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1.
Harefuah ; 159(11): 809-814, 2020 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-33210851

RESUMO

INTRODUCTION: Anaplastic thyroid cancer (ATC) is accepted as transformation of a pre-existing glandular papillary thyroid carcinoma (PTC). Anaplastic transformation within a neck PTC metastasis is extraordinary. We present a patient with an exceptional timeline of an untreated neck PTC recurrence and its rare anaplastic transformation. In 2010, a 68-year-old patient with PTC and neck metastasis, (Stage III/Stage II 7th/8th AJCC, respectively) underwent thyroidectomy and neck dissection followed with radioiodine treatment (150 mCi). In 2012, he received an additional 150 mCi following an iodine scan suggested right neck recurrence. In late 2013, ultrasound revealed a 2.3 cm, suspicious right neck lymph node (level II-III). Only in 2017, after growing to 2.7 cm, the patient consented to undergoing a fine needle aspiration. PTC was verified, yet intervention was declined. In June 2018, he presented with a rapid growing neck mass occupying right levels II,III, carotid artery encasement and jugular vein involvement. A large bore needle biopsy revealed a highly malignant tumor, surrounded by necrosis, positive for cytokeratin (CK MNF 116), thyroid lineage marker (PAX8), negative for TTF-1 and thyroglobulin, i.e., ATC. The patient passed away in November 2018. In comparison, a patient with an identical primary staging received equivalent primary treatment. Yet, among the PTC nodular metastasis found in the neck specimen, one had ATC transformation. Over a 12-year follow-up there was no recurrence. To conclude, untreated PTC neck recurrence may have long-term consequences, such as rare anaplastic transformation. Although a case study, it advocates treating PTC neck recurrence.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Idoso , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/cirurgia , Humanos , Radioisótopos do Iodo , Linfonodos , Metástase Linfática , Masculino , Recidiva Local de Neoplasia , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
2.
Anticancer Res ; 40(11): 6551-6561, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33109597

RESUMO

BACKGROUND: In patients with branch-duct intraductal papillary mucinous neoplasms (BD-IPMN), we aimed to develop a novel blood-based biomarker utilizing a gene-expression profile for the detection of pancreatic malignancies, such as IPMN-derived carcinoma (IPMC) or pancreatic ductal adenocarcinoma (PDAC). PATIENTS AND METHODS: We enrolled 40 patients with pancreatic tumors (24 BD-IPMNs, four IPMCs and 12 PDACs) and identified the characteristic gene-expression profiles in pancreatic malignancies. Subsequently, we constructed a gene-expression scoring system for the proper diagnosis of pancreatic malignancies. The result was validated in 14 patients (five IPMNs, three IPMCs and six PDACs). RESULTS: The scoring system utilizing the expression levels of 13 genes showed high diagnostic yield (sensitivity=94.0%, specificity=92.0% and area under the curve=0.94), which was confirmed in the validation set. Furthermore, its diagnostic yield was not reduced even in early-stage pancreatic malignancies (sensitivity=85.0%, specificity=93.0% and area under the curve=0.88). CONCLUSION: We developed a blood-based gene expression scoring system for cancer screening in patients with BD-IPMNs.


Assuntos
Adenocarcinoma Mucinoso/sangue , Carcinoma Ductal Pancreático/sangue , Carcinoma Papilar/sangue , Proteínas de Neoplasias/sangue , Adenocarcinoma Mucinoso/genética , Adenocarcinoma Mucinoso/patologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Carcinoma Ductal Pancreático/genética , Carcinoma Ductal Pancreático/patologia , Carcinoma Papilar/genética , Carcinoma Papilar/patologia , Progressão da Doença , Detecção Precoce de Câncer , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Masculino , Proteínas de Neoplasias/genética
3.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 34(9): 836-839;843, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33040510

