scholarly journals The relationship of thyroid cancer with dominant nodule in patients with nodular goiter who underwent total thyroidectomy and had thyroid carcinoma

2013 ◽  
Vol 28 (4) ◽  
pp. 182-185
Author(s):  
Koray Arisoy ◽  
Ferda Nihat Koksoy ◽  
Dogan Gonullu ◽  
Aysenur Ayyildiz Igdem ◽  
Bekir Kuru
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Nodular Goiter ◽  
Relationship Of ◽  
The Relationship

scholarly journals Serum TSH and Risk of Papillary Thyroid Cancer in Nodular Thyroid Disease

2012 ◽  
Vol 97 (4) ◽  
pp. 1134-1145 ◽  
Author(s):  
Emilio Fiore ◽  
Paolo Vitti
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Disease ◽  
Differentiated Thyroid Cancer ◽  
Nodular Goiter ◽  
Papillary Thyroid ◽  
Thyroid Malignancy ◽  
The Relationship ◽  
Serum Tsh

Context: TSH is the main factor involved in the control of proliferation of thyrocytes. Recently, a strong relationship between serum TSH and risk of thyroid malignancy has been reported. Objectives: The aim was to review published papers about the relationship between serum TSH and frequency of differentiated thyroid cancer. Evidence Acquisition: PubMed was used to identify studies focused on the relationship between TSH and differentiated thyroid cancer. Evidence Synthesis: In patients with nodular thyroid disease, the risk of thyroid malignancy increases with serum TSH, and even within normal ranges, higher TSH values are associated with a higher frequency and more advanced stage of thyroid cancer. The likelihood of papillary thyroid carcinoma is reduced when TSH is lower, as in thyroid autonomy, and increased when TSH is higher, as in thyroid autoimmunity. Treatment with l-thyroxine (LT4), which reduces serum TSH, is associated with significantly lower risk of developing clinically detectable thyroid cancer. Conclusions: TSH plays a key role in the development of clinically detectable thyroid cancer, and LT4 treatment reduces the risk of thyroid malignancy in patients with nodular thyroid disease. According to the guidelines of the main scientific societies, LT4 therapy is not currently recommended for the treatment of patients with nodular goiter. Even if the available data are not sufficient to advise LT4 treatment in all patients with nodular goiter with the aim of reducing the risk of papillary thyroid carcinoma, we propose that this indication should be reconsidered, taking into account recent evidence reported in the literature.

scholarly journals Association between Thyroiditis and Multifocality in Papillary Thyroid Carcinoma

2020 ◽  
Author(s):  
Rogério Aparecido Dedivitis ◽  
Leandro Luongo de Matos ◽  
Felipe Guilherme Silva Souza ◽  
Jose Luis Bogado Ortiz
Keyword(s):  
Retrospective Study ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Direct Relationship ◽  
Statistical Significance ◽  
Hashimoto Thyroiditis ◽  
Papillary Thyroid ◽  
Multifocal Lesions ◽  
The Relationship

Abstract Introduction Hashimoto thyroiditis (HT) shares many characteristics with papillary thyroid carcinoma (PTC), and some studies show that, when associated, PTC is diagnosed mostly with smaller lesions and multifocal pattern. Objective To evaluate the relationship between HT and PTC. Methods A retrospective study of 155 patients who underwent total thyroidectomy from 2009 to 2015. Demographical, clinical and ultrasonographical data, as well as anatomopathological findings were evaluated. Results There were signs of thyroidits in 35 patients, and 114 patients had a unifocal disease. There was no statistical significance between the variables studied and thyroiditis. However, when compared with the occurrence of unifocal or multifocal lesions, there was statistical significance regarding age (p = 0.038) and mass (p = 0.031). There was no direct relationship between thyroiditis and multifocality (p = 0.325) nor between thyroiditis and cervical extension of the disease (p = 0.300 e p = 0.434). Conclusion There was no relationship between thyroiditis and multifocality in cases of PTC.

