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Approach to a thyroid nodule

Claudio Spinelli
Thyroid tumors affect all age groups, including children and adolescents. Malignant cancer of the thyroid is a relatively uncommon disease in pediatric age. In the recent decades the incidence of paediatric differentiated thyroid carcinoma (DTC) has increased. DTC in paediatric age is rare and has an excellent prognosis. Compared to adult counterpart, DTC in childhood presents some different features as follows: larger volume at the diagnosis, more frequent multicentricity (both mono- and bilateral), earlier local involvement of soft tissue of the neck, earlier lymph node involvement, distant metastases 3-4 times more frequent (most often in the lungs and almost always functional) and more common post-operatory recurrence; nevertheless, the prognosis of DTC in childhood is better and the survival greater than in adult...
October 13, 2016: Current Pediatric Reviews
Friedhelm Raue, Karin Frank-Raue
Thyroid cancer is the most common endocrine malignancy. Differentiated thyroid cancer (DTC) with the two subtypes, papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC), is the most frequent subtype of thyroid cancer; more rare subtypes are medullary thyroid cancer (MTC) and anaplastic thyroid cancer (ATC). The incidence of DTC has increased rapidly in recent years due to the more frequent use of imaging methods such as ultrasound of the neck and fine-needle aspiration (FNA) of thyroid nodules...
October 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
William S Duke, F Christopher Holsinger, Emad Kandil, Jeremy D Richmon, Michael C Singer, David J Terris
BACKGROUND: Robotic facelift thyroidectomy (RFT) was developed as a new surgical approach to the thyroid gland using a remote incision site. Early favorable results led to this confirmatory multi-institutional experience. METHODS: Prospectively collected data on consecutive patients undergoing RFT in five North American academic endocrine surgical practices were compiled. Surgical indications, operative times, final pathology, nodule size, complications, and postoperative management (drain use and length of hospital stay) were evaluated...
October 13, 2016: World Journal of Surgery
Claudio Bellevicine, Roberta Sgariglia, Umberto Malapelle, Elena Vigliar, Mariantonia Nacchio, Giuseppe Ciancia, Markus Eszlinger, Ralf Paschke, Giancarlo Troncone
BACKGROUND: Fine-needle aspiration (FNA) cytology is accurate and cost-effective in the evaluation of thyroid nodules. Molecular techniques may contribute to risk stratification in indeterminate cases. Although next-generation sequencing (NGS) is a promising technique for the molecular testing of thyroid FNA specimens, thyroid-specific cancer gene panels are not commercially available. Conversely, the Ion AmpliSeq Cancer Hotspot Panel v2 (CHPv2), which includes the genes most frequently mutated in thyroid neoplasms, is commercially available and may represent an alternative to thyroid-specific panels...
September 26, 2016: Cancer
Sui Yu, Xiaoling Liu, Yifei Zhang, Jing Li, Shulin Chen, Haitao Zheng, Ruizhen Reng, Chenglin Zhang, Jian Chen, Li Chen
It is important to develop an effective auxiliary approach to distinguish papillary thyroid carcinoma (PTC) from benign nodules because a considerable proportion cannot be identified by fine-needle aspiration cytology at present, resulting in unnecessary thyroidectomy. Circulating miRNAs are potential biomarkers for differential diagnosis of tumors. We aimed to investigate the dysregulation of circulating miRNAs in PTC and evaluate the diagnostic value for differentiation of PTC from benign nodules. We first assessed the expression of miRNAs in patients with PTC, patients with benign nodules and healthy controls using a miRCURY LNA Array (n = 3 for each group)...
October 1, 2016: Oncotarget
Nunzia Brusca, Camilla Virili, Miriam Cellini, Silvia Capriello, Lucilla Gargano, Rita Salvatori, Marco Centanni, Maria Giulia Santaguida
OBJECTIVE: Autonomously functioning thyroid areas may be associated with subclinical or overt hyperthyroidism, but may exist even in the presence of normal TSH. This study was aimed at comparing the rate of autonomously functioning areas and their cardiac sequelae in patients with nodular goitre studied with the usual and a novel approach. DESIGN AND METHODS: A total of 490 adult outpatients with thyroid nodular goitre, living in a mild iodine-deficient area, were selected in our Referral Center for thyroid diseases from 2009 to 2014 on the basis of a suspicion of thyroid functional autonomy...
