Endocrine Abstracts

Introduction: The utility of serum calcitonin has been evaluated in a series of prospective, nonrandomized studies suggest that the use of routine serum calcitonin for screening may detect C-cell hyperplasia and medullary thyroid cancer at an earlier stage and overall survival may be improved. Elisei et al. estimated that routine measurement of plasma calcitonin in thyroid nodule patients would yield an additional 2.2 life-years per positive patient.<p class="abstex...

Background: Concomitent occurrence of primary (PHPt) or renal (RHPt) hyperparathyroidism and papillary thyroid microcarcinoma (PTMc) is rarely described in literature.Patients and methods: Between 1986 and 2010 sixtythree subjects undewent operations for PHTp (n=20) or RHTp (n=43) in our clinic. In three cases (4.7%) a synchronous PTMc was intraoperatively discovered.Results: First case, female – 56 years old pre...

Introduction: A value of thyroglobulin (Tg) undetectable under treatment with levothyroxine (LT) does not exclude residual/metastatic disease; this can be found in 18–35% of patients after recombinant TSH-stimulated Tg (sTg) measurements.Objective: Evaluating the role of recombinant TSH-stimulated thyroglobulin (sTg) measurements in patients with differentiated thyroid carcinoma, treated with suppressive LT doses, with basal Tg (bTG)<1 ng/ml.</p...

Introduction: In type-1 neurofibromatosis (NF-1) there is an increased risk of endocrine tumors, especially pheochromocytomas, whereas thyroid carcinomas seem to be extremely rare, with few cases reported in literature.Subjects and methods: In order to investigate the frequency of hypercalcitoninaemia and medullary thyroid cancer (MTC) in patients with NF-1, we evaluated the thyroid gland morphology and function in 17 patients with NF-1 by i) neck US, ii...

Introduction: Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid cancer measuring 10 mm or less in greatest dimension. Diagnosis of PTMC could be established during the surgery for benign thyroid lesions and after fine needle aspiration biopsy. Despite the small size, PTMC could be highly aggressive tumor showing metastases and elevated invasiveness. However, correlation between tumor size and risk of lymph-node metastases remains unclear.<p class="a...

The role of hormones and reproductive factors in thyroid carcinoma is suggested by its higher incidence in women. The association with estrogens or other specific hormonal factors remains unclear. We assessed the estrogen receptor alpha (ESRa), estrogen receptor beta (ESRb) and progesterone receptor (PRR) expression in follicular cell-derived tumours (FDT).Cross-sectional study of 50 (25%) males, median age 50.5 (interquartile range, IR, 34), and 149 (75...

Introduction: Medullary and papillary thyroid carcinoma (MTC and PTC) are two types of thyroid cancer that can originate from activating mutations or rearrangements in the RET gene. Therapeutic options are limited in recurrent disease but since RET is a tyrosine kinase (TK) receptor involved in cellular growth and proliferation, treatment with a TK-inhibitor might be promising. Several TK-inhibitors have been tested in clinical trials, but it is unknown which inhibitor is most...

Background: Loss of autophagy protein ATG16L1 enhances endotoxin-induced interleukin 1β (IL1β) production. IL1β has been found to have antineoplastic effects in thyroid malignancies. We hypothesized that a missense polymorphism in ATG16L1 autophagy gene (Thr300Ala) results in changes in the function of the molecule and influences susceptibility to and prognosis of epithelial cell derived thyroid carcinoma (TC).Objective: i) To assess the f...

Thyroid cancer is the most prevalent cancer among endocrine malignancies. Surgical resection combined with radioactive iodine therapy has been proved effective in treating differentiated thyroid cancer, including papillary and follicular thyroid cancers. However, regarding metastatic poorly differentiated or anaplastic thyroid cancers, there have been no available effective treatment modalities. The genomic instability, such as chromosome aneupolidy, represents a hallmark of s...

Objectives: The aim of the study was to compare serum calcitonin levels after calcium versus pentagastrin stimulation in healthy individuals and in patients with medullary thyroid carcinoma (MTC).Methods: The study enrolled 44 healthy individuals and 27 patients with MTC.Time of measurement: baseline, 2, 5 and 10 min after injection of: – Calcium 2.0 mg/kg body mass i.v. (10% Calcium Gluconate, Braun Mel...

