components. FNAB revealed that the thyroid nodule was benign. Our ultrasonographic evaluation was consistent with a thyroid nodule located at right lobe with a diameter of 43x18x28 mm. The patient underwent right thyroid lobectomy. Pathology report revealed macrofollicular variant of papillary thyroid carcinoma. The tumor was 3.5 cm in diameter with regular margin and 0.2 cm away from the surgical border. The tumor didn’t spread out of the thyroid capsule. Second thyroid surgery was performed due to remaining thyroid tissue. After that ablative radioactive iodine therapy was applied. Guidelines in Endocrine literature report that hyperfunctioning nodules are almost always benign. However, the risk of malignancy was reported as a weighted rate of 3.1%. As follicular lesions are seen in high percentage in hot nodules, surgery should be recommended in case of the cytological results of a follicular neoplasm of a hyperfunctioning nodule. So, hyperfunctioning thyroid nodules warrants careful evaluation and appropriate therapy. We wanted to draw attention of the clinicians for this rare issue.

scholarly journals MON-484 Thyroid Nodules: Not so Simple to Manage

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Alegyari Figueroa Cruz ◽  
Yineli Ortiz Torres ◽  
Victor J Carlo Chévere ◽  
Jose M Garcia-Mateo
Keyword(s):  
Decision Making ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Papillary Thyroid ◽  
Risk Of Malignancy ◽  
History Of ◽  
Bethesda System ◽  
Undetermined Significance

Abstract Thyroid Nodules: Not So Simple to Manage Thyroid nodules diagnosis and malignancy risk stratification remains a challenge for decision making between conservative vs invasive management. The development of the clinical guidelines provides alternatives for evaluation and management for thyroid nodules, but can be used for all patients? A 43 y/o female without known past medical history is referred to the endocrine service by her primary care physician for evaluation of a thyroid nodule. She was presenting with 1 month history of mild discomfort on the neck and was evaluated with thyroid US that was relevant for multiple bilateral solid nodules measuring &lt;1.0cm and a one spongiform measuring 1.7 x 1.2 x 1.3cm in the right lobe extending minimally to the capsule laterally and to the carotid artery wall. Patient denies cough, hoarseness, odynophagia, shortness of breath, family history of thyroid cancer or radiation exposure. On examination there were no goiter nor palpable thyroid nodules, as well as no clinical signs and symptoms of thyroid disease. Patient is clinically and biochemically euthyroid with a very low suspicion thyroid nodule (3% estimated malignancy risk). Despite nodule is below the 2.0cm cutoff point for fine needle aspiration biopsy (FNAB) according to American Association of Clinical Endocrinologist (AACE) and American Thyroid Association (ATA) guidelines, it was done based on additional suspicious sonographic features detect by the endocrinologist on evaluation of ultrasound images. FNAB was performed and reveals Atypia of undetermined significance/Follicular Lesion of undetermined significance (AUS/FLUS) Bethesda system category III with a risk of malignancy of 5–15%. Patient was reluctant to surgery given the very low risk nodule and biopsy results of AUS/FLUS. In order to further manage this patient with undetermined significance thyroid nodule, Gene Expression Classifier (GEC) Molecular Analysis (AFIRMA) was performed. AFIRMA test was done with a second FNAB that also reveals AUS/FLUS but was found positive for BRAFv600, Bethesda system category IV: Suspicious of Papillary Thyroid Carcinoma. BRAFv600 is the only mutation that have high specificity (99%) for papillary thyroid carcinoma and is associated with increased disease-specific mortality, aggressive histologic phenotypes, lymph node metastases, extrathyroidal extension and risk of recurrence. Based on this data patient now have 95% risk of malignancy and requires surgical therapy. Patient preferred total thyroidectomy over lobectomy; pathology results shows 2.0cm Papillary Thyroid Carcinoma Stage I (T1N0M0). Despite very low risk nodule finding, malignancy was diagnosed. As depicted in this case, thyroid nodules aren’t so simple to manage, and their management should involve imaging and pathology findings along with clinical judgement and patient individualization in decision making process.

scholarly journals Preoperative Typing of Thyroid and Parathyroid Tumors with a Combined Molecular Classifier

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 237
Author(s):  
Sergei E. Titov ◽  
Evgeniya S. Kozorezova ◽  
Pavel S. Demenkov ◽  
Yulia A. Veryaskina ◽  
Irina V. Kuznetsova ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Cell Carcinoma ◽  
Fine Needle Aspiration ◽  
Nuclear Dna ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Brafv600e Mutation ◽  
Medullary Thyroid ◽  
Fine Needle

In previous studies, we described a method for detecting and typing malignant tumors of the thyroid gland in fine-needle aspiration biopsy samples via analysis of a molecular marker panel (normalized HMGA2 mRNA level; normalized microRNA-146b, -221, and -375 levels; mitochondrial-to-nuclear DNA ratio; and BRAFV600E mutation) in cytological preparations by quantitative PCR. In the present study, we aimed to estimate the specificity of the typing of different thyroid tumors by the proposed method. Fine-needle aspiration cytological preparations from 278 patients were used. The histological diagnosis was known for each sample. The positive and negative predictive values of the method assessed in this study were, respectively, 100% and 98% for papillary thyroid carcinoma (n = 63), 100% and 100% for medullary thyroid carcinoma (n = 19), 43.5% and 98% for follicular carcinoma (n = 15), and 86% and 100% for Hürthle cell carcinoma (n = 6). Thus, we demonstrate that the diagnostic panel, including the analysis of microRNA expression, mRNA expression, the BRAFV600E mutation, and the mitochondrial-to-nuclear DNA ratio, allows the highly accurate identification of papillary thyroid carcinoma, medullary thyroid carcinoma, and Hürthle cell carcinoma but not malignant follicular tumors (positive predictive value was below 50%).

