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1.
Medicine (Baltimore) ; 99(51): e23846, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371167

RESUMO

ABSTRACT: Spontaneous intranodular hemorrhaging in benign partially cystic thyroid nodules was reported to cause neck swelling, difficulty swallowing, and other oppressive symptoms attributed to their growing progressively at high rates. In our study, the risk factors for hemorrhaging in these nodules were investigated.We retrospectively analyzed benign partial cystic thyroid nodules from September 2017 to December 2019, and divided them into 2 groups according to the occurrence of intranodular hemorrhage. Age, gender, follow-up time nodules initial maximum diameter, blood supply, spongiform content, nodules solid components, and internal solid portion were compared between the 2 groups at the first ultrasound examination. Chi-Squared and multivariate analysis were performed to evaluate the association of hemorrhage with clinical and ultrasonographic characteristics. ROC analysis was performed to evaluate the utility of factors in predicting hemorrhage.There were 59 occurrences of intranodular hemorrhage, which were associated with abundant blood supply, spongiform contents, and unsmooth margin of the internal solid portion. After multivariate analysis, abundant blood supply, and spongiform content were independent predictors for hemorrhage. In ROC analysis integrating these predictors, the sensitivity was 62.7% and specificity was 95.2% with the AUC 0.881.Partially cystic thyroid nodules with abundant blood supply, non-smooth margin of the internal solid portion and a spongiform internal content were apt to spontaneous intranodular hemorrhaging, which can be recognized as soon as possible by ultrasound.


Assuntos
Hemorragia/etiologia , Neoplasias da Glândula Tireoide/complicações , Nódulo da Glândula Tireoide/complicações , Adulto , Biópsia por Agulha Fina/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/fisiopatologia , Nódulo da Glândula Tireoide/fisiopatologia , Ultrassonografia/métodos
2.
Medicine (Baltimore) ; 99(45): e23018, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157950

RESUMO

BACKGROUND: This study will assess the effect of high-quality nursing (HQN) on alleviating depression and anxiety (DA) in patients with thyroid cancer (TC) during perioperative period (PPP). METHODS: We will search the following electronic databases (MEDLINE, EMBASE, PsycINFO, Cochrane Library, CINAHL, Web of Science, CBM, WANGFANG, and CNKI) from inception to the present and other literature sources without language limitation. All potential randomized controlled trials reporting on effect of HQN on DA in patients with TC during PPP will be considered for inclusion. Two researchers will separately carry out study selection, data extraction, and study quality evaluation. Any different opinion will be solved by a third author through discussion. All statistical analysis will be performed by RevMan 5.3 software. RESULTS: We will appraise the effect of HQN on DA in patients with TC during PPP through assessing outcomes of depression, anxiety, pressure, quality of life, and adverse events. CONCLUSION: This study will provide evidence to determine whether HQN is effective or not on DA in patients with TC during PPP. OSF REGISTRATION:: osf.io/sb5r8.


Assuntos
Enfermagem/métodos , Período Perioperatório/enfermagem , Neoplasias da Glândula Tireoide/enfermagem , Adulto , Ansiedade/etiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Enfermagem/estatística & dados numéricos , Período Perioperatório/psicologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/psicologia
3.
Ann Endocrinol (Paris) ; 81(5): 482-486, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32822652

