Endocrine Abstracts

Indoleamine 2,3-dioxygenase 1 (IDO1) is a single chain oxidoreductase that catalyzes tryptophan degradation to kynurenine. In cancer, it appears to exert an immunosuppressive function as part of an acquired mechanism of immune escape. In view of this notion, IDO1 has started to be considered a novel target in cancer therapy. Objective of this study was to evaluate IDO1 expression in papillary thyroid carcinoma (PTC) and to correlate its expression with genetic determinants of ...

Gender bias in the incidence of thyroid cancer is well known, however, the underlying mechanism is largely unknown. The current study determines variations in the molecular characteristics of thyroid cancers between men and women. Normal and cancerous thyroid tissues were collected from a total of 125 men and women who underwent surgical removal of the thyroid gland. Elevated levels of testosterone in serum and thyroid cancer tissues were observed in women while it decreased i...

Thyroid cancer is the most common endocrine malignancy characterized by a good prognosis. However, the subgroup of poorly differentiated thyroid carcinomas (PDTCs) includes neoplasia highly aggressive and scarcely responsive to currently available therapies.Site-selective cAMP analogs are able to inhibit the growth of poorly differentiated solid tumors and may represent valuable candidates for the therapy of PDTCs.We evaluated the ...

Both of peroxisome proliferator-activated receptor gamma (PPARγ) and estrogen receptor (ER) contribute to the development of thyroid cancer. Previously, the activation of ERα was found to promote the proliferation of thyroid cancer cells, whereas activation of either ERβ or PPARγ resulted in apoptosis of thyroid cancer cells. Furthermore, a transactivation between ER and PPARγ was reported in estrogen-responsive malignancy, such as breast cancer. Howev...

Background: It is a controversial issue whether the risk of cancer for a thyroid nodule is different in patients with Hashimoto’s thyroiditis (HT) and in patients without thyroid autoimmunity. Some studies have reported an increased risk of malignancy in thyroid nodules associated with HT while only limited data based on fine-needle aspiration cytology (FNAC) are available.Methods: Between May 2005 and April 2011, 3279 ultrasonography-guided FNACs w...

Background: Patients thyroidectomized for thyroid cancer need variable doses of levothyroxine (LT4) to obtain TSH suppression. A predetermined thyroid function set-point for each individual has been hypothesized, suggesting a genetic influence in the regulation of pituitary-thyroid axis. We hypothesized of the TRHR gene could be associated with a different hypothalamo-pituitary sensitivity to the negative feedback of the thyroid hormones.<p class=...

Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor highly resistant to chemo-and radiotherapy. Since several reports showed that cAMP has an antiproliferative effect on different types of solid tumors both in vitro and in vivo, we evaluated the potential anti-neoplastic activity of cAMP analogues (8-Cl-cAMP and the equimolar combination of 8-PIP-cAMP and 8-HA-cAMP) in two MTC cell lines (TT and MZ-CRC-1 that harbor C634W and M918T RET mutations, respecti...

Objective: Bicalutamide is approved as an adjuvant to primary treatments (radical prostatectomy or radiotherapy) or as monotherapy in men with locally advanced, nonmetastatic prostate cancer (PCa); however, this treatment induces gynaecomastia in most of patients, which results in treatment withdrawal. Optimal therapy for these breast events is not known so far. We conducted a meta-analysis to assess the efficacy of different treatment options for bicalutamide induced gynaecom...

BRAFV600E mutation is the most frequent genetic alteration (29–83%) of papillary thyroid carcinoma (PTC). Many authors have demonstrated that the presence of the mutation is associated with a more advanced tumor stage at diagnosis and a worse outcome but anyone assessed if BRAFV600E mutation could be useful prognostic marker in low risk PTC patients (T1-T2N0M0, 7th TNM classification).Aim of this study was to evaluate if the presence of BRAFV600E mu...

Introduction: Although numerous noninvasive markers are being used in order to determine preoperative thyroid cancer risk in patients with multi-nodular goiter, none of them are optimal. The objective of this study was to compare retrospectively the TSH level between two groups of subjects who underwent total thyroidectomy for a nodule and whose final histology was benign or malignant.Methods: Our study included 208 patients that underwent thyroidectomy ...

Background: It is well established that 1,25-dihydroxyvitamin D3 (1,25-D3) inhibits cell growth and induces apoptosis in numerous tumors. Increased expression of 1,25-D3 inactivating enzyme, (24-hydroxylase - CYP24A1), has been observed in numerous thyroid cancer cell lines after calcitriol treatment in vitro. We examined the expression of CYP24A1 as well as the activating 1-α-hydroxylase (CYP27B1) gene in human thyroid cancer tissue.Methods:...

Up to now there are few studies about differential proteomics in thyroid. Our group has developed a method for standard human primary thyroid culture maintaining the phenotype through passages. Thus, we believe of great interest the search for biomarkers in these cultures by 2D-PAGE coupled to MALDI-TOF/TOF-MS.Aims: i) To standardize the conditions for sample extraction and controls. ii) To compare and identify the differential proteomic pattern between ...

Introduction: Recent studies have shown that chronic lymphocytic thyroiditis is associated with increased risk of developing papillary thyroid carcinoma (PTC). Although still controversial, these carcinomas appear to have a better prognosis. This study aims to evaluate the presence of thyroiditis in thyroids with PTC and the association with histological variables of prognostic value, Tg and evidence of metastasis in 131I scan.Methods: Descrip...

