Endocrine Abstracts

Sarcoïdosis is a relatively frequent systemic disease of unknown origin. Prevalence is about 4.7–64 in 100 000. We report the case of a 53-year-old woman followed in our institution since 2007 for a thyroid carcinoma. In 2010, she was diagnosed refractory thyroid carcinoma because of a high thyroglobulin assay (477 μg/l) without uptake on post-therapeutic (131I) whole body scan. Thereafter, the story is marked by the appearance in 2011 of multiple cer...

Introduction: This audit aims to evidence the compliance of our practice with guidelines on the management of thyroid cancer. This may help to promote quality improvement in areas where there is substandard clinical care and service provision.Method: In this retrospective study, patients diagnosed with thyroid cancers at our unit between 2009 and 2014 were identified. Electronic records were examined to establish the dates of referral, clinic attendance,...

A 45-year-old male known case of sporadic medullary thyroid carcinoma with metastasis to lymph nodes and bone. He underwent total thyroidectomy and modified neck dissection and external radiation in 2003. He was admitted with MTC which was progressive with rising calcitonin from 9000 to 40 000 μg/l. He underwent urgent tracheostomy and assessed by ENT and found to have bilateral vocal cord palsy. Patient improved; however on further assessment he was found to have severe ...

Introduction: Thyroid malignancy associated with hyperthyroidism is considered rare. Retrospective studies have shown the incidence of thyroid malignancy in hyperthyroid patients to be low (0.7–8.5%). To assess the clinical relevance of this association, thyroid status in a cohort of patients with thyroid malignancy were analysed.Method: Thyroid malignancies diagnosed histologically in 56 patients, over a 18-month period beginning from April 2013, i...

Introduction: Complete ablation of residual thyroid tissue in patients with papillary thyroid cancer decreases locoregional recurrence, distant metastases and cancer death. No single group achieved 100% complete ablation post first ablation dose with variable successful complete ablation rate. In patients who failed to achieve complete ablation a reablation dose is recommended to have complete ablation outcome. Post second ablation dose some patients still have small residual ...

Well-differentiated thyroid carcinoma (WDTC) is the most common thyroid malignancy. Although, associated with good prognosis, it may have a highly recurrent and fatal outcome in selected groups of patients. Filipinos in particular were reported to be the ethnic group with the highest incidence of thyroid cancer in several studies. Thyroid cancer among Filipinos were also observed to be more aggressive and recurrent in nature. This paper aims to describe the experience of a Phi...

The incidence of recurrent well-differentiated thyroid cancer (WDTC) continues to rise as better imaging test and more sensitive monitoring improves disease surveillance. Despite its excellent prognosis, increasing morbidity from recurrent diseases continues to affect long-term outcome of most patients leading to higher medical cost and poorer quality of life. Filipino ethnicity in particular was reported to have the highest incidence of thyroid cancer with a highly aggressive...

Follicular variant papillary thyroid cancer (FV-PTC) appeared to be the most common subtype representing between 9 and 22.5% of all PTC cases. With the dramatic increase in thyroid cancer incidence, FV-PTC has also been increasingly diagnosed in recent times. Despite its high incidence, the clinical behaviour, prognosis and outcome of FV-PTC remains controversial and challenging for most physicians. This study aims to compare the disease characteristics of FV-PTC with Classic-...

Introduction: The ability to diagnose thyroid cancers pre-op or intra operatively by Fine needle aspiration cytology (FNAC) or frozen section (FS) leads to the delivery of appropriate one stage surgical management. We aim to study the concordance and discordance of FNAC and FS with final histology in thyroid pathologies.Methods: All thyroid procedures from 2007 to 2011 (n=423), involving FNAC and or Frozen Section (FS) in their management pathwa...

Introduction: Papillary microcarcinomas tirodieos (MCT) are tumours less than or equal to centimeter size, mostly indectectables in the clinic and found incidentally after a thyroidectomy performed for another reason, management is under discussion and its prevalence is increased ~30%, it is believed that the increased use of thyroid ultrasound.Review: 16 patients with MCT in a province of southern Spain and evaluate the clinical and prognostic variables...

Objective: The purpose of this retrospective study was to correlate BRAF (V600E) mutation with clinicopathological characteristics in papillary thyroid microcarcinoma (PTMC).Methods: We reviewed the clinical records of patients who were operated for a papillary thyroid microcarcinoma (PTMC) between May 2011 and October 2012 in Inje University Haeundae Paik Hospital. We investigated the prevalence of the BRAF (V600E) mutation, and relations between the pr...

