scholarly journals Clinical, Pathological, Treatment Pattern and Post-management Follow-up Features of Differentiated Thyroid Carcinoma (DTC) in a Tertiary Level Health Care Center of Bangladesh

2020 ◽  
Vol 32 (1) ◽  
pp. 25-28
Author(s):  
Parvez Ahmed ◽  
Subrata Ghosh ◽  
Mostafa Shamim Ahsan ◽  
Nasrin Begum ◽  
Mosharruf Hossain ◽  
...  

Introduction: This study evaluates clinical, pathological, treatment pattern and post-management follow-up features of differentiated thyroid carcinoma affected patients who had attended Rajshahi Medical College Hospital as well as private clinics and then Institute of Nuclear Medicine & Allied Sciences, Rajshahi for primary surgical management and post-operative radioiodine ablation therapy respectively. Materials and Methods: It is a retrospective study. Clinico-pathological, treatment and post-management follow-up features of 254 patients of histologically proved differentiated thyroid carcinoma (DTC) were recorded from their ultrasonography report, pre-operative cytology, operation note, post-operative histopathology and radioiodine ablation therapy related follow-up book between 2011 and 2015 and analyzed using statistical software IBM SPSS v. 16. Results: Among the sample (n=254), 211 (83 %) were female and 43 (17 %) were male. Mean age group was 30-39 years. In relation to FNAC findings of thyroid nodules among this study sample (n=254), 223 (88%) had malignant cytology, 16 (6%) had borderline cytology and 15 (6%) had benign cytology. Regarding the histopathological findings of thyroid nodules, 241 (95 %) had papillary carcinoma and 13 (5 %) had follicular carcinoma. Regarding radioiodine ablation dose, 198 (78%) had been given 138 millicurie (5.1 gigabecquerel) and 56 (22%) had been given 178 millicurie (6.6 gigabecquerel). Conclusion: Early and successful management of differentiated thyroid carcinoma is required to practice widely and equitably in order to significantly reduce mortality and morbidity related to such conditions. Medicine Today 2020 Vol.32(1): 25-28

2016 ◽  
Vol 55 (06) ◽  
pp. 221-227
Author(s):  
Mona Mustafa ◽  
Peter Bartenstein ◽  
Torsten Kuwert ◽  
Daniela Schmidt ◽  
Harun Ilhan

SummarySPECT/CT detects radioiodine-positive cervical lymph node metastases (LNMs) of differentiated thyroid carcinoma (DTC) at the time of postsurgical radioablation (RA). Preliminary evidence indicates that the majority of LNMs are successfully treated by RA. The aim of this study was to confirm this evidence in a bicentric setting and to evaluate whether size is a predictor for successful elimination. Patients and methods: Since 01/2007 and 05/2008, respectively, SPECT/spiral-CT is performed routinely in all patients with DTC at RA in two University Clinics. The outcome of iodine-positive LNMs identified by SPECT/CT until 12/2012 was analyzed by follow-up diagnostic 131I scans and serum thyreoglobulin (Tg) values. LNM volume and short-axis diameter were evaluated as prognostic factors by a receiver-operating characteristic (ROC) analysis. Results: 79 patients with 97 iodine-positive LNMs were included. Surgery was carried out in 8 patients with 13 LNMs due to the presence of additional iodine-negative lesions. Of the remaining 84 LNMs, 74 (88%) were successfully treated as demonstrated by radioiodine scans at follow-up. 10 LNMs persisted. 67/70 LNMs smaller than 0.9 ml were treated successfully, whereas this was the case of only 6/14 exceeding this threshold. Using this cut-off level to predict treatment success, sensitivity, specificity, positive and negative predictive value were 92%, 73%, 96%, and 57%. Results for short-axis diameter (cut-off level < 1cm) were 90%, 69%, 94% and 56%. Conclusion: RA is effective in the treatment of the majority of 131I-positive LNMs identified in SPECT/CT images. In this study, 88% of iodine-positive LNM in DTC were successfully treated by radioiodine given at RA. Both LNM volume and diameter are reliable predictors of treatment success.


Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1504
Author(s):  
Angela Spanu ◽  
Susanna Nuvoli ◽  
Andrea Marongiu ◽  
Ilaria Gelo ◽  
Luciana Mele ◽  
...  