Introduction: Thyroid FNAB is the gold standard to discriminate malignant from benign thyroid nodules. However, inadequate cytology ranges from 1 to 20% (up to 33.6%) in different settings and could depend on several factors, including the operator’s skills.Aim: To evaluate the effect of operator’s experience on US-FNAB diagnostic adequacy we reviewed 7029 US-FNABs performed from January 2006 to March 2009.Materials and M...

Introduction: There is no consensus about the usefulness of repeating the US-FNAB during the follow-up of nodules when a benign (Thy2) or indeterminate (Thy3) report is obtained at first US-FNAB.Aim of the study: To investigate the clinical value of repeating US-FNAB after a previous adequate Thy2 or Thy3 US-FNAB.Methods: We reviewed the US-FNABs performed from 2006 to 2009. All clinical data of the patients were collected and anal...

Aim: The aim of the study was to determine the association between Hashimoto’s thyroiditis (HT) and differentiated thyroid carcinoma (DTC).Patients and methods: Seven hundred seventy two patients with thyroid nodular goiter who underwent fine-needle aspiration cytology (FNAC), followed up at Endocrinology and Metabolism out-patient clinic of Cerrahpasa Medical School, University of Istanbul between January 2000 and December 2010 were included retros...

Background and aim: The clinical significance of papillary thyroid microcarcinoma (PTMC) is debatable. The purpose of this study is to analyse the clinicopathological characteristics of patients with PTMC and document the risk factors for poor prognosis.Materials and methods: Eighty-eight patients (18 males, 70 females) were included in the study. Clinical and laboratory parameters were recorded.Results: The mean age of the patient...

The prevalence of differentiated thyroid carcinoma (DTC) in lingual thyroid (LT) and thyroglossal duct cysts (TDC) is around 1%. Nowadays, almost 200 cases of DTC were reported in TDC and <60 cases in LT. Here we report four cases of neoplasia in LT (1/4) and TDC (3/4) in a consecutive series of 950 DTC patients (0.4%).Case 1: D.F. 63 year-old woman with thyroid follicular carcinoma in ectopic gland located at her tongue’s basis. March 2009: the...

Introduction: US-FNAB is the most cost/effective and accurate diagnostic procedure for the evaluation of thyroid nodules. In the clinic, the nursing assistance is not always available for the US-FNAB procedure in all endocrinological centers and its value remains to be established.Aim of the Study: To demonstrate the role of nursing assistance in US-FNAB procedures in improving the efficiency of this procedure.Methods: All clinical...

Backgrounds: Mutiplicity of papillary thyroid carcinoma (PTC) are not an unusual finding, although the origin of these foci is unclear. Either intraglandular metastases from a single dominant tumor or unrelated neoplastic clones were definitively proven as the means by which multicentric PTC form. In addition, there is insufficient clinical information concerning multicentric PTC presentation, prognosis, and long-term follow-up studies after treatment. Multiplicity of PTC has ...

Background: The main objective of this study is to establish the rate of malignancy in residual thyroid tissue in patients with DTC, and whether the serum thyroglobulin (Tg) level before complementary thyroidectomy and histopathologic characteristics of the tumor would be able to foresee malignancy in residual tissue.Methods: Our study included 58 patients with DTC that underwent complementary thyroidectomy that results were analyzed retrospectively. Pat...

Introduction: Several studies in literature have shown that some features of thyroid nodules at US are associated with malignancy. However, previous studies were focused mainly on subjects affected by multinodular goiter (about 70%) rather than subjects with thyroid cancer (about 30%). Furthermore, the main limitation of previous studies was the lack of thyroidectomy in all subjects.Aim of the study: To evaluate the diagnostic value of US features in a s...

Introduction: We assessed the incidence of ultrasound (US) thyroid scan anomalies in adult volunteers in the district of ModenaMethods: From December 2010 to October 2011 we performed US thyroid scan (Siemens Acuson Antares, 10 Mega Hertz-Linear scanner- B mode) in a cohort of 201 volunteers, recruited by local advertisement, women (n=135) and men (n=66), mean age 46±10.7. All participants were unaware of any thyroid disease and at the...

Introduction: Infiltration of larynx by thyroid cancer represents fourth stage of the disease and is threatening disease. Lethal outcome of advanced thyroid cancer, which invades trachea and larynx, is usually associated with airway obstruction.Patient and method: We are presenting 58 year old woman operated due to the advanced papillary carcinoma Patient underwent total thyroidectomy, central neck dissection, modified radical dissection of the right sid...

Background: To evaluate outcomes and toxicities in patients with non-anaplastic thyroid cancer treated with intensity modulated radiation therapy (IMRT).Materials and methods: This was a single institution retrospective review of 18 patients with non-anaplastic thyroid cancer treated with IMRT at King Fahad Medical City between April 2005 and December 2010. The median age was 69 years. Among the 18 patients, fifteen had papillary carcinoma, two had T3 an...

Aim: Neopterin is a mareker of inflammation secreted from monocytes and macrophages. It is found to be increased in malignant diseases. The aim this study was to evaluate the urine neopterin levels in thyroid cancer.Materials and methods: Sixty nine patients with thyroid cancer, 76 patients with benign thyroid pathology and 33 healthy subjects were evaluated. First morning urine samples were collected from the patients and the normal subjects for neopter...

Introduction: The effect of hyperthyroidism on the development of differentiated thyroid cancer (DTC) has been controversial in the international bibliography. The aim of our study was to find the possibility of thyroid cancer appearance in patients with hyperthyroidism who underwent total thyroidectomy in comparison with patients without thyroid hyperfunction.Material-Methodology: Between 2005–2010 228 patients (182 females/46 males) underwent tota...