September 19, 2016: European Journal of Endocrinology
Hannah Rachael Nieto, Kristien Boelaert
Differentiated thyroid cancer is the most common endocrine malignancy and the incidence is increasing rapidly worldwide. Appropriate diagnosis and post-treatment monitoring of patients with thyroid tumours is critical. Fine needle aspiration cytology remains the gold standard for diagnosing thyroid cancer and whilst there have been significant refinements to this technique, diagnostic surgery is often required for patients suspected to have malignancy. Serum thyroid stimulating hormone (TSH) is raised in patients with malignant thyroid nodules compared to those with benign disease, and TSH is proportionally higher in more aggressive tumours...
September 15, 2016: Endocrine-related Cancer
Pembegul Gunes, Sule Canberk, Mine Onenerk, Murat Erkan, Nilufer Gursan, Emine Kilinc, Gamze Zeynep Kilicoglu
OBJECTIVE: To determine the malignancy rate in the non-diagnostic (ND) category of the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) based on a different approach in relation to histopathology diagnoses. STUDY DESIGN: All ND fine needle aspirations (FNAs) that were performed under ultrasound guidance by an interventional radiologist with rapid on-site evaluation were included in the study. Slides were reevaluated to identify the cause of inadequacy as "qualitative" or "quantitative...
2016: PloS One
Bashar Matti, Ruben Cohen-Hallaleh
The last few years have witnessed numerous publications addressing the management of thyroid nodules and differentiated thyroid cancers. The purpose of this review is to provide a simplified summary of the newly released guidelines by the American Thyroid Association. A systematic approach has been recommended to evaluate a thyroid nodule through clinical assessment, measurement of serum Thyroid Stimulating Hormone, neck ultrasonography and Fine Needle Aspiration where appropriate. This is followed by cytology analysis using the Bethesda scoring system to detect malignancy...
September 9, 2016: New Zealand Medical Journal
Nassim Essabah Haraj, Hayat Ahandar, Siham El Aziz, Asma Chadli
The presence of hyperthyroidism is no longer an insurance against the occurrence of thyroid cancer. The combination of the two is common. This is a retrospective study of 355 files of patients followed for differentiated thyroid cancer in the endocrinology department at CHU IBN ROCHD from 1986 to 2014. 12 of those patients were followed for hyperthyroidism, and a fortuitous association with differentiated thyroid cancer was found during the anatomopathological exam, giving us a 3.38% prevalence. The average age of discovery is 44...
2016: Pan African Medical Journal
Patrick Hanley, Katherine Lord, Andrew J Bauer
Importance: Normal thyroid gland function is critical for early neurocognitive development, as well as for growth and development throughout childhood and adolescence. Thyroid disorders are common, and attention to physical examination findings, combined with selected laboratory and radiologic tools, aids in the early diagnosis and treatment. Objective: To provide a practical review of the presentation, evaluation, and treatment of thyroid disorders commonly encountered in a primary care practice...
October 1, 2016: JAMA Pediatrics
Ashish Verma, S K Bhartiya, S P Basu, V K Shukla, Ram C Shukla
BACKGROUND: Hemi-agenesis of thyroid is a rare congenital condition with the clinical significance lying only in cases where the remnant tissue is affected by a pathology mandating removal of the gland. Henceforth, the hemi-thyroidectomy technically becomes a total thyroidectomy with a need for long term thyroid replacement therapy. CASE SUMMARY: We present a series of three cases noted over a period of two years where preoperative imaging evaluation confirmed the developmental abnormality...
2016: International Journal of Surgery Case Reports
Flavia Magri, Spyridon Chytiris, Luca Chiovato
PURPOSE OF REVIEW: Elastography is a novel noninvasive diagnostic tool that is helpful in the evaluation of thyroid nodules. The purpose of this review is to provide a comprehensive summary of the use of elastography in the clinical thyroid setting. RECENT FINDINGS: Initial and subsequent studies show that elastography has both a sensitivity and specificity that approaches 100% for the determination of thyroid cancer within a thyroid nodule. In addition, the technique also has a very high negative predictive value and thus, may also be helpful in identification of thyroid nodules that do not need further diagnostic evaluation, including fine-needle aspiration biopsy...