RESUMO

Objective:A prospective randomized controlled study of patients with thyroid papillary carcinoma requiring lateral neck dissection was conducted to investigate the thoroughness, safety and cosmetic features of endoscope-assisted lateral neck dissection. Method:Patients who underwent total thyroidectomy, bilateral central lymph node dissection and unilateral lateral neck dissection for papillary thyroid cancer were randomly divided into two groups: endoscopic assisted group and open group, 18 cases in each group. The clinical characteristics, operation conditions, postoperative complications and aesthetic satisfaction of the two groups were compared. Result:There were no statistically significant differences between the endoscopic group and the open group in age, gender, tumor size, dissection side, operation time, postoperative hospital stay, number of lymph nodes to be dissected, number of metastatic lymph nodes, postoperative hoarseness, and hypoparathyroidism(P>0.05); No hematoma or lymphatic leakage occurred in the two groups after surgery, and no tumor recurrence or residual was found in the ultrasound review at 6 months after surgery. Serum Tg level in the endoscopic group was higher than that in the open group at 6 months after surgery, but the difference between the two groups was not statistically significant(P>0.05); The neck pain score at day 3 after operation, the neck numbness and discomfort score at month 1 after operation, and the aesthetic satisfaction score at 3 months after operation in the endoscope assisted group were better than that in the open group(P<0.05). Conclusion:Endoscope-assisted lateral neck dissection is safe, feasible and with excellent cosmetic effect for the treatment of lymph node metastasis in the lateral cervical region of papillary thyroid carcinoma.


Assuntos
Carcinoma Papilar , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Carcinoma Papilar/cirurgia , Humanos , Recém-Nascido , Linfonodos , Metástase Linfática , Esvaziamento Cervical , Estudos Prospectivos , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia
4.
Medicine (Baltimore) ; 99(38): e22338, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957404

RESUMO

The ability to identify patients with aggressive papillary thyroid microcarcinoma (PTMC) from the low-risk patients is critical to planning proper management of PTMC. Lymph node metastases showed association with recurrence and low survival rate, especially in patients with >5 or ≥2 mm metastatic lymph nodes. Therefore, this study aimed to investigate the preoperatively predictive factors of non-small-volume (metastatic lymph nodes >5 or ≥2 mm in size) central lymph node metastases (NSVCLNM) in PTMC patients. A total of 420 patients with clinically node-negative (cN0) PTMC without extrathyroidal extension underwent thyroidectomy plus central neck dissection (CND) between January 2013 and December 2015, were retrospectively analyzed. Of the 420 patients, 33 (7.9%) had NSVCLNM. The 5-year recurrence-free survival was significantly less in cN0 PTMC patients with NSVCLNM, when compared with patients without NSVCLNM (80.8% vs 100%, P < .001). Multivariate logistic regression revealed age ≤36 years (P < .001), male sex (P = .002), ultrasonic tumor sizes of >0.65 cm (P < .001), and ultrasonic multifocality (P = .039) were independent predictive factors of NSVCLNM. A prediction equation (Y = 1.714 × age + 1.361 × sex + 1.639 × tumor size + 0.842 × multifocality -5.196) was developed, with a sensitivity (69.7%) and a specificity (84.0%), respectively, at an optimal cutoff point of -2.418. In conclusion, if the predictive value was >-2.418 according to the equation, immediate surgery including CND rather than active surveillance might be considered for cN0 PTMC patients.


Assuntos
Carcinoma Papilar/patologia , Metástase Linfática/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Carcinoma Papilar/mortalidade , Carcinoma Papilar/cirurgia , Feminino , Humanos , Metástase Linfática/diagnóstico , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Melhoria de Qualidade , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Neoplasias da Glândula Tireoide/mortalidade , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adulto Jovem
5.
Medicine (Baltimore) ; 99(30): e21346, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791734