Introduction: The coexistence of Hashimoto thyroiditis with welll differentiated thyroid carcinoma (DTC) has been discussed as far as the follow-up and prognosis of patients with chronic autoimmune thyroiditis (CAT) are concerned. The aim of our study was to find the coincident appearance of the two disorders in histologic specimens from patients who underwent total thyreoidectomy.Material-Methodology: Between 2005–2010 228 patients (182 women/46 me...

Papillary carcinoma is the most common histological type of thyroid cancer. The optimal treatment remains controversial, particularly with regard to the papillary microcarcinoma (≤ 10 mm).The aim of this study is the characterization of patients with this condition undergoing surgery in our hospital over a period of 30 years, evaluating treatment outcomes.Between January 1, 1980 and December 31, 2010, a total of 564 patients ...

Synopsis: Thyroid cancer with concomitant thyrotoxicosis is variably reported to be rare. Malignancy occurs as postoperative incidental finding of a small malignant focus in Graves’ disease, as part of a toxic multinodular or a toxic adenoma. We report two cases of large toxic multinodular goiters with metastasis diagnosed preoperatively as follicular neoplasm and confirmed postoperatively as differentiated thyroid cancer. Review of literature, pathophysiology and treatme...

Introduction: The antitumor activity of a novel cyclic amide, CLM94, with anti-VEGFR-2 and antiangiogenic activity, in primary anaplastic thyroid cancer (ATC) cells in vitro and in vivo, has been studied.Design and Methods: CLM94 was tested: i) in two human cell lines (HMVEC-d, dermal microvascular endothelial cells; 8305C, undifferentiated thyroid cancer) at 0.001–100 mcM; ii) in ATC cells at the concentrations of 10, 30, 50 mcM; iii)...

Background: Anaplastic thyroid-carcinomas (ATC) and a subset of papillary (PTC) and follicular (FTC) thyroid carcinomas behave aggressively showing metastatic spread and radio-resistance. Both the PI3K and HIF pathways are associated with aggressiveness and metastasis in thyroid carcinoma.Aims: To assess if the PI3K/HIF pathways contribute to radio-resistance and assess the effect of PI3K/HIF inhibition on radio-sensitivity of thyroid-carcinoma cells (85...

Anaplastic Thyroid Carcinoma (ATC) is the most aggressive thyroid gland malignancy characterized by undifferentiated morphology. It has been suggested that cancer stem cells (CSCs) might play a central role in ATC. Previously on the basis of CD133 positivity, our group suggested that CD133+ cancer stem cells (CSCs) might play a central role in ATC. Here we analyzed a panel of different stem cell markers in order to identify a peculiar CSC pattern in ATC....

Introduction: The human Pituitary Tumor Transforming Gene (hPTTG) is a phosphorylated proto-oncogene induced in multiple tumour types. hPTTG phosphorylation is mediated by cyclin-dependent kinase 2 (CDC2) and expression is regulated by specificity protein 1 (SP1). In thyroid cancer, hPTTG induces genetic instability and propagates growth through induction of growth factors (GFs).Methods: The interplay between hPTTG phosphorylation, SP1 regulation and GF ...

Background: Serum thyroglobulin (Tg) measurements are one of the main pillars of thyroid cancer follow-up, because of the high organ and disease specificity of Tg in athyrotic patients. However, 20–25% of patients have detectable serum anti-Tg auto-antibodies (TgAB), which might cause false low Tg measurements in immunometric assays (IMA). This can lead to significant challenges in patient management. Measurement of Tg by liquid chromatography-tandem mass spectrometry (LC...

Mitogen-activated protein kinase (MAPK) pathway abnormalities, specifically rearrangements (RET/PTC) or activating mutations (RAS or BRAF), are highly prevalent in papillary thyroid carcinomas (PTCs). Constitutive activation of this signaling cascade causes sustained phosphorylation of extracellular signal-regulated kinase (ERK). DUSP5, which is positively regulated by ERK signaling, acts as a negative regulator of its activity. We have previously shown that DUSP5 is overexpre...

Context: An increased mortality by cancer is reported in grafted patients.Objective: This multicentric study aimed to investigate whether the prognosis of thyroid cancer was modified by transplantationResults: Sixty nine patients (35 M/34 F; median age 41 years) with a history of both thyroid cancer and transplantation were recruited via specialized networks (TUTHYREF and DIVAT). Evolution and outcome were retrospectively analyzed ...

Context: Initial studies reported that RET rearrangements, RAS mutations and BRAF mutation are mutually exclusive genetic events in papillary thyroid carcinoma (PTC). Subsequently, simultaneous occurrence of BRAF mutation and RET/PTC or H4-PTEN has been described in few PTC cases, indicating that these genetic alterations might coexist in PTC in the same cell or in different cells, at least sporadically. In light of the recent finding that frequently BRAF mutation is present o...

Introduction: Tubulin is a multifunctional cytoskeletal protein involved in key cellular processes, including cell movement, intracellular transport and mitosis. An increased expression of βIII-tubulin (TUBB3) has been observed in several cancer types and associated with aggressive and drug refractory disease.Expression of claudins (CLDNs), the main component of tight junctions, is frequently altered in human cancers, including papillary thyroid car...

Introduction: CHEK2 is a gene encoding a protein involved in the mechanism of repairing damaged DNA. Mutations in the CHEK2 gene are associated with an increased risk of various neoplasms. The most common mutations in the Polish population are: I157T, less frequently IVS2+1G> A and 1100delC.Materials: The study consisted of 277 patients with papillary thyroid carcinoma: 252 female, 25 male, aged 15 to 76 years.Method: Patients ...

