Clinical characteristics and prognosis of familial nonmedullary thyroid carcinoma.

INTRODUCTION: Familial non-medullary thyroid carcinoma (FNMTC) is defined by the presence of 2 or more first-degree family members with differentiated thyroid carcinoma (DTC). The aim of this study is to compare clinicopathological features and prognosis of FNMTC and sporadic carcinoma (SC). MATERIALS AND METHODS: Retrospective study of DTC included in the hospital database during the period 1990-2018. RESULTS: A total of 927 patients were analyzed, 61 of them were FNMTC, with a mean follow-up of 9.7 ±â€¯6.5 years. The prevalence of FNMTC was 6.6%, with a lower TNM staging presentation (P = 0.003) consequence of a higher proportion of tumors smaller than 2 cm (P = 0.003), combined with a greater multifocality (P = 0.034) and papillary histologic subtype (P = 0.022) compared to SC. No significant differences in age at diagnosis (P = 0.347), gender (P = 0.406), neither in other aggressiveness markers (bilaterality, extrathyroidal extension, lymph node involvement and metástasis) were detected. Rate of persistence/recurrence (P = 0.656), disease-free survival (P = 0.929) and mortality caused by the tumor itself (P = 0.666) were comparable. Families with ≥3 affected relatives, had smaller tumors (P = 0.005), more multifocality (P = 0.040) and bilaterality (P = 0.002), as well as a higher proportion of males (P = 0.020). Second generation patients present earlier FNMTC compared to those of the first generation (P = 0.001). CONCLUSION: In our study FNMTC presents a lower TNM staging, higher multifocality and papillary variant, with similar aggressiveness and prognosis compared to SC.

Clinical characteristics and prognosis of familial nonmedullary thyroid carcinoma. / Características clínicas y pronósticas del carcinoma familiar de tiroides no medular.

INTRODUCTION: Familial non-medullary thyroid carcinoma (FNMTC) is defined by the presence of 2or more first-degree family members with differentiated thyroid carcinoma (DTC). The aim of this study is to compare clinicopathological features and prognosis of FNMTC and sporadic carcinoma (SC). MATERIALS AND METHODS: Retrospective study of DTC included in the hospital database during the period 1990-2018. RESULTS: A total of 927 patients were analyzed, 61 of them were FNMTC, with a mean follow-up of 9.7±6.5 years. The prevalence of FNMTC was 6.6%, with a lower TNM staging presentation (P=.003) consequence of a higher proportion of tumors smaller than 2 centimeters (P=.003), combined with a greater multifocality (P=.034) and papillary histologic subtype (P=.022) compared to SC. No significant differences in age at diagnosis (P=.347), gender (P=.406), neither in other aggressiveness markers (bilaterality, extrathyroidal extension, lymph node involvement and metástasis) were detected. Rate of persistence/recurrence (P=.656), disease-free survival (P=.929) and mortality caused by the tumor itself (P=.666) were comparable. Families with ≥3 affected relatives, had smaller tumors (P=.005), more multifocality (P=.040) and bilaterality (P=.002), as well as a higher proportion of males (P=.020). Second generation patients present earlier FNMTC compared to those of the first generation (P=.001). CONCLUSION: In our study FNMTC presents a lower TNM staging, higher multifocality and papillary variant, with similar aggressiveness and prognosis compared to SC.

Glucose metabolism before and after treatment in patients with acromegaly. / Alteraciones en el metabolismo glucémico antes y después del tratamiento en pacientes con acromegalia.

INTRODUCTION: The aim of this study was to ascertain the prevalence of carbohydrate changes in patients diagnosed with acromegaly, and to evaluate what happens two years after treatment. It was also intended to assess which factors are associated to the occurrence of such changes. MATERIAL AND METHODS: Sixty-six patients diagnosed with acromegaly at our center were enrolled and divided into groups with normal glucose metabolism, prediabetes, and diabetes. After 2 years of treatment of acromegaly, prevalence carbohydrate changes was assessed again depending on the patient condition (cured, controlled with medical treatment, or uncontrolled). RESULTS: At the time of diagnosis of acromegaly, 27.3% of the patients had diabetes (n=18), 39.4% had prediabetes (n=26), and 33.3% had no changes (n=22). Significant differences were found in IGF-1 and z-score of IGF-1 (median of 18.1 in diabetics and 10.6 in non-diabetics, P=.005). Two years after treatment, there was a significant decrease in the prevalence of diabetes and prediabetes in cured patients (from 29.2% to 8.3% and from 45.8% to 16.7%, respectively, P=.003), but not in patients controlled with medical treatment or not controlled. CONCLUSION: At our center, 66.6% of patients with acromegaly had changes in carbohydrate metabolism at diagnosis, with a prevalence of diabetes of 27.3%. Two years after treatment of acromegaly, prevalence of diabetes and prediabetes decreased in cured patients.