RESUMO

RATIONALE: Papillary thyroid carcinoma (PTC) is the most common type of primary thyroid cancer with a low incidence of distant metastases. PTC represents more than 70% to -90% of thyroid malignancies. Distant metastases have only been observed in only 1% to 15% of patients with PTC. In this article, we reported the case of a patient with PTC and hyperthyroidism as well as simultaneous multiple metastases. PATIENT CONCERNS: A 47-year-old man was admitted to our hospital on February 22, 2019, with several neck masses that had been present for 12 months, low back pain for 9 months, and lower limb paraplegia for 3 months. DIAGNOSES: According to the patient physical examination, adjuvant examination (e.g., ultrasound, computed tomography, magnetic resonance imaging, blood test, and biopsy) and medical history, the clinical diagnosis was as follows: thyroid papillary carcinoma; cervical lymph node metastasis; multisite bone metastasis (6th and 7th cervical vertebrae, left clavicle proximal, right scapula bone, thoracic vertebrae, lumbar vertebrae, sacral vertebrae, bilateral ilium, and left pubic bone); muscular metastasis (the right medial femoral muscle, the vastus lateralis muscle, left thigh muscle, and the flexor superficialis of the left forearm); possible mediastinal lymph node metastasis; and paraplegia due to the soft-tissue metastasis around the 9th thoracic vertebral spine; and hyperthyroidism (free thyroxine: 36.59 pmol/L, free triiodothyronine: 9.58 pmol/L, thyroid-stimulating hormone: 0.005 µIU/mL, thyroid autoantibody: 2.53 IU/L). INTERVENTIONS AND OUTCOMES: The patient refused to undergo further intervention or follow-up. LESSONS: In summary, this is the 1st case of in which a patient with PTC and hyperthyroidism, as well as simultaneous multiple skeletal muscles and bone metastases, lymph node metastasis, and paraplegia was observed. In practice, in cases where patients have PTC and hyperthyroidism, practitioners should perform further examinations to rule out the presence of distant metastases. We believe that the use of ultrasound has a unique advantage in the diagnosis of PTC and skeletal muscle metastasis.


Assuntos
Carcinoma Papilar/patologia , Hipertireoidismo/diagnóstico , Paraplegia/etiologia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Paraplegia/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Recusa do Paciente ao Tratamento , Ultrassonografia/métodos
6.
Rev Col Bras Cir ; 47: e20202545, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32844910

RESUMO

INTRODUCTION: papillary thyroid carcinoma is a tumor with good prognosis. However, some patients treated present neck recurrence. OBJECTIVE: to evaluate the risk factors for neck recurrence. METHODS: a retrospective study enrolled 89 patients (68 women and 21 men) diagnosed with papillary carcinoma who underwent total thyroidectomy. In 21 patients, neck dissection was performed and 62 patients underwent radioiodinetherapy. Twelve patients relapsed with metastasis in this period with an average of 3.6 years. RESULTS: out of 89 patients, 76.4% were female. Relapse occurred in nine (13.23%) women and three (14.28%) men. The average age of the patients was 44 years in the control group and in patients with relapsed. Eighteen patients (23.37%) in the control group and eight (64.28%) who relapsed had positive lymph nodes at initial diagnosis. The tumor size was significantly larger in the group of patients with cervical recurrence (3.3cm vs. 1.6cm - p=0.008, Student t test), whereas the presence of metastatic lymph nodes at the moment of the first operation was also significant (p=0.004 -Fisher exact test). The tumor size was an independent risk factor for recurrence at the multivariate anaylsis (OR=2.4, IC95%:1.3-4.6 - p=0,007, logistic regression). CONCLUSION: there is an increase in the risk of lymph node recurrence during the follow up of 2.4 folds for each increase of 1cm in the longer nodule diameter.


Assuntos
Carcinoma Papilar/cirurgia , Esvaziamento Cervical , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Adulto , Carcinoma Papilar/patologia , Feminino , Humanos , Metástase Linfática , Masculino , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia
7.
Am J Surg Pathol ; 44(9): 1161-1172, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32804453