Background: The expanding use of 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG PET) has led to the identification of increasing numbers of patients with an incidentaloma in the thyroid gland. The aim of this study was to review the proportion of incidental thyroid cancers found by 18F-FDG PET or PET/CT imaging.Methods: Studies evaluating thyroid carcinomas discovered incidentally in patients or healthy vo...

Background: Locoregional nodal metastases are the first step of tumor spread in MTC and have been shown to be a prognostic factor for survival. Neither palpation nor neck ultrasound can estimate nodal staging accurately.Aim: To identify predictive factors for LNI in MTC through a retrospective study on 142 consecutive patients operated in Lille University Hospital between 1995 and 2010.Methods: Analyses were carried on 54 patients ...

Introduction: Although overall accuracy of fine needle aspiration (FNA) in identifying thyroid cancer is considered excellent, 20–30% of aspirates do not allow definitive diagnosis of malignancy. Proto-oncogene somatic mutations such as BRAFV600E in FNA strongly suggest the presence of malignancy. However, only few studies reported the use of circulating BRAFV600E-mutated alleles in plasma as an useful marker for non invasive diagnosis and follow up of this disease.<p...

Research objective: After the Chernobyl nuclear reactor accident, there was a dramatically increase in thyroid cancer incidence in children and adolescents in Belarus, Ukraine and the Russian Federation. The increasing incidence of thyroid cancer in last 10 years not only in former Soviet Union but also in the United States, is real medical problem. ‘Project Chernobyl’ has been established in New-York for early diagnostics of radio induced thyroid cancer among people...

Thyroglobulin (Tg) is a tumoral marker of differentiated thyroid cancer (DTC). Iterative Tg assays are then mandatory for their follow-up. The maximum imprecision of any Tg measurement should be <5%. However, it is unlikely that current Tg assays can maintain such tight precision over the 6–12 months time period used for monitoring patients with DTC. This precision can be overcome by measuring archived frozen samples from the patient in the same run as the current spe...

The reported prevalence of RET somatic mutations in sporadic MTC is about 40–50% and the most frequent somatic mutation is Met918Thr in exon 16. MTC harboring a somatic RET mutation have been demonstrated to have a more advanced stage at diagnosis and a worse outcome. Although RET mutations are believed to be driving events in the MTC tumorigenesis only the finding of somatic mutations in microMTC can confirm this hypothesis.Aim of the present work ...

Aim: To develop a cost-effective instrument to evaluate the preoperative malignancy risk of thyroid nodules (TNs).Patients&Methods: A meta-analysis of the clinical (C) and ultrasonographic (U) features associated with an increased risk of malignancy was conducted searching in the PubMed database. For each of them we computed the odds ratio and we consequently assigned a score. The resulted C+U score along with the 5-tiered score of fine-needle aspira...

Context: Although unexplained conflicting results are present in the literature, most of studies report the association of BRAFV600E in papillary thyroid carcinoma (PTC) with a more advanced disease and with a worst prognosis. We recently demonstrated that in most of the cases PTC consists of a mixture of tumour cells with wild-type and mutant BRAF. Hence, we examined the association of percentage of BRAFV600E alleles with clinicopathologic parameters at diagnosis and disease ...

Background: The accuracy of sentinel lymph node biopsy (SLNb) in decisions for surgical management of lymph nodes in differentiated thyroid ccarcinoma (DTC) was demonstarted in a few previous studies.Aim: To determine whether SLN biopsy of first draining node/s in jugulo-carotid chain is accurate technique to select patients with true positive LN for selective modified radical neck dissection (MRND).Patients and methods: We have pe...

The aims of this study are to assess the clinical characteristics of papillary and follicular thyroid cancer in young patients. We performed a retrospective analysis of 116 patient aged 20 years who underwent thyroidectomy and a mean follow-up of 11.1±0.6 years. There were 28 (24.1%) patients were classified into the residual cancer or relapse groups. Two of the 28 patients died of thyroid cancer. Thirteen patients who showed relapsed underwent 131I whole body scan; six o...

Introduction: Activating somatic mutation of the BRAF gene (V600E) has been identified as the most common genetic event in papillary thyroid carcinoma (PTC) with a variable frequency (32–87%) in various races by different methods.In this study, we report the genetic analysis of BRAF mutation in a Korean cohort of 211 PTC by peptide nucleic acid clamp real-time PCR.Methods: PNA clamp real-time PCR was applied for BRAF analysis ...

Background: The most important aspect in the diagnostic approach of thyroid nodule is identifying the malignancy. Elastography is a newly technique that measures the elasticity of tissue, after applying a external force, standardized control. US elastography is currently used in differentiation of malignant from benign lesions.Material, Method: This prospective study included 69 patients, mean age 50.08±12.43 years, 67 females and 2 men, with thyroi...

Subcutaneous lipomas (SL) are the most common benign mesenchymal tumors with an estimated prevalence of 1%. They usually appear single, between 50–60 years of age, without gender differences. However, multiple lipomatosis (ML) occurs in 5–10% of patients, more frequently in men and almost 30% of them have family history of ML. Cytogenetic abnormalities are found in 50–80% of cases (at 12q15) and the presence of an underlying mitochondrial dysfunction has been su...

The introduction of the new classification of the thyroid FNAB results which stratifies the risk of malignancy of thyroid follicular lesions is of special interest in endemic and postendemic areas. In such regions patients with non-neoplastic nodular goitre predominate and nodules diagnosed previously as ‘follicular neoplasm’ showed to be thyroid cancer less frequently than in iodine-rich areas.The aim of the study was to evaluate the frequency...

