scholarly journals Risk Factors for Recurrent Papillary Thyroid Carcinoma

2018 ◽  
Vol 32 (2) ◽  
pp. 25-29
Author(s):  
Jonel Donn Leo S. Gloria ◽  
Alfredo Quintin Y. Pontejos ◽  
Precious Eunice R. Grullo
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid ◽  
Clinicopathologic Factor

Objective:  To identify risk factors associated with disease recurrence among Filipinos with papillary thyroid carcinoma (PTC). Methods: Design:           Retrospective cohort study Setting:           Tertiary National University Hospital Participants: 76 patients diagnosed with papillary thyroid carcinoma, classified as low and low-to-intermediate risk (2015 ATA classification) that underwent total thyroidectomy with or without neck dissection from 2010-2014 and were followed up from 10 months to 5 years. Log rank and Cox regression analyses were used to determine significant risk factors for recurrence. Results:  29 (38.15%) had recurrence.  On univariate analysis, age, tumor size, multifocality, extrathyroidal extension, presence of lateral neck nodes and RAI therapy were statistically associated with recurrence.  However, on multivariate analysis, no clinicopathologic factor was statistically associated with recurrence. Conclusion: Age of >45 years, female sex, tumor size of >2 cm, multifocality, presence of microscopic extrathyroidal extension, and lymph node metastasis might contribute to the recurrence of papillary thyroid cancer while post-operative radioactive ablation may have some protective effect.  However, this study suggests that other factors must be included in the model to better understand the relationship between these factors and recurrence.   Keywords: papillary thyroid cancer, thyroid neoplasm, recurrence

scholarly journals Incidental Diffuse Sclerosing Variant Papillary Thyroid Cancer in Grave’s Disease

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A891-A892
Author(s):  
Nicolle Canales ◽  
Yadiel Rivera Nieves ◽  
Nydia Ivette Burgos Ortega ◽  
Janet Marie Colon Castellano ◽  
Nicole Hernández Cordero ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Papillary Thyroid Cancer ◽  
Outpatient Basis ◽  
Thyroid Function Tests ◽  
Papillary Thyroid ◽  
Diffuse Sclerosing Variant

Abstract The diffuse sclerosing variant papillary thyroid carcinoma (DSPTC) is an uncommon form of this neoplasm. Some studies describe its high propensity for tumor invasion, metastasis, and mortality compared with classic papillary thyroid carcinoma. Histologic features of DSPTC may resemble diffuse inflammation as seen with Grave’s or Hashimoto’s thyroiditis, which makes initial diagnosis challenging. A 27-year-old female with Noonan’s Syndrome was evaluated on an outpatient basis after developing atrial fibrillation de novo. Thyroid function tests were consistent with hyperthyroidism with TSH: <0.005 (n: 0.300-3.000 uIU/mL), FT4: 3.59 (0.71-1.85 ng/mL) and FT3: 16.77 (n: 2.0-7.0 pmol/L). Diffuse goiter was noted on physical exam, but no ophthalmopathy or dermopathy was present. TRAB and TSI were elevated at 38.4 (n: <16%) and 423% (n: <140%) respectively. A twenty-four-hour radioiodine uptake was 48% (n:10-35%) and described as essentially homogenous with two foci of decreased radiotracer concentration suggestive of cold nodules. Thyroid ultrasound showed diffuse nodularity bilaterally with associated clusters of calcifications and no discrete nodules. No abnormal appearing lymph nodes were identified. Fine-needle aspiration of both nodular areas was positive for DSPTC. Total thyroidectomy with central neck dissection was performed. Gross and microscopic post-surgical pathology confirmed the presence of diffuse sclerosing papillary thyroid cancer, along with local metastasis to one central lymph node. Patient was scheduled for radioactive iodine therapy. Diffuse sclerosing variant is considered an aggressive histotype of papillary thyroid cancer. Ultrasound features include diffuse scattered microcalcifications with or without discrete nodules that may be confused with chronic inflammatory changes. Despite the limited number of cases, DSPTC is recognized to have specific characteristics, a high female to male ratio, and a young patient age. DSPTC has a high potential for aggressive biologic behavior if not treated promptly at the time of diagnosis. When suspected, total thyroidectomy with lymph node excision followed by radioiodine therapy has been proposed as the correct management to decrease the risk of persistent or recurrent disease.