Introduction: The risk for thyroid malignancy is higher in subjects with Graves’ disease particularly papillary thyroid cancer (PTC). However, coincidence of both PTC and follicular thyroid cancer (FTC) in these subjects is rare. In this case report we present a subject with Graves’ disease with a pathological diagnosis of PTC and FTC having aggravated orbitopathy following remnant ablation.Case report: A 53-year-old subject was referred to our...

Introduction: ‘Atypia of undetermined significance/follicular lesion of undetermined significance’ (AUS/FLUS) is a heterogeneous diagnostic thyroid fine needle aspiration biopsy (FNAB) category. AUS/FLUS is comprised of cases that cannot be definitively diagnosed as benign, suspicious for/consistent with neoplasm, suspicious for malignancy or malignant. The recommended management strategy for these cases is to perform a repeat FNAB after an appropriate time course. A...

Background and objectives: Medullary thyroid carcinoma (MTC) originates from thyroid C-cells and is a calcitonin (CT) secreting tumour with aggressive behaviour. Surgery is recommended in all patients with basal or calcium-stimulated CT values of 100 pg/ml or higher due to the high probability of MTC. The objective of this study was to investigate the utility of calcium stimulation test for CT in order to distinguish MTC from C-cell Hyperplasia (CCH) preoperatively and to exam...

Background: Primary thyroid lymphoma (PTL) is a rare thyroid malignancy. Nevertheless, it frequently presents diagnostic and therapeutic challenges. We describe two patients with PTL with different clinical presentation/clinical picture and outcome.Patients and methods: Two female patients underwent total thyroidectomy, the first, a 67-year-old female patient, because of nodular goitre and the second, a 79-year-old female patient, because of a large, pai...

Introduction: Diagnostic and post-therapy radioiodine whole body scan (WBS) is used in the follow-up of differentiated thyroid carcinoma (DTC) for the detection of local recurrence or remote metastasis. We report a case of false-positive uptake of radioiodine WBS.Case report: A 37-year-old female patient underwent subtotal thyroidectomy for multinodular goitre and histology revealed multifocal papillary thyroid carcinoma, of follicular type with three fo...

Introduction: Occurrence of follicular thyroid carcinoma (FTC) is limited almost within thyroid gland, but distant metastasis is discovered uncommonly as first presentation. We experienced a rare case about recurrent bone metastasis of FTC with unknown primary site.Case report: A 58-year-old woman complained about back pain for 3 years. A 5 cm sized mass in right 8th posterior rib was discovered and performed resection. The result of pathology was bone m...

Aims: To study if BRAF V600E mutation in thyroid fine needle aspiration (FNA) is associated with specific ultrasound (US) characteristics.Patients and methods: From 2010 to 2014 we reviewed patients with thyroid nodules with the following inclusion criteria: US guided FNA of the nodule and molecular testing for BRAF V600E on the FNA. BRAF mutation was detected using fluorescence melting curve. An expert on US, blinded to the BRAF status reviewed US exami...

Thyroid cancers are divided into two main subgroups according to their embryonic origin: papillary cancer, the most common histologic type, seen in 75–80%, and medullary cancer, seen in 5–10% (sporadic or as a component of multiple endocrine syndrome). Because of the different phenotypic characteristics of these two cancers, it’s unusual for them to present simultaneously. Since 1980, only a few cases of simultaneous papillary and medullary thyroid cancer have b...

The high pprevalence of thyroid cancer among the male population of Ukraine during the active reproductive age (over 25 years) makes it reasonable to study the effect of the disease on testicular function. The purpose of work was to examine the state of androgen levels and pituitary hormones in men with thyroid cancer.Design and methods: The study involved 14 male patients aged from 21 to 40 years, with thyroid cancer. The control group were 46 healthy m...

Cold nodules are one of the most common findings on scintigraphic examinations of the thyroid gland. About 5–10% of these nodules turn out to be histologically malignant. Our aim was to examine some somatogenetic alterations associated with thyroid cancer in FNA samples of the thyroid. These alterations included single nucleotide mutations (BRAF, HRAS, NRAS, KRAS) and genetic translocations (RET/PTC1, RET/PTC3, PAX8ex7/PPARgamma, PAX8ex9/PPARgamma). The SNPs were tested b...

Introduction: Primary thyroid lymphoma (PTL) is rare and constitutes 2–5% of thyroid malignancies. The risk however increases with background Hashimoto’s thyroiditis. (HT) We report a patient with HT complicated by thyroid lymphoma and did a literature review on this topic.Case presentation: A 61-years-old Chinese lady with background HT on levothyroxine presented with an enlarging goitre of 6 months duration. There was weight loss of 3–4 ...

