Read by QxMD icon Read

Approach to a thyroid nodule

Ronit Koren, Yifat Wiener, Karen Or, Carlos A Benbassat, Shlomit Koren
OBJECTIVES: To study the current practices in the management of subclinical hypothyroidism (SCH) and thyroid nodules during pregnancy of obstetricians/gynecologists (OB/GYNs) and endocrinologists in Israel. METHODS: An electronic questionnaire was sent by email to all members of the Israeli Endocrine Society and the Israel Society of Obstetrics and Gynecology. Questionnaires included demographic data and clinical scenarios with questions regarding the screening and management of pregnant women with SCH, hypothyroxinemia, and a palpable thyroid nodule...
March 2018: Israel Medical Association Journal: IMAJ
Mijin Kim, Minkyu Han, Jeong Hyun Lee, Dong Eun Song, Kyunggon Kim, Jung Hwan Baek, Young Kee Shong, Won Gu Kim
OBJECTIVE: Distinguishing malignancy from benign thyroid nodule has always been challenging, especially in follicular lesions. Thyroid nodules with small size and indeterminate cytology do not lead to immediate surgery. We tried to evaluate whether tumor size and tumor growth rate can distinguish follicular thyroid carcinoma (FTC) from follicular adenoma (FA). DESIGN AND PATIENTS: This retrospective study included patients with pathologically proven FTCs (n=50) and FAs (n=110) who underwent preoperative serial neck ultrasonography (US) at least 3 times: it comprises 30% of all follicular tumors (32% FAs and 25% FTCs)...
March 6, 2018: Clinical Endocrinology
Cosimo Durante, Giorgio Grani, Livia Lamartina, Sebastiano Filetti, Susan J Mandel, David S Cooper
Importance: Thyroid nodules are common, being detected in up to 65% of the general population. This is likely due to the increased use of diagnostic imaging for purposes unrelated to the thyroid. Most thyroid nodules are benign, clinically insignificant, and safely managed with a surveillance program. The main goal of initial and long-term follow-up is identification of the small subgroup of nodules that harbor a clinically significant cancer (≈10%), cause compressive symptoms (≈5%), or progress to functional disease (≈5%)...
March 6, 2018: JAMA: the Journal of the American Medical Association
Andrey Bychkov, Chan Kwon Jung, Zhiyan Liu, Kennichi Kakudo
The introduction of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was initiated and promoted by pathologists. Recent Asian studies added new knowledge to the existing literature to aid a better understanding of NIFTP. Our original data and the results of a meta-analysis suggest that the initial rate of NIFTP has been overestimated, averaging 9.1% (95% confidence interval [CI] 6.0-12.7%) of all papillary thyroid cancers worldwide. The incidence of NIFTP in the Asian population (1...
February 23, 2018: Endocrine Pathology
Isabel Amendoeira, Tiago Maia, M Sobrinho-Simões
The 2017 edition of the WHO book on Classification of Tumours of Endocrine Organs includes a new section entitled "Other encapsulated follicular-patterned thyroid tumours", in which the newly created NIFTP (Non-invasive follicular thyroid neoplasm with papillary-like nuclear features) is identified and detailed described. Despite deleting the word "carcinoma" from its name, NIFTP is not a benign tumor either, and is best regarded as a neoplasm with "very low malignant potential"...
February 9, 2018: Endocrine-related Cancer
Dumitru A Iacobas, Neha Y Tuli, Sanda Iacobas, John K Rasamny, Augustine Moscatello, Jan Geliebter, Raj K Tiwari
We hypothesize that distinct cell phenotypes are governed by different sets of gene master regulators (GMRs) whose strongly protected (by the homeostatic mechanisms) abundance modulates most cell processes by coordinating the expression of numerous genes from the corresponding functional pathways. Gene Commanding Height (GCH), a composite measure of gene expression control and coordination, is introduced to establish the gene hierarchy in each phenotype. If the hypothesis is true, than one can selectively destroy cancer nodules from a heterogeneous tissue by altering the expression of genes whose GCHs are high in cancer but low in normal cell phenotype...
January 5, 2018: Oncotarget
Martina Sollini, Luca Cozzi, Arturo Chiti, Margarita Kirienko
In thyroid imaging, "texture" refers to the echographic appearence of the parenchyma or a nodule. However, definition of the image characteristics is operator dependent and influenced by the operator's experience. In a more objective texture analysis, a variety of mathematical methods are used to describe image inhomogeneity, allowing assessment of an image by means of quantitative parameters. Moreover, this approach may be used to develop an efficient computer-aided diagnosis (CAD) system to yield a second opinion when differentiating malignant and benign thyroid lesions...