Introduction: Follicular variant papillary thyroid carcinoma (FVPTC) is the most common variant of papillary thyroid carcinoma (PTC) after classical PTC (CPTC). In this study, we aimed to compare functional status, ultrasonographical features, cytological results and histopathological characteristics of patients with CPTC and FVPTC.Methods: Patients diagnosed with CPTC and FVPTC in our clinic were reviewed retrospectively. Data of preoperative thyroid fu...

Introduction: Increased exposure to sunlight and high serum levels of Vitamin D were reported to relate with decreased risk of various cancer types, such as prostate, breast and colon. Vitamin D receptor and 1α-hydroxylase expression were shown in papillary thyroid carcinoma. In this study, we aimed to evaluate serum 25-OH vitamin D levels in patients with benign and malignant thyroid nodulesMethods: Patients admitted to our thyroid clinic were recr...

Introduction: Patients bearing thyroid cancer that have already gone into surgery and 131I therapy that in the follow-up have high thyroglobulin levels and negative 131I whole body scan represent a diagnostic and therapeutic challenge. 99mTc HYNIC Octreotide recognizes somatostatin receptors that are expressed in thyroid cancer. The objective of this paper is to evaluate these patients by means of 99mTc HYNIC Octreotide and to correlate the results with other imaging methods.<...

Background: The most reliable biochemical markers in the follow-up of medullary thyroid carcinoma (MTC) are serum calcitonin (CAL) and carcinoembrional antigen (CEA).Case: A 82 years male presented with rapidly growing neck tumour in April 2008. The patient underwent total thyroidectomy with lymph node dissection (June 2008). The pathology revealed MTC localized only in the left lobe (pT3NoMx), the immunohistology showed CAL-, synaptophysin, chromogranin...

Papillary thyroid carcinoma (PTC) is most frequent endocrine cancer on the other hand papillary microcarcinoma can be seen increasing frequency in recent years. In this study we compare clinical and histopathological characteristics of thyroid papillary microcarcinoma and papillary thyroid carcinoma retrospectively.Eighty one PTC and 38 PMC total 119 patients followed between 2005 and 2009 were enrolled study. Average follow-up time is 35 months in PTC a...

Even though it is unusual, many cases presenting with combinations of thyroid carcinomas have been reported. Concurrent occurances of medullary – papllary carcinoma, follicular – papillary – medullary carcinoma, follicular – anaplastik – papillary carcinoma, papillary – follicular carcinoma have been presented. The cases reported up to now had no thyroid autoimmunity. We present a case with known Hashimoto’s thyroiditis having a combination o...

Introduction: The association between autoimmune thyroid diseases and papillary thyroid carcinoma (PTC) is still controversial and it is based only on retrospective analyses.Objective: Aim of the present research was to evaluate this association in a prospective study of unselected consecutive thyroid nodules (TN) submitted to fine-needle aspiration cytology (FNAC), anti-thyroid autoantibodies (ATA) measurement and histological analyses of surgical sampl...

Introduction: Primary malignant thyroid teratoma is a rare neoplasm. Even rarer is the concomitance of the mentioned tumor and papillary thyroid cancer.Case report: We report a case of a 44-year old woman diagnosed with Hasimoto thyroiditis and multinodular, non-toxic goiter since 2004. The two larger, initially non palpable nodules were located in right thyroid lobe, 16 and 12 mm in diameter respectively. Under suppressive thyroxine therapy the diameter...

Increasing incidence of papillary thyroid microcarcinoma (PTMC) is due to accurate histological study of surgical specimens (incidental, INC) or to improved preoperative diagnostic techniques (preoperatively diagnosed, PD). We evaluate the differences between both groups of PTMC from 2000 to 2009.We reviewed data of patients diagnosed of PTMC (<10 mm) during the last decade with complete follow-up since surgery. Demographic data, tumour size, histolo...

Aim: In this study, we aimed to determine the strain index (SI) as well as the ES scoring of thyroid nodules, and establish the role for these parameters in the differential diagnosis of thyroid nodules using histopathological analysis as a reference standart.Materials and method: Real-time ES in transverse axis (TA) and longitudinal exis (LA) was performed in 391 nodules of 292 patients. ES scoring was made for all the nodules. SI in TA and LA was calcu...

Aim: We aimed to determine strain index (SI) values using Elastosonography (ES) in histopathologically confirmed differentiated thyroid carcinomas (DTC) and investigate the role of these values for the differential diagnosis of nodular thyroid diseases.Material and method: ES in longitudinal axis (LA) was performed in 391 thyroid nodules of 292 patients. ES scores of thyroid nodules were determined and SI in LA for each nodule was calculated. The finding...