Objectives: We previously published the result of CYP24A1 gene expression in one hundred, solely papillary thyroid carcinoma (PTC) compared to its own tumour free control from the same patient. We report an increase in CYP24A1 gene transcription in more than half of analysed PTCs. Elevated CYP24A1 protein expression was also observed in the cancerous tissue section compared to peritumoural normal thyroid tissue. In the present study we aimed to examine CYP24A1 gene transcripti...

Introduction: Brain metastases of thyroid carcinomas are rare (0.1–5%) according to the literature data. They generally occur in a context of metastatic spread which has a serious impact on survival. We report two cases and will review the literature data.Observations: Case 1: 57-year-old patient monitoring for papillary thyroid carcinoma in its solid form trabecular classified T4N0M1with lung metastases. Following a neurological symptoms of tonic-c...

Introduction: Papillary thyroid cancer (PTC) is the most frequently observed type of thyroid cancer. It usually shows favorable prognosis although some aggressive pathological subtypes have been defined. In this case report we present an aggressive form of PTC with previously non defined histological features.Case report: At initial evaluation the subject presented with a mass in the neck. Neck ultrasonography (USG) revealed a 49×23 mm hypo echoic n...

Thyroid cancer is highly prevalent in women aged 15–44 years, suggesting that in females the fertile age could be regarded as a risk factor. Consistently, in the last decades epidemiological and experimental findings indicated a possible role of oestrogens in the development and progression of differentiated thyroid tumours. We studied the expression of oestrogen receptor α (ER α) and Progesteron receptor (PR) in 182 female and male patients with papillary thyro...

Background: Papillary thyroid carcinoma (PTC) in patients with background Graves’ disease (GD) has been associated with a higher risk of post-operative tumour recurrence. We present a case and review the literature for possible explanations.Case presentation: A 55-year-old gentleman with GD treated with carbimazole presented 1 year after initial diagnosis with a 3 cm palpable thyroid nodule. Fine needle aspiration cytology (FNAC) was suggestive for ...

Background: Recent studies have shown that the incidence of differentiated thyroid cancer (DTC) is increasing.Objective: Evaluate the incidence of DCT in a center of the south of Spain for the last 15 years and analyse the clinical and morphological factors related to DTC.Methods: We reviewed the series of patients undergoing thyroid surgery at our hospital over a 15-year period and identified patients with DTC. Patients were divid...

Introduction: The Bethesda System 2010 introduced six diagnostic categories and divided follicular proliferation in two risk classes: Thyr3 and Thyr4. In literature about 5–15% of Thyr3 nodules are malignant and the risk of malignancy for Thyr4 is closer to 15–30%. We have analysed our cases surgically treated in recent years.Materials and method: We have prospectively categorised into a dedicated database patients submitted to thyroidectomy at...

Introduction: Anaplastic thyroid cancer is a devastating disease with median survival between 1.2 and 10 months. The disease accounts for as little as 0.9–1.6% of total thyroid cancer cases, but may account for up to half of all thyroid cancer mortality. The aim of our study is to evaluate the prognostic factors and outcomes of patients diagnosed with anaplastic thyroid cancer in Ireland and review emerging treatments for this disease.Methods and de...

Despite the importance of the Ret receptor, it is clear that other signal transduction pathways, tyrosine kinase receptors, and tumours suppressor genes are involved in MTC tumorigenesis and progression. Differences in the clinical behaviour of patients harbouring the same Ret mutations may be related to these other genes. Alterations of genes involved in the G1 phase of the cell cycle, including the cyclins, CDKs and CDK inhibitors, are common events in neoplastic development...

Background: Thyroid carcinoma has increased annually. Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy and thought to have favourable prognosis. Distant metastases are common in lungs and bones. However, brain metastases are rare and its prognosis is unfavourable. Here we reported a case of solitary brain metastases of PTC mimicking cavernous angioma in a 76-year-old woman patient.Methods: We collected her data retrospectively....

Introduction: Incidental papillary thyroid carcinoma (PTC) in patients undergoing thyroidectomy for benign multinodular disease is a well-recognised finding. Its true prevalence remains uncertain and shows great variability between studies, ranging from 7–25%. Our purpose was to review the prevalence of PTC in thyroid glands removed for benign nodular disease at a Northern Portuguese tertiary hospital.Methods: From December 2012 to December 2014, th...

Background: There are only few reports regarding the role of serum galectin-3 (Gal-3) as an early biochemical marker in thyroid carcinoma.Aim: To evaluate the potential overexpression of Gal-3 in sera from patients with confirmed diagnosis of papillary thyroid carcinoma (PTC).Patients and methods: We retrospectively investigated serum Gal-3 in 40 patients referred to the surgical department for thyroidectomy. Sera were collected be...

