Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 143
Filtrar
1.
Medicine (Baltimore) ; 98(50): e18213, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852078

RESUMO

We aimed to investigate the association between excess body mass index (BMI) and papillary thyroid cancer (PTC) in an operative population, and the impact of higher BMI on clinicopathological aggressiveness of PTC.Charts of 10,844 consecutive patients with thyroid nodules undergoing partial or total thyroidectomy between 1993 and 2015 were reviewed. Patients diagnosed with PTC were stratified in 4 groups: BMI < 18.5 (underweight), 18.5 ≤ BMI < 24 (normal-weight), 24 ≤ BMI < 28 (overweight) and BMI ≥ 28(obese). The impacts of high BMI on prevalence and clinicopathological parameters of PTC were retrospectively analyzed in both univariate and multivariate binary logistic regression analysis.For every 5-unit increase in body mass, the odds of risk-adjusted malignance increased by 36.6%. The individuals who were obese and overweight were associated with high risk of thyroid cancer [odds ratio (OR)= 1.982, P < .001; OR= 1.377, P < .001; respectively] compared to normal weight patients, and this positive association was found in both genders. Obesity was independent predictors for tumors larger than 1 cm (OR = 1.562, P < .001) and multifocality (OR = 1.616, P < .001). However, there was no difference in cervical lymph node (LN) metastasis among BMI groups. Crude analysis showed BMI was associated with advanced tumor-node-metastasis (TNM) stage (relative risk, approximately 1.23 per 5 BMI units, P < .001), but this association disappeared after adjusting for confounding factors.Obesity was significantly associated with the risk of PTC in a large, operative population. Higher BMI was significantly associated with larger tumor size and multifocal tumor.


Assuntos
Índice de Massa Corporal , Obesidade/complicações , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Tireoidectomia/métodos , Estudos de Casos e Controles , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Câncer Papilífero da Tireoide/etiologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/cirurgia
2.
Am Surg ; 85(11): 1265-1268, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31775969

RESUMO

We investigated whether laryngoscopy should be performed before total thyroidectomy on all patients without a history of neck surgery. A total of 2523 patients who underwent total thyroidectomy between January 1, 2013, and March 18, 2018, were retrospectively examined. Preoperative vocal cord examination was performed on 2070 of these patients by the otorhinolaryngology department using indirect laryngoscopy. Patients with a history of neck or thyroid surgery were not included in the study. The patients were evaluated in terms of age, gender, symptom (hoarseness/dyspnea), comorbidity, surgical history, biopsy, nodule diameter, pathological diagnosis, and tracheal deviation. Preoperative vocal cord paralysis was detected in 0.8 per cent of the patients (17/2070). Four patients (23.5%) were male and 13 patients (76.5%) were female. The mean age was 62 (range, 25-82) years. Seven of the 17 patients (41%) were symptomatic, with complaints of dyspnea in five and hoarseness in two. The univariate analysis revealed that a nodule diameter >30 mm and the presence of dyspnea were associated with vocal cord damage. Furthermore, the multivariate analysis showed that dyspnea alone was an independent variable (P = 0.011). It is recommended that preoperative vocal cord evaluation should be performed only in patients with severe symptoms, such as dyspnea.


Assuntos
Laringoscopia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Paralisia das Pregas Vocais/diagnóstico , Adenocarcinoma Folicular/diagnóstico , Adenocarcinoma Folicular/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Dispneia/etiologia , Feminino , Rouquidão/etiologia , Humanos , Laringoscopia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Estudos Retrospectivos , Fatores Sexuais , Avaliação de Sintomas/métodos , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/cirurgia , Paralisia das Pregas Vocais/complicações
3.
Chirurgia (Bucur) ; 114(5): 586-593, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31670634

