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Approach to a thyroid nodule

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https://www.readbyqxmd.com/read/28332158/first-clinical-use-of-the-echotrack-guidance-approach-for-radiofrequency-ablation-of-thyroid-gland-nodules
#1
Alfred Michael Franz, Alexander Seitel, Nasrin Bopp, Christian Erbelding, Dominique Cheray, Stefan Delorme, Frank Grünwald, Hüdayi Korkusuz, Lena Maier-Hein
PURPOSE: Percutaneous radiofrequency ablation (RFA) of thyroid nodules is an alternative to surgical resection that offers the benefits of minimal scars for the patient, lower complication rates, and shorter treatment times. Ultrasound (US) is the preferred modality for guiding these procedures. The needle is usually kept within the US scanning plane to ensure needle visibility. However, this restricts flexibility in both transducer and needle movement and renders the procedure difficult, especially for inexperienced users...
March 22, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28332058/bilateral-axillo-breast-approach-robotic-thyroidectomy-baba-rt-does-not-interfere-with-breast-image-follow-up
#2
Hyeong Won Yu, Young Jun Chai, Hyungju Kwon, Su-Jin Kim, June Young Choi, Kyu Eun Lee
BACKGROUND: Bilateral axillo-breast approach robotic thyroidectomy (BABA RT) is frequently performed and has excellent cosmetic results. However, there has been concern that subcutaneous tunneling in construction of the operation field might interfere with subsequent breast imaging. In this study, we evaluated whether BABA RT interferes with breast imaging by evaluating serial perioperative results of mammography and ultrasonography. METHODS: We selected female patients who underwent BABA RT between 2008 and 2012, and who also had mammography or ultrasonography pre- and postoperatively, and compared the results of pre- and postoperative imaging...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28331494/an-approach-to-macroscopic-central-lymph-nodes-detected-during-surgery-in-patients-with-thyroid-micropapillary-carcinoma-should-we-resort-to-dissection
#3
Osman Kurukahvecioglu, Kursat Dikmen, Hasan Bostanci, Murat Akin, Ferit Taneri
Background. High-resolution ultrasonography and the ability to perform fine-needle aspiration biopsy even for nodules smaller than three millimeters have considerably increased the detection rate of thyroid micropapillary carcinoma (TMPC). Despite favorable prognosis, the prevalence of cervical lymph node metastases in patients with TMPC is approximately 30%. Aim. In this study, we aimed to determine the central lymph node metastasis rate and its relation to the characteristics of the tumor. Methods. One hundred nine patients who underwent surgery due to TMPC between December 2009 and January 2014 were analyzed retrospectively...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28322617/clinicians-views-on-management-and-terminology-for-papillary-thyroid-microcarcinoma-a-qualitative-study
#4
Brooke Nickel, Juan P Brito, Alexandra Barratt, Susan Jordan, Ray Moynihan, Kirsten McCaffery
BACKGROUND: There is growing acceptance that the increase in thyroid cancer incidence is in part a result of overdiagnosis of small low-risk papillary microcarcinomas (PMCs) with indolent clinical course. Although surgery is the cornerstone treatment for patients with PMCs, recent management guidelines are shifting toward inclusion of more conservative treatments such as active surveillance. There is little evidence on clinicians' experience in managing PMC patients and their attitudes toward treatment options, including their willingness to accept a nonsurgical option...
March 21, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28266693/fine-needle-thyroid-aspiration-biopsy-clinical-experience-at-the-endocrinology-clinics-of-the-university-hospital-of-puerto-rico
#5
Milliette Alvarado-Santiago, Dalitza Alvarez-Valentin, Oscar Ruiz-Bermudez, Lorena Gonzalez-Sepulveda, Myriam Allende-Vigo, Eduardo Santiago-Rodriguez, Sona Rivas-Tumanyan
OBJECTIVE: This study aimed to establish a profile of the ultrasound-guided thyroid fine-needle aspiration biopsies (FNABs) performed at the endocrinology clinics of the University Hospital of Puerto Rico. METHODS: A retrospective study was conducted to assess all the thyroid FNABs performed from July 1, 2011, to December 31, 2013. Data on socio-demographic, FNAB cytology, surgery, and histopathology were collected from medical records. A chi-square test was used to assess associations between predictors and outcome...
