Endocrine Abstracts

Introduction: medullary thyroid carcinoma (MTC) is a neuroendocrine thyroidal cancer. World Health Organization recognizes a grading system for almost all neuroendocrine tumors; however, a shared grading system for MTC is still lacking. We performed a clinical and pathological review of 257 MTCs to evaluate which histologic features have an impact on the disease specific survival and to propose a new grading system.Method: We retrospectively reviewed cli...

Introduction: MTC is a rare neuroendocrine tumor arising from thyroid parafollicular cells. After initial treatment, patients should be divided according to their clinical status in cured, biochemical persistence (BIO) and structural persistence (STR) of the disease. Concerning BIO patients less is known about the structural disease appearance rate and the time elapsed between the first evaluation after surgery and the appearance of structural disease.Me...

Aims: Surgery is the only curative treatment for medullary thyroid cancer (MTC) patients and the gold standard practice is still represented by total thyroidectomy and prophylactic central neck compartment lymphnode dissection. As it happened for differentiated thyroid cancer, in the last years some authors proposed less aggressive and extent surgical modality as hemithyroidectomy and ipsilateral neck compartment dissection in unilateral and solitary sporadic MTC cases. Few st...

Background: CV-PTC is often indolent with excellent long-term response, while TCV-PTC (≥50% of tall cells) have aggressive features and worse clinical behavior. Less is known about the clinical behavior of CV-PTC with tall cells <50% (TC/CV-PTC) that, so far, is considered as low risk tumor.Aim: To evaluate the histological presentation of CV-PTC, TC/CV-PTC, TCV-PTC and their clinical behavior after 6 years of follow up.M...

Introduction: Total thyroidectomy (TT) plus central neck compartment (CC) lymphnode dissection is still the recommended initial gold standard treatment for medullary thyroid cancer (MTC), even in the absence of a pre-surgical positive neck US evidence of lymphnode metastases. Considering the risk of surgical complications of this prophylactic surgery and the low rate of histologic finding of CC lymphnode metastases, a more tailored lymphnode’ surgery should be proposed. A...

Introduction: Despite its neuroendocrine origin, only recently an international study group proposed a dedicated grading system (IMTCGS) for medullary thyroid carcinoma (MTC). IMTCGS is an independent and powerful tool able to predict disease specific survival (DSS) as well as distant metastasis-free (DMFS) and locoregional recurrence-free survivals (LRFS), regardless of other risk factors, including staging.Objectives: To evaluate the performance of IMT...

Background: Distant metastases at diagnosis is the worst prognostic factor for disease specific survival (DSS) in sporadic medullary thyroid carcinoma (MTC). Also, lymph node metastases are negative prognostic factors both for DSS and recurrence free survival (RFS). The question whether central (N1a) and latero-cervical compartment lymph nodes metastasis (N1b), separately evaluated, can have a different impact on DSS and RFS remains to be clarified.Patie...

Fine-Needle Aspiration Biopsy (FNAB) is the recommended diagnostic tool for differentiating malignant from benign thyroid nodules and provides indication for surgical decisions. According to the Italian system, thyroid nodules are classified as TIR 1/1C, TIR 2, TIR 3A, TIR3B, TIR4 or TIR5, which correspond to Thy I, Thy II, Thy III, Thy IV, Thy V and Thy VI categories of the Bethesda system. TIR 3 identifies the indeterminate nodules. Surgery is usually recommended for TIR 3B,...

Background: CCH and serum hypercalcitoninemia (iperCT) can be found in benign thyroid diseases such as thyroiditis and in some cases of papillary (PTC) or follicular (FTC) thyroid microcarcinomas. The question of whether the association with these latter is related to the malignancy of the nodule is still unclear.Aim of the study: To evaluate the difference in the CCH prevalence, at histology, in a series of benign (BTN) and malignant (PTC/FTC) thyroid n...

Genetic intratumor heterogeneity has been recently demonstrated in some solid human cancers and a few years ago RET mutated and not mutated cells were described in medullary thyroid carcinoma (MTC). Nobody reported the presence of two different RET mutations.Aim of our study was to investigate the RET somatic mutation profile in primary MTC (pMTC) and in the corresponding metastatic tissues (mets).We studied pMTC and mets of 22 MTC...