Introduction: Hyalinizing trabecular adenomas (HTA) of the thyroid is an unusual disorder. HTA can be present as a thyroid nodule or incidental finding in a thyroidectomy specimen. Most behave as benign neoplasms, but their cytological features can be similar to those of papillary thyroid carcinoma.Case report: A 68 year old woman admitted to our institution with a solitary thyroid nodüle. Her serum free thyroxine (fT4), free triiodothyro...

Introduction: Several recent studies have reported an increase in the incidence of thyroid cancer during the last decades. The delineation between low-risk and high-risk tumor size is not well defined. The purpose of this study was to evaluate the relationship between the primary tumor size of differentiated thyroid cancer and clinicopathologic data.Methods: We have analysed all records of all patients submitted to thyroidectomy at our hospital between 2...

Introduction: Recent data reveal that in the last 25 years it has been a 2.4 fold increase in thyroid cancer, with concomitant rise in thyroid microcarcinoma cases. The main purpose of this study was to analyse the surgical indications that leads to incidentally noted papillary microcarcinoma diagnosis.Methods: We analysed clinicopathologic data of nineteen cases of incidentally found papillary thyroid microcarcinoma, from 1244 thyroid surgeries realized...

Background: Thyroid carcinoma is the most common endocrine malignancy. BRAF (V600E) mutation is the most frequent detected genetic change in papillary thyroid carcinomas (PTC). There are some discrepancies regarding the overall frequency of the mutation, its prevalence in PTC-variants and its relationship with clinicopathological parameters of poor outcome.Aims: To investigate the relationship of clinicopathological features of PTC with BRAF mutation wit...

Introduction: In population, thyroid nodule incidence is 1 to 30%; malignancy incidence is 1–20% up to different series, which make us to realize diagnostic methods with variable sensibility and specificity, taking as point of reference, the cytological analysis.Materials and methods: Fifty consecutive patients (44 women, 6 men) with thyroid nodule, performed neck ultrasonography (ALOKA SSD3500 equipment); material of FNA was processed according to ...

Incidental thyroid carcinoma (IC) is defined as a tumor diagnosed at histology after surgery for benign diseases and without a preoperative diagnosis of malignancy. Since the prevalence of IC reported in the literature is extremely variable (4.6–17%), mostly due to the limited number of cases, we aimed to study the features of IC in our large series. We retrospectively evaluated 1955 patients who consecutively underwent total thyroidectomy for non malignant diseases from ...

TSH supression therapy with thyroid hormone is a mainstay of thyroid cancer treatment. Effectiveness of thyroid hormone therapy may be disrupted by nonadherence of the patient, interfering drugs, foods and intestinal disorders. We here present a case of papillary thyroid cancer with unsuccessful supression therapy.Case: A 38 year old woman, underwent total thyroidectomy for euthyroid multinodular goitre, with a pathological diagnosis of papillary thyroid...

Background and patients: The clinical significance and management of papillary thyroid microcarcinoma (PTMC) is widely debated. The objective of this study was to assess the clinical presentation, tumor characteristics and the outcome of the disease in patients with PTMC. In this retrospective study we evaluated 286 patients who were followed for a minimum of three years.Results: Of the 286 patients with a mean age 48.9 years, 226 (79%) were females. Two...

Incidental thyroid carcinoma includes thyroid carcinomas detected after surgery in patients whose thyroid has been correctly studied with no data of malignancy. Lately, the widely spread use of image techniques and thorough search of thyroid nodule complains, have lead to a growing number of thyroid carcinomas. But still there are some of these incidentally discovered after thyroidectomy.We report 98 cases of thyroid carcinomas incidentally found from a ...

The pentagastrin-stimulated calcitonin test is known and widely used in monitoring patients with MTC. Given the problems of pentagastrin availability other diagnostic tests are being tried.The goal of the study was the evaluation of safety and tolerance of high-dose calcium to stimulate calcitonin in MTC patients.Materials: The study included 41 patients after surgery for medullary thyroid cancer who were under observation. Patient...

Introduction: The Pg calcitonin stimulation test is widely used in monitoring patients with MTC. In view of accessibility problems of Pg it is necessary to use high doses of calcium as the calcitonin stimulant.Objective: The aim of the study was the comparison of calcitonin concentrations after Pg and calcium stimulation, respectively.Materials: The study was performed in 31 patients under observation after deemed surgically cured ...