RESUMO

Background: All patients undergoing thyroid operations should be subjected to preoperative neck ultrasound (US) followed by fine needle aspiration cytology (FNAC) of suspicious lesions. In Western countries, thyroid surgeons routinely perform neck ultrasound. The role of prophylactic central neck dissection (PCND) remains a topic of debate. For treatment of papillary thyroid carcinoma (PTC), in 2014 we introduced two new adjuncts: PCND based on criteria of the European Society of Endocrine Surgeons (ESES) consensus group and surgeon-performed US (S-US). Methods: In order to better understand the role of these two adjuncts in our shift of strategy we aimed to evaluate the outcomes of our patients in two successive 5-year time periods based on a retrospective analysis of our prospectively maintained database (total of 286 patients were included in this study). Results: The two groups were similar regarding epidemiological and clinical data. FNAC was done in only 21.66% of all PTC cases. PTC diagnosis was done in the majority of suspicious cases by FS. S-US guided the selective lateral node dissections (LND), leading to more lymph node metastases detections and it also surpassed endocrinologist performed US (E-US) in terms of PPV. PCND rate of complications was significantly higher due only to transient hypoparathyroidism. Conclusions: Preoperative surgeon-performed ultrasonography is a useful tool in the arsenal of PTC treatment. The systematic preoperative FNAC diagnosis and intraoperative frozen sections in uncertain cases are mandatory. PCND is a safe method of treatment and staging in PTC.


Assuntos
Esvaziamento Cervical/métodos , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Humanos , Excisão de Linfonodo/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , Resultado do Tratamento , Ultrassonografia
4.
J Cancer Res Clin Oncol ; 145(11): 2751-2759, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31571010

RESUMO

PURPOSE: Papillary thyroid carcinoma (PTC), the most common malignant tumor of the thyroid, has been criticized as overtreated by some researchers in recent years. Active surveillance (AS) was first proposed at Kuma Hospital in 1993, and popularized in other institutes ever since. We provide a brief review of low-risk PTC active monitoring studies to date, and discuss the advantages of AS and limitations of existing studies. RESULTS: Most papillary thyroid microcarcinomas do not show significant growth or new lymph node metastasis in a 10-year AS period. Patients who undergo delayed surgery during AS generally have a good prognosis. Tumor progression correlates with age, calcification pattern, and Ki-67 positivity. Serum thyroid stimulating hormone concentration and pregnancy might also influence tumor progression in some studies. CONCLUSION: Active surveillance for low-risk PTC has shown its safety and feasibility in certain populations. In the future, it is warranted to determine valuable tumor progression predictors and most suitable PTC patients for AS.


Assuntos
Vigilância da População/métodos , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Conduta Expectante/métodos , Humanos , Câncer Papilífero da Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia
5.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(4): 517-523, 2019 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-31484615

RESUMO

To analyze the potential associations of ultrasound-guided fine-needle aspiration(FNA),BRAF V600E gene mutation detection,and the combination of these two techniques with the clinicopathological features of papillary thyroid cancer(PTC). Methods Patients with PTC confirmed by surgery from April 2016 to July 2017 were included in this study.The relationship between clinicopathological features and BRAF V600E mutation,FNA results,and the combination of them were explored. Results The sensitivity of FNA was 86.3%(227/263)and the mutation rate of BRAF V600E was 85.9%(226/263)in 263 patients with PTC.The mutation rate of papillary thyroid microcarcinoma(PTMC)was 91.1%(153/168)and that of non-PTMC was 76.8%(73/95).A total of 225 patients underwent lymph node dissection.The lymph node metastasis rate was 35.6%(80/225),and it was 23.8%(34/143)in PTMC,56.1%(46/82)in non-PTMC;in addition,9.9%(26/263)of PTC patients had extracapsular invasion.BRAF V600E mutation rate was higher in patients with the following features:aged over 45 years(P=0.043);the tumor was FNA diagnosed as malignant or suspected malignant(P=0.011);the tumor had a maximum diameter of ≤1 cm(P=0.001);and the primary tumor was in stage T1(P=0.039);however,there was no significant difference in BRAF V600E mutation rate among patients with different sex,capsule invasion,or lymph node metastasis.The diagnostic sensitivity of FNA was not statistically different under different clinical and pathological characteristics.The clinicopathologic features of FNA and BRAF V600E double-positive patients were not significantly different from those of other patients. Conclusion FNA-confirmed malignancy,BRAF V600E gene mutation,and their double-positive results are not correlated with the invasive pathological features of PTC,and thus their roles in guiding an extended operation(or not)are limited.