THE RELATIONSHIP OF BRAFV600E MUTATION STATUS TO FDG PET/CT AVIDITY IN THYROID CANCER: A REVIEW AND META-ANALYSIS

2018 ◽  
Vol 24 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Prasanna Santhanam ◽  
Rodhan Khthir ◽  
Lilja B. Solnes ◽  
Paul. W. Ladenson
Keyword(s):  
Thyroid Cancer ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Brafv600e Mutation ◽  
Mutation Status ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Relationship Of ◽  
The Relationship

scholarly journals Difficult Decision on Tyroid Surgery of Expert Witness: Complication or Malpractice

2017 ◽  
Vol 23 (2) ◽  
pp. 89-92
Author(s):  
Ali Rıza Tümer ◽  
Mahmut Şerif Yıldırım ◽  
Savaş Koçak
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Cancer Patients ◽  
Thyroid Surgery ◽  
Expert Witness ◽  
Nodular Goiter ◽  
Laryngeal Nerve ◽  
Subtotal Thyroidectomy ◽  
Difficult Decision ◽  
Common Problems

Objective: Recurrent laryngeal nerve (RLN) paralysis and hypocalcemia following thyroid surgery have been designated as complication or malpractice. In this study, it was aimed to evaluate surgeons’ opinions towards RLN injury and hypocalcemia after bilateral subtotal thyroidectomy (BST) and total thyroidectomy (TT) in nodular goiter and thyroid carcinoma. Materials and Methods: We prepared a questionnaire to determine approaches of surgeons in such cases. We grouped the respondents according their thyroid surgery experiments and asked them to determine whether it is malpractice or complication in cases with unilateral or bilateral RLN paralysis and hypocalcemia after “bilateral subtotal thyroidectomy” and in cases with unilateral or bilateral RLN paralysis after “total thyroidectomy”. Results: In all groups describing bilateral RLN injury was more common. Problems which are defined as “complication” in cancer patients, were more likely defined as “malpractice” in benign cases. However, these differences were generally not statistically significant. Conclusion: There is no consensus about malpractice and complication discrimination among physicians. Every physician should evaluate every specific case in its own nature and conditions when asked to determine whether the case should be determined as complication or malpractice.

scholarly journals Incidental Diffuse Sclerosing Variant Papillary Thyroid Cancer in Grave’s Disease

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A891-A892
Author(s):  
Nicolle Canales ◽  
Yadiel Rivera Nieves ◽  
Nydia Ivette Burgos Ortega ◽  
Janet Marie Colon Castellano ◽  
Nicole Hernández Cordero ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Papillary Thyroid Cancer ◽  
Outpatient Basis ◽  
Thyroid Function Tests ◽  
Papillary Thyroid ◽  
Diffuse Sclerosing Variant

Abstract The diffuse sclerosing variant papillary thyroid carcinoma (DSPTC) is an uncommon form of this neoplasm. Some studies describe its high propensity for tumor invasion, metastasis, and mortality compared with classic papillary thyroid carcinoma. Histologic features of DSPTC may resemble diffuse inflammation as seen with Grave’s or Hashimoto’s thyroiditis, which makes initial diagnosis challenging. A 27-year-old female with Noonan’s Syndrome was evaluated on an outpatient basis after developing atrial fibrillation de novo. Thyroid function tests were consistent with hyperthyroidism with TSH: <0.005 (n: 0.300-3.000 uIU/mL), FT4: 3.59 (0.71-1.85 ng/mL) and FT3: 16.77 (n: 2.0-7.0 pmol/L). Diffuse goiter was noted on physical exam, but no ophthalmopathy or dermopathy was present. TRAB and TSI were elevated at 38.4 (n: <16%) and 423% (n: <140%) respectively. A twenty-four-hour radioiodine uptake was 48% (n:10-35%) and described as essentially homogenous with two foci of decreased radiotracer concentration suggestive of cold nodules. Thyroid ultrasound showed diffuse nodularity bilaterally with associated clusters of calcifications and no discrete nodules. No abnormal appearing lymph nodes were identified. Fine-needle aspiration of both nodular areas was positive for DSPTC. Total thyroidectomy with central neck dissection was performed. Gross and microscopic post-surgical pathology confirmed the presence of diffuse sclerosing papillary thyroid cancer, along with local metastasis to one central lymph node. Patient was scheduled for radioactive iodine therapy. Diffuse sclerosing variant is considered an aggressive histotype of papillary thyroid cancer. Ultrasound features include diffuse scattered microcalcifications with or without discrete nodules that may be confused with chronic inflammatory changes. Despite the limited number of cases, DSPTC is recognized to have specific characteristics, a high female to male ratio, and a young patient age. DSPTC has a high potential for aggressive biologic behavior if not treated promptly at the time of diagnosis. When suspected, total thyroidectomy with lymph node excision followed by radioiodine therapy has been proposed as the correct management to decrease the risk of persistent or recurrent disease.