Background: Thyroid cancer has been increasing worldwide and became one of the most popular cancer. Recent reports have shown that an elevated thyrotropin(thyroid stimulating hormone, TSH) level is associated with risk of thyroid cancer. Nevertheless, the association between TSH level and thyroid cancer risk is not yet known in patients diagnosed with papillary thyroid microcarcinoma (PTMC).Methods: We collected cases of 212 patients who underwent thyroi...

Introduction: The use of radioiodine is a common treatment for differentiated thyroid cancer. However, special care should be exercised in treating patients who are on hemodialysis, due to the renal elimination of the radionuclide, which implies several technical difficulties and safety concerns. We have previously described the procedure and the short-term outcome and safety in three patients (Jimenez et al, Thyroid 2001; 11(11):1031–1034). Our results showed that the ra...

Current guidelines recommend measurement of rhTSH-stimulated Tg, with neck ultrasound 6–12 months after the initial therapy for DTC (Total thyroidectomy plus 100 mCiI131 ablation of the thyroid bed). Uncertainty persists regarding whether the subsequent follow up should be based on measurement of basal serum Tg or whether rhTSH-stimulated Tg should be performed and at what frequency. The aim of our study was to evaluate the utility of repeated rhTSH-stimulated Tg.<p c...

Introduction: Thyroid carcinomas (TC) are rare; the incidence in the French Marne-Ardennnes thyroid registry is 10/100.000 in 2010. The 10 year survival rate is greater than 90%. Nevertheless some TC are refractory to conventional therapy.Aim of the study: To describe frequency and clinical features of refractory TC (RTC).Patients and methods: Retrospectiv study from the database of the registry. 1427 patients with TC were diagnose...

Introduction and aim: MTC accounts for 5–10% of all thyroid cancers. Because of elevation postoperative calcitonin, short doubling time of calcitonin and no disease in available imaging techniques in some MTC patients, searching for new targets for radioisotope diagnostics is necessary.Among other overexpression of GLP-1 receptors have been shown on parafollicular thyroid C-cells.The aim of this study was to present the first ...

In this study we describe a new allelic variant of RET, identified in a family with Medullary Thyroid Cancer (MTC) and negative for the classical RET mutations, that causes an Arg982Cys substitution in exon 18.The “in silico” analysis has shown that this variant has a reduced compatibility [score 15] with the normal biological activity of the native protein and could therefore be a transforming mutation.The aim of this wo...

Introduction: Surgery is the usual therapeutic approach for treatment of recurrent lymph node metastases due to thyroid carcinoma. However, there is no evidence of improvement in the final prognosis and is not an option without risk, especially in patients such as those who already underwent several surgeries or suffered from comorbidities.PEI is a useful alternative for treatment of selected thyroid diseases. Here, we present our experience in patients ...

Background: Recommendations on the timing of prophylactic thyroidectomy (PTTE) in patients with familial medullary carcinoma (FMTC) are based on classification of RET mutations into four risk levels according to genotype - phenotype correlations. In clinical practice it is/was not always possible to fulfill the recommended timing of PTTE.Objectives: To study the clinical course of FMTC patients with various RET mutations who were operated with a time del...

Papillary thyroid carcinoma (PTC) is a malignant tumor of follicular cell origin that is characterized by a broad diversity of morphological features. There are 15 different histological types of PTC in the recent edition of WHO classification. Morphology of PTC is important to estimate a metastatic potential of tumor and to make an accurate prognosis of clinical behaviour.Objective of the work is to study a relationship between frequency of regional met...

Background: Thyroid carcinoma in a thyroglossal duct cyst is very rare and surgical management is based on the individual experience.Patients and methods: Twelve cases of primary TDC thyroid carcinoma operated in one Institution during last 25 years. Sistrunk`s procedure was done in all cases followed by dissection of submental and prehyoid lymph nodes and bilateral biopsy of level 3. In the same act 11 of 12 patients underwent total thyroidectomy. In ca...

Objective: Acoustic Radiation Force Impulse (ARFI)-Imaging is a novel ultrasound-based elastography method enabling quantitative measurement of tissue stiffness. The aim of the present study was to evaluate ARFI for the differentiation of thyroid nodules and to compare it with the well known qualitative Realtime-Elastography (RTE)Materials and Methods: ARFI-imaging involves the mechanical excitation of tissue using short-duration acoustic pulses to gener...

Introduction: We study the calcitonin levels measurement in the washout of FNAB needles after sampling each thyroid nodule (FNAB-CT) as an approach to calcitonin normal value in them and distinguish of MTC and to correlate with serum CT (sCT) and cytology FNAB.Material & Methods: 109 consecutive subjects (mean age 53.7±13.4, range 18–85 yr, 79.8% females, 27.5% smokers, 18.3% autoimmune thyroid disease) initially no suspicious for MTC who u...

Thyroid paraganglioma (TP) is a rare disorder that sometimes poses problems in differential diagnosis with medullary thyroid carcinoma (MTC). So far, differential diagnosis is solved with the help of some markers that are frequently expressed in MTC (TTF1, calcitonin, and CEA). However, some of these markers are not absolutely specific of MTC and may be expressed in other tumors. Here we report 3 new cases of TP and describe our strategy to design a diagnostic immunohistochemi...

The management of papillary thyroid microcarcinomas (PTMC) has been controversial and only observation without surgery has been advocated for the low-risk PTMC. Radio-frequency ablation(RFA)has been applied to thyroid nodule, which shows safe and useful results for benign thyroid nodules. In our institution, not only benign nodules, but thyroid malignancies have been attempted to be therapeutic objectives by RFA. The aim of this study is to evaluate the efficacy of RFA for pri...