RESUMO

BACKGROUND: In acromegaly, chronic growth hormone (GH) and insulin-like growth factor-1 (IGF-1) exacerbate comorbidities in multiple organs. Differentiated thyroid carcinoma (DTC) has been reported as being a comorbid condition in acromegaly. Acromegaly is usuallysporadic, but 5% of cases may be genetic. The most frequent inheritable form of acromegaly is related to germline mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene. Epidemiological data on the relationship between active acromegaly, its familial forms and DTC are sparse. We present the investigation of a FIPA family (familial isolated pituitary adenoma) with homogeneous acromegaly and 6 sporadic acromegaly patients with DTC. PATIENTS AND METHODS: A study of 59 acromegaly patients assessed thyroid nodules on ultrasound and fine-needle aspiration biopsy following the ATA 2015 criteria. We diagnosed 7 differentiated thyroid carcinomas. Resected thyroid carcinoma tissues were stained using an anti-AIP antibody. Analysis of germline and tumor-derived DNA for variants in the AIP and MEN1 genes were performed in the FIPA kindred. RESULTS: We describe one FIPA patient and 6 sporadic acromegaly cases with DTC. The FIPA family (AIP mutation negative) consisted of two sisters, one of whom had a DTC with intermediate risk and incomplete structural response to therapy. In our study, DTC in sporadic acromegaly had a low recurrence rate (6/6), and excellent response to therapy (6/6). Immunohistochemistry for AIP showed similar or increased staining intensity in DTC versus normal thyroid tissue. CONCLUSION: In our cohort of sporadic and familial forms of acromegaly with DTC, AIP did not appear to influence thyroid cancer progression.


Assuntos
Acromegalia/epidemiologia , Adenocarcinoma/epidemiologia , Adenoma/epidemiologia , Adenoma Hipofisário Secretor de Hormônio do Crescimento/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Acromegalia/diagnóstico por imagem , Acromegalia/etiologia , Acromegalia/patologia , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Adenoma/complicações , Adenoma/diagnóstico por imagem , Adenoma/patologia , Adulto , Idoso , Argentina/epidemiologia , Biópsia por Agulha Fina , Estudos de Coortes , Comorbidade , Progressão da Doença , Feminino , Mutação em Linhagem Germinativa , Adenoma Hipofisário Secretor de Hormônio do Crescimento/complicações , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico por imagem , Adenoma Hipofisário Secretor de Hormônio do Crescimento/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Ultrassonografia
4.
Sci Rep ; 10(1): 10651, 2020 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-32606302

RESUMO

Papillary thyroid carcinoma (PTC) is considered the most prevalent thyroid malignancy. The association between Hashimoto's thyroiditis (HT) and PTC is still unclear. We aimed to examine the clinicopathological impact of immunohistochemical staining of FOXP3 and Cytokeratin 19 in PTC and concomitant HT and their correlation with patients' outcome and survival. Eighty thyroid biopsies obtained from patients with PTC were immunostained by FOXP3 and CK19.The patients were treated by radioactive iodine (I131) and followed up. FOXP3 and CK19 expression were detected in 45% and 80% studied cases of PTC respectively. 16.7% of PTC with associated HT showed FOXP3+ lymphocytes in lymphocytic infiltrate of HT, while most of PTC associated HT express cytoplasmic CK19 positive Hurtle cells. FOXP3 was more expressed in PTC female patients more than 45 years with higher stage, lymph node, and distant metastasis, extracapsular extension, number of I131doses, and cumulative radioiodine doses with a highly statistically significant difference (p < 0.001). The relation was significant between CK19 immunostaining as regard 10-year Overall Survival and death (p value = 0.027 and 0.036, respectively). HT represents a step in the process of autoimmune inflammatory disease ending by the evolution of PTC with better prognosis, therefore appropriate follow up of these cases is needed. FOXP3 tends to be more expressed in PTC cases with worse prognostic variables and is predictable to become a recent prognostic and targeted therapy for PTC. There was a significant relation between CK19 immunostaining and 10 year overall survival.


Assuntos
Biomarcadores Tumorais/metabolismo , Fatores de Transcrição Forkhead/metabolismo , Doença de Hashimoto/metabolismo , Queratina-19/metabolismo , Câncer Papilífero da Tireoide/metabolismo , Neoplasias da Glândula Tireoide/metabolismo , Adulto , Biomarcadores Tumorais/genética , Feminino , Fatores de Transcrição Forkhead/genética , Doença de Hashimoto/complicações , Doença de Hashimoto/genética , Doença de Hashimoto/patologia , Humanos , Queratina-19/genética , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/genética , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia
5.
Pediatr Blood Cancer ; 67(9): e28300, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32614144

