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Approach to a thyroid nodule

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https://www.readbyqxmd.com/read/28540810/minimally-invasive-local-ablative-therapies-in-combination-with-radioiodine-therapy-in-benign-thyroid-disease-preparation-feasibility-and-efficiency-preliminary-results
#1
Alexander Mader, Oscar Maximilian Mader, Daniel Gröner, Yücel Korkusuz, Shadi Ahmad, Frank Grünwald, W Tilman Kranert, Christian Happel
PURPOSE: Initial studies of combinations of radioiodine therapy (RIT) and local ablative procedures for the treatment of thyroid nodules have shown promising results. The goal of this study was to evaluate the effectiveness of RIT combined with radiofrequency ablation (RFA) in patients with goitres and to determine which ablative procedure is the most suitable for a combined therapy. METHODS: Thirty patients with goitres were divided into two subgroups. A test group of 15 patients received combined therapy (RIT + RFA) and a control group of 15 patients received RIT mono therapy...
May 5, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28537891/multiplex-pcr-approach-to-simultaneously-identify-several-mutations-in-fine-needle-cytology-thyroid-samples
#2
Emilia Vuttariello, Marco Borra, Elvira Mauriello, Celeste Calise, Barbara D'Andrea, Anna Capiluongo, Franco Fulciniti, Anna Cipolletta, Mario Monaco, Luciano Pezzullo, Gennaro Chiappetta
The most frequent initial manifestation of thyroid cancer is the appearance of a nodule. More than 20% of the general population has a palpable thyroid nodule and the percentage rises to 70% based on ultrasound identification. In 95% of cases the nodule is simply a hyperplastic or benign lesion. The most reliable diagnostic test for thyroid nodules is fine needle aspiration (FNA), but cytological discrimination between malignant and benign follicular neoplasms remains difficult. Cytological analysis is now, almost routinely, being combined with molecular genetics to enable the pathologist to make a more objective diagnosis...
May 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28523498/maldi-msi-analysis-of-cytological-smears-the-study-of-thyroid-cancer
#3
Niccolò Mosele, Andrew Smith, Manuel Galli, Fabio Pagni, Fulvio Magni
Fine needle aspiration (FNA) biopsies are the current gold-standard for the preoperative evaluation of thyroid nodules. However, a significant number of them (15-30%) are unable to be affirmatively diagnosed and are given an "indeterminate for malignancy" final report, meaning that the malignant nature of the thyroid nodule remains unknown and the recommended therapeutic approach is total thyroidectomy. Furthermore, cytomorphological evaluation of biopsies taken post-surgery indicates that approximately 80% of nodules within this group of patients are in fact benign, and the total thyroidectomy unwarranted...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28521616/a-10-gene-classifier-for-indeterminate-thyroid-nodules-development-and-multicenter-accuracy-study
#4
Hernan E Gonzalez, Jose R Martínez, Sergio Vargas, Antonieta Solar, Loreto Pamela Véliz, Francisco Cruz, Tatiana Arias, Soledad Loyola, Eleonora Horvath, Hernán Tala, Eufrosina Traipe, Manuel Meneses, Luis Marin, Nelson Wohllk, Rene Eduardo Diaz, Jesús Véliz, Pedro Pineda, Patricia Arroyo, Natalia Mena, Milagros Bracamonte, Giovanna Miranda, Elsa Bruce, Soledad Urra
BACKGROUND: In most of the world, diagnostic surgery remains as the most frequent approach for indeterminate thyroid cytology. Although several molecular tests are available for central-lab testing in the US, there are no available kits for local laboratory testing. The aim of this study was to develop a prototype in-vitro diagnostic (IVD) gene classifier for diagnosis of indeterminate thyroid cytology. METHODS: In a first stage, the expression of 18 genes was determined by qPCR in a broad histopathological spectrum of fresh tissue biopsies (114)...
May 18, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28506419/radioguided-thyroidectomy-for-follicular-tumors-multicentric-experience
#5
D Parmeggiani, C Gambardella, R Patrone, A Polistena, M De Falco, R Ruggiero, R Cirocchi, A Sanguinetti, V Cuccurullo, M Accardo, N Avenia, G Docimo, S Tolone, V Bassi, L Docimo, G Conzo
BACKGROUND: The diagnosis of thyroid nodular diseases requires an integrated approach that has been widely established over the past years. This strategy includes: ultrasonography (US) with; implemented Color-Power-Doppler, conventional scintigraphy also with positive indicators, specific pathological studies targeted by immunohistochemically-assays, and the fine needle; aspiration biopsy (FNAB), which, usually, in case of "Follicular Lesions" (10-20%) findings is; unable to distinguish carcinoma from follicular adenoma, then indicating the necessity of surgery to; obtain a correct diagnosis...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28506417/new-perspectives-in-the-diagnosis-of-thyroid-follicular-lesions
#6
REVIEW
Enke Baldini, Salvatore Sorrenti, Francesco Tartaglia, Antonio Catania, Andrea Palmieri, Daniele Pironi, Angelo Filippini, Salvatore Ulisse
Thyroid nodules are very common, affecting 19%-67% of the adult population. However, about 10% of them harbor a malignant lesion. Consequently, the first aim in their clinical evaluation is to exclude malignancy. Fine-needle aspiration cytology (FNAC) represents the main diagnostic tool for the evaluation of thyroid nodules. However, FNAC has a main diagnostic limit, namely cellular atypias of indeterminate significance, which require surgical excision and histological examination to differentiate benign from malignant lesions...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28497767/-evaluation-of-a-thyroid-nodule
#7
Geir Tryggvason, Birgir Briem
Thyroid nodules are common and their incidence has increased due to various factors. Systematic approach to the work-up of thyroid nodules is necessary to decrease overdiagnosis as well as over treatment. Applying the trifecta of history, physicial examination and high-resolution ultrasound (HRUS) as well as fine needle aspiration biopsy (FNAB) with added TSH measurement is important in the work-up. HRUS is a central part in the diagnostic approach, being able to risk classify nodules and selecting nodules for FNAB...