Anaplastic thyroid cancer (ATC) is one of the most lethal endocrine malignancy, with a mean survival of about 6 months. Until now, the most effective therapy for ATC comprises a multimodal treatment protocol, including surgery, chemotherapy (doxorubicin and cisplatin), and hyperfractionated accelerated external beam radiotherapy, with a median patient survival of 10 months. A possible increase in the effectiveness of the treatment could be achieved testing the sensitivity of &...

Follicular thyroid carcinoma (FTC) is the second most common thyroid malignant epithelial tumor. It is clinically asymptomatic, usually represented by a single nodule, less often multiple, with origin from thyroid follicular epithelial cells. Despite its well-differentiated characteristics, FTC may develop distant metastases through hematogenous dissemination. The molecular alterations involved in the pathogenesis of follicular neoplasia are not completely known. Recent studie...

Introduction: Papillary thyroid carcinoma can be found very rarely in a thyroglossal duct cyst (TDC) (1%), this cancer variant being the most common type. Although, most of the TDC develop in the midline of the thyroglossal duct (~70%), some cysts occur off midline, within 2 cm of the midline.Case presentation: The female patient of 34-year-old presented at the Maxillofacial Surgery Department in October 2014, with a right submandibular painless neck mas...

Introduction: Nowadays, use of chemotherapy in well-differentiated non medullary thyroid cancer, locally advanced stage and/or with radioiodine-refractory metastases is considered of scanty value. However, in the last 40 years was not published any phase III study nor a systematic review of its use in clinical setting.Methods: A systematic literature search was performed in databases such as Medline and Embase, among others. Two independent reviewers ana...

Introduction: The aim of this study was to determine the frequency and types of accompanying malignancies in Turkish subjects with differentiated thyroid cancer (DTC) residing in the northern region of Cyprus.Subjects and methods: We retrospectively analysed 567 subjects with a diagnosis of DTC in the Departments of Endocrinology and Nuclear Medicine.Results: Four hundred and forty-eight (79%) were females and 119 (21%) were males....

Aim: Investigate, in patients with differentiated thyroid cancer (DTC) if thyroglobulin (Tg) values, immediately before and six months post radioiodine ablation are good predictors of disease progression.Materials and methods: Basal Tg values (Tg-B) and rhTSH stimulated Tg (Tg-S) before ablation (0) and 6 months later (6) from 142 DTC patients, with post-surgical ablation therapy between 2003 and 2009 with a follow up of 5 years, were analysed.<p cla...

The clinical significance and potential morbidity of papillary thyroid microcarcinomas (PTMC) is discussed. Particularly the differences between those PTMC identified postoperatively in histological examination (incidentals), and those diagnosed preoperatively (non-incidentals). We retrospectively analysed differences in clinical presentation and course after treatment in these two groups. The study population consisted of 199 patients with PTMC who underwent surgery from 2000...

There is a specific unit specialised in treating differentiated thyroid cancer (DTC) at the Endocrinology Department from a hospital the southwest of Spain that attends patients from two different provinces. Owing to environmental pollution, one of them has higher incidence of cancer.To evaluate the changes in the clinical presentation of DTC over time and analyse possible differences between patients from the two provinces, we designed a descriptive ret...

Background: Fine-needle aspiration (FNA) biopsies are the cornerstone of preoperative evaluation of thyroid nodules, but FNA diagnostic performance has varied across different studies. We conducted a study to evaluate the effectiveness of ultrasound guided FNA in the thyroid nodule and to review the correlation between cytopathology and histopathology.Methods: Prospective FNAs were collected from 332 patients who underwent thyroid surgery between 2008 an...

Introduction: Neoplasms of the thyroid gland are classified according to the cell that it originates and commonly they originate from follicular or parafollicular C cells. The most common differentiated thyroid cancers (DTC) are papillary and follicular carcinomas. Coexistence of two different histological types of primary follicular thyroid neoplasm is a rare condition. There are previous reports of concomitant medullary and papillary thyroid cancers. However, there is scarce...

The prevalence of solid thyroid nodules is very high in the general population. Appropriate selection of cases for surgery is the most important task, when evaluating nodules. The present study wants to see if the use of Thyroid Imaging Reporting and Data System (TIRADS) could decrease the number of needed FNAB procedures.Material and method: 174 nodules evaluated by conventional ultrasound and real time elastography, with linear multifrequency probe, Hi...

