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Multinodular goiter

Irene Gullo, Rui Batista, Pedro Rodrigues-Pereira, Paula Soares, Helena Barroca, Maria do Bom-Sucesso, Manuel Sobrinho-Simões
Objectives: Multinodular goiter (MNG) and well-differentiated thyroid carcinoma (WDTC) are emerging phenotypes of DICER1 syndrome. Methods: Histologic and molecular findings of botryoid-type embryonal rhabdomyosarcoma (bERMS) and thyroid nodules from a 12-year-old DICER1 mutation carrier (p.Arg1060Ilefs*7) were investigated, providing interesting clues for understanding thyroid carcinogenesis. Results: The patient had bERMS at age 7 years...
March 10, 2018: American Journal of Clinical Pathology
P F Alesina, B Meier, J Hinrichs, W Mohmand, M K Walz
PURPOSE: Visualization and precise dissection of the parathyroid glands are a crucial step of thyroidectomy. Moreover, identification of parathyroid adenoma in patients with primary hyperparathyroidism can be challenging due to the possible abnormal location of the enlarged parathyroid. Near-infrared fluorescence (NIR) can be adopted during video-assisted neck surgery in addition to standard endoscopic magnification to enhance the visualization of the parathyroid tissue. METHODS: Between July and August 2017, five patients (one male, four females) underwent video-assisted neck surgery at our hospital...
March 13, 2018: Langenbeck's Archives of Surgery
Florian Verrier, Catherine Dubois d'Enghien, Marion Gauthier-Villars, Valérie Bonadona, Cécile Faure-Conter, Frédérique Dijoud, Dominique Stoppa-Lyonnet, Claude Houdayer, Lisa Golmard
Germline DICER1 pathogenic variants predispose to numerous benign and malignant tumors. In this report, we describe DICER1 gene analysis in an adolescent diagnosed with multinodular goiter, ovarian Sertoli-Leydig cell tumor, and lung cyst. DICER1 mutational screening at the DNA level failed to detect any pathogenic variant. Subsequent messenger RNA (mRNA) analysis revealed a 132 nucleotide intronic sequence exonization. This truncating event was caused by a deep intronic mutation generating a de novo acceptor splice site...
February 22, 2018: Pediatric Blood & Cancer
Daniela Bosco, A Cammarata, R Cannarella, R Latino, R Lanteri, A Di Cataldo, A Calogero
Thyroid hemiagenesis is a rare congenital abnormality in which one of the thyroid lobes is not developed. It can be associated with various thyroid diseases, such as Grave's disease, nodular goiter and thyroid neoplasm, rarely with hyperparathyroidism. We report a case of a 50-year old woman with left thyroid lobe agenesis diagnosed by ultrasonography and scintigraphy. Right thyroidectomy was performed and the histopathological examination showed diffuse hyperplasia, multinodular goiter and Hashimoto's thyroiditis...
November 2017: Il Giornale di Chirurgia
Ewelina Motylewska, Tomasz Stępień, Magdalena Borkowska, Krzysztof Kuzdak, Agnieszka Siejka, Jan Komorowski, Henryk Stępień, Hanna Ławnicka
INTRODUCTION: βKlotho (βKL) is known to act as co-receptor for fibroblast growth factor receptor 4 (FGFR4) which is the main cognate receptor for fibroblast growth factor 19 (FGF19). Dysregulation of this FGF19/FGFR4/βKL signaling axis has been implicated in the pathogenesis of several cancers. However, its role in the pathogenesis of thyroid cancer has not been determined. MATERIALS AND METHODS: The aim of this study was to assess FGF19, FGFR4 and βKL concentrations in a group of 36 patients with papillary thyroid cancer (PTC), 11 patients with follicular thyroid cancer (FTC), 9 patients with anaplastic thyroid cancer (ATC) and a group of 19 subjects with multinodular nontoxic goiter (MNG)...
February 10, 2018: Cytokine
Danilo Villalta, Federica D'Aurizio, Mirella Da Re, Debora Ricci, Francesco Latrofa, Renato Tozzoli
PURPOSE: Thyrotropin receptor (TSHR) autoantibodies (TRAbs) are a hallmark of Graves' disease (GD). The aim of this study was to evaluate the diagnostic accuracy of a new third generation automatic fluorescence enzyme immunoassay for TRAb measurement in GD, in comparison with two current IMAs. METHODS: Sera of 439 subjects (57 patients with untreated GD, 34 with treated GD, 15 with GD and Graves' orbitopathy, 52 with multinodular non-toxic goiter, 86 with Hashimoto's thyroiditis, 20 with toxic adenoma or toxic multinodular goiter, 55 with non-thyroid autoimmune diseases and 120 normal controls) were tested for TRAbs with the ELiA ™ anti-TSH-R assay (ThermoFischer Scientific, Uppsala, Sweden), the TRAK ™ RIA, Brahms (Thermo Scientific, Hennigsdorf, Germany) and the Immulite ™ TSI assay (Siemens Healthcare, Llanberis, UK)...
