scholarly journals Prevalence of thyroid malignancy and hormonal dysfunction following radiation exposure in childhood

2021 ◽  
Vol 50 (5) ◽  
pp. 402-410
Author(s):  
Yee Sian Tiong ◽  
Edwin Yuen Hao Tong ◽  
Chia Ching Lee ◽  
Rajeev Parameswaran ◽  
Timothy Cheo ◽  
...  

ABSTRACT Introduction: Childhood radiation exposure is a known risk factor for thyroid malignancy and dysfunction. However, local data are limited and there is no consensus on the modality and frequency of screening in this high-risk group. Methods: Retrospective analysis study evaluating patients with childhood radiation exposure in 2006–2016 and minimum of 1-year follow-up. Results: Of the 132 childhood cancer survivors in the study, thyroid malignancy was detected in 2 cases (1.5%) and thyroid nodules in 13 (9.8%). The earliest thyroid malignancy was detected 5 years post-radiotherapy via ultrasound. Of the 84 patients who had screening thyroid function test, 26 (31.0%) were detected with abnormal test results post-radiation, majority being subclinical hypothyroidism. Conclusion: Regular screening via clinical examination for thyroid nodules should be performed at least annually. Where feasible and if resources permit, consideration should be given to using ultrasound for thyroid nodule(s) and malignancy screening at 5 years post-radiation therapy. Screening for thyroid dysfunction can be considered from 6–12 months post-radiotherapy. Keywords: Childhood post-radiotherapy complications, post-radiotherapy secondary malignancies, thyroid cancer, thyroid dysfunction, thyroid nodules

2015 ◽  
Vol 54 (03) ◽  
pp. 94-100 ◽  
Author(s):  
P. B. Musholt ◽  
T. J. Musholt

SummaryAim: Thyroid nodules > 1 cm are observed in about 12% of unselected adult employees aged 18–65 years screened by ultrasound scan (40). While intensive ultrasound screening leads to early detection of thyroid diseases, the determination of benign or malignant behaviour remains uncertain and may trigger anxieties in many patients and their physicians. A considerable number of thyroid resections are consecutively performed due to suspicion of malignancy in the detected nodes. Fine needle aspiration biopsy (FNAB) has been recommended for the assessment of thyroid nodules to facilitate detection of thyroid carcinomas but also to rule out malignancy and thereby avoid unnecessary thyroid resections. However, cytology results are dependent on experience of the respective cytologist and unfortunately inconclusive in many cases. Methods: Molecular genetic markers are already used nowadays to enhance sensitivity and specificity of FNAB cytology in some centers in Germany. The most clinically relevant molecular genetic markers as pre-operative diagnostic tools and the clinical implications for the intraoperative and postoperative management were reviewed. Results: Molecular genetic markers predominantly focus on the preoperative detection of thyroid malignancies rather than the exclusion of thyroid carcinomas. While some centers routinely assess FNABs, other centers concentrate on FNABs with cytology results of follicular neoplasia or suspicion of thyroid carcinoma. Predominantly mutations of BRAF, RET/PTC, RAS, and PAX8/PPARγ or expression of miRNAs are analyzed. However, only the detection of BRAF mutations predicts the presence of (papillary) thyroid malignancy with almost 98% probability, indicating necessity of oncologic thyroid resections irrespective of the cytology result. Other genetic alterations are associated with thyroid malignancy with varying frequency and achieve less impact on the clinical management. Conclusion: Molecular genetic analysis of FNABs is increasingly performed in Germany. Standardization, quality controls, and validation of various methods need to be implemented in the near future to be able to compare the results. With increasing knowledge about the impact of genetic alterations on the prognosis of thyroid carcinomas, recommendations have to be defined that may lead to individually optimized treatment strategies.


2019 ◽  
Vol 70 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Manijeh Mohammadi ◽  
Carrie Betel ◽  
Kirsteen Rennie Burton ◽  
Kevin McLughlin Higgins ◽  
Zeina Ghorab ◽  
...  