Assuntos
Biópsia por Agulha Fina , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Humanos , Metástase Linfática , Mutação , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/genética
6.
Pan Afr Med J ; 33: 77, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448039

RESUMO

We report the case of a 45-year old woman with a 15-day history of anterior cervical swelling increasing very quickly in size associated with a 7-day history of local inflammation. Clinical examination showed voluminous tender and fixed swelling occupying all the anterior cervical region. The skin's surface was inflammed with permeation nodule (Figure 1, A). The patient was febrile at 38° with good overall physical condition Cervical ultrasound showed voluminous right laterocervical mass that, given the size, made surgical exploration difficult. CT scan showed voluminous thyroid mass, multi-cystic in the superficial tissues, compressing the trachea and the esophagus and pressing the vascular axis of the neck (Figure 1, B and C). Laboratory tests showed leukocytosis 13500 cells/ml, anemia to 8.3 g/dl, CRP 42mg/L and normal thyroid test. Fine needle aspiration biopsy showed purulent and very inflammed material without cytologic signs of malignancy. The patient underwent surgery. Surgical exploration showed several superficial cystic and haemorrhagic cubicles with, in depth, tumor tissue infiltrating the trachea. The tumor laterally invaded the right vascular axis and spread to the suprahyoid muscles, the right submandibular region and the twelfth cranial nerve. Total extended thyroidectomy was performed. Histological examination showed papillary thyroid carcinoma measuring 11cm along its longer axis. Based on our literature review, this is the first case of locally invasive papillary cystic carcinoma of the thyroid revealed by subacute infection.


Assuntos
Celulite (Flegmão)/diagnóstico , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Tireoidectomia/métodos , Biópsia por Agulha Fina , Celulite (Flegmão)/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Pescoço , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tomografia Computadorizada por Raios X
7.
BMJ Case Rep ; 12(8)2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31439567

RESUMO

A 67-year-man presented to the emergency department with massive hemoptysis, coughing up about 250 mL frank blood in 2-3 hours. Physical examination was significant for tachycardia, tachypnea and blood around the mouth. A CT of the chest did not reveal any aetiology of hemoptysis. Flexible fiberoptic bronchoscopy was remarkable for an actively oozing 1×1 cm sessile subglottic polyp on the anterior tracheal wall. CT neck revealed a 2.5×2.4 cm pretracheal soft tissue mass, bulging into the subglottic trachea. Fine needle aspiration confirmed papillary thyroid carcinoma with BRAF mutation. The patient underwent radical resection and surgical pathology confirmed a 2.5 cm papillary thyroid carcinoma with extensive extra-thyroid extension into the tracheal mucosa. Invasion of the trachea and surrounding structures like larynx and oesophagus is not usual for papillary thyroid carcinoma and may be associated with aggressive cancer behaviour and relatively poor outcome and prognosis.


Assuntos
Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Traqueia/diagnóstico , Idoso , Biópsia por Agulha Fina , Broncoscopia , Hemoptise/etiologia , Humanos , Masculino , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/secundário , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/diagnóstico por imagem , Neoplasias da Traqueia/secundário , Neoplasias da Traqueia/cirurgia
8.
Endocr Pathol ; 30(3): 189-200, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31338752

RESUMO

A re-named diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) likely impacts the prevalence of thyroid cancer and risk of malignancy in populations based on the established Bethesda System of Reporting Thyroid Cytopathology (TBSRTC). This study was done to investigate the prevalence and cytological distribution of NIFTP. PRISMA guided systematic review was done from a database search of Pubmed, EMBASE, and Medline using the search terms "non-invasive follicular thyroid neoplasm with papillary-like nuclear features", "non-invasive follicular variant of papillary carcinoma", "niftp", and "Bethesda" until November 2018. Original articles with surgically proven diagnoses of NIFTP using strict NIFTP criteria were included. Twenty-nine studies with 1563 cases of NIFTP were included. The pooled prevalence of NIFTP in cases which would be classified previously as the follicular variant of papillary thyroid cancer (FVPTC) and papillary thyroid cancer (PTC) were 43.5% (95% CI 33.5-54.0%) and 4.4% (95% CI 2.0-9.0%) respectively. The pooled TBSRTC distribution of cases diagnosed as NIFTP was: from the non-diagnostic category 3.6% (95% CI 2.4-5.3%), benign 10.0% (95% CI 7.2-13.6%), AUS/FLUS 34.2% (95% CI 28.2-40.8%), FN/SFN 22.7% (95% CI 17.2-29.4%), suspicious for malignancy 22.4% (95% CI 17.7-27.9%), and malignant 7.5% (95% CI 4.2-12.9%). While a significant reduction in FVPTC prevalence is anticipated, a modest reduction of PTC prevalence is also expected with adoption of the NIFTP terminology that would be distributed mainly among lesions classified as indeterminate thyroid nodules. Further studies are needed to identify unique clinical characteristics of these lesions preoperatively.