March 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28266288/parathyroid-adenomas-in-adults-and-adolescents-critical-appraisal-and-surgical-strategy-in-18-cases
#6
Mihai Radu Diaconescu, Ioan Costea, Mihai Glod, Radu Terinte, Smaranda Diaconescu
Background: Our study underline scarcity of isolated case reports or small case series of parathyroid adenoma (PA) published in autochthonous medical literature,their variable clinical expression among the "historic" varieties but also the diagnostic difficulties and delays of diagnosis as well consecration of surgery as the golden therapeutic standard of this disorder. PATIENTS AND METHOD: Demographic, clinical presentations, laboratory and imaging data, operative findings and procedures together with pathology account and outcome from the case reports of 18 patients with documented PHP were retrospectively analyzed...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28222720/birt-hogg-dub%C3%A3-syndrome-a-literature-review-and-case-study-of-a-chinese-woman-presenting-a-novel-flcn-mutation
#7
Shengyu Hao, Fei Long, Fenglan Sun, Teng Liu, Daowei Li, Shujuan Jiang
BACKGROUND: The Birt-Hogg-Dubé (BHD) syndrome is a very rare autosomal dominant form of genodermatosis caused by germline mutations in the folliculin (FLCN) gene, which is mapped to the p11.2 region in chromosome 17. BHD commonly presents cutaneous fibrofolliculomas, pulmonary cysts, renal cell carcinoma, and recurrent pneumothoraxes. The disease is easily ignored or misdiagnosed as pneumothorax, pulmonary lymphangiomyomatosis (LAM), or emphysema. Follow-up and guidelines for managing recurrent pneumothoraxes in these patients are lacking...
February 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28217407/elastography-targeted-thyroid-nodule-aspiration-a-novel-approach
#8
Elliot Landau, Danielle Del Re, Bina Kviatkovsky, Aryeh Rothstein, Jonathan Scheiner, Cheryl Lin
OBJECTIVES: Since 2009, the rate of nondiagnostic (ND) thyroid nodule fine-needle aspiration (FNA) has ranged from 2% to 20%. A ND result can cause further patient morbidity secondary to repeated procedures and delay in diagnosis. The use of real-time strain elastography (RTE) in determining nodule malignant risk has gained considerable focus recently. A less studied area where RTE may prove beneficial is its role in targeting areas for FNA. Our hypothesis is that FNA performed in concurrence with RTE will show a decreased rate of ND results leading to fewer repeated FNA...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28192631/thyroid-cytology-nuclear-versus-architectural-atypia-within-the-atypia-of-undetermined-significance-follicular-lesion-of-undetermined-significance-bethesda-category-have-significantly-different-rates-of-malignancy
#9
Tiffany Rui Xuan Gan, Min En Nga, Jeffrey Huey Yew Lum, Wendy Meihua Wong, Wee Boon Tan, Rajeev Parameswaran, Kee Yuan Ngiam
BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology is the most widely used classification system for the reporting of thyroid fine-needle aspiration cytology (FNAC) specimens. However, the "atypical" category ("atypia of undetermined significance" [AUS] or "follicular lesion of undetermined significance" [FLUS]) continues to cause diagnostic and therapeutic dilemmas. The objectives of this study were to describe the differential malignancy rates of FNACs diagnosed as AUS/FLUS based on nuclear or architectural atypia and to assess the significance of demographic and ultrasonographic features in predicting malignancy in this category...
