Endocrine Abstracts

Cytological evaluation establishes the diagnosis of a benign or malignant nodule in 70–80% of all cases, but the remaining cases lack the features needed for a definitive diagnosis. Molecular tests have been developed to assist in determining if a nodule with indeterminate cytology is benign or malignant. The first studies focused on the analysis of the most common thyroid cancer (TC) mutation, BRAFV600E. However, since many TCs are driven by other mutations, testing for ...

The evaluation of a thyroid nodule is a very common clinical problem and fine needle aspiration biopsy (FNAB) is the only test that can provide a definitive preoperative diagnosis of malignancy. The sensitivity and specificity of FNAB are limited by aspirates that yield insufficient material for definitive diagnosis and those with indeterminate diagnoses, which can account for up to 30–40% of all specimens. The detection of several novel gene mutations in differentiated t...

There are growing evidences suggesting the existence of intra-tumor heterogeneity within the same patient, leading to a different genetic pattern between primary tumour and metastases.We report a paradigmatic example of genetic heterogeneity in thyroid cancer (TC). A 42 years old female patient was submitted, for a follicular TC, to total thyroidectomy and lymphadenectomy followed by radioiodine residue ablation in late 1999. In 2000 and 2001 diagnostic ...

Thyroid cancer (TC) is the most common endocrine malignancy, with an increasing number of diagnosis in the last decades. Of all TC histotypes, the poorly differentiated and anaplastic TCs (PDTC and ATC) have a very poor prognosis because of their invasiveness and metastatic behavior, as well as their insensitivity to radioactive-iodine treatment. In the last years, the stem-cell model has been proposed to further explain TC carcinogenesis. According to this model, only a subse...

Oxidative stress (OS) can have an impact both in the pathogenesis and in the progression of TC, as it has been shown to induce oncogenes and inhibit tumor suppressors. The main source of cellular ROS is represented by NADPH oxidases (NOXs). Aims of the study were to investigate the NOX-derived OS in TC samples, benign nodules and corresponding normal tissues, and to correlate the level of OS with histological classification, genetic profile and clinical and prognostic features...

Thyroid cancer (TC) is the most common endocrine tumor and its incidence has increased faster than in any other malignancy. Although TCs are usually well differentiated, disease recurrence or persistence is high, because of local and distant metastasis and therapeutic resistance. As in other cancer types, despite the promising results obtained in pre-clinical studies, the efficacy of Targeted Therapy is highly variable and therapy resistance is not uncommon. This may be due to...

Background: thyroid function (TSH levels) and thyroid autoimmunity are involved in the immunomodulation of early pregnancy stages and can affect assisted reproductive technology (ART).Aims: 1) to evaluate if pre-conceptional TSH is associated with an increased risk of miscarriage, 2) to identify a TSH cut-off significantly associated with risk of miscarriage, 3) to assess the impact of TSH levels on primary and surrogate outcomes.M...

Background: Pregnancy does not cause differentiated thyroid cancer (DTC) recurrence in patients without structural or biochemical evidence of disease at the time of conception. However, data regarding pregnancy’s impact in patients with persistent DTC before conception are still controversial.Aim: The aim of the study was to determine whether pregnancy could significantly influence the outcome in DTC patients in persistence before pregnancy, but wit...

The management of loco-regional metastases in patients with differentiated thyroid carcinoma is still debated. Current American Thyroid Association guidelines state that in this context the main goal is to differentiate between low-volume metastatic disease that will progress and that remaining stable over time.Aim of our study was to evaluate the behavior of suspicious or cytologically confirmed lymph node metastases, detected after initial treatment (i...

Radioiodine refractory differentiated thyroid cancer can be effectively treated with multi-tyrosine-kinase inhibitors (mTKI). Due to their pleiotropic mechanism of action, these drugs may cause different side effects. Hypocalcaemia has been reported in up to 35% of patients treated with mTKI, but little is known about its pathophysiology and clinical relevance. We report the case of a 78 years old woman treated for a multifocal papillary thyroid cancer, infiltrating perithyroi...