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Approach to a thyroid nodule

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
February 7, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28064410/detecting-n-ras-q61r-mutated-thyroid-neoplasias-by-immunohistochemistry
#10
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...
January 7, 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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27900100/avoidance-of-unnecessary-fine-needle-aspiration-with-the-use-of-the-thyroid-imaging-reporting-data-system-classification-and-strain-elastography-based-on-the-bethesda-system-for-reporting-thyroid-cytopathology
#15
Murat Erkan, Sule Canberk, Gamze Z Kilicoglu, Mine Onenerk, Atay Uludokumaci, Pembegul Gunes, Tugba Atasoy
Thyroid fine-needle aspiration (FNA) biopsy has been widely accepted as an accurate and cost-effective tool in the management of thyroid nodules. To avoid unnecessary FNAs and provide appropriate management, patient evaluation should be based on a multidisciplinary approach. For this purpose, the Thyroid Imaging Reporting and Data System (TI-RADS) and strain elastography (SE) were proposed as tools for the risk assessment of malignancy in thyroid nodules. The aim of the present study was to analyze the utility of TI-RADS system and SE, along with FNA, and prospectively evaluate 369 consecutive patients referred for FNA of a thyroid nodule...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27883069/quality-of-life-and-cost-effectiveness-of-radiofrequency-ablation-versus-open-surgery-for-benign-thyroid-nodules-a-retrospective-cohort-study
#16
Wen-Wen Yue, Xiao-Long Li, Hui-Xiong Xu, Feng Lu, Li-Ping Sun, Le-Hang Guo, Ya-Ping He, Dan Wang, Zhi-Qiang Yin
This study is to compare the health-related quality of life (HRQoL) and cost-effectiveness of radiofrequency ablation (RFA) and open thyroidectomy (OT) for benign thyroid nodules (BTNs) treatment. HRQoL and utility were assessed for 404 BTN patients immediately before treatments (RFA:OT = 137:267) and at 6-month visit. A cost-effectiveness analysis was performed from societal perspective in the China context. Resource use (hospitalization, sick leaves) was collected. We used the net monetary benefit approach and computed cost-effectiveness acceptability curves for RFA and OT...
November 24, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27849384/assessing-referrals-and-improving-information-availability-for-consultations-in-an-academic-endocrinology-clinic
#17
Chase D Hendrickson, Saumya Saini, Avin Pothuloori, John N Mecchella
OBJECTIVE: Outpatient specialty consultations rely on the timeliness and completeness of referral information to facilitate a valuable patient-specialist interaction. This project aimed to increase essential diagnostic information availability at the initial consultation for patients referred for common endocrine conditions frequently lacking such data-diabetes mellitus, thyroid nodule, thyrotoxicosis, and hypercalcemia. METHODS: At an endocrinology clinic at an academic medical center in rural New England, providers see several thousand new patients annually, the majority of whom are referred by providers external to the clinic's healthcare system...
February 2017: Endocrine Practice
https://www.readbyqxmd.com/read/27832468/nodular-thyroid-disease-in-the-elderly-novel-molecular-approaches-for-the-diagnosis-of-malignancy
#18
REVIEW
Salvatore Sorrenti, Enke Baldini, Francesco Tartaglia, Antonio Catania, Stefano Arcieri, Daniele Pironi, Pier Giorgio Calò, Angelo Filippini, Salvatore Ulisse
Epithelial thyroid cancers (TC) comprise two differentiated histotypes (DTC), the papillary (PTC) and the follicular (FTC) thyroid carcinomas which, following dedifferentiation, are assumed to give rise to the poorly differentiated thyroid carcinomas and the rare, but highly aggressive and invariably fatal, anaplastic thyroid carcinomas. Although thyroid cancer mortality has not been changed, its annual incidence has increased over the last two decades, mainly because of the improved ability to diagnose malignant transformation in small non-palpable thyroid nodules...
November 10, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27793213/a-panel-of-four-genes-accurately-differentiates-benign-from-malignant-thyroid-nodules
#19
Qing-Xuan Wang, En-Dong Chen, Ye-Feng Cai, Quan Li, Yi-Xiang Jin, Wen-Xu Jin, Ying-Hao Wang, Zhou-Ci Zheng, Lu Xue, Ou-Chen Wang, Xiao-Hua Zhang
BACKGROUND: Clinicians are confronted with an increasing number of patients with thyroid nodules. Reliable preoperative diagnosis of thyroid nodules remains a challenge because of inconclusive cytological examination of fine-needle aspiration biopsies. Although molecular analysis of thyroid tissue has shown promise as a diagnostic tool in recent years, it has not been successfully applied in routine clinical use, particularly in Chinese patients. METHODS: Whole-transcriptome sequencing of 19 primary papillary thyroid cancer (PTC) samples and matched adjacent normal thyroid tissue (NT) samples were performed...
October 28, 2016: Journal of Experimental & Clinical Cancer Research: CR
https://www.readbyqxmd.com/read/27770838/thyroid-gland-metastasis-from-cancer-of-the-uterine-cervix-an-extremely-rare-case-report
#20
Suleyman Utku Celik, Dilara Besli, Serpil Dizbay Sak, Volkan Genc
The thyroid gland is a relatively uncommon site for a metastatic disease, although it is richly supplied with blood. The metastases may originate from various primary sites, mainly kidney, lung, head and neck, and breast. Thyroid metastasis from cervical carcinomas is extremely rare; and only a few cases have been previously reported in the literature. In patient with thyroid nodules and an oncological history, the possibility of thyroid metastasis should be seriously considered. Despite the rarity of the metastasis of cervical carcinoma to the thyroid, it is difficult to say appropriate treatment approach for these lesions...
2016: Acta Medica (Hradec Králové)
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