Assuntos
Carcinoma Papilar, Variante Folicular , Núcleo Celular/patologia , Citodiagnóstico/métodos , Citodiagnóstico/estatística & dados numéricos , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Biópsia por Agulha Fina/normas , Biópsia por Agulha Fina/estatística & dados numéricos , Carcinoma Papilar, Variante Folicular/diagnóstico , Carcinoma Papilar, Variante Folicular/epidemiologia , Carcinoma Papilar, Variante Folicular/patologia , Citodiagnóstico/normas , Diagnóstico Diferencial , Fidelidade a Diretrizes/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Valor Preditivo dos Testes , Prevalência , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/epidemiologia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/patologia
9.
Medicine (Baltimore) ; 98(30): e16659, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348321

RESUMO

RATIONALE: Papillary thyroid cancer accounts for up to 85% of all cases of thyroid carcinoma. This disease entity is notorious for metastatic invasion of adjacent lymph nodes, including the cervical lymph nodes, potentially presenting as a growing lateral neck mass. However, these lesions tend to be recognized and diagnosed soon due to the palpable mass. PATIENT CONCERNS: This report describes a very rare case of a huge slow-growing neck metastasis based on a 6 mm papillary thyroid microcarcinoma. This patient presented with a painless, but continuously growing right lateral neck mass. Aside from that, no specific complaints were mentioned. DIAGNOSIS: The underlying cause of this patient's neck mass turned out to be an occult papillary thyroid microcarcinoma (Ø 6 mm) with metastatic invasion and subsequent cystic degeneration of cervical lymph nodes. Accurate diagnosis was made after surgical intervention through histopathological analysis. INTERVENTIONS: The patient underwent complete resection of the cervical mass in conjunction with total thyroidectomy and right cervical neck dissection, followed by adjuvant iodine- and chemotherapy. OUTCOME: Margin free surgical resection without any postoperative complications could be achieved. The patient received iodine supplementation and remained free of recurrence during regular clinical follow-ups for 2 years. The therapy was curative. LESSONS: This case report emphasizes the importance of a thorough diagnostic work-up including preoperative tissue sampling of any cervical neck mass, since a benign appearance on imaging does not exclude a malignant process.


Assuntos
Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Humanos , Metástase Linfática , Masculino , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia
10.
Medicine (Baltimore) ; 98(28): e16343, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305422

RESUMO

To estimate the BRAFV600E mutation frequency in Chinese patients with papillary thyroid carcinoma (PTC), and the diagnostic value of BRAFV600E mutation status in thyroid nodules with indeterminate TBSRTC categories.A total of 4875 consecutive samples for thyroid ultrasound-guided fine-needle aspiration cytology (FNAC) and BRAF mutation analysis were collected from patients at Jiangsu Province Hospital on Integration of Chinese and Western Medicine. Among all the cases, 314 underwent thyroidectomy. According to TBSRTC categories, FNAC was performed for a preoperative diagnosis. ROC of the subject was constructed to evaluate the diagnostic value of these 2 methods and their combination.BRAF mutation in FNAC of thyroid nodules occurred in 2796 samples (57.35%). Of 353 nodule samples from 314 patients with thyroid operation, 333 were pathologically diagnosed as PTC. Of these PTC patients, 292 (87.69%) were found to have BRAF mutation in their preoperative FNAC. In 175 cytologically indeterminate thyroid nodules, BRAF mutation identified 88% of PTC. According to ROC data, BRAF mutation testing had an obviously higher sensitivity (87.69%) and specificity (100.00%) than TBSRTC. Combining BRAF mutation testing and TBSRTC achieved the largest AUC (0.954). For 41 PTC with a negative BRAF mutation in preoperative evaluation, the repeated BRAF mutation testing found out 12 samples with BRAF mutation. The true BRAF mutation rate of Chinese PTC patients was 91.29%.Chinese patients with PTC have a higher frequency of BRAF mutation. The BRAF mutation testing affords a high diagnostic value in thyroid nodules with indeterminate cytology.