February 12, 2018: Auto- Immunity Highlights
Theodoros Piperos, Ioannis Kaklamanos, Dimosthenis Chrysikos, Maria Zarokosta, Eleni Boumpa, Menelaos Zoulamoglou, Vasileios Kalles, Georgia-Ioanna Gkogka, Theodoros Mariolis-Sapsakos
The extralaryngeal bifurcation point of the recurrent laryngeal nerve (RLN) is typically located in a mean distance of 0-2 cm from the cricothyroid joint (CTJ). In the presented case though, the left RLN was unexpectedly identified bifurcating in a mean distance of 7 cm from the left CTJ in a young woman with multinodular goiter during total thyroidectomy. The RLN was carefully exposed throughout its course for the avoidance of iatrogenic injury of the nerval structure. The operation was uneventful. The present manuscript aims to highlight a scarce anatomic variation and its implications for thyroidectomy...
January 2018: Journal of Surgical Case Reports
Monica Pennisi, Alessandro Conti, Renato Farina, Pietro Valerio Foti, Giuseppe Cocuzza, Andrea Boncoraglio, Valeria Costanzo, Giuliana Costanzo
Generally, small quantities of adipose tissue is present in the thyroid gland. The adenolipoma of the thyroid gland is considered a rare finding. It consists in a benign, encapsulated neoplasm composed of mature adipose tissue and glandular elements. We report a case of a 71 year-old female patient presenting with swelling of the anterior neck and history of airway obstruction. Ultrasound (US) examination showed a bulky multinodular goiter which caused dislocation and compression of the trachea. The scans performed at the level of the isthmic region showed the presence of a hyperechoic oval formation with a homogeneous echostructure and regular contours; these characteristics suggested the lipomatous nature of the nodule...
November 30, 2017: Journal of Ultrasound
Kathleen C Gallagher, Ariana B Geromes, John Stokes, India A Reddy, James S Lewis, Naira Baregamian
Primary amyloidosis (PA) is a protein deposition disorder that presents with localized or multisystemic disease. The incidence is low in the general public, ranging from three to eight cases per million, and with nonspecific presenting symptoms typically occurring later in life. Due to late presentation, substantial and irreversible damage has usually already occurred by the time of the diagnosis. However, if inadvertent diagnosis occurs before irreversible damage has taken place, as it did in the following case, some patients may benefit from the disease-arresting treatment...
February 1, 2018: Journal of the Endocrine Society
Anne Marij Geertruida Burgers, Maurits Wondergem, Friso Martijn van der Zant, Remco Johannes Jacob Knol
An 80-year-old woman was evaluated with F-fluorocholine PET/CT in suspicion of a parathyroid adenoma. No focal parathyroid tracer uptake suggestive of adenoma was found, and instead a unilateral multinodular goiter without elevated F-fluorocholine uptake was diagnosed. In addition, focal uptake was found in a cutaneous nodule dorsally on the right shoulder. Upon pathological evaluation, this proved to be a malignant melanoma.
January 19, 2018: Clinical Nuclear Medicine
Nuri A Sahbaz, Firat Tutal, Nihat Aksakal, Sami Acar, Kadir I Aksu, Umut Barbaros, Yesim Erbil
Retrosternal goiter prevalence is 5 to 40 per cent according to classifications in goiter series. Goiters with mediastinal extension were reported to be related with higher cancer rates. In our study, we aimed to investigate whether cancer incidence increased in retrosternal goiters compared with the cervical ones. Three hundred and ninety consecutive patients, who had surgery because of retrosternal goiter in Istanbul University Medical Faculty Department of General Surgery between 2005 and 2015 were included in the study (Group 1)...
December 1, 2017: American Surgeon
Bartosz Migda, Michal Migda, Anna Marta Migda, Jacek Bierca, Jadwiga Slowniska-Srzednicka, Wieslaw Jakubowski, Rafal Zenon Slapa
Purpose The goal this study was to evaluate the utility of four variants of the Thyroid Imaging Reporting and Data System (TIRADS) in the differentiation of focal lesions in individuals with multinodular goiter. Materials and Methods The study was approved by the Local Bioethical Committee. Each patient gave informed consent before enrolment. A total of 163 nodules in 124 patients with multinodular goiter were evaluated by ultrasound. B-mode and PD imaging and strain elastography were performed. Archived images were evaluated via retrospective analysis using four different proposed TIRADS classifications Results Sensitivity and specificity of the Horvath, Park, Kwak, and Russ classifications were 0...
January 15, 2018: Endokrynologia Polska
Özer Makay
Benign goiter is the most common endocrine disease that requires surgery, especially in endemic areas suffering from iodine-deficiency. Recent European and American guidelines recommended total thyroidectomy for the surgical treatment of multinodular goiter. Total thyroidectomy has now become the technique of choice and is widely considered the most reliable approach in preventing recurrence. Nevertheless, total thyroidectomy carries a substantial risk in terms of hypoparathyroidism and the morbidity associated with injury to the inferior laryngeal nerve...