October 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
Pinar Yazici, Banu Yilmaz, Emre Bozkurt, Mehmet Mihmanli, Mehmet Uludag
Background Oncocytic (Hürthle) cell in fine-needle aspiration biopsy (FNAB) remains challenging for surgeons. Surgical treatment is recommended for oncocytic change in FNAB, since it can sometimes be a struggle to determine the nature of thyroid nodules. We aimed to investigate the clinical significance of oncocytic changes in FNAB in terms of management of patients. Methods The FNAB samples of 172 patients with thyroid nodules were reviewed. Of these, 39 patients with cytologic findings of oncocytic changes on FNAB [POC: predominance of oncocytic cells; SFON-H: suspicious for follicular or oncocytic neoplasm (Hürthle cell type), SM-O: suspicious for malignancy-papillary or follicular carcinoma; oncocytic variant)] were included...
February 2016: Acta Chirurgica Belgica
Qiang Zhang, Guowei Lu, Dajian Li
Neurogenic tumors located in the posterior mediastinum, generally require surgery which be confronted with greater risk,therefore, to design the best surgical approach and surgical methods is essential. A 67-year-old female patient had pharyngeal foreign body sensation and dysphagia. Thyroid ultrasound showed the right thyroid had a little nodule, and the left thyroid had a hypoechoic lumps. Neck enhanced CT showd mediastinal mass, esophageal tumor origin or stromal tumor? We used the jugular approach to resect the tumor which eventually diagnosed as schwannoma...
February 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Jianlin Xu, Ding Zhang, Qian Niu, Yonggang Nan, Changbei Shi, Hua Zhao, Xiaoyan Liang
Current methods for diagnosing thyroid carcinoma are time consuming or expensive. Thus, alternative approaches are required. In the present study, microRNAs (miRNAs) with higher sensitivity and specificity were screened while distinguishing between differentiated thyroid carcinoma (DTC) and subtype papillary thyroid carcinoma (PTC). A total of 120 cases suspected of having thyroid carcinoma were selected and examined using clinical color Doppler ultrasound, and computed tomography scan at the same time. The tissue specimens were obtained with fine needle aspiration, multiphase biopsy and surgical resection...
July 2016: Oncology Letters
Venjamin Majstorov
BACKGROUND: Patients with thyroid nodules represent common problem in daily routine of thyroidologists as well as other medical specialties. Fortunately only small number of thyroid nodules turns out to be malignant. Ultrasound is most frequently used imaging modality in the evaluation of thyroid nodules and certain ultrasonographic features are associated with greater risk for malignancy. AIM: The aim of our study was to evaluate the diagnostic performance of various ultrasonographic findings regarding thyroid malignancy...
December 15, 2015: Open Access Macedonian Journal of Medical Sciences
Irfan Ahmeti, Lliljana Simonovska, Branka Krstevska, Nevena Ristevska
AIM: To estimate suspect nodule for benign or malignant characteristics, and to verify cytological features of the node with the fine needle aspiration (FNA) under ultrasound. DESIGN: A total of 106 patients were analyzed. FNA biopsy was performed at outpatient clinic via ultrasound. Inform consent was signed for each patient. Preparation of procedure with local anaesthesia was made by assistant nurse. PROCEDURE: Parallel approach of ultrasound guided fine needle aspiration (USGFNA) was used for each patient...
June 15, 2015: Open Access Macedonian Journal of Medical Sciences
John C Lam, Stephen R Robinson, Andrew Schell, Stephen Vaughan
BACKGROUND: Neurocysticercosis occurs when the eggs of the pork tapeworm (Taenia solium) migrate and hatch into larvae within the central nervous system. Neurocysticercosis is the most common cause of seizures in the developing world and is characterized on brain imaging by cysts in different stages of evolution. In Canada, cases of neurocysticercosis are rare and most of these patients acquire the disease outside of Canada. We report the case of a patient with multiple intracranial lesions whose history and diagnostic imaging were consistent with neurocysticercosis...
2016: Journal of Medical Case Reports
G Gill, K Kalyanasundaram, G Varughese, P Wilson, L Varadhan
We set out to investigate the concordance rates that were observed between fine needle aspiration cytology (FNA) compared with that of the post operative histology obtained for thyroid nodules over an 8 year period at a large university hospital.A retrospective analysis of 355 cases was conducted; patients operated for hyperthyroidism were excluded for the purposes of this study. We identified malignancy in a total of 101 cases (28%) The chance of malignancy with 2 Thy1 specimens was 5% in this study and 9% was observed in those with a Thy 2 FNA...
July 2016: Experimental and Clinical Endocrinology & Diabetes
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