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BACKGROUND: Anaplastic thyroid carcinoma(ATC) is a rare pathological type of thyroid malignancy. Primary squamous cell carcinoma of thyroid(PSCCT) is now considered as a subtype of ATC, hereinafter referred to as ATC-SCC subtype. ATC-SCC subtype combined with follicular thyroid carcinoma is exceedingly rare, with fewer cases reported. The ATC-SCC subtype is a highly invasive tumor with a poor prognosis for patients after metastasis occurs, and current treatment of this type of tumor is tricky. CASE PRESENTATION: A 68-year-old female patient presented with a gradually growing swelling of right cervical region. Comprehensive auxiliary examinations and postoperative pathology confirmed the diagnosis of ATC-SCC subtype with follicular thyroid carcinoma, and the metastasis squamous cell carcinoma of the right cervical lymph nodes originates from ATC-SCC subtype. The patient received chemoradiotherapy postoperative. However, the residual cervical lymph nodes metastasis with squamous cell carcinoma still infiltrated surrounding structures in the neck extensively after palliative resection. The patient died 7 months after surgery. CONCLUSION: Our case highlights that cervical lymph node metastasis may be a significant factor in the poor prognosis of ATC-SCC subtype. This malignancy should be detected and treated early.
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Adenocarcinoma Folicular , Metástasis Linfática , Carcinoma Anaplásico de Tiroides , Neoplasias de la Tiroides , Humanos , Femenino , Anciano , Neoplasias de la Tiroides/patología , Adenocarcinoma Folicular/patología , Adenocarcinoma Folicular/secundario , Carcinoma Anaplásico de Tiroides/patología , Carcinoma Anaplásico de Tiroides/diagnóstico , Carcinoma Anaplásico de Tiroides/terapia , Pronóstico , Resultado Fatal , Cuello/patología , Ganglios Linfáticos/patología , Carcinoma de Células Escamosas/secundario , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/diagnósticoRESUMEN
Patients with Hashimoto's thyroiditis had increased numbers of Th17 cells in serum and thyroid tissue, significantly elevated levels of interleukin 17 (IL-17), and an imbalance in the ratio of Th17 cells to regulatory T cells (Tregs). The reduced Tregs' ratio leads to a reduction in immunosuppressive function within the thyroid gland, while Th17 cells are involved in the development of HT by regulating the expression of pro-inflammatory cytokines in the thyroid gland and mediating thyroid tissue fibrosis through the secretion of IL-17.
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Enfermedad de Hashimoto , Interleucina-17 , Linfocitos T Reguladores , Células Th17 , Enfermedad de Hashimoto/inmunología , Enfermedad de Hashimoto/sangre , Enfermedad de Hashimoto/metabolismo , Humanos , Interleucina-17/metabolismo , Interleucina-17/sangre , Células Th17/inmunología , Células Th17/metabolismo , Linfocitos T Reguladores/inmunología , Linfocitos T Reguladores/metabolismo , Glándula Tiroides/inmunología , Glándula Tiroides/metabolismo , AnimalesRESUMEN
Background: Papillary thyroid carcinoma (PTC) accounts for about 60% of adult thyroid carcinoma and generally has an excellent prognosis. Primary squamous cell carcinoma of thyroid (PSCCT) is a rare thyroid tumor with high malignancy and poor prognosis. In 2022, the 5th edition of World Health Organization (WHO) has classified it as a subtype of anaplastic thyroid carcinoma (ATC), abbreviated as ATC-squamous cell carcinoma (SCC) subtype. Poorly differentiated thyroid carcinoma (PDTC) is a kind of follicular-derived malignancy, which is prone to recurrence and distant metastasis. Here, we report a rare case of the coexistence of PTC, ATC-SCC subtype and PDTC. Case Description: We herein report a case of 69-year-old female who initially presented with a history of left neck mass for one month. Comprehensive auxiliary examinations and postoperative pathology confirmed the diagnosis of PTC combined with ATC-SCC subtype, and PDTC. Total thyroidectomy with radical left cervical lymph node dissection was performed, followed by thyroid-stimulating hormone (TSH) suppressive therapy, 131I, radiotherapy and chemotherapy. The patient showed no tumor recurrence or metastasis after a 5-month postoperative follow-up. Conclusions: The simultaneous occurrence of PTC, ATC-SCC subtype, and PDTC is extremely rare in clinical terms or literature reports. The treatment has not been standardized, and early radical surgery is the first choice. In addition, the combination of adjuvant therapies such as TSH suppressive therapy, radiotherapy, chemotherapy and 131I may further improve the prognosis of the patient.