scholarly journals MON-444 The Case of a Rare Anaplastic Thyroid Cancer Variant with Rhabdoid Features

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jennifer Foster ◽  
Veronica Diedrich ◽  
Talayna Leonard ◽  
Mahmood Shahlapour ◽  
Mohamad Hosam Horani
Keyword(s):  
Breast Cancer ◽  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Treatment Options ◽  
Anaplastic Carcinoma ◽  
Chemoradiation Therapy ◽  
High Grade ◽  
History Of ◽  
Rhabdoid Features

Abstract Introduction: We present a very rare case of a variant of anaplastic carcinoma, a high-grade thyroid carcinoma with rhabdoid features. Less than 15 cases have been reported in English literature over the last 20 years. The prognosis of thyroid cancer with this variant phenotype is unfortunately very poor with a mean survival time of only 6 months after diagnosis. Treatment includes surgery, often a total thyroidectomy due to the rapid rate of growth of this tumor type. The benefits of chemotherapy and radiation are not yet apparent. Case presentation: A 49 year old female with history of breast cancer status-post recent chemoradiation therapy presented to the emergency department for a rapidly enlarging, right-sided neck mass. The mass had been present for approximately one month, but it was estimated to have grown from 3cm to 5cm within the two weeks prior. The patient was being followed by her ENT specialist and had a recent outpatient CT scan done. The results of the CT revealed a large thyroid tumor partially obstructing the esophagus and given the rapid progression of symptoms, she was instructed to go straight to the ED for emergent admission. Upon arrival, the patient reported not having consumed any solids or liquids for the past day due to concerns of aspiration and increasing neck pain. She had complaints of worsening dysphagia. Initial lab work revealed low thyroglobulin (1.4 ng/mL), elevated T4 (15.42 nmol/L) presumably due to Tamoxifen exposure, and elevated PTH (96.9 pg/mL), likely primary hyperparathyroidism. She was admitted and endocrine was consulted for further evaluation. The patient underwent a fine-needle aspiration biopsy showing high-grade anaplastic carcinoma with extensive necrosis and rhabdoid features. The tumor was eventually classified as stage 4B with gross extra thyroidal extension to the adventitial layers of the esophagus, thus it was determined to be unresectable. It was recommended at that time she have a percutaneous tracheostomy and feeding tube to protect her airway. However, the patient requested to be discharged so that she could obtain a second opinion regarding treatment options and prognosis. She subsequently underwent a total thyroidectomy at another hospital. Conclusion: It remains unclear whether this patient’s history of breast cancer treated with chemoradiation therapy played a role in the development of this rare thyroid carcinoma. Some cases of the rhabdoid phenotype are documented to have transformed from papillary thyroid carcinoma, for which radiation therapy is a well-known risk factor. Future studies should use molecular markers, such as BRAF V600E mutations common to papillary and anaplastic thyroid carcinomas, to help differentiate between types of thyroid cancers and avoid delayed treatment options for rapidly metastasizing thyroid tumors.

scholarly journals The Value of Peripheral Enhancement Pattern for Diagnosing Thyroid Cancer Using Contrast-Enhanced Ultrasound

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yan Zhang ◽  
Ming-bo Zhang ◽  
Yu-kun Luo ◽  
Jie Li ◽  
Zhi-li Wang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Diagnostic Value ◽  
Contrast Enhanced Ultrasound ◽  
Enhancement Pattern ◽  
Contrast Enhanced ◽  
Peripheral Ring ◽  
Conventional Ultrasound ◽  
Relationship Of ◽  
Peripheral Enhancement ◽  
The Relationship