February 2018: European Journal of Radiology
Fabio Medas, Ernico Erdas, Gian Luigi Canu, Alessandro Longheu, Giuseppe Pisano, Massimiliano Tuveri, Pietro Giorgio Calò
BACKGROUND: Hyperthyroidism is associated with high incidence of thyroid carcinoma; furthermore, tumors arisen in hyperthyroid tissue show an aggressive behavior. Thyroid Stimulating Hormone (TSH) and Thyroid-stimulating antibodies, present in Graves's disease, seem to play a key role in carcinogenesis and tumoral growth. METHODS: We retrospectively reviewed our series of patients who underwent thyroidectomy for thyroid carcinoma. We compared pathological features and surgical outcomes of hyperthyroid versus euthyroid patients...
January 22, 2018: Journal of Otolaryngology—Head & Neck Surgery
So Lyung Jung, Jung Hwan Baek, Jeong Hyun Lee, Young Kee Shong, Jin Yong Sung, Kyu Sun Kim, Ducky Lee, Ji-Hoon Kim, Seon Mi Baek, Jung Suk Sim, Dong Gyu Na
Objective: To assess the efficacy and safety of thyroid radiofrequency (RF) ablation for benign thyroid nodules by trained radiologists according to a unified protocol in a multi-center study. Materials and Methods: From 2010 to 2011, 345 nodules from 345 patients (M:F = 43:302; mean age ± SD = 46.0 ± 12.7 years, range = 15-79) who met eligibility criteria were enrolled from five institutions. At pre-ablation, the mean volume was 14.2 ± 13.2 mL (1.1-80.8 mL)...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Michiya Nishino, Marina Nikiforova
CONTEXT: - Approximately 15% to 30% of thyroid nodules that undergo fine-needle aspiration are classified as cytologically indeterminate, presenting management challenges for patients and clinicians alike. During the past several years, several molecular tests have been developed to reduce the diagnostic uncertainty of indeterminate thyroid fine-needle aspirations. OBJECTIVE: - To review the methodology, clinical validation, and recent peer-reviewed literature for 4 molecular tests that are currently marketed for cytologically indeterminate thyroid fine-needle aspiration specimens: Afirma, ThyroSeq, ThyGenX/ThyraMIR, and RosettaGX Reveal...
January 16, 2018: Archives of Pathology & Laboratory Medicine
Norihiko Ishikawa, Yumiko Ohtake, Go Watanabe
A 66-year-old woman was referred to our institute for an enlarging tumor of the thyroid, and neck and chest computed tomography scan showed not only a thyroid tumor, but also an anterior mediastinal tumor and ground-glass nodules in the lung. Because of persisting symptoms, an enlarging thyroid mass, and the possibility of cancer, excision of the tumors was proposed. A 6-cm-long vertical skin incision was made in the right axilla, a mini-thoracotomy was made in the third intercostal space, and an additional port was placed in the fifth intercostal space...
January 6, 2018: Journal of Robotic Surgery
Elizabeth J de Koster, Lioe-Fee de Geus-Oei, Olaf M Dekkers, Ilse van Engen-van Grunsven, Jaap Hamming, Eleonora P M Corssmit, Hans Morreau, Abbey Schepers, Jan Smit, Wim J G Oyen, Dennis Vriens
Indeterminate thyroid cytology (Bethesda III and IV) corresponds to follicular-patterned benign and malignant lesions, which are particularly difficult to differentiate on cytology alone. As approximately 25% of these nodules harbor malignancy, diagnostic hemithyroidectomy is still custom. However, advanced preoperative diagnostics are rapidly evolving.This review provides an overview of additional molecular and imaging diagnostics for indeterminate thyroid nodules in a pre-operative clinical setting, including considerations regarding cost-effectiveness, availability, and feasibility of combining techniques...
January 2, 2018: Endocrine Reviews
S Bakkar, M Al Hyari, M Naghawi, C Corsini, P Miccoli
PURPOSE: To report the clinical implications of an initial experience with transoral endoscopic thyroidectomy vestibular approach (TOETVA). METHODS: From March to November 2017, five cases of TOETVA were performed. Data reported include patient demographics, indication for surgery, extent of surgery, operative time, the need to convert to cervicotomy, the length of hospital stay and post-operative pain and morbidity. Unconventional complications regarded as specific for TOETVA were reported...