RESUMO

Given the high incidence and excellent prognosis of many papillary thyroid microcarcinomas, the Porto proposal uses the designation papillary microtumor (PMT) for papillary microcarcinomas (PMCs) without risk factors to minimize overtreatment and patients' stress. To validate Porto proposal criteria, we examined a series of 190 PMC series, also studying sex hormone receptors and BRAF mutation. Our updated Porto proposal (uPp) reclassifies as PMT incidental PMCs found at thyroidectomy lacking the following criteria: (a) detected under the age of 19 years; (b) with multiple tumors measuring >1 cm adding up all diameters; and (c) with aggressive morphologic features (extrathyroidal extension, angioinvasion, tall, and/or hobnail cells). PMCs not fulfilling uPp criteria were considered "true" PMCs. A total of 102 PMCs were subclassified as PMT, 88 as PMC, with no age or sex differences between subgroups. Total thyroidectomy and iodine-131 therapy were significantly more common in PMC. After a median follow-up of 9.6 years, lymph node metastases, distant metastases, and mortality were only found in the PMC subgroup. No subgroup differences were found in calcifications or desmoplasia. Expression of estrogen receptor-α and estrogen receptor-ß, progesterone receptor, and androgen receptor was higher in PMC than in nontumorous thyroid tissue. BRAF mutations were detected in 44.7% of PMC, with no differences between subgroups. In surgical specimens, the uPp is a safe pathology tool to identify those PMC with extremely low malignant potential. This terminology could reduce psychological stress associated with cancer diagnosis, avoid overtreatment, and be incorporated into daily pathologic practice.


Assuntos
Biomarcadores Tumorais/análise , Biomarcadores Tumorais/genética , Carcinoma Papilar/química , Carcinoma Papilar/genética , Mutação , Proteínas Proto-Oncogênicas B-raf/genética , Receptores de Esteroides/análise , Neoplasias da Glândula Tireoide/química , Neoplasias da Glândula Tireoide/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar/patologia , Carcinoma Papilar/terapia , Análise Mutacional de DNA , Receptor alfa de Estrogênio/análise , Receptor beta de Estrogênio/análise , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Radioterapia Adjuvante , Receptores Androgênicos/análise , Receptores de Progesterona/análise , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia , Resultado do Tratamento , Adulto Jovem
8.
PLoS One ; 15(8): e0238207, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841270

RESUMO

BACKGROUND: Although infrequent, distant metastasis from differentiated thyroid cancer is the main cause of mortality in patients and mostly involves the lung, bone, and brain. Distant metastases to other sites in differentiated thyroid cancer patients are rare, thus, the clinical course of unusual metastases has not been adequately researched. In the present study, the clinico-pathological findings and treatment outcomes of unusual metastases in differentiated thyroid cancer patients in Korea were evaluated. PATIENTS AND METHODS: We retrospectively reviewed the medical records of differentiated thyroid cancer patients with unusual metastases in four Korean tertiary hospitals (Chonnam National University Hwasun Hospital, Asan Medical Center, Busan National University Hospital, Severance Hospital). Unusual metastases were diagnosed using (1) cytology or histology and/or (2) imaging studies including fluorodeoxyglucose F 18 positron emission tomography/computed tomography and/or iodine 131 whole body scans with simultaneously elevated serum levels of thyroglobulin. The pathological findings of primary thyroid cancer, diagnostic method for unusual metastases, and treatment responses of unusual metastases were examined. RESULTS: In all, 25 unusual metastatic foci of 19 patients were analyzed; 13 patients (68.4%) had papillary thyroid carcinoma including 4 follicular variant papillary thyroid carcinomas. The median time interval between the first diagnosis of primary thyroid cancer and unusual metastases diagnosis was 110 months (11.0-138.0 months). Only 4 patients (21.1%) had synchronous unusual metastases and 6 patients (31.6%) were symptomatic. Unusual metastases included 19 metastases to solid organs (6 to kidney, 5 to liver, 4 to pancreas, 3 to adrenal gland, and 1 to ovary) and 6 to the skin and muscles. Unusual metastases were pathologically proven in 10 patients (52.6%) and 11 of 16 patients (68.8%) who received iodine 131 whole body scans had radioiodine-refractory differentiated thyroid cancer. Among 5 patients treated with tyrosine kinase inhibitors, 4 treated with lenvatinib showed stable disease or a partial response at the first treatment response. Six patients (31.6%) died due to disease progression during the median 20.0-month follow-up period (11.0-55.0 months). CONCLUSION: Unusual metastases from differentiated thyroid cancer are thought to be underestimated due to disease rarity and their metachronous nature with other distant metastases. The most of unusual metastases in differentiated thyroid cancer patients are existed with usual distant metastasis and clinical outcomes of those could not be significantly different from the prognosis of usual distant metastasis.