Context and Objectives: The prognosis of medullary thyroid carcinoma (MTC), derived from parafollicular C-cells, depends on the completeness of the first surgical treatment. The C-cells produce calcitonin, a peptid hormone that is used as biochemical and immunohistochemical tumor marker. The aim of study was to evaluate an individualized approach to patients with C-cell disease, i.e. MTC and C-cell hyperplasia (CCH), using the intraoperative calcitonin testing-assisted surgica...

Introduction: Activating point mutations in the RAS genes (H-RAS, K-RAS, N-RAS) are reported in thyroid tumors. The aim of this study was to determine the frequency of RAS mutations in 98 patients with thyroid tumors.Methods: DNA was extracted from 72 fresh frozen thyroid samples and 26 paraffin-embedded formalin-fixed samples. The cohort contained 83 PTCs (56 FVPTCs, 14 mixed follicular-classical types, 11 classical variants and two other rare variants)...

Objective: In this study, we aimed to evaluate ultrasonographical and elastosonographical characteristics, cytological results and histopathological features of nodules in patients with Hurthle cells in cytological examination and operated for various reasons.Method:57 patients and 57 nodules detected to have Hurthle cells in thyroid fine needle aspiration biopsy (FNAB) were included in the study.Results: Among 57 nodules with Hurt...

Introduction: Routine central lymph node dissection (CLND) in papillary thyroid carcinoma (PTC) is controversial. Selective biopsy of the sentinel lymph node (SLN) could improve the surgical approach, as negative cases would benefit from avoiding a more aggressive technique and in positive samples a more accurate staging would be obtained.Aim: To analyze the usefulness of SLN biopsy in the surgical treatment of PTC.Patients and Met...

Introduction: Familial adenomatous polyposis (FAP) is a dominantly inherited disease characterized by colorectal adenomas, extracolonic gastrointestinal manifestations and extraintestinal diseases. Among them, differentiated thyroid cancer (DTC) is considered very frequent with an approximately risk 160 times higher than in general population, and with a prevalence of the cribriform-morular variant. As this esteem comes from scattered data, we evaluated in a prospective contro...

Introduction: Hashimoto’s thyroiditis can be accompanied by thyroid cancer. It is reported that there is an association between selenium deficiency and thyroid cancer. In addition, it is known that chronic inflammation is another causal factor in the etiology of cancer.In this study, we aimed to determine whether selenium or oxidative stress is a modifying factor for the association between Hashimoto’s thyroiditis and cancer.<p class="abste...

DTC carries a good prognosis when adequately treated by means of total thyroidectomy, iodine-131 (I-131) treatment and TSH-suppressive therapy, and carefully followed up (i.e. serum thyroglobulin, I-131 total). In some cases, however, false-positive scans can occur. A 42-yr-old woman with recurrent chest infections and bronchiectasis was submitted to total thyroidectomy because of a13 mm nodule in the right lobe that showed a papillary thyroid carcinoma at FNAB histological ex...

Papillary thyroid cancer (PTC) is the most common endocrine malignancy. Its management has not changed significantly in recent decades, and most patients receive the same treatment. Moreover, there are not alternative treatments for low response or aggressive neoplasias. The availability of reliable prognostic markers that would allow the PTC to be identified based on their aggressiveness at the time of diagnosis would derive in an individualized treatment. In a previous study...

The wide variability of analysis obtained from the fine needle aspiration cytology (FNAC) of thyroid nodules is attributed to experience differences in their interpretation. It is known that reproducibility is a critical parameter for the clinical usefulness of a diagnostic test. However, interobserver and intraobserver reproducibility of cytological examinations of the thyroid has been very little investigated. We studied 74 patients who underwent FNAC and a thyroidectomy. Th...

Introduction: Fine-needle biopsy(FNB) is an essential diagnostic tool in the evaluation of thyroid nodules, however, follicular neoplasm(FN) does not exclude malignancy. Some sonographic and cytological features have been described as being associated with increased risk of malignancy. The authors aimed to identify demographic, sonographic and cytologic features associated with malignancy in patients with a cytological diagnosis of FN.Methods: Descriptiv...

Introduction: Ultrasoundelastography (USE) evaluates the tissue elasticity according to the local tissue displacement after a small compression applied by an ultrasound transducer. This technique is based on the concept that a hard lesion is associated to a higher risk of malignancy. The USE has been recently applied for characterization of thyroid nodules. The aim of our preliminary study was to assess the validity of USE for screening benign and malignant thyroid nodules.</p...

Objective: Patients with differentiated thyroid carcinoma have an increased prevalence of insulin resistance and, diabetes increases the risk of thyroid cancer. In this study we aimed to evaluate tumor features in diabetic and non-diabetic differentiated thyroid cancer patients.Methods: One hundred patients with differentiated thyroid cancer were enrolled in the study. Twenty one of the 100 patients were diagnosed as diabetic and 79 non-diabetic. All par...

Objectives: Thyroglobulin (Tg) play an important role in managements of well-differentiated thyroid carcinoma (DTC). Undetectable TSH-stimulated serum Tg level in the absence of antithyroglobulin antibody (AbTg) indicates complete remission. Circulating AbTg may interfere with Tg assay and may cause false negative results. Moreover, undetectable Tg is observed in a part of patients after total thyroidectomy(TT), even if serum AbTg concentration is low.Th...

Introduction: Medullary thyroid carcinoma MTC represents 5% of all thyroid cancers. It is familial in 30% of the cases. The most frequent metastatic localizations are lymph nodes, liver, lung and bone. We describe prostatic and vesical localizations of a MTC in a patient with multiple endocrine neoplasia (MEN 2B).Case report: A 44 years old patient with MEN 2B operated in 1989 for MTC, bilateral pheochromocytoma and had a cutanuous neurofibroma. He prese...