scholarly journals Incidence and Clinical Significance of Delphian Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

2020 ◽  
Author(s):  
Wei Liu ◽  
Zhenglin Wang ◽  
Cong Wang ◽  
Zhilong Ai
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Clinical Significance ◽  
Tumor Size ◽  
Frozen Section ◽  
Extrathyroidal Extension ◽  
Capsular Invasion ◽  
Papillary Thyroid

Abstract Background: Some studies have reported that Delphian lymph node (DLN) metastasis is associated with a poor prognosis of papillary thyroid carcinoma (PTC), but the number of the available studies is limited and the results are inconsistent. The aim of this investigation was to study the incidence and clinical significance of DLN metastasis in patients with unilateral PTC.Methods: This was a cross-sectional study from January 2016 to December 2019. The data were obtained from the department of general surgery in Shanghai Zhongshan Hospital affiliated to Fudan University. This study included 522 patients with unilateral PTC and had DLN harvested. The associations between DLN metastasis and the clinical characteristics of the patients, i.e. age, sex, tumor size, multifocality, capsular invasion, extrathyroidal extension, central lymph nodes (CLN) metastasis (excluding DLN), and lateral lymph nodes (LLN) metastasis was analyzed.Results: Among all the 522 patients, 133 (25.5%) patients had metastasized DLN lymph nodes. DLN metastasis was significantly associated with age (p = 0.047), male (p < 0.001), larger tumor size (p < 0.001), capsular invasion (p < 0.001), extrathyroidal extension (p = 0.004), tumor location in upper third (p = 0.003), other CLN metastasis (p < 0.001), number of positive CLN (excluding DLN) (p < 0.001), LLN metastasis (p = 0.036), number of positive LLN (p = 0.004) and number of DLN removed (p = 0.043). No association was found between DLN metastasis and multifocality, number of CLN removed and number of LLN removed.Conclusions: DLN metastasis is associated with some adverse prognostic markers of PTC. If the DLN is positive on intraoperative frozen section, careful dissection of CLN and careful evaluation of LLN are essential, and intensive follow-up should be warranted.

scholarly journals Autoimmune Rheumatic Disease (Polymyositis and Dermatomyositis) associated with Papillary Thyroid Carcinoma: Report of Two Cases and Review of the Literature

2013 ◽  
Vol 5 (2) ◽  
pp. 55-58
Author(s):  
Geeta Lal ◽  
Anuradha R Bhama
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Rheumatic Disease ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Review Of The Literature ◽  
Thyroid Resection ◽  
Autoimmune Rheumatic Disease ◽  
Metastatic Lung

ABSTRACT Autoimmune rheumatic diseases, such as polymyositis and dermatomyositis, have been demonstrated to carry a risk of the development of malignancy. Thyroid cancer is a rare occurrence in this setting; however, multiple cases have been reported. We present two cases of papillary thyroid carcinoma associated with dermatomyositis and polymyositis. The first patient is a 64-year-old female found to have papillary thyroid cancer after the diagnosis of polymyositis who underwent thyroid resection. The second patient is a 51-year-old male who was found to have synchronous papillary thyroid cancer and small cell carcinoma of the lung. He did not undergo thyroid resection due to widely metastatic lung cancer. We describe two cases of papillary thyroid cancer associated with autoimmune rheumatic disease. Though it is rare, thyroid cancer should remain in the differential diagnosis of a patient with new onset autoimmune rheumatic disease, as this may alter the eventual management of these patients. How to cite this article Lal G, Bhama AR. Autoimmune Rheumatic Disease (Polymyositis and Dermatomyositis) associated with Papillary Thyroid Carcinoma: Report of Two Cases and Review of the Literature. World J Endoc Surg 2013;5(2):55-58.