Introduction: Cytokeratin-19 (CK19), p53 and Ki-67 are some of the proposed markers for differentiating benign from malignant thyroid tumors.Material and method: We evaluated the tissue expression of the three markers in 60 thyroid lesions including: 8 cases of nodular hyperplasia (NH), 16 follicular adenomas (FA), 26 papillary carcinomas (PC) and 10 follicular carcinomas (FC). Tissue sections fixed in formalin and embedded in paraffin were immunohistoch...

Introduction: Fine-needle aspiration (FNA) biopsy of thyroid nodules is minimally invasive and safe. The clinical importance of the thyroid nodule evaluation is primarily related to the need to exclude thyroid cancer. We aimed to investigate the relationship between preoperative FNA cytology and results of thyroidectomy in this study.Materials and Methods: Histopathologic examination reports of 302 patients undergoing thyroidectomy and preoperative FNA c...

Objective: Thyroid fine-needle aspiration biopsy (FNAB) is the golden standard for approaching thyroid nodule’s malignancy. It is recommended to carry out an FNAB from the dominant nodule in multi nodular goiter. In our study, we compared the FNAB results that we carried out from dominant nodule and any other nodule which have features that may be malignant to US. Besides, the relationship between the results of cytology and US features of nodules has been analyzed.<p...

Background and aims: The value of the revised (2009) UICC/TNM criteria for medullary thyroid cancer (MTC) is not established. We aimed to evaluate its predictive value, analyzing the consequences of the inclusion of T3N0M0 patients previously included in stage III of the 6th edition, in stage II of the 7th.Patients and methods: We retrospectively analysed the clinical records of 85 patients operated for MTC and followed in two tertiary hospitals in the c...

Currently there is no widely accepted definition of very low-risk papillary thyroid carcinoma (PTC). Although unifocal microcarcinomas without extrathyroidal extension and no local or distant metastases have been recognized as having an excellent overall prognosis the threshold for such a favourable clinical behaviour remains controversial. The study aim was to identify the clinicopathological characteristics of T1 tumours (≤2 cm) presenting a very low-risk of mortality ...

It has been demonstrated that everolimus, an mTOR inhibitor, has potent anti-proliferative effect in a human Medullary Thyroid Carcinoma (MTC) cell line, TT, and in two human MTC primary cultures. We aimed at evaluating the possible antiproliferative effects of everolimus in a group of 20 human MTC in primary culture. To this purpose, 20 MTCs were dispersed in primary cultures, treated without or with 1 nM – 1 μM everolimus, 10 nM SOM230, and/or 50 nM IGF1. Cell viab...

Introduction: Thyroid lymphoma is a rare disease. Furthermore, coincidence of extrathyroidal lymphoma is very rare.Case: A 69 years-old woman patient was admitted to the hospital with dyspnea, hoarse voice and swelling of throat for a month. In her history, she had been diagnosed as gastric lymphoma 6 years ago, while she was being investigated for upper gastrointestinal bleeding. Six cures of chemotherapy has been applied. She was not on follow up. In p...

Introduction: Radiodine (131I) is widely used in the treatment of patients with thyroid cancer. This therapy is associated with some adverse effects including possible impairment of ovarian function and earlier menopause.Objective: The aim of this study was to evaluate female fertility after treatment with 131I of differentiated thyroid cancer (DTC).Methods: We retrospectively analysed 250 women with DTC treat...

Objective: To assess the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of sonographic index point and resistivity index in predicting the risk for malignancy in thyroid nodules.Methods: Fifty consecutive patients undergoing thyroid ultrasound for clinical nodular thyroid diseases prior to planned surgery were recruited for the study. Sonographic index point was calculated for each nodule using morphological...

The aim of our study is to detect parameters which may predict recurrences during long-term follow-up in papillary thyroid cancer patients who achieved remission after primary treatment. The data of 492 patients who achieved selected remission criteria after primary treatment were recorded. Remission criteria were for anti-thyroglobulin (antiTg)-negative patients: no uptake in first iodine-131 whole body scan (WBS) after primary treatment and stimulated thyroglobulin (Tg) leve...

Differentiated thyroid cancer (DTC) is more frequent in women than in men.The aim of the study was to analyze whether factors connected with the female sex could increase the risk of DTC.Material and methods: Ninety nine patients with a mean age±S.D. of 40.5±5.9 years with DTC and 51 healthy women with a mean age of 36.52±8.3 years were examined. Gynecological and obstetric histories were taken and ser...