Thyroid cancer is the most common endocrine malignancy. It is known that cancer progression involve dysregulation of growth factors (FGFs) and their receptors (FGFRs) have been identified. In thyroid tumors. In particular, FGFR1 and FGFR3 are expressed in most well differenziated tumors, FGFR4 is predominantly expressed in aggressive tumor types and cells lines, while FGFR2 is the only receptor consistently detected in normal human thyroid tissue and its expression is downmodu...

Introduction: Thyroid cancer in childhood and adolescence represents 1.5–3% of all carcinomas in this group of age. Our purpose is to define clinical and pathological features, therapeutical complications and follow-up characteristics and survival of a group of children and adolescents with thyroid carcinomas.Design: We report a retrospective study of 26 children and adolescents with thyroid carcinoma who were investigated in our institution from Ja...

Objective: In the Bethesda classification (BC), which is used in cytopathologic evaluation of thyroid nodules, follicular lesion of undetermined significance (FLUS) does not involve sufficient cellular atypia for follicular neoplasia or malignancy, while it doesn’t comprise the cytologic benign criteria. Therefore, there is no consensus for those nodules to follow-up and therapeutic approaches. In this study, we aimed to determine the ultrasonographic features and histopa...

Introduction: thyroid carcinoma is an uncommon malignancy, but it’s incidence appears to be increasing slowly (female 2–3.8/100.000 - male 1.2–2.6/100.000). This is the most common malignant endocrine tumour, represents about 1% of all malignancies. The majority of these patients females, mostly between the age of 30–60. The main differentiated histological types are papillary and follicular. The options of the treatment are surgical removal (mainly total),...

Introduction Thyroid cancer (TC) is rare in childhood. The aim of the present study was to describe the tumoral characteristics of children and adolescents with TC and to investigate the frequency of microcarcinomas in that population.Methods We studied the medical records of 101 children and adolescents (≤ 21 years-old) who were diagnosed with TC between January 1977 and December 2011 in Theagenio Cancer Hospital. The following characteristics wer...

Multiple endocrine neoplasia type2 (MEN 2) (OMIM 171400) is an autosomal dominant inherited cancer syndrome caused by activating mutations in the RET proto-oncogene. MEN 2 is classified into three subtypes: MEN 2A, MEN 2B and familial medullary thyroid carcinoma(FMTC). MEN 2B accounts for 5–10% of MEN2 cases. More than 95% of MEN 2B patients carry M918T mutation of RET, and 2–3% harbor A883F mutation. There has been three reports of cases with MEN 2B phenotype caused...

It is established that somatic oncogene mutation (BRAF, NRAS, HRAS, KRAS) and gene translocations (RET/PTC, PAX8/PPAR-gamma) are associated with the development of thyroid cancer. Somatic single nucleotide polymorphisms were analyzed by LigthCycler melting method, while translocations were identified by real-time polymerase chain reaction technique. In 22 intraoperative thyroid tissue samples (11 pathologic and 11 normal). In tumorous sample 3 BRAF, 2 NRAS and one HRAS mutatio...

The clear cell renal carcinoma (CCRC) is the best known primary site of metastatic thyroid. The thyroid metastases can be the first sign of a kidney tumor, or appear long after the nephrectomy, in which case can may mistakenly diagnose a thyroid cancer early.Goal: Examine ways of presentation, diagnosis and treatment of patients with thyroid metastases from clear cell renal carcinoma (TMCCRC).Method: From January 1, 1985 to July 31...

Background: Conventional ultrasound remains the most used imaging evaluation in case of a thyroid nodule.Material, method: This prospective study included 69 patients (107 nodules). Conventional and Doppler ultrasound was performed with a HITACHI EUB 7500 HV machine with 6–13 MHz variable frequency linear probe, with Doppler software. All patients underwent surgery after complete evaluation.Postsurgical histopathological exam was performed. We analy...

Aim: In this study, our aim is to evaluate the ultrasonographic features and histopathologic results of the thyroid nodules which are defined as AUS and contribute to the therapeutic approach of these nodules.Methods: We evaluated 95 nodules of 92 patients, who have nodular or multinodular goiter and had diagnosed AUS at least in one nodule with fine-needle aspiration (FNA). Patients’ thyroid function tests, ultrasonographic features of the nodules ...

Chernobyl accident was followed by numerous publications overestimating its medical consequences, where spontaneous diseases have been without sufficient reasons classified as radiogenic. Among medical consequences of the accident, cause-effect relationship between ingestion of radioiodine and thyroid cancer in patients exposed at a young age is regarded to be proven. Significant incidence increase of pediatric thyroid cancer started 4 years after the accident, coinciding with...

Thyroid nodules are common and majority is benign. Even so, clinicians and patient always concern about the risk for malignancy. In the past it was believed that hyperthyroidism excluded the possibility of a thyroid carcinoma. We describe here two patients presenting “hot” thyroid nodules with final diagnosis of papillary thyroid carcinoma. Informed consent was obtained. Case 1: A 39-years-old female, presenting with irritability, disquiet, and neck swelling. A nodul...

Introductions: Some surgeons are easy to avoid total thyroidectomy as a surgical treatment for Graves’disease and even for thyroid cancer, because of possible complications (i.e. laryngeal nerve injury, hypoparathyroidism, etc). We studied the benefits and complications of total thyroidectomy in 206 patients with Graves’ disease or with thyroid cancer who were treated in our institution.Methods: Surgical outcomes were analysed in the following ...