RESUMO

BACKGROUND: the available studies on Hurthle cell carcinoma (HCC) in pediatric age are scarce and based on isolated case reports. Aims of the present study were to review the available pediatric literature on HCC (2000-2019), to describe the cohort of children with this cancer histotype, and to estimate its relative prevalence in pediatric age. PROCEDURE: We retrospectively reconstructed an HCC course in five patients < 19 years who were identified in our departments during the period 2000-2019, and we reviewed the available pediatric studies on this differentiated thyroid cancer (DTC) variant. RESULTS: HCC occurred with a relative prevalence of 5.8% at a median chronological age of 12.5 years. None of HCC patients exhibited, at diagnosis, thyroid dysfunction, extensive lateral neck disease, or distant metastases, and all showed a persistent remission over time. Three patients showed, at diagnosis, antecedents of other diseases (Hashimoto's thyroiditis, neurofibromatosis type 1, and osteosarcoma). CONCLUSIONS: (1) In childhood, the relative prevalence of HCC among different thyroid cancer histotypes is 5.8%, that is close to the one previously reported both in the general population and in other less numerous children's cohorts; (2) HCC may develop even early, at the age of 7; (3) in childhood, HCC does not seem to have a more aggressive behavior when compared with other DTC histotypes; (4) antecedents of other diseases are not infrequent in the history of children with HCC.


Assuntos
Adenoma Oxífilo/epidemiologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/epidemiologia , Adenoma Oxífilo/complicações , Adolescente , Criança , Feminino , Doença de Hashimoto/complicações , Humanos , Masculino , Neurofibromatose 1/complicações , Osteossarcoma/complicações , Estudos Retrospectivos , Testes de Função Tireóidea , Neoplasias da Glândula Tireoide/complicações , Adulto Jovem
7.
PLoS One ; 15(6): e0234566, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603365

RESUMO

Hashimoto's thyroiditis (HT) is present in the background of around 30% of papillary thyroid carcinomas (PTCs). The genetic predisposition effect of this autoimmune condition is not thoroughly understood. We analyzed the microarray expression profiles of 13 HT, eight PTCs with (w/) coexisting HT, six PTCs without (w/o) coexisting HT, six micro PTCs (mPTCs), and three normal thyroid (TN) samples. Based on a false discovery rate (FDR)-adjusted p-value ≤ 0.05 and a fold change (FC) > 2, four comparison groups were defined, which were HT vs. TN; PTC w/ HT vs. TN; PTC w/o HT vs. TN; and mPTC vs. TN. A Venn diagram displayed 15 different intersecting and non-intersecting differentially expressed gene (DEG) sets, of which a set of 71 DEGs, shared between the two comparison groups HT vs. TN ∩ PTC w/ HT vs. TN, harbored the relatively largest number of genes related to immune and inflammatory functions; oxidative stress and reactive oxygen species (ROS); DNA damage and DNA repair; cell cycle; and apoptosis. The majority of the 71 DEGs were upregulated and the most upregulated DEGs included a number of immunoglobulin kappa variable genes, and other immune-related genes, e.g., CD86 molecule (CD86), interleukin 2 receptor gamma (IL2RG), and interferon, alpha-inducible protein 6 (IFI6). Upregulated genes preferentially associated with other gene ontologies (GO) were, e.g., STAT1, MMP9, TOP2A, and BRCA2. Biofunctional analysis revealed pathways related to immunogenic functions. Further data analysis focused on the set of non-intersecting 358 DEGs derived from the comparison group of HT vs. TN, and on the set of 950 DEGs from the intersection of all four comparison groups. In conclusion, this study indicates that, besides immune/inflammation-related genes, also genes associated with oxidative stress, ROS, DNA damage, DNA repair, cell cycle, and apoptosis are comparably more deregulated in a data set shared between HT and PTC w/ HT. These findings are compatible with the conception of a genetic sequence where chronic inflammatory response is accompanied by deregulation of genes and biofunctions associated with oncogenic transformation. The generated data set may serve as a source for identifying candidate genes and biomarkers that are practical for clinical application.