Assuntos
Neoplasias da Glândula Tireoide/patologia , Adulto , Idoso , Antineoplásicos/uso terapêutico , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/patologia , Carcinoma Papilar/secundário , Terapia Combinada , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica/diagnóstico por imagem , Metástase Neoplásica/patologia , Metástase Neoplásica/terapia , Especificidade de Órgãos , Compostos de Fenilureia/uso terapêutico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Prognóstico , Inibidores de Proteínas Quinases/uso terapêutico , Quinolinas/uso terapêutico , República da Coreia , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/terapia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/terapia , Fatores de Tempo , Imagem Corporal Total
9.
J Cancer Res Ther ; 16(3): 624-629, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32719278

RESUMO

Objective: Thyroglobulin antibodies (TgAb) are detected in thyroid cancer patients up to 25%. We investigated the prognostic value of TgAb positivity in patients with papillary thyroid carcinoma (PTC) after initial therapy. Patients and Methods: A database of 109 consecutive patients who underwent total thyroidectomy and therapeutic lateral neck dissection followed by remnant ablation for PTC between January 1989 and December 2014 was reviewed We recorded the patients' all serum Tg and TgAb levels over time to establish changing trends. Patients were classified as either positive or negative according to serum TgAb levels. The recurrence or persistence rates in both groups were compared. Results: Of the 109 patients enrolled 14 patients had TgAb positivity. Thirty-two (29.3%) showed disease recurrence or persistent disease during 101 months of follow-up. Twenty-seven of 95 patients (28.4%) with negative TgAb had persistent or recurrent disease, whereas 5 of 14 patients (35.7%) with positive TgAb had persistence or recurrence (P = 0.57). No significant difference in disease-free survival (115.3 ± 10.8 vs. 224.1 ± 16.6 months, P = 0.78) and overall survival (P = 0.59) was observed between TgAb positive and TgAb negative patients. Conclusions: TgAb status is not useful as a prognostic and predictive factor for clinical outcomes in patients with PTC in our experience.


Assuntos
Autoanticorpos/sangue , Carcinoma Papilar/sangue , Recidiva Local de Neoplasia/sangue , Tireoglobulina/imunologia , Câncer Papilífero da Tireoide/sangue , Adolescente , Adulto , Idoso , Autoanticorpos/imunologia , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/imunologia , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/imunologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/imunologia , Adulto Jovem
12.
Artigo em Chinês | MEDLINE | ID: mdl-32668875

RESUMO

Objective: To investigate the distant metastasis after primary treatment of papillary thyroid cancer (PTC) in children and adolescents. Methods: A retrospective analysis of 180 cases (54 boys and 126 girls, with an age range of 6-18 years) with PTC treated at the Chinese Medical Academy Cancer Hospital and Zhejiang Cancer Hospital from January 1, 2001 to December 31, 2014 was performed. Patients' clinical and pathological data were collected. The follow-up results were statistically analyzed. The distant metastasis rate during the follow-up period was analyzed by the Kaplan-Meier method. Log-Rank test was used for univariate analysis and Cox regression model was established in multivariate analysis. Results: Twenty-four cases (13.3%) had distant metastases during following-up with a median of 92 months. The Log-Rank test showed that the younger age ≤15 years old (χ(2)=11.803, P=0.001), the larger tumor diameter >20 mm (χ(2)=5.776, P=0.016), multifocal (χ(2)=11.205, P=0.001), bilateral tumor distribution (χ(2)=19.804, P=0.001), invaded capsule (χ(2)=10.808, P=0.001), and bilateral lymph nodes metastasis (χ(2)=6.278, P=0.012) were risk factors for distant metastasis after initial treatment. The Cox regression analysis showed that age ≤15 years (hazard ratio [95% confidence interval]: 4.08[1.504-11.111], P=0.006) and bilateral tumor distribution (hazard ratio [95% confidence interval]: 4.77[1.903-11.966], P=0.001) were independent risk factors for distant metastasis after initial treatment. The risk factors for local recurrence and distant metastasis were similar, but the local recurrence could not be a significant predictor for distant metastasis. It was indicated that distant metastasis rate was lower in patients with total thyroidectomy in multifocal lesions groups (χ(2)=5.891, P=0.015). Conclusions: Age, tumor size, invaded capsule, bilateral lymph nodes metastasis, multifocal and bilateral lesions are factors for predicting distant metastasis after primary treatment of PTC in children and adolescents. Total thyroidectomy is recommended for patients with multifocal and bilateral lesions.