Aim: 402 patients who were admitted and FNA was done in the Endocrinology Clinic at EBEAH were enrolled in this study. 340 (85%) of them were females and 62 (15%) of them were males. The age range was between 16 and 82. There weren’t any statistical differences in age between both sexes. Thyroid cancer is reported to constitute <2% of cancers in humans. At the same time, it is the most lethal endocrine malignancy. In the literature it is stated that 3% of all cancers ...

The pathologist cannot easily decide some thyroid fine-needle aspiration biopsy (FNA) into the benign, suspicious, or malignity and this condition are reported as ‘atypia of undetermined significance’ (AUS) or ‘follicular lesion of undetermined significance’ in the Bethesda system. Diagnosis of AUS of a thyroid nodule is leaved an endocrinologist as well as the patients in a difficult situation. However, the risk of malignancy at AUS is ~5–15%. Our aim...

Introduction and aim: Bethesda system for thyroid cytopathology has been widely used recently. Approximately 3–7% of thyroid fine-needle aspiration (FNA) biopsy is considered as malign. Suspicious or malign nodules should likely to be resected. Aim of this study is to confirm the diagnosis of malign or suspicious for malignity according to Bethesda classification in patients with nodular goitre after thyroidectomy.Materials and methods: Results of F...

Introduction and aim: Interpretation of follicular neoplasia classification according to Bethesda system in thyroid fine needle aspiration biopsy is very different among pathologist. A number of definition including ‘follicular lesion’, ‘follicular proliferation’, ‘follicular lesion of undetermined significance’, and ‘follicular neoplasia’ were used in terminology. A clearly discrimination between nodular goitre, follicular adenoma, and ...

Introduction: Medullary thyroid carcinoma (MTC) could be familial in 30% of cases. Here, we report a family of FMTC with rarely seen RET p.S891A mutation.Case presentation: A 49-year-old man presented with a single nodule in the left lobe of thyroid. Thyroid ultrasonography (US) showed a nodule and pathological cervical lymph nodes. There was no relevant family history. Fine-needle aspiration cytology (FNAC) of the nodule was consistent with a diagnosis ...

Introduction: Medullary thyroid cancer arises from the calcitonin-secreting parafollicular C cells and consists of a spectrum of disease that ranges from extremely indolent tumours, where patients may survive for many years with a large tumor burden, to aggressive types associated with a high mortality rate. The objective of our study is to evaluate the prognostic factors and outcomes of patients diagnosed with medullary thyroid cancer in a homogenous population, and to examin...

Thyroid cancers represent ~1% of new cancer diagnoses. Thyroid malignancies are divided into papillary carcinomas (80%), follicular carcinomas (10%), medullary carcinomas (5–10%), anaplastic carcinomas (1–2%), and other rare tumours (primary thyroid lymphomas and primary thyroid sarcomas). The main therapeutic options are surgery (mainly total thyreoidectomy), radioiodine treatment, levothyroxine therapy (TSH suppression dose), others (external beam irradiation, chem...

Introduction: TSH-stimulated serum thyroglobulin (Tg) is used as a sensitive marker for the detection of early recurrence or residual disease following treatment for differentiated thyroid cancer (DTC). However, stimulated Tg, using TSH or thyroid hormone withdrawal, is either costly or cumbersome for patients.Aim: To compare the performance of basal T4 suppressed, with stimulated Tg measurement, in the follow up of patients treated for DTC.</...

Introduction: A weekly endocrinology–radiology multidisciplinary (MDT) meeting has been recently introduced in our hospital to discuss indications and suitability of thyroid nodules for fine-needle aspiration (FNA). In a recent 5 years retrospective audit, 80% of thyroids FNAs were performed under ultrasound (US) guidance in our institution with an overall inadequacy (Thy1) rate of 11.1%.Objectives: The aim of this study was to assess whether such a...

Aim: It is well known that there is a strong relationship between chronic inflammation and tumorigenic process. The cytological diagnosis of follicular neoplasm (FN) carries a 20–30% risk of malignancy for thyroid nodules. In this study, we aimed to evaluate whether preoperative neutrophil to lymphocyte ratio (NLR) is a predictive factor for malignancy in thyroid nodules diagnosed as FN on cytology.Materials and methods: A total of 139 patients with...

Background: Thyroid fine-needle aspiration (FNA) is a safe, valuable and cost effective procedure and is now regarded as the investigation of choice for preoperative assessment of thyroid nodules. The reported sensitivity of thyroid FNA varies from 65 to 98% and the specificity from 73 to 98%.Aim: The aim of this study was to assess the accuracy of this procedure correlating cytology with histological outcomes, and to audit our practice against standard ...