Assuntos
Perfilação da Expressão Gênica , Doença de Hashimoto/genética , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/genética , Adolescente , Adulto , Idoso , Transformação Celular Neoplásica/genética , Feminino , Predisposição Genética para Doença , Doença de Hashimoto/complicações , Humanos , Inflamação/genética , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/complicações , Neoplasias da Glândula Tireoide/complicações , Regulação para Cima
8.
Eur J Endocrinol ; 183(4): D1-D13, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32698136

RESUMO

The literature on an association between acromegaly and cancer is particularly abundant on either colorectal cancer or thyroid cancer, and an endless debate is ongoing whether patients with acromegaly should be submitted to specific oncology screening and surveillance protocols. The aim of the present work is to review the most recent data on the risk of either colorectal cancer or thyroid cancer in acromegaly and discuss the opportunity for specific screening in relation to the accepted procedures in the general population.


Assuntos
Acromegalia/complicações , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer , Programas de Rastreamento , Monitorização Fisiológica , Neoplasias da Glândula Tireoide/diagnóstico , Acromegalia/diagnóstico , Acromegalia/epidemiologia , Acromegalia/terapia , Adenoma/complicações , Adenoma/diagnóstico , Adenoma/epidemiologia , Adenoma/terapia , Neoplasias Colorretais/complicações , Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/normas , Endocrinologia/métodos , Endocrinologia/normas , Adenoma Hipofisário Secretor de Hormônio do Crescimento/complicações , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico , Adenoma Hipofisário Secretor de Hormônio do Crescimento/epidemiologia , Adenoma Hipofisário Secretor de Hormônio do Crescimento/terapia , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Oncologia/métodos , Oncologia/normas , Monitorização Fisiológica/métodos , Monitorização Fisiológica/normas , Vigilância da População/métodos , Guias de Prática Clínica como Assunto/normas , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-32481566

RESUMO

OBJECTIVES: The formation of uterine fibroids (UF) is potentially linked to the development of thyroid cancer through a common factor: female sex hormones. METHODS: We conducted a nationwide population-based cohort study to determine whether Taiwanese women with UF have an increased risk of thyroid cancer. The data of both the UF and control groups were derived from the National Health Insurance Research Database (NHIRD) of Taiwan. Groups were matched by the year of UF diagnosis, age, income, urbanization level, occupation, and comorbidities. A Cox proportional hazard regression model was used to compare the incidence of thyroid cancer between the UF and control groups. In addition, the model was used to determine the hazard ratio of thyroid cancer in the UF group in comparison with the control group. RESULTS: Women with UF had a statistically significantly increased risk of thyroid cancer compared with controls (adjusted hazard ratio (aHR): 1.64, 95% confidence interval (CI): 1.26-2.13). Stratified analyses showed that women with UF who had a significantly increased risk of thyroid cancer were more likely to be middle aged, have middle and higher income levels, and a medium follow-up period (1-5 years) of UF. No other UF patient characteristics and comorbidities showed association with the risk of thyroid cancer. In addition, UF patients had a significantly increased risk of thyroid cancer regardless of whether or not they underwent myomectomy. CONCLUSIONS: The results suggest that women with UF have an increased risk of subsequent thyroid cancer. Further research is needed to explore whether surveillance strategies for the early detection of thyroid cancer using ultrasonography should be implemented among patients with UF.