scholarly journals Prediction of thyroid nodule histopathology by expert ultrasound evaluation

2021 ◽  
Author(s):  
Olav Inge Håskjold ◽  
Henrik Stenestø Foshaug ◽  
Therese Benedikte Iversen ◽  
Helga Charlotte Kjøren ◽  
Vegard Heimly Brun
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
High Resolution ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Histopathological Diagnosis ◽  
Papillary Thyroid ◽  
Ultrasound Evaluation

Objective: The basis of thyroid nodule diagnostics is ultrasound guided fine needle biopsy with cytological evaluation (FNC), if US appearance is not clearly benign. The aim of this study was to investigate the predictive potential of dedicated, expert high resolution ultrasound, to see if histopathological entities of thyroid nodules can be diagnosed without invasive FNC biopsies. Design: Prospective case cohort study. Methods: 180 patients with 221 thyroid nodules were examined with ultrasound and prospectively assigned to the expected histopathological diagnosis: colloid nodule, adenomatoid colloid nodule, follicular adenoma, follicular carcinoma, follicular variant of papillary thyroid carcinoma, papillary thyroid carcinoma, or other thyroid cancer. In 101 of these, we later obtained histopathological reports for comparison. Results: Overall accuracy for classification into discrete histopathological categories by expert ultrasound was 71.3% and Cohen’s Kappa was 0.62. The sensitivity and specificity for detecting malignancy was 97.3% and 78.1%. The diagnostic accuracy for malignancy was 85.1%. ACR-TIRADS scores for the same nodules had a sensitivity of 97.3%, specificity of 26.6%, and accuracy of 52.5%. Conclusion: Dedicated expert high-resolution ultrasound without FNC can reliably distinguish benign versus malignant nodules, but also differentiate between several histopathological entities in thyroid nodules. There is potential for a reduction in the number of invasive FNC biopsies and diagnostic operations.

Follicular thyroid carcinoma and follicular variant papillary thyroid carcinoma: Clinical and histological features depending on the initial size

2017 ◽  
Author(s):  
Fernando Garcia Perez ◽  
Guillermo Martinez de Pinillos Gordillo ◽  
Mariana Tome Fernandez-Ladreda ◽  
Eyvee Arturo Cuellar Lloclla ◽  
Jose Alvaro Romero Porcel ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Follicular Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Initial Size ◽  
Histological Features

A case report: co-occurence of medullary thyroid carcinoma and papillary thyroid carcinoma

2017 ◽  
Author(s):  
Beliz Camur ◽  
Mehmet Celik ◽  
Buket Yilmaz Bulbul ◽  
Semra Ayturk ◽  
Ebru Tastekin ◽  
...  
Keyword(s):  
Case Report ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Medullary Thyroid

scholarly journals INCIDENTAL PULMONARY METASTASES REVEALING SUBCENTIMETER PAPILLARY THYROID CARCINOMA

2020 ◽  
Vol 6 (5) ◽  
pp. e273-e278
Author(s):  
Ruey Hu ◽  
George Xu ◽  
Thomas Stricker ◽  
Bingshan Li ◽  
Vivian L. Weiss ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Active Surveillance ◽  
Thyroid Nodules ◽  
Lung Metastases ◽  
Molecular Testing ◽  
American Thyroid Association ◽  
Cancer Genes ◽  
Papillary Thyroid

Objective: Here we present 2 cases of papillary thyroid microcarcinomas (PMCs) that had metastasized at presentation. The 2015 American Thyroid Association and the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) criteria do not recommend biopsy of the majority of subcentimeter thyroid nodules, as PMCs are mostly indolent with excellent prognosis. However, the paradigm of active surveillance presents a conundrum on how to identify the rare patient with distant metastatic disease while avoiding unnecessary intervention in the majority. Methods: After initial discovery of incidental lesions on chest computed tomography, core or wedge biopsies of the lung lesion were performed. Thyroid nodules on ultrasound were classified by TI-RADS. Tumor DNA was sequenced, annotated, filtered on 119 known cancer genes, and filtered for variants with an exome allele frequency of <0.001. Results: A 70-year-old woman and a 29-year-old woman presented with incidental pulmonary lesions on computed tomography scan. Lung biopsy revealed lung metastases from papillary thyroid carcinoma. The thyroid nodules in both patients were TI-RADS 3 and American Thyroid Association low-suspicion. Molecular testing showed a c.1721C>G mutation (p.Thr574Ser) in the TSHR gene in patient 1 and a codon 61 mutation in the NRAS gene in patient 2. Both patients were iodine-avid, with complete structural remission in one patient and ongoing treatment with evidence of structural response in the other. Conclusion: The 2 presentations demonstrate unexpected and concerning behavior of PMCs. Both thyroid tumors were subcentimeter in diameter, meaning they would have escaped detection using traditional risk-stratification algorithms in active surveillance. Further knowledge of tumor genetics and microenvironment may assist in predicting tumor behavior in PMCs.

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