Introduction: Papillary thyroid carcinoma (PTC) has generally good prognosis, and distant spread is rare. Common sites of distant metastasis are lung parenchyma and bone. Pleural metastasis is less common (0.6%), and most cases have been detected because of pleural effusion. Malignant pleural effusion is a poor prognostic factor among patients with PTC. We report a case of pleural metastasis of PTC proved by pleural biopsy.Case report: A 62-year-old man ...

Introduction: Serum calcitonin levels (sCT) in medullary thyroid carcinoma (MTC) correlate with the tumour size and disease progression. Lymph node (LN) metastases can be verified even in sCT lower than 100 pg/ml. The extent of LN dissection has not yet been standardised. The aim of this pilot study was to show our experience with sentinel lymph node (SLN) biopsy of jugulo-carotid chain (JCC) in selection of patients with MTC for modified radical neck dissection (MRND).<p ...

Background: Well-differentiated thyroid carcinoma in children is rare but it shows aggressive behaviour. Gross lymph node metastases and distant metastases are common on first clinical presentation.Patients and methods: During 33 years (1981–2014) at the Institute of Oncology and Radiology of Serbia 24 children were operated due to papillary thyroid carcinoma. Mean age was 12.6 (range 7–16) years. At the time of diagnosis 12.5% patients had lun...

Introduction: The aim of this study was to determine frequency of lymphonodal metastases in jugulo-carotid chain (JCC) and central neck compartment in incidental thyroid microcarcinomas (ITMC), as well as to examine whether sentinel lymph node (SLN) biopsy of JCC is an accurate technique to select patients with true positive, but clinically and ultrasonically negative lymph nodes, for modified radical neck dissection (MRND).Materials and methods: Out of ...

Objective: To evaluate the prevalence of thyroid cancer in patients with suspected thyroid nodule referred from primary care.Methods: Retrospective cohort study which included patients with suspected thyroid nodule referred from primary care to a high-resolution thyroid nodule clinic. Demographic and clinical characteristics were collected, all patients underwent thyroid ultrasound and subsequently, a fine-needle aspiration (FNA) was performed if thyroid...

Introduction: Papillary thyroid carcinoma (PTC) is the most frequently occurring subtype of thyroid differentiated cancers. PTC frequently metastasizes to the cervical lymph node region and metastasis rate of approximately 20–90% is available when diagnosed. Distant metastasis are usually the lungs, bone and brain metastases. Furthermore rarely the adrenal gland, skeletal muscle, ovaries, submandibular gland, sphenoid sinuses, liver and pancreatic metastases can be occurr...

Introduction: The incidence of thyroid cancer (TC) is low, but rising over time. Some studies point to a possible increase in mortality rate (MR) from this cancer in certain areas of Spain and Andalusia. Our purpose was to analyse the TC mortality in Andalusia and study how it has changed in the last years. We also analysed differences by age, sex, and geographic area.Methods: All deaths from TC were collected between January 1, 1975 and December 1, 2011...

Introduction: Chronic lymphocytic thyroiditis (LT) is a very common condition, and its coexistence with papillary thyroid carcinoma has often been reported. Analytical and echographic challenges must be kept in mind in the follow-up of patients with both these disorders.Case report:: We present the case of a woman with a history of multinodular goitre who underwent left thyroidectomy and isthmectomy at the age of 43, with the histopathological finding of...

Medullary thyroid cancer (MTC) is a form of thyroid carcinoma which originates from the calcitonin-secreting neuroendocrine parafollicular cells of the thyroid. It accounts for 5–10% of all thyroid cancers, and it mostly occurs as a sporadic entity (sMTC), but a familial pattern is also possible. Somatic mutations of RET are reported in 20–80% of sMTCs. The majority of MTCs harbour a RET M918T-exon 16 mutation. In sporadic MTCs the RET gene is mutated in codon 918, w...

Introduction: BRAF(V600E) mutation has received great attention to improve risk stratification in patients with PTC. Its prognostic value in the different Cytological variants (CytV) of PTC is not well established. The aim of this study was to investigate differences in clinicopathological features according to CytV, among patients harbouring the mutation.Methods: We evaluated 102 patients with pathological diagnosis of PTC. All of them underwent total t...

Diabetes mellitus is a risk factor for cancer, specifically of breast, endometrium, bladder, liver, colorectum, and pancreas. The pathophysiology of how diabetes contributes to cancer growth or development is an area of active investigation. The aims is to study the frequency and morphological features of thyroid cancer in patients with type 2 diabetes mellitus (DM).Materials and methods: The study involved 45 patients with thyroid cancer and type 2 DM. ...

