scholarly journals Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2323
Author(s):  
Hyunju Park ◽  
Jun Park ◽  
So Young Park ◽  
Tae Hyuk Kim ◽  
Sun Wook Kim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Cause Of Death ◽  
Differentiated Thyroid Cancer ◽  
Causes Of Death ◽  
Clinical Course ◽  
Common Causes ◽  
Regional Disease ◽  
Well Differentiated

Because of the low mortality rate of well-differentiated thyroid cancer (WDTC), investigation of the clinical course leading to death is limited. We analyzed the cause of death and clinical course from diagnosis to death in patients who died of WDTC. A total of 592 WDTC patients died between 1996 and 2018. After exclusion, 79 patients were enrolled and divided into four groups based on their clinical course; that is, inoperable at the time of diagnosis (inoperable), distant metastasis (DM) detected at the time of diagnosis (initial-DM), DM detected during follow-up (late-DM), and loco-regional disease (L-R). Lung (55.6%) in papillary thyroid carcinoma (PTC) and bone (46.7%) in follicular thyroid carcinoma (FTC) were the most common metastasis locations. The most common causes of death were respiratory failure (32.3%) and airway obstruction (30.6%) in PTC, and complications due to immobilization arising from bone metastasis (35.3%) in FTC. Brain metastasis was found in 13.3% of patients and had the worst prognosis. The overall survival (OS) differed significantly (p = 0.001) according to clinical course; the inoperable had the shortest survival, followed by the initial-DM, L-R, and late-DM. However, OS did not differ significantly between PTC and FTC patients with initial-DM (p = 0.83). Other causes of death were far more common than death resulting from WDTC. In patients dying of WDTC, the major cause of death varied by metastatic site. OS differed according to clinical course, but not histologic type. Timing and DM sites differed between PTC and FTC.

Infections and demanding endocrine care contribute to increased mortality in patients with APECED

2021 ◽  
Author(s):  
Joonatan Borchers ◽  
Outi Mäkitie ◽  
Saila Laakso
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Clinical Course ◽  
Circulatory System ◽  
National Registry ◽  
Adrenal Crisis ◽  
Age At Death ◽  
Common Causes ◽  
Overall Mortality

Objective: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) has variable clinical course. Overall mortality is increased but reasons for this remain largely unknown. Our objective was to assess the causes of death and factors contributing to increased mortality. Design: A follow-up study of the Finnish APECED cohort in 1970-2019. Methods: In 34 deceased patients with APECED, causes of death and clinical course preceding the death were analyzed using national registry data, death certificates, autopsy reports, and patient records. Results: Most common causes leading to death were infections (24%), oral and esophageal malignancies (15%; median age at death 36.7 years; median survival 1.5 years), and diseases of circulatory system (18%). Adrenal crisis was an independent cause of death in two patients. In addition, in four patients, adrenal crisis was a complicating factor during a fatal infection. Other APECED manifestations leading to death were hypoparathyroidism, diabetes, and hepatitis. Other causes of death included accidents (12%), alcohol related causes, and amyotrophic lateral sclerosis. Challenges in the overall, and especially in the endocrine, care contributed to deaths related to carcinomas and adrenal crisis. Age at death and year of death correlated (r = 0.345, P = 0.045), suggesting improved longevity. Conclusions: Infections, malignancies and diseases of circulatory system are the most common primary causes of death in patients with APECED. Adrenal crisis is an independent cause of death but more often a contributing factor in fatal infections. Despite the high overall mortality and the demanding care, our results suggest improved patient survival in recent years.

scholarly journals Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer

2013 ◽  
Vol 5 (2) ◽  
pp. 45-49
Author(s):  
Ian C Bennett ◽  
Magdalena Biggar ◽  
Clement Wong ◽  
Michael Law
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Differentiated Thyroid Cancer ◽  
Intraoperative Ultrasound ◽  
Surgical Excision ◽  
Ultrasound Guided ◽  
Cervical Lymph Nodes ◽  
Intraoperative Localization

ABSTRACT As a result of sensitive thyroglobulin assays and widespread use of cervical ultrasound, endocrine surgeons are encountering patients with impalpable suspicious or frankly metastatic cervical lymph nodes in the follow-up phase after treatment for welldifferentiated thyroid cancer. The surgical excision of impalpable disease of recurrent or persistent thyroid cancer can represent a significant challenge which may require some means of intraoperative localization to ensure that affected nodes are removed. Surgeon-performed intraoperative ultrasound (IOUS) can be used for guiding excision of suspicious but impalpable cervical nodes. The IOUS-guided excision technique is described. The successful application of IOUS to localize and guide resection of impalpable nodal recurrences of papillary thyroid carcinoma in two patients is reported. The utilization of IOUS to guide resection of impalpable pathological nodes in the context of thyroid carcinoma is a safe and practical technique which avoids the need for additional localization procedures and unnecessary potential morbidity for the patient. How to cite this article Biggar M, Wong C, Law M, Bennett IC. Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer. World J Endoc Surg 2013;5(2):45-49.

scholarly journals Management of differentiated thyroid cancer diagnosed during pregnancy

1999 ◽  
pp. 404-406 ◽  
Author(s):  
L Vini ◽  
S Hyer ◽  
B Pratt ◽  
C Harmer
Keyword(s):  
Thyroid Cancer ◽  
Bone Metastases ◽  
Differentiated Thyroid Cancer ◽  
Subtotal Thyroidectomy ◽  
Second Trimester ◽  
Original Cohort ◽  
Well Differentiated ◽  
Disease Free ◽  
In Pregnancy

OBJECTIVE: To assess the outcome of thyroid cancer diagnosed during pregnancy. DESIGN: Retrospective analysis of patients diagnosed between 1949 and 1997 with thyroid cancer presenting during pregnancy. RESULTS: Nine women with a median age of 28 years were identified. A thyroid nodule was discovered by the clinician during routine antenatal examination in four cases, the remainder had noted a lump in the neck. In all patients, the nodule was reported to almost double in size during the pregnancy. One patient underwent subtotal thyroidectomy during the second trimester; eight were operated on within 3 to 10 months from delivery. Total thyroidectomy was performed in five and subtotal thyroidectomy in four. All tumours were well differentiated and ranged in size from 1 to 6 cm. OUTCOME: The median follow-up was 14 years (5-31 years). One patient relapsed locally requiring further surgery. One patient developed bone metastases dying 7 years after presentation; her planned treatment had been delayed because of an intervening pregnancy. Eight of the original cohort of patients are currently disease free. CONCLUSIONS: Differentiated thyroid cancer presenting in pregnancy generally has an excellent prognosis. When the disease is discovered early in pregnancy, surgery should be considered in the second trimester but radioiodine scans and treatment can be safely delayed until after delivery. In all cases, treatment should not be delayed for more than a year.

Skull metastasis of thyroid carcinoma

1985 ◽  
Vol 63 (4) ◽  
pp. 526-531 ◽  
Author(s):  
Yoshihide Nagamine ◽  
Jiro Suzuki ◽  
Ryuich Katakura ◽  
Takashi Yoshimoto ◽  
Naoya Matoba ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Clinical Course ◽  
Detailed Examination ◽  
Thyroid Tumor ◽  
Content Type ◽  
Skull Metastasis ◽  
The Past ◽  
The Mean ◽  
Well Differentiated

✓ Over the past 33 years the authors have treated 12 cases of skull metastasis from thyroid carcinoma, accounting for 2.5% of a total of 473 cases of thyroid cancer. A study of these 12 cases revealed the following characteristics. 1) The mean age of the patients was 60.4 years and the predominant incidence was in the seventh decade of life. 2) The incidence of skull metastasis from thyroid cancer was higher among women than among men. 3) The primary sign was a soft hemispheric tumor resting on the skull. 4) The tumors were rich in vascularity with osteolytic changes in the skull. 5) The average period from diagnosis of the thyroid tumor until thyroidectomy was 14.3 years, and until discovery of the skull metastasis was 23.3 years. The clinical course was thus very long. 6) The most frequent histopathological presentation was follicular adenocarcinoma. Such lesions were morphologically well differentiated, with little pleomorphism and atypism, but detailed examination showed infiltration into the vascular lumen or capsule. 7) The mean survival time in these patients was 4.5 years from the time of diagnosis. The prognosis in this lesion was relatively poor, considering its long clinical course.