Assuntos
Carcinoma Papilar , Carcinoma , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Adolescente , Carcinoma/cirurgia , Criança , Feminino , Humanos , Masculino , Metástase Neoplásica , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
14.
Zhonghua Zhong Liu Za Zhi ; 42(6): 463-468, 2020 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-32575941

RESUMO

Objective: To explore the differential protein expressions in papillary thyroid carcinoma (PTC) with or without Hashimoto's thyroiditis (HT). Methods: Tissue microarray was prepared and the protein expression levels of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF), vascular endothelial growth factor (VEGF), cyclinD1, mesothelial cell (MC) , CD56 and Galectin3 in the PTC tissues with or without HT were detected by immunohistochemical staining. Results: The positive expression rates of BRAF protein in the PTC tissues with or without HT groups were 55.4% (36/65) and 63.6% (42/66), respectively, without significant difference (P=0.336). The positive expression rates of VEGF protein in the PTC tissues with or without HT groups were 25.7% (19/74) and 25.8%(17/66), respectively, without significant difference (P=0.991). The positive expression rates of cyclin D1 protein in the PTC tissues with or without HT groups were 93.4% (71/76) and 97.6% (80/82), without significant difference (P=0.206). The positive expression rates of MC protein in the PTC tissues with or without HT groups were 86.1% (62/72) and 83.5%(71/85), without significant difference (P=0.654). The positive expression rates of Galectin3 protein in the PTC tissues with or without HT groups were 98.7% (76/77) and 97.5% (78/80), without significant difference (P=0.583). The positive expression rates of CD56 in the PTC tissues and adjacent thyroid follicular epithelial cells were 27.4% (32/117) and 65.0% (76/117), respectively, and the difference was statistically significant (P=0.001). The positive expression rates of CD56 in PTC tissues with or without HT were 35.5% (24/68) and 16.5% (13/79), respectively, and the difference was statistically significant (P=0.009). Conclusions: There are no significant differences in the expressions of BRAF, VEGF, CyclinD1, MC and Galectin3 between the PTC tissues with or without HT. However, the significantly differential expression of CD56 between the two group suggests that CD56 may be related to the pathogenesis of PTC with HT. CD56 may be used as a potential molecular marker in PTC diagnosis.


Assuntos
Adenocarcinoma Papilar/genética , Antígeno CD56/metabolismo , Carcinoma Papilar/patologia , Doença de Hashimoto/genética , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adenocarcinoma Papilar/metabolismo , Adenocarcinoma Papilar/patologia , Animais , Biomarcadores/análise , Carcinoma Papilar/metabolismo , Ciclina D1/genética , Galectinas , Doença de Hashimoto/metabolismo , Doença de Hashimoto/patologia , Humanos , Camundongos , Valor Preditivo dos Testes , Proteínas Proto-Oncogênicas B-raf/metabolismo , Câncer Papilífero da Tireoide/metabolismo , Câncer Papilífero da Tireoide/patologia , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/metabolismo , Análise Serial de Tecidos , Fator A de Crescimento do Endotélio Vascular/genética
15.
Medicine (Baltimore) ; 99(25): e20278, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32569161