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BACKGROUND: Parathyroid carcinoma (PC) is a rare endocrine malignancy causing pathological changes such as abnormal bone metabolism, elevated serum calcium, and impaired renal function, and uncontrollable hypercalcemia is the main cause of death in PC patients. The diagnosis of PC is challenging and relying on postoperative histopathology. Radical surgery at the first time is the only effective therapy to cure PC. Hungry bone syndrome (HBS) is a relatively uncommon complication of parathyroidectomy characterized by profound and prolonged hypocalcemia, timely electrolyte monitoring and alternative interventional protocols can prevent symptomatic hypocalcemia. CASE: A 57-year-old man presented with multiple pathological fractures and muscle atrophy as the main symptoms accompanied by bone pain, hypercalcemia, elevated parathyroid hormone (PTH), and an enlarged left-sided neck mass. After consultation of multidisciplinary team, he was treated conservatively with plaster bandage fixation and infusion of intravenous zoledronic acid; and then complete resection of parathyroid mass + removal of involved tissue structures + left thyroid and isthmus lobectomy + lymph node dissection in the VI region in left neck were performed. The postoperative histopathology suggested a diagnosis of parathyroid carcinoma. Calcium and fluid supplementation and oral levothyroxine tablets were given postoperatively. Unexpectedly, the patient's PTH level decreased rapidly at 24 h postoperative, and serum calcium and phosphorus decreased continuously, and he felt numb around perioral sites and fingertips, which considered to be postoperative HBS complicated by parathyroidectomy. Then, a large amount of calcium supplementation and vitamin D were given timely and the patient got better at 1 month postoperatively. At 9-month postoperative, his bone pain and fatigue were significantly relieved compared with before with calcium, phosphorus, and PTH levels at normal range. CONCLUSION: The possibility of parathyroid disease, particularly PC, should be considered in the presence of multiple pathological fractures, muscle atrophy, generalized bone pain, hypercalcemia, and clear neck mass. Radical resection of the tumor lesions at the first surgery is a key element affecting the prognosis of PC, and the effective management of preoperative hypercalcemia and postoperative HBS is also of great significance for improving prognosis.
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Fracturas Espontáneas , Hipercalcemia , Hipocalcemia , Neoplasias de las Paratiroides , Masculino , Humanos , Persona de Mediana Edad , Hipocalcemia/etiología , Hipocalcemia/complicaciones , Neoplasias de las Paratiroides/complicaciones , Neoplasias de las Paratiroides/diagnóstico , Neoplasias de las Paratiroides/cirugía , Calcio , Hipercalcemia/complicaciones , Fracturas Espontáneas/complicaciones , Fósforo , Atrofia Muscular/complicaciones , DolorRESUMEN
@#[摘 要] 目的:探讨circ_0072088对甲状腺癌IHH4细胞恶性生物学行为的影响及其可能的机制。方法:选取2015年4月至2019年3月于青海大学附属医院就诊的确诊为甲状腺癌后接受切除手术且术前未进行任何治疗的48例甲状腺癌患者的甲状腺癌组织及其对应癌旁组织。根据GEO数据集(GSE93522)分析鉴定甲状腺乳头状癌中差异表达的circRNA。用qPCR法检测circ_0072088在甲状腺癌组织和细胞中的表达水平。采用CCK-8法和Transwell法检测circ_0072088和miR-532-3p过表达对甲状腺癌IHH4细胞增殖、迁移和侵袭的影响。采用生物信息学和双荧光素酶报告基因实验验证甲状腺癌细胞中circ_0072088与miR-532-3p、miR-532-3p和WEE1基因之间的关系。结果:circ_0072088在甲状腺癌组织和细胞中呈高表达(P<0.05或P<0.01)。circ_0072088过表达促进了甲状腺癌细胞的增殖、迁移和侵袭(P<0.05或P<0.01),而转染 miR-532-3p模拟物能够减弱这种作用(P<0.05或P<0.01)。此外,机制研究表明,circ_0072088可以与miR-532-3p靶向结合,且WEE1是miR-532-3p的下游靶基因。结论:circ_0072088通过调控miR-532-3p/WEE1轴促进IHH4细胞的增殖、迁移和侵袭。