January 2017: Læknablađiđ
https://www.readbyqxmd.com/read/28493593/superior-parathyroid-gland-approach-to-the-recurrent-laryngeal-nerve
#8
Ezzeddin Elsheikh
BACKGROUND: The superior parathyroid gland is known to be almost constant in its location under the false thyroid capsule. Could it be a landmark to point to the site of incision of the false thyroid capsule and find the plane of the recurrent laryngeal nerve (RLN) during thyroidectomy? METHODS: The study included 48 patients with benign goiter scheduled for hemithyroidectomy or total thyroidectomy; there were 16 cases of solitary thyroid nodules, 27 cases of multinodular goiter, and 5 cases of toxic goiter...
May 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/28490006/adenoid-cystic-carcinoma-of-the-larynx-presenting-as-a-thyroid-mass-and-brief-literature-review
#9
Sadegh Shirian, Maryam Maghbool, Azita Aledavood, Shahrzad Negahban, Bijan Khademi, Yahya Daneshbod
BACKGROUND: Adenoid cystic carcinoma (ACC) of the larynx and trachea is very rare. CASE: A 45-year-old man with ACC of the larynx presenting as a thyroid mass is reported in this study. Physical examination revealed a large solid thyroid nodule in the left lobe without any lymphadenopathy. A technetium thyroid scan showed multinodular goiter with cold nodules in the left lobe, isthmus, and functioning nodules in the right lobe. A large thyroid mass originating from the left side of the larynx, mostly the left vocal cord and the infraglottic part, was seen using enhanced magnetic resonance imaging after rupture of the thyroid cartilage on the left side...
May 11, 2017: Acta Cytologica
https://www.readbyqxmd.com/read/28474427/robotic-thyroidectomy-and-parathyroidectomy-an-initial-experience-with-retroauricular-approach
#10
Mohammed Alshehri, Hossam Eldin Mohamed, Thomas Moulthrop, Emad Kandil
BACKGROUND: New approaches for robotic-assisted thyroidectomy were recently described. The purpose of this study was to present the report of our initial experience using a retroauricular approach for thyroid and parathyroid surgeries. METHODS: This is a prospective study that was conducted under institutional review board approval and all surgeries were performed by a single surgeon at a North American academic institution. Some patients underwent an additional concomitant neck lift surgery in addition to the thyroid surgery...
May 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/28459025/improving-bethesda-reporting-in-thyroid-cytology-a-team-effort-goes-a-long-way-and-still-miles-to-go%C3%A2
#11
Subramanian Kannan, Nalini Raju, Vikram Kekatpure, Naveen Hedne Chandrasekhar, Vijay Pillai, A Renuka Keshavamurthy, Moni Abraham Kuriakose, Pobbisetty Radhakrishnagupta Rekha, Nisheena Raghavan, Akhila Lakhsmikantha, Srinivas Ramaiah, Brijal Dave
CONTEXT: Fine-needle aspiration cytology is the first step in evaluation of thyroid nodules. Although the Bethesda classification for reporting thyroid cytology has been purported that this uniformity in reporting cytology thereby facilitating clinical decision-making, there are also studies indicating that the reporting percentage and the rates of malignancy in each category vary considerably from center to center making the clinical decision more difficult. AIM AND MATERIALS AND METHODS: We looked at our retrospective cytology and histopathology data of thyroid nodules operated between 2012 and 2014 and then prospectively collected data during 2015-2016...
March 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28448992/bethesda-made-it-clearer-a-review-of-542-patients-in-a-single-institution
#12
Yunus Acar, Lütfi Doğan, H Erhan Güven, Bülent Aksel, Niyazi Karaman, Cihangir Özaslan, M Ali Gülçelik
BACKGROUND: It is essential to interpret fine needle aspiration biopsy (FNAB) material correctly to create a common language among pathologists and surgeons, leading to a uniform approach to thyroid nodule management. We aimed to compare FNAB reports of patients at our institution who were treated with total thyroidectomy, before and after the Bethesda classification system. PATIENTS AND METHODS: Patients who underwent total thyroidectomy for thyroid nodules are reviewed...