December 2017: Gland Surgery
Fereidoun Azizi, Ladan Mehran, Farhad Hosseinpanah, Hossein Delshad, Atieh Amouzegar
INTRODUCTION: Secondary and tertiary preventions are concerned with the recognition of the disease process in a very early stage and delay in progression to complete disease and minimization of complications and the impact of illness. METHODS: All articles related to secondary and tertiary prevention of thyroid diseases were reviewed. Using related key words, articles published between 2001 and 2015 were evaluated, categorized, and analyzed. RESULTS: In secondary prevention, congenital hypothyroidism and subclinical hypo and hyperthyroidism are equally important...
January 10, 2018: Endocrine Research
Jacek Daroszewski, Katarzyna Paczkowska, Aleksandra Jawiarczyk-Przybyłowska, Marek Bolanowski, Michał Jeleń
INTRODUCTION: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies and constitutes approximately 1.6-5% of malignant neoplasms of thyroid. ATC usually presents with local symptoms due to rapidly enlarging thyroid mass, and has only seldom been reported to be a cause of thyrotoxicosis. Up to date only 9 cases of ATC presented with thyrotoxicosis have been described. CASE REPORT: We report a case of 66-year-old woman, who had had a large, euthyroid multinodular goiter for almost 50 years...
January 10, 2018: Endokrynologia Polska
Harpreet Kaur, Amar Parkash Kataria, Magila Muthuramalingapandian, Harjinder Kaur
Patients with large goiters pose a great challenge to the anesthesiologist regarding securing the airway without compromising the safety of the patient. The technique of intubation depends on the choice and expertise of anesthesiologist. Awake fiberoptic intubation (AFOI) is the preferred technique. We present the case of large multinodular goiter with difficult airway in which AFOI was successfully used to secure the airway. Proper assessment, planning, and preparation for airway management should be done preoperatively to ensure patient safety...
October 2017: Anesthesia, Essays and Researches
Akif Enes Arıkan, Serkan Teksöz, İsmail Ahmet Bilgin, Özge Tarhan, Ateş Özyeğin
Although vocal cord paralysis (VCP) following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology. Vocal cord paralysis following thyroidectomy can be caused by a vocal cord hematoma with an incidence of 1.4% due to direct injury during orotracheal intubation. In this article, we present a case of VCP caused by vocal cord hematoma. A 32-year-old male patient who has been receiving propylthiouracil treatment for toxic multinodular goiter since 10 years was admitted to our hospital to be operated because of persisting complaints...
2017: Turkish Journal of Surgery
Ming-Li Yang, Bo Lu
OBJECTIVE: The present work aimed to further explore the therapeutic potential of Xing Qi Hua Ying Tang (XQHYT) by conducting a systemic clinical study in patients with goiter. DESIGN: Seventy-two patients with either multinodular or diffuse goiter were enrolled and randomly assigned into treatment group receiving XQHYT (n = 36) and control group receiving Hai Zao Yu Hu Tang (n = 36). LOCATION: Traditional Chinese Medicine Hospital of Shanxi...
December 7, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Ariadna Zybek-Kocik, Nadia Sawicka-Gutaj, Ewelina Szczepanek-Parulska, Mirosław Andrusiewicz, Joanna Waligórska-Stachura, Piotr Białas, Tomasz Krauze, Przemysław Guzik, Jerzy Skrobisz, Marek Ruchała
BACKGROUND: Irisin is a new adipo-myokine, encoded by the FNDC5 gene. Currently, there is a discussion regarding the relation between thyroid function and irisin concentration. This prospective study assesses the influence of thyrometabolic changes on serum irisin concentration in association with altered muscle metabolism. This is performed on a large cohort of patients affected by severe hypo- or hyperthyroidism, as well as by the expression of the FNDC5 gene in thyroid tissue affected by different pathologies...
March 2018: Clinical Endocrinology
Maria Apellaniz-Ruiz, Leanne de Kock, Nelly Sabbaghian, Federica Guaraldi, Lucia Ghizzoni, Guglielmo Beccuti, William D Foulkes
OBJECTIVE: Familial multinodular goiter (MNG), with or without ovarian Sertoli-Leydig cell tumor (SLCT), has been linked to DICER1 syndrome. We aimed to search for the presence of a germline DICER1 mutation in a large family with a remarkable history of MNG and SLCT, and to further explore the relevance of the identified mutation. DESIGN AND METHODS: Sanger sequencing, Fluidigm Access Array and multiplex ligation-dependent probe amplification (MLPA) techniques were used to screen for DICER1 mutations in germline DNA from 16 family members...
February 2018: European Journal of Endocrinology
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