Endocrine Abstracts

Recent studies support a causal relationship between radiation, formation of RET/PTC rearrangements, and development of papillary carcinomas. The evidence that RET/PTC rearrangements result directly from radiation-induced DNA damage is compelling, and further substantiated by evidence that predisposition to radiation-induced intrachromosomal inversions involving the RET gene may be favored by the three-dimensional organization of human chromosome 10 during interphase. Thus, il...

Fine needle aspiration biopsy (FNAB) has become the mainstay of thyroid nodule evaluation. While the overall accuracy of FNAB is excellent, an indeterminate or suspicious biopsy can pose a diagnostic and management dilemma. Fortunately, only 20-25% of indeterminate nodules are ultimately found to be malignant. Unfortunately, approximately 75-80% of patients undergo a surgical procedure that may have not been necessary. Recent advances in molecular diagnostics such as immunocyt...

Outcomes with DTC measured in terms of cancer-specific mortality, tumor recurrence and disease-free survival rates give different views of the efficacy of treatment. In our cohort of 1528 patients (median age 34 yr, range 5-91 yr) after a median follow-up of 16.6 yr, 40-yr cancer-specific mortality was 8% and recurrence rate was 37%. A delay in treatment of 12 months or more significantly increased the 40-yr cancer-specific mortality (6.6% vs 13.5%, P=0.002). Treatment variabl...

Thyroid cancer is the commonest endocrine malignancy but there is much debate about the role of specific treatment modalities, including the extent of surgery, post-operative ablation with iodine-131, need for TSH-suppressive doses of thyroxine, role of serum thyroglobulin measurements and imaging during follow-up. Recent data have suggested poorer outcome for thyroid cancer in the UK than other countries and recent audits have highlighted shortcomings in patient management. T...