Objectives: Coexisting thyroid nodules affect the treatment choice for PHPT. We aimed to evaluate the incidence of concomitant thyroid nodules in patients with primary hyperparathyroidism and to investigate the relationship between thyroid nodule volume, thyroid gland volume and thyroid nodules with clinical and laboratory parameters.Materials and methods: This study was carried out at Ankara University Endocrinology and Metabolism Department. 183 patien...

Introduction: We evaluated the characteristics of differentiated thyroid carcinoma in geriatric patients and factors that influenced long-term survival in this retrospective study design. Among 1188 patients with differentiated thyroid carcinoma who were treated at our institution over the past 7 years, 144 patients were identified who were age 65 years or older(age range:65–88 years) at the time of their initial diagnosis. This study conducted a retrospective analysis of...

Thyroid cancer is the most prevalent cancer among endocrine malignancies. In clinically, surgical resection combined with radioactive iodine therapy has been proved effective in treating differentiated thyroid cancer, including papillary and follicular thyroid cancers (FTC). However, patients with incurable differentiated thyroid cancer (DTC), poorly differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC) exhibit worse prognosis. Therefore, a novel and effecti...

Introduction: Currently, about 5–15% of non-medullary thyroid cancers (FNMTC) are considered to be of familial origin. These are either syndrome-associated tumours or non-syndromic tumours. The aim of the study was to determine the clinical, pathological and biochemical characteristics of FNMTC compared to non-familial ones with a follow-up of 10 years.Methods: Among FNMCT followed by a single physician, 62 patients with papillary cancer were screen...

The routine use of adjuvant RAI treatment in low-risk DTC remains controversial due to the lack of unequivocal evidences of its effectiveness in radically operated subjects. The aim of the study was a retrospective evaluation of long-term outcomes of combined DTC treatment to evaluate the impact of adjuvant RAI therapy in the low risk group. Primary hypothesis was: ‘if adjuvant RAI treatment was unnecessary, a delay in RAI administration would have no impact on long-term ...

In PTC, radioiodine required dose for thyroid remnant ablation is uncertain. Recent works show that low doses may be sufficient for low risk patients.Aim: To evaluate the efficacy and safety of thyroid remnant ablation in patients with low-risk PTC by using 1100 MBq (30 mCi) outpatient doses.Materials and methods: Twenty-five patients (24 women, 55 years-old mean age, range 34–77) referred for ablation of postsurgical thyroid ...

Introduction: Thyroid cancer is the most common endocrine cancer and medullary thyroid carcinoma (MTC) is one of the most malignant thyroid tumours which occur in both hereditary (25%) and sporadic (75%) forms. Mutations of the RET proto-oncogene in MTC development have been well demonstrated. The aim of the study was to investigate the mutational spectrum of exons 3, 5, 8, and 10–18 of RET proto-oncogene in MTC patients.Material and methods: This r...

Introduction: Thyroid cancer is the most common endocrine cancer and medullary thyroid carcinoma (MTC) is one of the most malignant thyroid tumours which occur in both hereditary (25%) and sporadic (75%) forms. Mutations of the RET proto-oncogene in MTC development have been well demonstrated. The aim of the study was to investigate the mutational spectrum of exons 3, 5, 8, and 10–18 of RET proto-oncogene in MTC patients.Material and methods: This r...

Introduction: High values of fine needle aspiration washout thyroglobulin (FNA-Tg) are diagnostic for metastatic lesions of thyroid cancer. However, there is not a consensus on cut-off for high Tg level. The most important confounding factor for FNA-Tg is inability to calculate Tg per unit volume because residual aspiration material in the needle cannot be known exactly. Another problem is possible contamination of whole blood during lymph node aspiration. In this study, we ai...

A global TC risk in a single thyroid nodule is rather small and ranges between 1 and 11%. However, taking into consideration Bethesda System for Reporting Thyroid Cytopathology TC risk varies between distinct categories: 0–3, 5–15, 15–30, 60–75 and 97–99% for Bethesda class II–VI, respectively. However, these values may differ in a centre, specialized in TC. Therefore, the aim of this study was to evaluate the TC risk in patients referred to a ter...

Introduction: The increased incidence of thyroid cancer is driven mainly by a large increase in papillary thyroid cancer (PTC). The number of patients that succumb to the disease has remained stable. The aim of our study is to analyze the incidence and mortality of thyroid cancer in Ireland.Methods and design: A retrospective analysis of the National Cancer Registry was undertaken, between 1st of January 1998 and the 31st December 2007. The Kaplan–M...