2017: Oncology Research and Treatment
https://www.readbyqxmd.com/read/28432675/transoral-thyroidectomy-advantages-and-limitations
#13
G Dionigi, R P Tufano, J Russell, H Y Kim, E Piantanida, A Anuwong
In this opinion paper of the Journal of Endocrinological Investigation, leading experts in the field report on their current clinical experience with a novel approach for thyroid gland surgery, namely, "transoral thyroidectomy" (TOT). This feasible and novel surgical procedure does not require visible incisions and is, therefore, a truly scarless surgery. Patients meeting the following criteria can be considered as candidates for TOT: (a) an ultrasonographically (US) estimated thyroid diameter ≤10 cm; (b) US-estimated gland volume ≤45 mL; (c) nodule size ≤50 mm; (d) presence of a benign tumor such as a thyroid cyst or a single- or multi-nodular goiter; (e) Bethesda 3 and/or 4 category and (f) papillary microcarcinoma without the evidence of metastasis...
April 21, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#14
Lillie Morgan, Humberto Choi, Michal Reid, Ali Khawaja, Peter J Mazzone
RATIONALE: The USPSTF recommends lung cancer screening with low-dose chest CT scans (LDCT) for a well-defined high-risk population. Data on the frequency and impact of incidental findings on LDCT scans performed within a centralized lung cancer screening program has not been reported. OBJECTIVES: Previous studies have reported IFs in the setting of clinical trials. We present our findings in a real clinical setting where the decision to manage these findings may depend on factors that are not captured in a research trial such as disclosing IFs, patient preferences, severity of comorbidities, and physician expertise...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28405949/transoral-endoscopic-thyroidectomy-preliminary-experience-in-italy
#15
Gianlorenzo Dionigi, Alessandro Bacuzzi, Matteo Lavazza, Davide Inversini, Luigi Boni, Stefano Rausei, Hoon Yub Kim, Angkoon Anuwong
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a feasible novel surgical procedure that does not need visible incisions. We describe our initial experience with TOETVA. We recruited 15 patients who were willing to undergo TOETVA. Inclusion criteria were (a) patients who had a neck ultrasound (US) with a estimated thyroid diameter not larger than 10 cm; (b) US estimated gland volume ≤45 mL; (c) nodule size ≤50 mm; (d) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (e) follicular neoplasm; (f) papillary microcarcinoma without evidence of metastasis...
April 12, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28387647/management-of-childhood-thyroid-nodules-surgical-and-endocrinological-experience-in-more-than-one-hundred-cases
#16
Emre Divarcı, Ülgen Celtik, Zafer Dökümcü, Orkan Ergün, Geylani Özok, Samim Özen, Damla Gökşen Şimşek, Şükran Darcan, Nazan Çetingül, Aylin Oral, Yeşim Ertan, Bengü Demirağ, Ahmet Çelik
OBJECTIVE: The management of childhood thyroid nodules is still a big challenge for clinicians. In this study, we aimed to present our surgical and endocrinological experience in more than one hundred cases as a large experience in children. METHODS: Retrospective analysis of patients admitted with a thyroid nodule between 2006-2014 was performed. Detailed ultrasonography and fine needle aspiration biopsy(FNAB) were the corner stones of the diagnostic approach. RESULTS: One hundred-three children(72F,31M) with a mean age of 13...
April 7, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28371486/identification-of-parathyroid-tissue-in-thyroid-fine-needle-aspiration-a-combined-approach-using-cytology-immunohistochemical-and-molecular-methods
#17
Robert P Domingo, Lorna L Ogden, Laura C Been, Giulia C Kennedy, S Thomas Traweek
OBJECTIVES: Parathyroid (PT) lesions can be difficult to recognize in thyroid fine needle aspirations (FNAs), and when not identified correctly, PT cells may be mistaken for potentially abnormal thyroid cells. We therefore studied the utility of combining cytology, immunohistochemistry, and a molecular classifier to identify PT cells in thyroid FNAs. METHODS: Thyroid FNAs were received in CytoLyt, and were evaluated initially using The Bethesda System for Reporting Thyroid Cytology (TBSRTC)...
June 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28361927/molecular-profiling-of-thyroid-nodule-fine-needle-aspiration-cytology
#18
REVIEW
Markus Eszlinger, Lorraine Lau, Sana Ghaznavi, Christopher Symonds, Shamir P Chandarana, Moosa Khalil, Ralf Paschke
The differential diagnosis and malignancy risk stratification of thyroid nodules requires multidisciplinary expertise and knowledge of both local ultrasonography practices and the local malignancy rates for a given fine-needle aspiration (FNA) result. Even in such a multidisciplinary setting, FNA cytology has the inherent limitation that indeterminate cytology results cannot distinguish between follicular adenomas, follicular thyroid carcinomas or follicular variant papillary thyroid carcinomas. Accumulating evidence suggests that this limitation can be overcome by using molecular diagnostic approaches...
March 31, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28332158/first-clinical-use-of-the-echotrack-guidance-approach-for-radiofrequency-ablation-of-thyroid-gland-nodules
#19
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
#20
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
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