scholarly journals Squamous Cell Carcinoma of the Thyroid as a Result of Anaplastic Transformation from BRAF-Positive Papillary Thyroid Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Alina Basnet ◽  
Aakriti Pandita ◽  
Joseph Fullmer ◽  
Abirami Sivapiragasam
Keyword(s):  
Squamous Cell Carcinoma ◽  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Cell Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Squamous Cell ◽  
Malignant Neoplasm ◽  
Papillary Thyroid ◽  
Anaplastic Transformation

Papillary thyroid carcinoma (PTC) is the most common malignant neoplasm of the thyroid. Majority of the PTC carries an excellent prognosis. However, patients with tall cell variant (TCV) of papillary thyroid carcinoma have a worse prognosis than those with the classic variant. On the other hand, squamous cell carcinoma of the thyroid (SCT) is an unusual neoplasm thought to arise as a primary tumor or as a component of an anaplastic or undifferentiated carcinoma. We report a patient with TCV of PTC presenting years later with squamous transformation. In addition, the patient was found to have BRAF mutation. Such dedifferentiation is considered to be a rare phenomenon and has been reported only in the form of case reports in the literature. The relationship between BRAFV600E mutation and squamous cell transformation of papillary thyroid cancer is unknown at this time. Meticulous pathology is needed to identify such variants. Our patient responded to treatment with concurrent chemotherapy with carboplatin and paclitaxel along with radiation.

scholarly journals A Case of Miliary Nodules, Hemoptysis and Hot Thyroid Cancer: Unusual Presentation of Papillary Thyroid Cancer

2015 ◽  
Vol 7 (3) ◽  
pp. 72-75
Author(s):  
Jesse SL Hu ◽  
Rajeev Parameswaran
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Neck Dissection ◽  
Young Patient ◽  
Papillary Thyroid Cancer ◽  
Braf Mutation ◽  
Unusual Presentation ◽  
Papillary Thyroid ◽  
History Of

ABSTRACT Background Papillary thyroid carcinoma is the commonest thyroid cancer. Patients usually present with thyroid nodule and rarely with hyperthyroidism such that 2009 ATA guidelines recommended that cytological evaluation is not necessary in patients with hyperfunctioning nodules as they rarely harbor malignancy. We report a case of an unusual presentation of metastatic papillary thyroid carcinoma in a young patient. Case presentation A 17-year-old girl, presented to our hospital with 3 days of fever, cough and hemoptysis. Chest X-ray showed extensive miliary nodules and was treated for presumed miliary tuberculosis. Biochemical investigations revealed a hyperthyroid state (fT4 55.7 TSH < 0.02), with negative antibodies (TRAB and TSI). Radioisotope scan showed increased uptake on right lobe. She underwent bronchoscopy and biopsy which revealed metastatic papillary thyroid carcinoma. Clinical examination revealed a small goiter with palpable cervical node at level III on the left. There were no clinical signs of Graves’ disease and she had no history of previous radiation or family history of endocrine disease. Ultrasound revealed multiple hypodense thyroid nodules with microcalcification and increased vascularity. Ultrasound of the neck showed the presence of abnormal lymphadenopathy. She underwent total thyroidectomy, bilateral central neck dissection and left lateral modified neck dissection. Histology showed 1.3 cm papillary thyroid carcinoma involving the left lobe and multifocal papillary thyroid microcarcinomas involving both lobes. Ten out of 27 nodes were involved. She was BRAF mutation positive. She recovered well postoperatively and was rendered hypothyroid. She underwent radioiodine ablation which showed no more disease in the neck but unfortunately there was no uptake in the lung metastases. Conclusion Metastatic papillary thyroid cancer developing in a young patient with hyperthyroidism is extremely rare and suggests a more aggressive behavior as confirmed by BRAF mutation. How to cite this article Hu JSL, Parameswaran R. A Case of Miliary Nodules, Hemoptysis and Hot Thyroid Cancer: Unusual Presentation of Papillary Thyroid Cancer. World J Endoc Surg 2015;7(3):72-75.