Assuntos
Leiomioma , Neoplasias da Glândula Tireoide , Adulto , Estudos de Coortes , Feminino , Humanos , Incidência , Leiomioma/complicações , Pessoa de Meia-Idade , Fatores de Risco , Taiwan/epidemiologia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/epidemiologia
10.
Medicina (B Aires) ; 80(3): 289-291, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32442945

RESUMO

Hypoparathyroidism (HypoPT) is a rare disease characterized by low calcium and inappropriately low circulating parathormone levels. We present the case of a 25-year-old high-performance athlete male, with history of HypoPT after total thyroidectomy for papillary thyroid carcinoma (T3 N1b M0) two years before, who was referred to our clinic for symptomatic hypocalcemia. The patient reported serum calcium average levels of 7mg%, presented symptoms of hypocalcemia at rest and had multiple hospital admissions. First, standard treatment was optimized by calcium supplementation up to 12g/d and active vitamin D, not showing clinical or biochemical improvement. Malabsorption and complications of chronic HypoPT were ruled out. The 36-Item Short Form Health Survey (SF-36) demonstrated an impaired quality of life (QoL). Full-length recombinant human parathyroid hormone [rhPTH(1-84)] therapy was started with 50υg/d subcutaneous, and later adjusted to 75υg/d and the oral treatment gradually decreased. Currently, he is asymptomatic, with serum calcium levels above 9mg%, without receiving oral medication. He performs sports activity and shows marked improvement in quality of life according to SF-36 questionnaire.


Assuntos
Hipoparatireoidismo/tratamento farmacológico , Hormônio Paratireóideo/uso terapêutico , Adulto , Calcitriol/uso terapêutico , Hormônios e Agentes Reguladores de Cálcio/uso terapêutico , Terapia de Reposição Hormonal/métodos , Humanos , Hipoparatireoidismo/etiologia , Masculino , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Vitamina D/uso terapêutico
11.
Eur J Endocrinol ; 183(1): G41-G48, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32438345

RESUMO

Most patients with thyroid nodules and thyroid cancer (TC) referred for diagnostic work-up and treatment are not considered at higher risk of infection from SARS-CoV-2 compared to the general population. On the other hand, healthcare resources should be spared to the maximum extent possible during a pandemic. Indeed, while thyroid nodules are very common, only a small percentage are cancerous and, in turn, most thyroid cancers are indolent in nature. Accordingly, diagnostic work-up of thyroid nodules, thyroid surgery for either benign or malignant thyroid nodules and radioiodine treatment for differentiated thyroid cancers may be safely postponed during SARS-CoV-2 pandemic. Appropriate patient counselling, however, is mandatory and red flags should be carefully identified prompting immediate evaluation and treatment as appropriate. For these selected cases diagnostic work-up (e.g. ultrasound, scintigraphy, fine-needle aspiration), surgery and radioiodine therapy may proceed despite the threat of SARS-CoV-2 infection and COVID-19, after an individual risk-benefit analysis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Nódulo da Glândula Tireoide/diagnóstico , Infecções por Coronavirus/virologia , Gerenciamento Clínico , Endocrinologia/métodos , Humanos , Pandemias , Pneumonia Viral/virologia , Medição de Risco , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/terapia , Neoplasias da Glândula Tireoide/virologia , Nódulo da Glândula Tireoide/complicações , Nódulo da Glândula Tireoide/terapia , Nódulo da Glândula Tireoide/virologia
13.
Sci Rep ; 10(1): 5765, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32238870

RESUMO

Although differentiated thyroid carcinoma (DTC) has a good prognosis and survival rate, long-term medication and recurrence monitoring might be needed. The factors that affect postoperative health-related quality of life (HRQoL) in patients with DTC in different regions remain unclear or conflicting. The purpose of this study was to assess the factors that influence the HRQoL of DTC patients after surgery. This study selected 174 patients with DTC who underwent thyroidectomy. Additionally, 174 participants who were matched by age, gender, and socioeconomic status were recruited from the population as the control group. Both the DTC and control population groups were invited to answer the HRQoL questionnaire SF-36. Scores on seven domains of the HRQoL including role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role-emotional (RE), and mental health (MH), were significantly lower for DTC patients than for the control population. The patients with no comorbidities had much higher scores on the 8 domains of the SF-36 than DTC patients with two or more comorbidities (all P < 0.05). Hypertension, diabetes and depression were the predictive factors of a poor Physical Component Summary (PCS) score and diabetes and depression were predictive factors of the Mental Component Summary (MCS) score at one year of follow-up (all P < 0.05). HRQoL is significantly influenced by many sociodemographic and clinical factors. Hypertension, diabetes and depression had a negative impact on HRQoL in DTC patients. More attention and targeted intervention should be given to DTC patients after surgery to improve quality of life.


