Endocrine Abstracts (2017) 49 P6 | DOI: 10.1530/endoabs.49.P6

Thyroid oncology in the crossroads of precision and narrative medicine

Manuel Sobrinho Simões


Thyroid cancers are the solid tumours of mankind with the lowest mutational load. This holds particularly true for papillary carcinomas (PTC) whose pathogenesis appears to be understandable by a limited number of genetic alterations (That is why they are so frequently multifocal). The utilization of NGS allowed the establishment of three molecular subtypes of well differentiated thyroid carcinomas: BRAF-life (Conventional and tall cell PTC, mainly), RAS-like (Follicular variant PTC and follicular carcinoma) and No BRAF/No RAS. Precision medicine is playing a major role in thyroid oncology but its shortcomings are becoming evident. Somatic copy number alterations play also a role in some tumour subtypes and, furthermore, one is progressively aware of the important role played by host factors: Stromal reaction (including extracellular matrix characteristics, subsets of fibroblasts and degree of desmoplasia), ‘social’ RNAs, immune cells, hormones, growth factors. The data brought in by the latter narrative medicine approach is turning easier the diagnosis and treatment of thyroid cancer patients.

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