Background. Contrast-enhanced ultrasound (CEUS) scanning can detect differences between thyroid tumors and surrounding tissues. However, enhancement patterns within nodules are insufficient for the diagnosis of thyroid carcinomas. The peripheral enhancement patterns of nodules may provide useful diagnostic information. The objective of this study was to investigate the diagnostic accuracy of the peripheral enhancement patterns during CEUS scanning of thyroid nodules. Material and Methods. 120 nodules with peripheral rings during CEUS and definite pathology confirmed by surgery were included in this study. The internal and peripheral CEUS enhancement patterns of these nodules were assessed, and the diagnostic value of CEUS was compared with the conventional ultrasound. The relationship of types of peripheral rings and sizes of nodules was analyzed, respectively. Results. There were 78 benign and 42 malignant nodules. Peripheral irregular ring performs well in detecting malignancy. It improves the diagnostic performance of CEUS by combining with internal enhancement patterns (diagnostic sensitivity of 97.6%, specificity of 98.7%, and accuracy of 98.3%) and adds value to conventional ultrasound (95.2%, 70.5%, and 79.2%). The sizes of the nodules with regular high-enhanced rings (2.34 ± 1.33 cm) were larger than the other three types of peripheral rings (P<0.05). Conclusions. Features of peripheral ring on CEUS are important for the diagnosis of thyroid cancer; they can further contribute to the accuracy combining with the internal enhancement pattern, which could avoid the unnecessary biopsy.

scholarly journals SUN-LB76 Euthyroid Ophthalmopathy in Coexistence With Differential Thyroid Carcinoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Dioni Garate ◽  
Adriana Villarreal ◽  
Gisella Alfaro ◽  
Elizabeth Salsavilca ◽  
Erika Chiu
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Thyroid Function ◽  
Autoimmune Disorder ◽  
Differentiated Thyroid Carcinoma ◽  
Upper Eyelid ◽  
Normal Thyroid Function ◽  
Normal Ranges ◽  
Relationship Of ◽  
Orbital Fibroblasts

Abstract Introduction: Thyroid ophthalmopathy (TAO) is a rare autoimmune disorder in euthyroid patients; less frequent in those with negative autoantibodies and thyroid cancer. TSH-R stimulating antibodies bind to said receptor in orbital fibroblasts, producing the secretion of cytokines, hyaluronic acid and adipogenesis that contribute to TAO1. Clinical case: 54-year-old woman has had orbital alterations compatible with TAO for four years, CAS score 2/7-Eugogo Mild, studies of thyroid function and TSI/AbTPO/AbTg antibodies in normal ranges; therefore, she received oral corticotherapy and subtenonial corticosteroid injections. She was subsequently evaluated in Endocrinology, where goiter was found. Thyroid ultrasound showed hypoechogenic left thyroid nodule (14 mm), FNA: Bethesda VI and Pathological anatomy: Papillary thyroid carcinoma. She received ablative therapy with I-131 (30 mCi). Currently with excellent response. During follow-up, ophthalmologic evaluation showed: CAS score 0/10 and VISA score 0/10. Presents palpebral retraction, corneal erosions and PIO elevation. In Tomography: increase in volume of the lacrimal glands and extraocular muscles predominantly in the upper and medial rectum, as well as a thickening of the upper eyelid lift muscle, with greater involvement in the left orbit. These findings are compatible with inactive TAO with an expansive “white eye” phenotype, generally with a lower risk of compressive neuropathy.Discussion: In addition to normal thyroid function and mild TAO, the patient has the characteristic of presenting negative antibodies. Associated with TSH-R, factors such as IGF-1 can be found in the pathogenesis of TAO, which can generate a similar effect1. Likewise, IGF-1 stimulates cell proliferation, and is related to neoplasms such as thyroid carcinoma2. Conclusions Differentiated thyroid carcinoma should be ruled out in all patients with TAO, whether euthyroid or not. Studies confirming the relationship of IGF-1, TAO and thyroid carcinoma are necessary. References: 1. Yu et al. Thyroid-associated orbitopathy in patients with thyroid carcinoma A case report of 5 case. Medicine (2017) 2. Manzella et al Activation of the IGF Axis in Thyroid Cancer: Implications for Tumorigenesis and Treatment. International Journal of Molecular Sciences, (2019). 20 (13), 3258.

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