Assuntos
Mutação , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/metabolismo , Nódulo da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Biópsia por Agulha Fina , Criança , China , Análise Mutacional de DNA , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas B-raf/metabolismo , Sensibilidade e Especificidade , Câncer Papilífero da Tireoide/genética , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/terapia , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia , Ultrassonografia de Intervenção , Adulto Jovem
11.
BMC Surg ; 19(1): 94, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311533

RESUMO

BACKGROUND: The coexistence of hyperparathyroidism and thyroid cancer presents important diagnostic and management challenges. With minimally invasive parathyroid surgery trending, preoperative thyroid imaging becomes more important as concomitant thyroid and parathyroid lesions are reported. The aim of the study was to evaluate the rate of thyroid cancer in patients operated for either primary (PHPT) or secondary hyperparathyroidism (SHPT). METHODS: Our retrospective study included PHPT and SHPT patients submitted to parathyroidectomy and, when indicated, concomitant thyroid surgery between 2010 and 2017. RESULTS: Parathyroidectomy was performed in 217 patients: 140 (64.5%) for PHPT and 77 (35.5%) for SHPT. Concomitant thyroid surgery was performed in 75 patients with PHPT (53.6%), and 19 papillary thyroid carcinomas (PTC) were found, accounting for 13.6% from all cases with PHPT and 25.3% from PHPT cases with concomitant thyroid surgery. Thirty-one of operated SHPT patients (40.3%) also underwent thyroid surgery and 9 PTC cases were diagnosed (11.7% of all SHPT patients and 29% of patients with concomitant thyroid surgery). We found differences between PHPT and SHPT patients (p < 0.001) with respect to age (54.6 ± 13y versus 48.8 ± 12y), female-to-male ratio (8:1 versus ~ 1:1), surgical technique (single gland parathyroidectomy in 82.8% PHPT cases; versus subtotal parathyroidectomy in 85.7% SHPT cases) and presurgical PTH (357.51 ± 38.11 pg/ml versus 1020 ± 161.38 pg/ml). Morphopathological particularities, TNM classification and multifocality incidence of PTC were similar in the two groups. All PTC from patients with SHPT were thyroid microcarcinomas (TMC, i.e. tumors with a diameter smaller than 1 cm), whereas seven out of the 19 cases with PTC and PHPT were larger than 1 cm. CONCLUSIONS: PTC was frequently and similarly associated with both PHPT and SHPT irrespective of presurgical PTH levels. Thyroid tumors above 1 cm were found only in patients with PHPT. Investigators should focus also on associated thyroid nodular pathology in patients with PHPT.


Assuntos
Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Secundário/complicações , Paratireoidectomia , Câncer Papilífero da Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Adulto , Idoso , Feminino , Humanos , Hiperparatireoidismo Primário/cirurgia , Hiperparatireoidismo Secundário/cirurgia , Incidência , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico
12.
Hell J Nucl Med ; 22(2): 116-122, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31273353

RESUMO

OBJECTIVE: Oncocytic variant (OV) is an unusual subtype of papillary thyroid cancer whose histopathologic diagnostic criteria, clinicopathologic features and biological behavior are different and have not been comprehensively studied, characterized in literature. Previous studies present conflicting results upon its prognosis. We investigated demographic and clinicopathologic risk factors affecting its prognosis while presenting our clinical experience. SUBJECTS AND METHODS: This is a retrospective cohort study reviewing 101 patients of OV from an archive of 4500 well-differentiated thyroid cancer patients treated with iodine-131 (131I) between 1991 and 2017. Predefined parameters of age, gender, tumor size (TS), total 131I dose, time to recurrent disease, overall survival, extrathyroidal extension, multifocality, vascular invasion, accompanying other variants, capsular status of thyroid gland, initial cervical lymph node (LN) metastases, preablation stimulated thyroglobulin level, background thyroiditis and stage were evaluated by statistical comparison between metastatic and nonmetastatic groups. RESULTS: Seventeen cases (17%) developed metastases/recurrence, 70% of the recurrences occured before 24 months. Four patients (4%) died during the follow-up. Metastatic sites were usually cervical LN, local recurrence in thyroid bed and lungs. Multivariate analysis revealed stage (IV) and TS were the main parameters impacting recurrence/metastases. In the follow-up, isolated cervical LN metastases were found in 41% of metastatic cases, while 12% had sole recurrence in thyroid bed. Eighty eight percent of the metastatic disease included locoregional (cervical) and/or remote LN. The recurrences were associated with initial thyroid masses greater than 3.5cm in diameter. CONCLUSION: We found that the prognosis of OV is not poor in our series. Stage (IV) and tumor size are the main risk factors in metastatic development.