Objective To determine the incidence of malignancy, follow-up ultrasound (US), and repeat fine needle aspiration (FNA) in thyroid nodules that have been previously biopsied as benign. Methods This is a retrospective, descriptive study of benign thyroid nodules evaluated by US between 2010-2011. We determined the frequency of follow-up ultrasounds and FNAs, mean years of follow-up, interval between follow-up US, change in nodule size, reasons for repeat FNA (rFNA), frequency of thyroidectomy, and thyroid malignancy during 5 years of follow-up. Results A total of 733 benign thyroid nodules were reviewed in 615 patients. Mean years of US follow-up was 3.47 ± 1.65 years; 275 (37.5%) had no follow-up US; 109 (14.9%) had 1 follow-up US; 93 (12.7%) had 2 follow-up US; and 256 (34.9%) had 3 or more follow-up US. Assessment of thyroid nodule size showed that 215 (28.8%) nodules decreased in size, 145 (19.4%) increased in size by less than 50%, and 91 (12.1%) increased in size by more than 50%. Of the 733 nodules, 17 nodules (2.3%) underwent thyroidectomy for which the pathology result of 9 (1.2%) showed malignancy, and 65 (8.9%) thyroid nodules underwent rFNA. When applying the 2015 recommendations for repeat FNA, 35% were done unnecessarily. Conclusion In our sample of initially benign thyroid nodules, only 9 patients (1.2%) had pathology-proven malignancy after a mean follow-up of 3.5 years. Over 30% of patients had more than 3 rUSs. Decreased interval and frequency of rUS should be considered in future guidelines for thyroid management.


2009 ◽  
Vol 59 (6) ◽  
pp. 437-439 ◽  
Author(s):  
K. K. Karipidis ◽  
G. Benke ◽  
M. R. Sim ◽  
L. Fritschi ◽  
C. Vajdic ◽  
...  

2021 ◽  
Vol 66 (4) ◽  
pp. 18-24
Author(s):  
I. Ushakov ◽  
Vladimir Fyodorov

Purpose: Comparative assessment of radiation-induced changes in neurons of the cerebral cortex after a single and fractionated exposure to ionizing radiation in doses of 0.1 – 1.0 Gy. Material and methods. The study was carried out in compliance with the rules of bioethics on 180 white outbred male rats at the age of 4 months. by the beginning of the experiment, exposed to a single or fractionated exposure to γ-quanta of 60Co in total doses of 0.1; 0.2; 0.5 and 1.0 Gy. Neuromorphological and histochemical methods were used to assess morphometric and tinctorial parameters of nerve cells, as well as changes in the content of protein and nucleic acids in neurons in the early and late periods of the post-radiation period. Using one-way analysis of variance, a comparative assessment of neuromorphological indicators under various modes of radiation exposure is given. Results: In the control and irradiated animals throughout their life, undulating changes in the indicators of the state of the neurons of the brain occur with a gradual decrease by the end of the experiment. Despite a number of features of the dynamics of neuromorphological parameters, these irradiation regimes do not cause functionally significant changes in the neurons of the cortex. However, in some periods of the post-radiation period, the changes under the studied irradiation regimes were multidirectional and did not always correspond to age control. Significant differences in the response of neurons to these modes of radiation exposure in the sensory and motor areas of the cerebral cortex have not been established. Conclusion: No functionally significant radiation-induced changes in neurons were found either with single or fractionated irradiation. At the same time, different modes of irradiation in general caused the same type of changes in neurons. However, in some periods of observation, changes in neuromorphological parameters under the studied irradiation regimes were not unidirectional and differed from age control, which indicates a possible risk of disturbances in the functioning of the nervous system against the background of other harmful and dangerous factors.


2014 ◽  
Vol 58 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Pedro Weslley Rosario ◽  
Maria Regina Calsolari

Objective: To establish serum TSH reference values for a population of Brazilian elderly, and to compare them to those found in the adult population. Subjects and methods: Healthy volunteers aged 70 to 85 years, without known thyroid disease or risk factors for thyroid dysfunction, who did not use any medication that could potentially interfere with TSH, were selected. Subjects with goiter, palpable thyroid nodules, anti-thyroperoxidase antibodies, or altered free T4 were excluded. The sample consisted of 360 older adults (180 per sex). Results: TSH values corresponding to the 2.5th and 97.5th percentile of the sample were 0.2 and 4.62 mIU/L, respectively. TSH > 2.5 mIU/L was seen in 25.26% of the volunteers, > 3 mIU/L in 15.26%, and > 4 mIU/L in 6.1% of them. TSH values were slightly higher than those previously reported for adults (18-60 years). Conclusion: This study suggests an upper limit for normal TSH of approximately 4.6 mIU/L for the Brazilian elderly population.


Author(s):  
Jibril Yahya Hudise ◽  
Khalid Ali Alshehri ◽  
Saad Nasser Alqarni ◽  
Yara Assiri ◽  
Ashwaq Asiri ◽  
...  

<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>


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