Assuntos
Qualidade de Vida , Neoplasias da Glândula Tireoide/cirurgia , Adulto , Estudos Transversais , Emoções , Feminino , Nível de Saúde , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Período Pós-Operatório , Neoplasias da Glândula Tireoide/complicações , Tireoidectomia
14.
Hormones (Athens) ; 19(2): 233-243, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32201929

RESUMO

PURPOSE: Patients with thyroid cancer are often assumed to have no quality of life (QOL) impairments after treatment because of thyroid cancer's good prognosis. However, the QOL implications of surgical complications and the necessity to take lifelong medication are seldom assessed. METHODS: Patients who had surgery due to thyroid cancer at the University Medical Center Mainz between 2010 and 2015 and who had calcium or parathyroid hormone levels below the reference values immediately following surgery were eligible for this study. QOL was assessed using the EORTC QLQ-C30 and the thyroid cancer module EORTC QLQ-THY34. Multiple logistic regression was used to determine factors associated with a worse QOL compared with a general population. RESULTS: A total of 75 (56%) of 134 eligible patients participated in the study. Patients with persistent/prolonged calcium or vitamin D intake reported worse QOL in the domains of global health, physical functioning, role functioning, emotional functioning, and insomnia than patients without current intake. Current calcium and vitamin D intake, higher education, living with a partner, and age had an effect on the odds of having worse QOL than the age- and sex-adjusted general population. CONCLUSION: Prolonged calcium and/or vitamin D intake are negatively associated with certain domains of QOL in thyroid cancer patients who are at least 1 year post surgery. Assessment of calcium and vitamin D and diagnosis of hypoparathyroidism are therefore important for the follow-up of thyroid cancer survivors since it may affect their QOL.


Assuntos
Cálcio/administração & dosagem , Sobreviventes de Câncer , Hipoparatireoidismo/tratamento farmacológico , Qualidade de Vida , Neoplasias da Glândula Tireoide/cirurgia , Vitamina D/administração & dosagem , Adulto , Idoso , Feminino , Seguimentos , Nível de Saúde , Humanos , Hipoparatireoidismo/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/tratamento farmacológico
17.
Pathology ; 52(3): 318-322, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32107082

RESUMO

The impact of concurrent autoimmune thyroid disease on the tumour microenvironment and disease progression in papillary thyroid cancer (PTC) is not well understood. Studies evaluating the programmed cell death ligand 1 (PD-L1) tumour expression in PTC have shown variable results, and the effect of lymphocytic thyroiditis (LT) on tumour PD-L1 expression has not been adequately assessed. The main aim of this study was to determine expression of PD-L1 in PTC with and without LT. We examined 81 PTC cases; 28.5% of all reviewed PTC had presence of LT. In PTC specimens without LT, tumour PD-L1 expression was significantly lower compared to PD-L1 expression in PTC with LT, 6.9% vs 39.1%, respectively. Expression of PD-L1 did not differ with PTC stage, even when sub-categorised according to the presence and absence of LT. Utility of PD- L1 expression as a prognostic marker in thyroid cancer needs to be interpreted with caution.