Introduction: The fine needle aspiration cytology (FNAC) of thyroid nodules is the procedure of choice in the diagnostic approach of nodular thyroid disease. Despite showing a sensitivity of 83% and a specificity of 92%, many of the results are non-diagnostic. One of the factors that can contribute to this number is the proper procedure of the smear.Objective: To compare the FNAC’s results in our team with and without the contribution of an expert C...

Cardiovascular deleterious effects of short term hypothyroidism are not well known. We aimed to investigate proprotein convertase subtilisin/kexin type 9 (PCSK9), soluble lectin-like oxidized LDL receptor 1 (sLOX-1) and ankle brachial index (ABI) in patients with thyroid cancer with short term overt hypothyroidism due to thyroid hormone withdrawal (THW). Twenty-one patients who require radioactive iodine (RAI) ablation or RAI scan and thirty-six age, sex, BMI similar euthyroid...

Objective: Thyroid incidentaloma is a common endocrinological disorder. Current literature regarding the risk of thyroid cancer in incidentalomas found in patients with non-thyroid cancer is limited. The aim of the present study was to investigate the frequency of thyroid malignancy in thyroid incidentalomas detected in patients with non-thyroid cancer.Methods: The database of 287 thyroid nodules from 161 patients with a history of non-thyroid cancer fol...

International best practice guidelines provide well-defined recommendations for the management of differentiated thyroid cancer (DTC) measuring ≤1 cm, >4 cm and for those with defined risk factors. However, the extent of surgery and requirement for radioiodine remnant ablation (RRA) are less clearly defined for tumours 1–4 cm in size. Guidelines recommend a ‘personalised decision making’ approach for this cohort, with therapeutic decisions based on pat...

Introduction: The association between autoimmune thyroid disease and thyroid cancer is a dynamic field regarding the prevalence data and the common pathogenic background.Aim: We report a sixth decade women case with a 1 year history of Graves’ disease that was discovered with an aggressive differentiated thyroid carcinoma.Case report: M.E. 56-year-old female has a 10 months history of daily medium dose of thyamazolum which was...

Objective: The frequency of differentiated thyroid cancer in the Graves’ disease are controversial. The aim of this study was to evaluate the frequency of thyroid cancers in patients operated because of Graves’ disease.Subjects and methods: Sixty-six patients in whom thyroidectomy was performed because of Graves’ disease between 2001 and 2012 were evaluated retrospectively. Patients who had received radioactive iodine treatment and externa...

Introduction: Although the association between thyroid autoimmunity and papillary thyroid carcinoma (PTC) is supported by clinical studies, evidence to their pathophysiologic link and causal relationship is lacking. Moreover, there is a paucity of data regarding the association of thyroid autoimmunity with the less common types of differentiated thyroid cancer (DTC). The aim of the current paper was to investigate the association of autoimmunity and PTC vs follicular or medull...

Introduction: The aim of this study was to validate the American Thyroid Association (ATA) risk of recurrence staging system (2009).Methods: Retrospective analysed 300 adult (239 women, 61 men) differentiated thyroid cancer patients followed for a median of 57 months (range 38–97).Results: ATA risk stratification of patients according to the system 54.7% low-risk, 39.7% moderate risk, and 5.7% were in the high risk group. The ...

Introduction: Primary squamous cell carcinoma (PSCC) of thyroid is a rare type of thyroid malignancies because thyroid gland lacks squamous epithelium. It is seen in <1% of all thyroid malignancies. During last 30 years only about 90 cases were published. PSCC is an aggressive tumour as well as rare.Case report: We present a 60-year-old female who had been followed up for multiple nodules in thyroid in our outpatient clinic for 2 years. Her serum fre...

Introduction: There are new therapies indicated in medullary thyroid cancer (MTC) based on different molecular targets, that appear to be effective in some cases with advanced disease, although many are still under investigation.Material and methods: We retrospectively evaluated five cases of medullar thyroid advanced carcinoma that later were referred to Oncology Department for Chemotherapy treatment.Results: Five patients (mean a...

Papillary microcarcinoma (PMC) of thyroid is being increasingly detected following thyroid surgery for various reasons. The management of incidental PMC, not clinically or radiologically evident, is not well defined often leading to over treatment. Identifying risk factors for recurrence could help in administering appropriate management.Aims and methods: To review the incidence of PMC and management locally. Retrospective review of case notes of patient...

Introduction: Total thyroidectomy (TT) is a safe and effective operation. The most frequent complication after TT is hypoparathyroidism. Surgical trauma, devasculisation of parathyroid glands and inadvertent parathyroidectomy have been identified as the main causes resulting in postoperative hypocalcaemia. The objectives of this study are to investigate the incidence of intrathyroid parathyroid glands (ITPGs) in a large cohort and to clarify their histological characteristics....