February 13, 2017: Cancer
https://www.readbyqxmd.com/read/28182829/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-from-a-to-z
#10
Gianlorenzo Dionigi, Matteo Lavazza, Alessandro Bacuzzi, Davide Inversini, Vincenzo Pappalardo, Ralph P Tufano, Hoon Yub Kim, Angkoon Anuwong
We depict the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Patient selection criteria are (1) ultrasonographically (US) estimated thyroid diameter no larger than 10cm, (2) US estimated gland volume ≥45mL, (3) nodule size ≥5mm, (4) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter, (5) follicular neoplasm, and (6) papillary microcarcinoma without evidence of metastasis. TOETVA is carried out through a three-port technique placed at the oral vestibule, one 10mm port for 30° endoscope and two additional 5mm ports for dissecting and coagulating instruments...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28149809/transoral-endoscopic-thyroidectomy-via-vestibular-approach-operative-steps-and-video
#11
Gianlorenzo Dionigi, Alessandro Bacuzzi, Matteo Lavazza, Davide Inversini, Vincenzo Pappalardo, Luigi Boni, Stefano Rausei, Marcin Barczynski, Ralph P Tufano, Hoon Yub Kim, Angkoon Anuwong
In this video we describe transoral endoscopic thyroidectomy vestibular approach (TOETVA). Inclusion criteria are (I) patients who had a ultrasonographically (US) estimated thyroid diameter not larger than 10 cm; (II) US estimated gland volume ≤45 mL; (III) nodule size ≤50 mm; (IV) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (V) follicular neoplasm; (VI) papillary microcarcinoma without evidence of metastasis. The procedure is carried out through three-port technique placed at the oral vestibule, one 10-mm port for 30° endoscope and two additional 5-mm ports for dissecting and coagulating instruments...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28144094/evaluation-of-thyroid-lesions-by-fine-needle-aspiration-cytology-based-on-bethesda-system-for-reporting-thyroid-cytopathology-classification-among-the-population-of-south-bihar
#12
Richa Bhartiya, Mahasweta Mallik, Nawanita Kumari, Brijendra Narayan Prasad
BACKGROUND: Fine-needle aspiration (FNA) of the thyroid gland has proven to be an important and widely accepted, cost-effective, simple, safe, and accurate method triaging patients with thyroid nodules. Awareness and understanding of wide spectrum thyroid disorders are of great value because most lesions are treatable by medical or surgical management. AIM: The aim of this study is to determine the accuracy of FNA cytology (FNAC) in the diagnosis of thyroid lesion using the Bethesda system for reporting thyroid cytopathology nomenclature (BSRTC) and to correlate these with histopathological findings...
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28125944/applying-criteria-of-active-surveillance-to-low-risk-thyroid-papillary-cancer-over-a-decade-how-many-surgeries-and-complications-can-be-avoided
#13
Andrew Griffin, Juan P Brito, Manisha Bahl, Jenny K Hoang
BACKGROUND: The 2015 American Thyroid Association guidelines acknowledged that "an active surveillance management approach can be considered as an alternative to immediate surgery" in patients with low risk papillary thyroid carcinoma (PTC). The aim of this study is to determine the proportion of PTC that would meet criteria for active surveillance and the surgeries and complications that could have been avoided. METHODS: We retrospectively reviewed 681 patients with thyroid cancer who underwent thyroid surgery from 2003 to 2012...
January 26, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28114855/niftp-accounts-for-over-half-of-carcinomas-harboring-ras-mutations
#14
Vera A Paulson, Priyanka Shivdasani, Trevor E Angell, Erik K Alexander, Edmund Cibas, Jeffrey F Krane, Neal I Lindeman, Justine Barletta
BACKGROUND: Molecular testing of thyroid nodules is increasingly being utilized to guide clinical management decisions. RAS mutations are the most frequent mutations detected in the context of an indeterminate fine needle aspiration (FNA) diagnosis. The term noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently introduced to promote conservative management of tumors previously classified as noninvasive follicular variant of papillary thyroid carcinoma (FVPTC)...
January 23, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28071986/evaluation-of-a-two-year-routine-application-of-molecular-testing-of-thyroid-fine-needle-aspirations-using-a-seven-gene-panel-in-a-primary-referral-setting-in-germany
#15
Markus Eszlinger, Katharina Böhme, Maha Ullmann, Fabian Görke, Udo Siebolts, Anna Neumann, Christiane Franzius, Sabine Adam, Thomas Molwitz, Christian Landvogt, Bassam Amro, Anja Hach, Berit Feldmann, Dieter Graf, Antje Wefer, Rainer Niemann, Catharina Bullmann, Günther Klaushenke, Reinhard Santen, Gregor Tönshoff, Velimir Ivancevic, Andreas Kögler, Erhard Bell, Bernd Lorenz, Gerald Kluge, Christoph Hartenstein, Ilka Ruschenburg, Ralf Paschke
BACKGROUND: Major differences with respect to the diagnostic performance of a "ruling in" approach in the presurgical diagnosis of indeterminate thyroid fine-needle aspirations (FNAs) have been reported. Therefore, the aim of this prospective multicenter study was to investigate the specific diagnostic impact of mutation testing using a seven-gene panel in a routine primary referral setting analyzing FNAs from endocrinology and nuclear medicine practices in Germany. METHODS: RNA and DNA was extracted from 564 routine air-dried FNA smears obtained from 64 physicians and cytologically graded by one experienced cytopathologist...