Assuntos
Antígeno B7-H1/biossíntese , Biomarcadores Tumorais/análise , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Tireoidite Autoimune/patologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/metabolismo , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/metabolismo , Tireoidite Autoimune/complicações , Tireoidite Autoimune/metabolismo
18.
J Nucl Med ; 61(8): 1161-1170, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31924716

RESUMO

Radioactive iodine (131I) therapy may be used to treat thyroid cancer in end-stage renal disease patients who undergo hemodialysis. Because iodine uses predominantly renal clearance, treatment management in hemodialysis patients may be problematic, and no formal recommendations on hemodialysis currently exist. This work details our experience with treating thyroid cancer with iodine in chronic renal failure patients who require hemodialysis and details the dosimetry results obtained during treatment to ensure that the dose to the bone marrow (BM) was acceptable. Methods: We treated 6 patients in the metabolic radiotherapy unit after thyroid stimulation. Two hemodialysis sessions in the metabolic radiotherapy unit were performed at 42 and 90 h after radiopharmaceutical administration. BM toxicity was estimated with activity measurements from blood samples and with whole-body measurements that were regularly repeated during hospitalization and measured with a γ-counter. The patients underwent thyroid and hematologic monitoring to assess treatment efficacy and therapeutic toxicity in the short, medium, and long term. Results: Whole-body activity was reduced on average by 66.7% (range, 60.1%-71.5%) after the first dialysis session and by 53.3% (range, 30.4%-67.8%) after the second. The mean estimated total absorbed dose to the BM was 0.992 Gy for all patients (range, 0.431-2.323 Gy). We did not observe any significant hematologic toxicity, and the clinical, biologic, and ultrasound test results confirmed the success of ablative treatment for most patients. Conclusion: In hemodialysis patients with thyroid cancer, an 131I activity approximately 30% lower than the nominal dose appears to strike an appropriate balance between absence of BM toxicity and therapeutic efficacy. To avoid overirradiation, we recommend pretherapeutic dosimetry studies for metastatic patients to calculate the amount of activity to be administered. We also recommend dosimetry monitoring during the hemodialysis sessions performed after therapeutic dose administration and under the same conditions.


Assuntos
Radioisótopos do Iodo/uso terapêutico , Falência Renal Crônica/complicações , Diálise Renal , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/radioterapia , Idoso , Feminino , Humanos , Radioisótopos do Iodo/efeitos adversos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Estudos Retrospectivos
20.
J Med Case Rep ; 14(1): 9, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31937367

RESUMO

BACKGROUND: True thymic hyperplasia is a rare condition characterized by enlargement of the thymus while its normal structure is retained. True thymic hyperplasia is known to accompany Graves' disease, but no association between true thymic hyperplasia and thyroid follicular tumor has been reported so far. We report a case of true thymic hyperplasia in a patient with a thyroid follicular tumor. CASE PRESENTATION: A 52-year-old Japanese man was referred to our hospital for evaluation of a thyroid mass and a mediastinal mass. His serum thyroglobulin level was high, and hemithyroidectomy was performed to remove the thyroid mass. The resected mass was diagnosed as a follicular tumor of uncertain malignant potential. After resection of the thyroid lesion, the patient's serum thyroglobulin levels were markedly decreased. Seven months later, the patient underwent resection of the mediastinal mass. On pathological examination, the mass was found to consist of lobules, which formed a corticomedullary structure with Hassall's bodies, indicating a normal thymic mass with hyperplastic thymic tissue, less organized cellular cords, and intermingled adipose tissue. Immunostaining for cytokeratin 19 and cytokeratin 7 indicated that the lesion was consistent with thymic tissue. The lesion was diagnosed as true thymic hyperplasia, and the histological findings suggested that secondary atrophy had occurred. No evidence of recurrence was observed at 24 months after surgery. CONCLUSIONS: We present a case of a combination of true thymic hyperplasia and thyroidal follicular tumors that, to our knowledge, has not been reported previously. High serum thyroglobulin levels might play a role in hyperplasia of the thymus. Although true thymic hyperplasia is a rare disorder, it should be included in the differential diagnosis of a mediastinal mass in patients with thyroid disease.


Assuntos
Hiperplasia do Timo/complicações , Hiperplasia do Timo/diagnóstico , Células Epiteliais da Tireoide , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/diagnóstico , Humanos , Masculino , Doenças do Mediastino/cirurgia , Pessoa de Meia-Idade , Toracoscopia , Hiperplasia do Timo/cirurgia , Tireoglobulina/sangue , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
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