Assuntos
Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/patologia , Adolescente , Adulto , Idoso , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Prognóstico , Recidiva , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
13.
Pan Afr Med J ; 32: 121, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223411

RESUMO

Thyroglossal duct carcinoma is a rare pathologic entity. The surgeon's main concern is whether to perform thyroidectomy or not. In this paper, we report another case of thyroglossal papillary duct carcinoma in a 14-old girl suspected preoperatively and confirmed postoperatively on the histological analysis of resected specimen by a Sistrunk procedure. Therapeutic strategy was completed by a total thyroidectomy with radioactive iodine therapy and suppressive levothyroxine therapy. In the absence of clear guidelines, the management of thyroglossal duct carcinoma is depending on the clinical situation and the experience of the team of surgeons.


Assuntos
Cisto Tireoglosso/patologia , Câncer Papilífero da Tireoide/terapia , Neoplasias da Glândula Tireoide/terapia , Adolescente , Feminino , Humanos , Radioisótopos do Iodo/administração & dosagem , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/métodos , Tiroxina/administração & dosagem
16.
Medicine (Baltimore) ; 98(19): e15559, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083219

RESUMO

This study aimed to compare the clinicopathologic characteristics and oncologic outcomes of papillary thyroid cancer (PTC) patients according to sex. Then, we validated prognostic variables to determine whether sex is a significant prognostic factor for PTC.Between January 2007 and December 2010, 1232 men and 7276 women PTC patients underwent surgery. The patient characteristics and 5-year oncologic outcomes were compared. The stepwise Cox proportional hazards model determined the significance of survival variables.Men PTC patients had more lymph node (LN) metastases than women, both in the total (P < .0001) and hemithyroidectomy (P < .0001) patients. Men and women showed similar 5-year recurrence-free survivals, both in total (P = .815) and hemithyroidectomy (P = .148) patients. The tumor size and the number of positive central nodes were associated with tumor recurrence, but not sex.Sex was not an independent prognostic factor for tumor recurrence. Multicenter clinical studies with long-term follow-ups are needed to validate these results.


Assuntos
Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/epidemiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica/diagnóstico , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Análise de Sobrevida , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
17.
Diagn Cytopathol ; 47(9): 876-880, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31074206

RESUMO

AIMS: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been widely adopted since its introduction. In this study, we aimed to report our experience using this reporting system at a College of American Pathologists (CAP)-accredited hospital laboratory in a large series of Chinese patients. METHODS: All patients who underwent preoperative ultrasound-guided thyroid fine-needle aspiration (FNA) from January 2011 to August 2016 were retrospectively analyzed. Thyroid FNAs were classified according to the Bethesda System. For patients who underwent subsequent surgery at our institution, the diagnostic performance of the preoperative FNA was further analyzed according to four different calculation criteria. All of the follicular variants of papillary thyroid carcinoma specimens were reviewed to exclude NIFTP (noninvasive follicular thyroid neoplasm with papillary-like nuclear features). RESULTS: A total of 13 351 thyroid FNAs were included in this analysis. Of the 12 530 sampled patients, 3594 (28.7%) underwent thyroidectomy, and the malignancy rates for each cytological category were as follows: 66.7% unsatisfactory, 14.2% benign, 53.5% undetermined significance, 30.2% follicular neoplasm, 82.0% suspicious, and 99.1% malignant. Only 12 (0.36% of all PTC) patients were reclassified as having NIFTP. The sensitivities of the preoperative FNAs were all above 95.0% and were as high as 99.0%. The specificities ranged from 50.3% to 63.9%, depending on which criteria were used. The positive predictive value was 95.4% for criteria 1 and 2 and was 94.2% for criteria 3 and 4. The negative predictive values ranged from 64.5% to 85.8%. The diagnostic accuracies all exceeded 90.0%, with the highest being 94.8%. CONCLUSION: This study revealed the great efficacy and accuracy of TBSRTC in a large Chinese population for the first time.