December 14, 2017: Journal of Endocrinological Investigation
Huan Xu, Chunrui Liu, Ping Yang, Juan Tu, Bin Yang, Dong Zhang
In order to reassure the majority of patients with benign nodules from unnecessary needle biopsy, there is an increasing clinical requirement to identify benign and malignant thyroid nodules during ultrasound diagnosis. A nonlinear approach based on statistical analysis of ultrasound radio-frequency (RF) signals was developed for differential diagnosing the thyroid nodules to improve the diagnostic accuracy. Data from 44 patients with solitary thyroid nodules were collected, following with the ultrasound-guided fine needle aspiration (FNA) as the ground truth...
December 5, 2017: Scientific Reports
Yousef Abdel-Aziz, Tariq Hammad, Mohamad Nawras, Hayder Abdulwahid, Ali Nawras
Medical literature about the role of endoscopic ultrasound (EUS) in identifying thyroid lesions is limited. We present a case of secondary thyroid cancer from renal cell carcinoma (RCC) metastasis, diagnosed by thyroid EUS-fine needle aspiration (FNA) approach that was done for staging of esophageal adenocarcinoma, in a patient with 11-year history of complete right nephrectomy for RCC. An 81-year-old female patient underwent EUS for the evaluation of a newly discovered distal esophageal cancer. A hypoechoic, round, and well-demarcated mass that measured 26...
2017: Case Reports in Gastrointestinal Medicine
Sepideh Siadati, Seyed Mozafar Rabiee, Ebrahim Alijanpour, Mohammad Ali Bayani, Novin Nikbakhsh
Background: Fine needle aspiration (FNA) is the most important method in the diagnosis of thyroid nodules before surgery. Recently, the efficiency of FNA in thyroid nodule management has been debatable. On the other hand, intraoperative frozen section (FS) has been used to confirm the diagnosis of FNA and select the proper surgical approach. In this regard, the present study aimed to assess the diagnostic value of FNA as compared to FS in the diagnosis of thyroid nodules. Methods: This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran...
2017: Caspian Journal of Internal Medicine
Naomi Rabinovics, Gideon Bachar, Tom Raz-Yarkoni, Raphael Feinmesser
AIMS: To review the experience of a single-center with RATS and to assess its outcome, feasibility and safety. BACKGROUND: With the advent of minimally invasive techniquesin thyroid surgery, robot-assisted transaxillary thyroid surgery (RATS) has become one of the most popular approaches. Its main advantages are improved cosmetic outcome, thereby increasing patient satisfaction, improved visualization and range of motion. Several large-scale studies, have demonstrated its safety and feasibility...
November 2017: Harefuah
S J Song, V A LiVolsi, K Montone, Z Baloch
OBJECTIVE: To investigate the corresponding cytological diagnoses, Gene Expression Classifier (GEC) results and ultrasound features of thyroid nodules diagnosed as non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), as well as any coexisting pathology. METHODS: We performed a retrospective review of thyroid nodules histologically diagnosed as NIFTP at our institution between 1st April 2016 and 1st April 2017. The following data points were collected: demographics, nodule size, ultrasound features, cytological diagnosis, GEC results, origin of sample (in-house vs outside hospital) and any additional pathology identified in the resection specimen...
December 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
Lenara Golbert, Ana Patrícia de Cristo, Carlo Sasso Faccin, Mauricio Farenzena, Heloísa Folgierini, Marcia Silveira Graudenz, Ana Luiza Maia
BACKGROUND: The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear. OBJECTIVE: To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules. METHODS: Patients with thyroid nodule(s) who underwent fine-needle aspiration biopsy under ultrasonographic guidance in a tertiary, university-based hospital were consecutively evaluated. Patients with known thyroid cancer and/or patients receiving thyroid medication were excluded...
2017: PloS One
Sogol Mostoufi-Moab, Emmanuel Labourier, Lisa Sullivan, Virginia LiVolsi, Yimei Li, Rui Xiao, Sylvie Beaudenon-Huibregtse, Ken Kazahaya, N Scott Adzick, Zubair Baloch, Andrew J Bauer
BACKGROUND: Thyroid nodules are less common in pediatric patients (i.e., those ≤18 years) than they are in adults. The Bethesda System for Reporting Thyroid Cytopathology allows for individual risk stratification, but a significant number of nodules are indeterminate. Incorporating gene mutation panels and gene expression classifiers may aid in preoperative diagnosis. The overall aim of this study was to assess the prevalence of oncogene alterations in a representative pediatric population and across a broad-spectrum of thyroid tumor diagnoses...
January 2018: Thyroid: Official Journal of the American Thyroid Association
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"