March 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28064410/detecting-n-ras-q61r-mutated-thyroid-neoplasias-by-immunohistochemistry
#16
A Crescenzi, F Fulciniti, M Bongiovanni, L Giovanella, Pierpaolo Trimboli
Recently, the immunohistochemistry (IHC) for N-RAS Q61R has been developed and commercialized for clinical practice. Here, we investigated the reliability of IHC to identify N-RAS Q61R mutated thyroid neoplasia. A series of 24 consecutive thyroid lesions undergone surgery following indeterminate cytology were enrolled. Paraffin sections were stained for IHC using the rabbit monoclonal anti-human N-RAS Q61R, clone SP174. N-RAS mutations in codon 61 were also investigated by automated sequencing. At histology, 12 cases of follicular carcinoma, cytologically defined as follicular lesions, 1 papillary cancer, 7 follicular adenomas, and 4 hyperplastic nodules were found...
March 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28028762/screening-for-thyroid-cancer-in-survivors-of-childhood-and-young-adult-cancer-treated-with-neck-radiation
#17
Emily S Tonorezos, Dana Barnea, Chaya S Moskowitz, Joanne F Chou, Charles A Sklar, Elena B Elkin, Richard J Wong, Duan Li, R Michael Tuttle, Deborah Korenstein, Suzanne L Wolden, Kevin C Oeffinger
BACKGROUND: The optimal method of screening for thyroid cancer in survivors of childhood and young adult cancer exposed to neck radiation remains controversial. Outcome data for a physical exam-based screening approach are lacking. METHODS: We conducted a retrospective review of adult survivors of childhood and young adult cancer with a history of neck radiation followed in the Adult Long-Term Follow-Up Clinic at Memorial Sloan Kettering between November 2005 and August 2014...
December 27, 2016: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/27965276/thyroid-nodules-and-cancer-management-guidelines-comparisons-and-controversies
#18
REVIEW
Fadi Nabhan, Matthew D Ringel
Thyroid cancer is an increasingly prevalent malignancy throughout the world. Management guidelines for both thyroid nodules and thyroid cancer have been published and updated by a number of societies internationally. All of these guidelines recognize this increasing incidence, particularly of small papillary thyroid cancers, due in part to improved technology enabling early or even 'over' diagnosis. Recent advances in molecular imaging and molecular methods have been developed to better characterize thyroid nodules, and a number of studies that have clarified risk stratification systems that can be modified over time allow for individualization of diagnosis, initial treatment, and subsequent follow-up strategies...
February 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/27928729/the-total-number-of-tissue-blocks-per-centimetre-of-tumor-significantly-correlated-with-the-risk-of-distant-metastasis-in-patients-with-minimally-invasive-follicular-thyroid-carcinoma
#19
Brian Hung-Hin Lang, Tony W H Shek, Arnold L H Wu, Koon Yat Wan
BACKGROUND: Given that careful histological examination plays a pivotal role in follicular thyroid carcinoma categorization, we hypothesize that the number of blocks taken at initial specimen review may be associated with survival outcomes of patients initially diagnosed with minimally invasive follicular thyroid carcinoma. METHODS: A total of 162 patients with confirmed minimally invasive follicular thyroid carcinoma were analyzed. The number of tissue blocks taken from each patient was recorded and the number of blocks per each centimeter of tumor was calculated...
February 2017: Endocrine
https://www.readbyqxmd.com/read/27908169/flexible-mini-gamma-camera-reconstructions-of-extended-sources-using-step-and-shoot-and-list-mode
#20
José Gardiazabal, Philipp Matthies, Jakob Vogel, Benjamin Frisch, Nassir Navab, Sibylle Ziegler, Tobias Lasser
PURPOSE: Hand- and robot-guided mini gamma cameras have been introduced for the acquisition of single-photon emission computed tomography (SPECT) images. Less cumbersome than whole-body scanners, they allow for a fast acquisition of the radioactivity distribution, for example, to differentiate cancerous from hormonally hyperactive lesions inside the thyroid. This work compares acquisition protocols and reconstruction algorithms in an attempt to identify the most suitable approach for fast acquisition and efficient image reconstruction, suitable for localization of extended sources, such as lesions inside the thyroid...
December 2016: Medical Physics
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