RESUMO

RATIONALE: Intracystic papillary breast carcinoma is extremely rare in males with a favorable prognosis. Clinical and mammographic manifestations of IPC are not specific, and no consensus has been reached on its management. PATIENT CONCERNS: Three cases of IPC of the breast in male patients who underwent surgery are presented. In each patient, clinical manifestations, radiological appearance, surgical procedures, pathological diagnosis, and prognosis were investigated. DIAGNOSIS: Ultrasonography showed a complex mass with cystic and nodular solid components in 2 patients and a solid hypoechoic mass in the other 1. Contrast-enhanced ultrasonography(CEUS) was performed for 1 patient demonstrated a solid component of the characteristic enhancement patterns. The final diagnosis of IPC was made after an excisional biopsy. INTERVENTIONS: A mastectomy with sentinel lymph node mapping was carried out in 2 patients, and it was negative for metastatic disease. The third patient received a mastectomy without an investigation of the axillary lymph node status. OUTCOMES: All the patients are disease-free during a median follow-up of 67 months (range, 13-120) months. LESSONS: It is difficult to diagnose IPC of the male breast before surgery, excisional biopsy is necessary. CEUS can be useful to diagnose IPC in male patients in the preoperative evaluation. Sentinel node biopsy may be considered in patients with IPC associated with DCIS or invasive carcinoma.


Assuntos
Neoplasias da Mama Masculina/diagnóstico por imagem , Carcinoma Papilar/diagnóstico por imagem , Idoso , Humanos , Masculino , Mamografia , Ultrassonografia
16.
Eur J Endocrinol ; 183(3): P1-P10, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32508309

RESUMO

The incidence of differentiated thyroid carcinoma (DTC) has increased rapidly over the past several years. Thus far, the only conclusively established risk factor for developing DTC is exposure to ionizing radiation, especially when the exposure occurs in childhood. Since the number of childhood cancer survivors (CCS) is increasing due to improvements in treatment and supportive care, the number of patients who will develop DTC after surviving childhood cancer (secondary thyroid cancer) is also expected to rise. Currently, there are no recommendations for management of thyroid cancer specifically for patients who develop DTC as a consequence of cancer therapy during childhood. Since complications or late effects from prior cancer treatment may elevate the risk of toxicity from DTC therapy, the medical history of CCS should be considered carefully in choosing DTC treatment. In this paper, we emphasize how the occurrence and treatment of the initial childhood malignancy affects the medical and psychosocial factors that will play a role in the diagnosis and treatment of a secondary DTC. We present considerations for clinicians to use in the management of patients with secondary DTC, based on the available evidence combined with experience-based opinions of the authors.


Assuntos
Carcinoma Papilar/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Sobreviventes de Câncer , Carcinoma Papilar/tratamento farmacológico , Carcinoma Papilar/cirurgia , Criança , Feminino , Humanos , Masculino , Fatores de Risco , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/cirurgia
17.
PLoS One ; 15(6): e0235056, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579575

RESUMO

Globally, cancer patients obtain much of their disease information online. Online health communities allow patients to share questions and information about diseases. However, there have been few studies on the factors affecting online health community participation behavior in cancer patients. Online social networking is associated with mental health problems, and patients with thyroid cancer experience high levels of distress, anxiety and depression. The purpose of this study was to investigate factors associated with use of online health communities by patients with thyroid cancer to understand the characteristics of patients participating in such online communities. A questionnaire survey was completed by 114 thyroid cancer patients admitted for surgery at a general hospital in Seoul, Korea. General characteristics, clinical characteristics, attitude toward cancer, distress, and anxiety and depression scores of patients who joined an online health community (user group) and patients who did not (non-user group) were compared. The factors affecting online health community participation were education (p = 0.049), tumor size (p = 0.010), attitude toward cancer (p = 0.022), and anxiety and depression (p = 0.021). The average score of satisfaction with the online health community was 4.25 of 5. The user group had larger tumors, a high awareness of the risk of thyroid cancer, and high levels of anxiety and depression. Patients who actively used the online health community have relatively larger cancer size and had higher levels of mental stress. As such patients are often very anxious and depend heavily on the gathered information, the quality of this information is important. Healthcare professionals need to develop appropriate interventions for patients participating in the online health community.