Assuntos
Câncer Papilífero da Tireoide , Glândula Tireoide , Neoplasias da Glândula Tireoide , Tireoidectomia , Biópsia por Agulha Fina , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/metabolismo , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/cirurgia , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/metabolismo , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia
19.
Indian J Pathol Microbiol ; 62(2): 206-210, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971541

RESUMO

Context: Thyroid cancers are the most common malignancy of the endocrine system. Over-expression of trophoblast cell-surface antigen 2 (TROP-2) in various tumors has been found to correlate with poor prognosis and aggressive tumor behavior. Aims: The aim of this study was to evaluateTROP-2 expression in thyroid neoplasms. Subjects and Methods: This study contained 152 cases, including 48 follicular nodular disease (FND), 29 follicular adenoma (FA), 57 papillary thyroid carcinoma (PTC), 12 follicular thyroid carcinoma (FTC), 3 medullary thyroid carcinoma (MTC), 2 poorly differentiated thyroid carcinoma (PDTC) and 1 undifferentiated thyroid carcinoma (UDTC). TROP-2 expression was investigated via immunohistochemistry in sections prepared from paraffin blocks of the cases. Results: The cases comprised 32 (21%) males and 120 (79%) females with a mean age of 46.8 years (range, 15-85 years). TROP-2 expression was observed in 74.6% of the malignant lesions of the thyroid except for medullary carcinoma, poorly differentiated and undifferentiated thyroid carcinoma. Immunoreactivity was 3.4% in FA, 41.7% of cases with FTC and 81.8% in PTC follicular variant (PTC fv). The difference between FA/FTC and FA/PTC follicular variant were both significant (P < 0.005, P < 0.001, respectively). There was no difference between FTC/PTC fv (P = 0.089). Conclusion: TROP-2 can be considered a useful marker for distinguishing PTC fv cases from follicular nodular disease and follicular adenoma cases because of its high sensitivity in the identification of papillary carcinomas of the thyroid.


Assuntos
Adenocarcinoma Folicular/diagnóstico , Antígenos de Neoplasias/genética , Moléculas de Adesão Celular/genética , Câncer Papilífero da Tireoide/diagnóstico , Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Neuroendócrino/diagnóstico , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/diagnóstico , Adulto Jovem
20.
Zhonghua Bing Li Xue Za Zhi ; 48(4): 288-292, 2019 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-30955264

RESUMO

Objective: To investigate the prevalence of BRAF V600E mutation in thyroid nodules and to analyze the relationship between BRAF V600E mutation and various clinicopathological features. Methods: BRAF V600E mutant gene test was done in 463 cases of thyroid nodules collected from April 2015 to July 2018 in Beijing Hospital. Pathologic sections of 444 cases of papillary thyroid carcinoma were reviewed and clinical information was collected.Statistical analysis of the relationship between BRAF V600E gene mutation and various clinicopathological features was performed with SPSS 21.0 statistical software. Results: There were 109 males and 354 females in the cohort, with a male to female ratio of 1.0∶3.2. The patient ranged in age from 16 to 82 years, with an average age of 46.1 years. The BRAF V600E mutation rates in papillary thyroid carcinoma, benign thyroid nodules and other thyroid carcinoma were 86.5%(384/444),0/15 and 1/4,respectively.There was significant correlation between BRAF V600E mutation and histological diagnosis of papillary thyroid carcinoma (P<0.05). There was no correlation with age, gender, multifocality, bilaterality, coexisting lymphocytic thyroiditis, nodular goiter, maximum diameter, capsule invasion, extrathyroidal extension and clinical stage (P>0.05). Conclusions: BRAF V600E gene mutation is closely related to the occurrence of papillary thyroid carcinoma. BRAF V600E has significant value in the diagnosis of papillary thyroid carcinoma. While BRAF V600E mutation is related to the histological diagnosis, it shows no correlation with other clinicopathologic features. BRAF V600E mutation is not an independent prognostic factor in papillary thyroid carcinoma patients.


Assuntos
Carcinoma Papilar/genética , Mutação , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA