scholarly journals A Search for Causes of Rising Incidence of Differentiated Thyroid Cancer in Children and Adolescents after Chernobyl and Fukushima: Comparison of the Clinical Features and Their Relevance for Treatment and Prognosis

2021 ◽  
Vol 18 (7) ◽  
pp. 3444
Author(s):  
Valentina Drozd ◽  
Vladimir Saenko ◽  
Daniel I. Branovan ◽  
Kate Brown ◽  
Shunichi Yamashita ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Children And Adolescents ◽  
Differentiated Thyroid Cancer ◽  
Age Groups ◽  
Distant Metastases ◽  
Lifestyle Changes ◽  
Radiation Doses ◽  
Related Factors ◽  
Fukushima Accident ◽  
Tumor Stages

The incidence of differentiated thyroid cancer (DTC) is steadily increasing globally. Epidemiologists usually explain this global upsurge as the result of new diagnostic modalities, screening and overdiagnosis as well as results of lifestyle changes including obesity and comorbidity. However, there is evidence that there is a real increase of DTC incidence worldwide in all age groups. Here, we review studies on pediatric DTC after nuclear accidents in Belarus after Chernobyl and Japan after Fukushima as compared to cohorts without radiation exposure of those two countries. According to the Chernobyl data, radiation-induced DTC may be characterized by a lag time of 4–5 years until detection, a higher incidence in boys, in children of youngest age, extrathyroidal extension and distant metastases. Radiation doses to the thyroid were considerably lower by appr. two orders of magnitude in children and adolescents exposed to Fukushima as compared to Chernobyl. In DTC patients detected after Fukushima by population-based screening, most of those characteristics were not reported, which can be taken as proof against the hypothesis, that radiation is the (main) cause of those tumors. However, roughly 80% of the Fukushima cases presented with tumor stages higher than microcarcinomas pT1a and 80% with lymph node metastases pN1. Mortality rates in pediatric DTC patients are generally very low, even at higher tumor stages. However, those cases considered to be clinically relevant should be followed-up carefully after treatment because of the risk of recurrencies which is expected to be not negligible. Considering that thyroid doses from the Fukushima accident were quite small, it makes sense to assess the role of other environmental and lifestyle-related factors in thyroid carcinogenesis. Well-designed studies with assessment of radiation doses from medical procedures and exposure to confounders/modifiers from the environment as e.g., nitrate are required to quantify their combined effect on thyroid cancer risk.

scholarly journals Preoperative Serum Thyroglobulin and Its Correlation with the Burden and Extent of Differentiated Thyroid Cancer

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 625
Author(s):  
Hosu Kim ◽  
So Young Park ◽  
Jun-Ho Choe ◽  
Jee Soo Kim ◽  
Soo Yeon Hahn ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Primary Tumor ◽  
Differentiated Thyroid Cancer ◽  
Medical Center ◽  
Distant Metastases ◽  
Predictive Biomarker ◽  
Tumor Burden ◽  
Serum Thyroglobulin ◽  
Preoperative Serum ◽  
Clinical Records

Lymph node metastasis (LNM) in differentiated thyroid cancer (DTC) is usually detected with preoperative ultrasonography; however, this has limited sensitivity for small metastases, and there is currently no predictive biomarker that can help to inform the extent of surgery required. We evaluated whether preoperative serum thyroglobulin levels can predict tumor burden and extent. We retrospectively reviewed the clinical records of 4029 DTC cases diagnosed and treated at a Samsung Medical Center between 1994 and 2016. We reviewed primary tumor size, number and location of LNM, and presence of distant metastases to reveal relationships between tumor burden and extent and preoperative serum thyroglobulin levels. We found a linear association between increasing preoperative thyroglobulin levels, the size of the primary tumor, and the number of LNM (r = 0.34, p < 0.001, r = 0.20, p < 0.001, respectively). Tumor extent also increased with each decile of increasing preoperative thyroglobulin level (r = 0.18, p < 0.001). Preoperative thyroglobulin levels of 13.15 ng/mL, 30.05 ng/mL, and 62.9 ng/mL were associated with the presence of ipsilateral lateral LNM, contralateral lateral LNM, and distant metastasis, respectively. Our results suggest that preoperative measurement of serum thyroglobulin may help to predict LNM and help to tailor surgery.

scholarly journals Late-onset distant metastases confer poor prognosis in patients with well-differentiated thyroid cancer

Gland Surgery ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 1857-1866
Author(s):  
Chan Kwon Jung ◽  
Sohee Lee ◽  
Ja Seong Bae ◽  
Dong-Jun Lim
Keyword(s):  
Thyroid Cancer ◽  
Poor Prognosis ◽  
Differentiated Thyroid Cancer ◽  
Late Onset ◽  
Distant Metastases ◽  
Well Differentiated

scholarly journals Regional Variation across Canadian Centers in Radioiodine Administration for Thyroid Remnant Ablation in Well-Differentiated Thyroid Cancer Diagnosed in 2000–2010

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
I. Rachinsky ◽  
M. Rajaraman ◽  
W. D. Leslie ◽  
A. Zahedi ◽  
C. Jefford ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Distant Metastases ◽  
Tnm Staging ◽  
Remnant Ablation ◽  
Thyroid Hormone Withdrawal ◽  
Care Patterns ◽  
Major Variation ◽  
Well Differentiated ◽  
Over Time

Background. Use of radioactive iodine (RAI) ablation has been reported to vary significantly between studies. We explored variation in RAI ablation care patterns between seven thyroid cancer treatment centers in Canada.Methods. The Canadian Collaborative Network for Cancer of the Thyroid (CANNECT) is a collaborative registry to describe and analyze patterns of care for thyroid cancer. We analyzed data from seven participating centers on RAI ablation in patients diagnosed with well-differentiated (papillary and follicular) thyroid cancer between 2000 and 2010. We compared RAI ablation protocols including indications (based on TNM staging), preparation protocols, and administered dose. We excluded patients with known distant metastases at time of RAI ablation.Results. We included 3072 patients. There were no significant differences in TNM stage over time. RAI use increased in earlier years and then declined. The fraction of patients receiving RAI varied significantly between centers, ranging between 20–85% for T1, 44–100% for T2, 58–100% for T3, and 59–100% for T4. There were significant differences in the RAI doses between centers. Finally, there was major variation in the use of thyroid hormone withdrawal or rhTSH for preparation of RAI ablation.Conclusion. Our study identified significant variation in use of RAI for ablation in patients with well-differentiated thyroid cancer both between Canadian centers and over time.

Differentiated thyroid cancer presenting as distant metastases

2002 ◽  
Vol 168 (5) ◽  
pp. 305-309 ◽  
Author(s):  
Anjali Mishra ◽  
Saroj Kanta Mishra ◽  
Birendra Kishore Das ◽  
Prasanta Kumar Pradhan
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Distant Metastases

scholarly journals A False Positive I-131 Metastatic Survey Caused by Radioactive Iodine Uptake by a Benign Thymic Cyst

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Avneet K. Singh ◽  
Adina A. Bodolan ◽  
Matthew P. Gilbert
Keyword(s):  
Thyroid Cancer ◽  
False Positive ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Case Reports ◽  
Distant Metastases ◽  
The United States ◽  
Thymic Cyst ◽  
Pathological Findings ◽  
Thymic Cysts

Thyroid carcinoma is the most common endocrine malignancy in the United States with increasing incidence and diagnosis but stable mortality. Differentiated thyroid cancer rarely presents with distant metastases and is associated with a low risk of morbidity and mortality. Despite this, current protocols recommend remnant ablation with radioactive iodine and evaluation for local and distant metastasis in some patients with higher risk disease. There are several case reports of false positive results of metastatic surveys that are either normal physiologic variants or other pathological findings. Most false positive findings are associated with tissue that has physiologic increased uptake of I-131, such as breast tissue or lung tissue; pathological findings such as thymic cysts are also known to have increased uptake. Our case describes a rare finding of a thymic cyst found on a false positive I-131 metastatic survey. The patient was taken for surgical excision and the final pathology was a benign thymic cyst. Given that pulmonary metastases of differentiated thyroid cancer are rare, thymic cysts, though also rare, must be part of the differential diagnosis for false positive findings on an I-131 survey.

scholarly journals Differentiated Thyroid Cancer With Liver Metastases: Lessons Learned From Managing a Series of 14 Patients

2015 ◽  
Vol 100 (3) ◽  
pp. 490-496 ◽  
Author(s):  
C. Brient ◽  
S. Mucci ◽  
D. Taïeb ◽  
M. Mathonnet ◽  
F. Menegaux ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Differentiated Thyroid Cancer ◽  
Kinase Inhibitors ◽  
Specific Treatment ◽  
Distant Metastases ◽  
Differentiated Thyroid Carcinoma ◽  
Lessons Learned ◽  
Liver Lesions

Liver metastases from differentiated thyroid carcinoma (LMDTC) are rare and usually occur in disseminated metastatic disease. The aim of this study was to review the diagnosis and management of LMDTC. Between 1995 and 2011, 14 patients with a mean age of 59.7 years (+/-10.2) were treated for LMDTC. Data were retrospectively reviewed and analyzed. Seven patients had distant metastases at diagnosis, including 2 with synchronous liver lesions. The average time of onset of LMDTC from initial diagnosis was 52.2 months (+/49.5). All LMDTC were discovered during routine radiologic monitoring. Histologic analysis confirmed LMDTC in 5 patients. Eight patients received tyrosine kinase inhibitors, 1 patient underwent resection of their LMDTC after chemotherapy. Six patients (disseminated metastases, significant comorbidities) did not receive any specific treatment. The median survival after diagnosis of LMDTC was 17.4 months (+/-3.3): 23.6 months (+/-2.9) for patients who underwent chemotherapy versus 3.9 months (+/-0.9) for patients who did not receive any specific treatment (P &lt; 0.001). Developing DTC liver metastasis is a very poor prognostic sign. Chemotherapy by TKIs, especially, hold promise in the cure of LMDTC for selected patients.

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