Assuntos
Carcinoma Papilar/psicologia , Participação da Comunidade/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Neoplasias da Glândula Tireoide/psicologia , Adolescente , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/etnologia , Ansiedade/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/etnologia , Depressão/diagnóstico , Depressão/etnologia , Depressão/patologia , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , República da Coreia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/etnologia , Adulto Jovem
18.
Zhonghua Yi Xue Za Zhi ; 100(24): 1866-1871, 2020 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-32575929

RESUMO

Objective: To investigate the rule of mediastinal lymph node metastasis of papillary thyroid carcinoma and the application of therapeutic mediastinal lymph node dissection through the sternotomy approach in the treatment of mediastinal lymph node metastasis of papillary thyroid carcinoma. Methods: All cases of papillary thyroid carcinoma with mediastinal lymph node metastasis treated through sternotomy cooperated by thoracic surgeons and head and neck surgeons from January 2006 to January 2017 in Cancer Hospital of Chinese Academy of Medical Sciences were included in this study. The distribution, metastasis rate, metastasis degree, surgical method, surgical complications and postoperative survival of patients with mediastinal lymph node metastasis were retrospectively analyzed. Results: A total of 31 patients (16 males and 15 females) with papillary thyroid cancer with mediastinal lymph node metastasis, with a median age of 46 (19-65) years, were enrolled in the group. Partial upper sternotomy was used in 28 cases, and total sternotomy was used in 3 cases. The mediastinal lymph nodes of papillary thyroid carcinoma metastasized farthest to the station 6, and the lymph node metastasis rate of each group from high to low was: 2R (61%), 1R (39%), 3A (39%), 1L (16%), 2L (10%), 4R (10%), 5 (3%) and 6 (3%). No metastasis was observed in station 3P, 4L and 7. In addition, the degree of lymph node metastasis at station 2R was the highest, reaching 35% (77/219). Extra-nodal invasion of mediastinal metastatic lymph nodes in thyroid papillary carcinoma is common (23%), easily fuses into masses (23%) and invades peripheral vascular nerves (26%). Up to 29% of blood transfusions are required during or after surgery due to oozing or bleeding (9/31). The 1-, 3-, 5-and 10-year survival rates of patients undergoing surgical treatment were 94%, 94%, 87% and 81%, respectively. Conclusion: Papillary thyroid carcinoma can metastasize to almost all mediastinal lymph nodes except station 3P, 4L and 7. Radical mediastinal lymph node dissection through sternotomy is an effective method for the treatment of mediastinal lymph node metastasis of thyroid papillary carcinoma.


Assuntos
Carcinoma Papilar , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Idoso , Feminino , Humanos , Excisão de Linfonodo , Linfonodos , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Estudos Retrospectivos , Esternotomia , Tireoidectomia
19.
Updates Surg ; 72(3): 867-869, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32537687

RESUMO

COVID-19 has profoundly modified the way healthcare is delivered. Jordan imposed lockdown and restrictive policies between March 17 and May 20, 2020. We aimed to assess the impact of such measures on thyroid cancer treatment plans. In the specified period, 12 patients were scheduled for surgery. Since papillary carcinoma was the preoperative diagnosis in all cases, radioactive iodine ablation (RIA) therapy was also planned 3-4 weeks following surgery after withdrawing thyroxine and achieving a thyroid stimulating hormone (TSH) level > 30 mU/L. Thyroxine withdrawal is the routine method applied for RIA in Jordan as it is less costly compared to the rapid method of exogenous stimulation using recombinant TSH. All surgical procedures were performed without delay since all patients were asymptomatic per flu-like illness and came from a region of low COVID-19 prevalence. These included total thyroidectomy (n = 11), bilateral therapeutic central compartment neck dissection (n = 7), lateral compartment neck dissection (n = 5). However, the RIA treatment plan was altered considerably according to the period in which they were operated. 6 out of the 7 patients operated in March changed to the stimulated method of RIA at a considerable additional extra cost. The seventh patient and the April patient opt to delay RIA until after lockdown. The remaining cases (operated in May) followed the usual withdrawal method as restrictions were due to an end. The restrictive measures applied during COVID-19 did not affect the safe and timely delivery of surgical care. However, it added a financial and psychological burden to the entire cancer management plan.


Assuntos
Betacoronavirus , Carcinoma Papilar/terapia , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Acesso aos Serviços de Saúde/organização & administração , Pneumonia Viral/epidemiologia , Neoplasias da Glândula Tireoide/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Humanos , Jordânia , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Estudos Retrospectivos , Tireoidectomia , Resultado do Tratamento
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