Introduction: Apart from pulmonary and bone localizations, distant metastases from well differentiated thyroid carcinomas are very rare. Among them the adrenal ones are exceptional, and have generally a poor prognosis. The proof of the thyroid origin is not easy except if there is a histological confirmation by a CT guided biopsy of the adrenal tumor as in this observationObservation: A woman aged 56 was referred to our unit for pulmonary metastases of a...

Introduction: The incidence of non-Hodgkin lymphoma (NHL) during pregnancy is quite low. There have been a few anecdotal reports of NHL that arises from the thyroid gland.Case Report: A 28-year-old female patient presented with a neck swelling, pain and respiratory distress while she was in the 17th week of her first pregnancy. Subtotal thyroidectomy was performed and combined histological and immunohistochemical analyses led to the diagnosis of diffuse ...

The recommended amount of administered radioiodine activity needed to successfully ablate thyroid remnants after total thyroidectomy is controversial. We compared the efficacy of 50mCi and 100mCi radioactive iodine for thyroid remnant ablation among patients with low stage and low to intermediate risk differentiated thyroid cancer who underwent total thyroidectomy through a retrospective cohort study in a tertiary multi-specialty referral center located in Quezon City, Philipp...

The need for thyroid residue ablation in papillary thyroid cancer (PTC), classified with the TNM staging (AJCC, 2002) as pT1, with a maximum diameter comprised between 1 and 2 cm (pT1/1-2) and/or multifocal, is still debated. Aim of this study was to compare the outcome of pT1N0M0 patients submitted or not to postsurgical radioiodine ablation. Consecutive patients followed-up at this Institution from 1996 to 2010 were enrolled. All pT1/1-2N0M0 cases were radioiodine ablated be...

In July 2010, a 69-year-old woman presented because of a CT proven 5th lumbar vertebral metastasis of thyroid carcinoma and in August she underwent a total thyroidectomy and central node dissection. Histopathology revealed a moderately differentiated Hürthle cell carcinoma which was according to TNM classification pT3N1M1 tumor. Thereafter, a right hemylaminectomy of L5 and metastasectomy was performed in order to decompress the L5 and S1 spinal nerves. The histopathology...

Introduction: In the last years, has produced an increment in diagnosis of thyroid cancer. Incidental thyroid carcinoma is defined as a tumour diagnosed after surgery for benign lesions.Aim. The objective of this study was to assess the clinical presentation, tumour characteristics and follow-up.Patients and methods: We analysed clinicopathologic data of incidentally thyroid carcinoma from 351 thyroid surgeries carry out in our hos...

Objective: We aimed to investigate the ultrasound (US) features and malignancy rates of thyroid nodules, below and above 1 centimeter diameter, according to fine needle aspiration biopsy (FNAB) results.Materials and Methods: Total 157 nodular goiter patients, 60 patients’ nodules were below 1 cm and 97 patients’ nodules were above 1 cm, analyzed retrospectively. The nodules with pure cystic, peripheral calcification and inadequate cytological r...

Introduction: A major objective of the ultrasound of thyroid nodules is the stratification of the risk for possible malignancy and the selection of nodules for fine-needle aspiration biopsy (FNAB) and cytological examination.Objective: The objective of this study was to assess the sonographic criteria used in the selection of thyroid nodules for FNAB and to compare them to the cytological reports.Methods/Design: This was a retrospe...

Background: Papillary thyroid carcinoma in children and adolescents is rare but it shows extremely aggressive behavior. Gross lymph node metastases and distant metastases are common on first clinical presentation.Patients and methods: Forty five children and adolescents were operated due to PTC. Mean age was 16.6 years (range 7–21). At the time of diagnosis 13% had lung metastases. Total thyroidectomy or completion of thyroidectomy was performed in ...

Introduction: Non-Hodgkin lymphoma (NHL) involving the thyroid gland constitutues 2–3% of all NHL cases, 2–8% of all thyroid malignancies. The majority of lymphomas arising in the thyroid gland are MALT lymphomas and diffuse large B cell lymphomas commonly occuring in the setting of thyroiditis. Most cases are seen in adult or elderly females. The thyroid enlargement is often rapid and can lead to symptoms of tracheal or laryngeal compression. Herein, we present a ca...

Introduction: Papilar thyroid carcinoma (PTC) is the most common thyroid neoplasia. It usually has a good prognose, being lymph node spread common. Distant metastasis are present in 9–10% of cases, worsening prognose. Cerebral metastasis are extremely rare, representing 1% of all metastasic PTC.Case report: A 68-year-old man was sent to the Endocrinology Unit for follow-up of a PTC that had been operated (total thyroidectomy) 2 months before. After ...

Introduction: Thyroid hyperfunctioning nodule usually represents benign tumor. Less than 1% of all cases have been reported as malignant lesion, especially in the presence of hyperthyroidism.Case report: An asymptomatic 46-year-old man with a history of diabetes mellitus type 2 came for regular diabetic check. Two palpable thyroid nodules were detected during a routine physical examination. Thyroid function tests showed hyperthyroidism: TSH <0.005 mI...

Background: Recent reports have mentioned rising incidence of thyroid cancer (TC) detected before and after thyroidec-tomy (Tx) for hyperthyroidism but “hyperfunctioning” TC is however a rare entity.Patients & Methods: Among a personal series of 464 patients which underwent Tx including 147 (33.6%) cases of thyroto-xicosis and 72 (13.6%) cases of TC, we founded 10 patients with hyperthyroidism and nodular or microscopic TC but only one case...