scholarly journals Decreased apolipoprotein A4 and increased complement component 3 as potential markers for papillary thyroid carcinoma: A proteomic study

2018 ◽  
Vol 33 (4) ◽  
pp. 455-462 ◽  
Author(s):  
Reyhaneh Farrokhi Yekta ◽  
Afsaneh Arefi Oskouie ◽  
Mostafa Rezaei Tavirani ◽  
Mohammad R. Mohajeri-Tehrani ◽  
Ahmad R. Soroush
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Complement Component ◽  
Assay Method ◽  
Enzyme Linked Immunosorbent Assay ◽  
Thyroid Tumors ◽  
Papillary Thyroid ◽  
Complement Component 3

Background: Thyroid carcinomas have comprised the fastest rising incidence of cancer in the past decade. Currently, the diagnosis of thyroid tumors is performed by the fine-needle aspiration biopsy (FNAB) method, which still holds some challenges and limitations, mostly in discriminating malignant and benign lesions. Therefore, the development of molecular markers to distinguish between these lesion types are in progress. Methods: A 2D-PAGE separation of proteins was performed followed by tandem mass spectrometry with the aim of discovering potential serum protein markers for papillary thyroid carcinoma and multinodular goiter. Protein–protein interaction network analysis revealed the most important pathways involved in the progression of papillary thyroid cancer. The enzyme-linked immunosorbent assay method was used to confirm a part of the results. Results: The significantly altered proteins included C3, C4A, GC, HP, TTR, APOA4, APOH, ORM2, KRT10, AHSG, IGKV3-20, and IGKC. We also confirmed that increased complement component 3 and decreased apolipoprotein A4 occurred in papillary thyroid cancer. Network investigations demonstrated that complement activation cascades and PPAR signaling might play a role in the pathogenesis of thyroid cancer. Conclusion: The results demonstrated that serum proteomics could serve as a viable method for proposing novel potential markers for thyroid tumors. Surely, further research must be performed in larger cohorts to validate the results.

Prognostic value of tumor size and minimal extrathyroidal extension in papillary thyroid carcinoma

2020 ◽  
Vol 220 (4) ◽  
pp. 925-931
Author(s):  
Chol-Ho Shin ◽  
Jong-Lyel Roh ◽  
Dong Eun Song ◽  
Kyung-Ja Cho ◽  
Seung-Ho Choi ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Size ◽  
Prognostic Value ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid ◽  
Minimal Extrathyroidal Extension

scholarly journals Preoperative Factors Associated with Extrathyroidal Extension in Papillary Thyroid Cancer

2020 ◽  
Vol 9 (5) ◽  
pp. 256-262 ◽  
Author(s):  
Chi-Yu Kuo ◽  
Po-Sheng Yang ◽  
Ming-Nan Chien ◽  
Shih-Ping Cheng
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Tumor Size ◽  
Braf Mutation ◽  
Extrathyroidal Extension ◽  
Additive Models ◽  
Braf V600e ◽  
Papillary Thyroid ◽  
Factors Associated ◽  
Preoperative Factors

Objective: Extrathyroidal extension may not be accurately recognized during thyroidectomy and can increase the risk of positive margins and even recurrence. This study aimed to investigate the preoperative factors associated with extrathyroidal extension. Methods: We analyzed 887 patients with papillary thyroid cancer (PTC) who underwent surgery in the period of 2005–2017. Binary logistic regression analyses and generalized additive models were used to identify associations. Results: Minimal extrathyroidal extension was present in 233 (26%) patients and advanced extrathyroidal extension was found in 60 (7%) patients. Age, BMI, and tumor size were independent predictors of all or advanced extrathyroidal extension. Among the 493 patients whose BRAF mutation status was available, age (OR = 1.025), BMI (OR = 1.091), tumor size (OR = 1.544), and BRAF V600E mutation (OR = 2.311) were independently associated with extrathyroidal extension. Conclusions: Older age, a greater BMI, a larger tumor size, and presence of the BRAF mutation were predictive of extrathyroidal extension. These factors should be taken into consideration in decision-making before surgery is performed.

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