131I Single-photon emission computerized tomography/computerized tomography (SPECT/CT) in the management of patients thyroidectomized for differentiated thyroid carcinoma (DTC) was further investigated. Retrospectively, 106 consecutive DTC patients were enrolled at the first radioiodine ablation, 24 at high risk (H), 61 at low risk (L) and 21 at very low risk (VL). 131I whole-body scan (WBS) and SPECT/CT were performed after therapeutic doses using a hybrid dual-head gamma camera. At ablation, SPECT/CT correctly classified 49 metastases in 17/106 patients with a significantly (p < 0.001) more elevated number than WBS which evidenced 32/49 foci in 13/17 cases. In this case, 86/106 patients could be monitored in the follow-up including 13/17 cases with metastases already at post-therapeutic scans. SPECT/CT after radioiodine diagnostic doses more correctly than WBS ascertained disease progression in 4/13 patients, stable disease in other 4/13 cases and disease improvement in the remaining 5/13 cases. Further 13/86 patients with only residues at post-therapeutic scans showed at SPECT/CT 16 neck lymph node (LN) metastases, three unclear and 13 occult at WBS. Significant involvement of some tissue risk factors with metastasis appearance was observed, such as minimal extrathyroid tumor extension and neck LN metastases. These risk factors should be carefully considered in DTC patient follow-up where 131I-SPECT/CT routinely use is suggested as a support tool of WBS.


1987 ◽  
Vol 26 (03) ◽  
pp. 139-142 ◽  
Author(s):  
G. Arning ◽  
O. Schober ◽  
H. Hundeshagen ◽  
Ch. Ehrenheim

In the follow-up of differentiated thyroid carcinoma it is discussed whether the tumormarker thyroglobulin can replace the1311 scan, especially when the thyroglobulin serum level is normal. A positive1311 scan of metastases in the follow-up of patients with differentiated thyroid carcinoma combined with a low serum thyroglobulin level is extremely rare. The literature shows a frequency of about 4%. Recently we found 3 cases with a positive1311 scan demonstrating pulmonary and bone metastases whereas the serum thyroglobulin level was low.


2020 ◽  
Vol 33 (11) ◽  
pp. 1431-1441
Author(s):  
Montserrat Negre Busó ◽  
Amparo García Burillo ◽  
Marc Simó Perdigó ◽  
Pere Galofré Mora ◽  
Maria Boronat de Ferrater ◽  
...  

AbstractObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences.ConclusionsDTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Chen ◽  
Yu kun Luo ◽  
Ying Zhang ◽  
Qing Song ◽  
Jie Tang

Abstract Background Treatment for radioiodine refractory differentiated thyroid carcinoma (RR-DTC) is challenging. The purpose of this study was to assess the efficacy and safety of ultrasound-guided implantation of radioactive 125I-seed in radioiodine refractory differentiated thyroid carcinoma. Methods Thirty-six cervical metastatic lymph nodes (CMLNs) diagnosed with RR-DTC from 18 patients were enrolled in this retrospective study. US and contrast-enhanced ultrasound (CEUS) examinations were performed before implantation. Follow-up comprised US, CEUS, thyroglobulin (Tg) level and routine hematology at 1–3, 6, 9 and 12 months and every 6 months thereafter. The volumes of the nodules were compared before implantation and at each follow-up point. The volume reduction rate (VRR) of nodules was also recorded. Results The median volume of the nodules was 523 mm3 (148, 2010mm3) initially, which decreased significantly to 53mm3 (0, 286mm3) (P < 0.01) at the follow-up point of 24 months with a median VRR as 95% (86,100%). During the follow-up period (the range was 24–50 months), 25 (69%) nodules had VRR greater than 90%, of which 12 (33%) nodules had VVR ≈ 100% with unclear structures and only 125I seed images were visible in the US. At the last follow-up visit, the serum Tg level decreased from 57.0 (8.6, 114.8) ng/ml to 4.9 (0.7, 50.3) ng/ml, (P < 0.01). Conclusion US-guided 125I seed implantation is safety and efficacy in treating RR- DTC. It could be an effective supplement for the comprehensive treatment of thyroid cancer.


Thyroid ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 475-476 ◽  
Author(s):  
Robin A.L. van der Wardt ◽  
Adrienne C.M. Persoon ◽  
Esther N. Klein Hesselink ◽  
Thera P. Links

2015 ◽  
Vol 2 (2) ◽  
pp. 81
Author(s):  
Sandesh Pawar ◽  
Sudhir D. Bhamre ◽  
Vijay Malpathak ◽  
Yamini Sorate

<strong>Aim</strong>: To observe the results and complications of lateral internal sphincterotomy in anal fissure. <strong>Materials&amp;Methods:</strong> The study was carried out as a prospective observational study of 40 patients at surgery department of a medical college&amp;tertiary health care center, over a period of two years that included cases of anal fissure in the age group of 16 years and above for conservative&amp;surgical management. <strong>Results</strong>: The recovery of the patient after this marvellous operation was fast and the pain relief was dramatic. On follow-up at 2 weeks post-operatively pain and other symptoms were present only in 11 patients (27.5%). On follow-up at 8 weeks post-operatively all 40 patients (100%) were symptom-free in this study. The complications that were observed within time frame of this study were Soiling in 4 patients (10%) and incontinence to flatus in 1 patient (2.5%). There was no recurrence of anal fissure observed in this study group within the time frame of this study. <strong>Conclusion</strong>: It is very evident from the above study that 'Lateral Internal Sphincterotomy' is by far the best operation for an indolent anal fissure.


Sign in / Sign up

Export Citation Format

Share Document