Iodine uptake in the chest in the follow-up of well-differentiated thyroid cancer

2011 ◽  
Vol 30 (1) ◽  
pp. 24-28
Author(s):  
M.P. García Alonso ◽  
M.A. Balsa Bretón ◽  
C. Paniagua Correa ◽  
L. Castillejos Rodríguez ◽  
F.J. Penín González ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Iodine Uptake ◽  
Well Differentiated

scholarly journals Clinical course and outcome of differentiated thyroid cancer patients with pregnancy after diagnosis of distant metastasis

2021 ◽  
Author(s):  
Haruhiko Yamazaki ◽  
Kiminori Sugino ◽  
Jaeduk Yoshimura Noh ◽  
Ryohei Katoh ◽  
Kenichi Matsuzu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Distant Metastasis ◽  
Differentiated Thyroid Cancer ◽  
Clinical Course ◽  
Progression Free Survival ◽  
Good Survival ◽  
Live Births ◽  
Comparator Group

Abstract Purpose There is no sufficient data about the clinical course and outcome in thyroid cancer patients who become pregnant after diagnosis of distant metastasis (DM). The current study was conducted to collect information regarding the clinical and reproductive characteristics, and outcomes in thyroid cancer patients who became pregnant after being diagnosed with DM. Methods Records of 125 differentiated thyroid cancer (DTC) patients with age ≤ 45 years at DM diagnosis who had visited Ito Hospital from January 2005 to June 2021 were retrospectively reviewed. Among those 125 patients, 28 who became pregnant after DM diagnosis were classified as pregnant group, and the remained 97 patients were classified as comparator group. Results In pregnant group, the median age at malignancy diagnosis, DM diagnosis, and first pregnancy after DM diagnosis was 25 years (range, 4–41 years), 27 years (range, 11–41 years), and 32 years (range, 25–45 years), respectively. Fifty-five pregnancies and 40 live births were reported. Three patients had live births by embryo transfer. Other pregnancy outcomes were miscarriage (n = 14) and induced abortion (n = 1). No one died during the follow-up period in this study. The 10-year progression free survival (PFS) rates of pregnant and comparator group were 92.1% and 74.4%, respectively. Conclusion DTC patients who became pregnant after DM diagnosis had good survival. Our results add to the information required for counseling thyroid cancer patients who have concerns about their fertility in the future.

scholarly journals Therapeutic Outcomes of Recurrent Well-Differentiated Thyroid Carcinomas

2019 ◽  
Vol 104 (7-8) ◽  
pp. 304-313
Author(s):  
Chih-Yiu Tsai ◽  
Shu-Fu Lin ◽  
Szu-Tah Chen ◽  
Chuen Hsueh ◽  
Yann Sheng Lin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Recurrent Disease ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Carcinomas ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Well Differentiated ◽  
Disease Specific

Objective The aim of this study was to evaluate outcomes of the recurrent and non-recurrent groups including disease-specific mortality of patients with well-differentiated thyroid carcinoma after multimodality treatment. In addition, prognostic factors for disease-specific mortality were analyzed. Summary of Background Data Among 2,844, there were 166 patients with recurrent disease. Recurrent disease was defined as the presence of papillary or follicular thyroid cancer 6 months after the initial thyroidectomy, including locoregional or distant metastasis, diagnosed using diagnostic or therapeutic 131I scans or other imaging techniques. Methods The study was a retrospective analysis of prospectively collected data for a long-term follow-up result of well-differentiated thyroid carcinoma patients. Results The mean age of 166 patients was 45.8 ± 1.2 years, 116 (69.9%) were women, 111 (66.9%) had locoregional neck recurrence, and 55 (33.1%) had metastatic recurrence in distant organs. We found that when recurrences were observed, more than half were detected within the first 5 years following the initial therapy. The longest period of time before relapse was 29.8 years. After a mean follow-up period of 12.7 ± 0.5 years, 37 (22.3%) patients experienced disease-specific mortality. Multivariable analysis revealed that older age, male sex, and development of a second primary malignancy were associated with disease-specific mortality. Higher post-operative levels of thyroglobulin predicted a shorter time to relapse. Conclusions These data indicate that among the recurrent cases over 50% of recurrent well-differentiated thyroid carcinomas were diagnosed within 5 years after initial thyroidectomy. Additionally, more than 20% of the patients died of thyroid cancer.

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