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Thyroid surgery

Sachin S Kumbhar, Ryan B O'Malley, Tracy J Robinson, Suresh Maximin, Neeraj Lalwani, David R Byrd, Carolyn L Wang
Optimal treatment of thyroid cancer is highly dependent on accurate staging of the extent of disease at presentation. Preoperative ultrasonography (US) is the most sensitive method for detecting metastatic lymph nodes and is recommended as part of the standard preoperative workup. Missed findings on preoperative scans may lead to understaging and inadequate surgical management, which subsequently predispose these patients to residual disease postoperatively and a higher risk for recurrence, possibly requiring repeat surgery...
October 21, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Alexandros Stamatopoulos, Davide Patrini, Efstratios Koletsis, Elaine Borg, Reena Khiroja, Martin Hayward, David Lawrence, Nikolaos Panagiotopoulos
IgG4-related disease (IgG4-RD) is a fibroinflammatory condition that can affect practically every organ. Although it was first identified in pancreas and salivary glands, major organs like liver, biliary tree, kidney, thyroid glands and lungs are commonly involved, sometimes resulting in organ failure. We describe a case of an 41-year-old man presented with back pain after a rotator cuff injury. A Computed Tomography (CT) revealed incidentally a right lower lobe paravertebral lesion extending across the T5 and T6 vertebral levels and invading into the adjacent pleural surface...
2016: Respiratory Medicine Case Reports
Terry C Lairmore
BACKGROUND: The last 200 years have seen remarkable achievements in the art and clinical practice of surgery. These advances include the introduction of antisepsis, anesthesia, vascular anastomosis, antimicrobials, organ transplantation, and the widespread application of minimally invasive operative procedures. Very recently, a surgical procedure has been shown to cure diabetes, representing the most effective treatment of a metabolic disorder by surgeons. METHODS: The author reviewed the major surgical milestones in the modern surgical era and prepared this monograph for presentation as the Claude H...
September 30, 2016: American Journal of Surgery
Seo Ki Kim, Inhye Park, Nayoon Hur, Jun Ho Lee, Jun-Ho Choe, Jung Han Kim, Jee Soo Kim
BACKGROUND: For the N1b papillary thyroid carcinoma (PTC) patients, modified radical neck dissection (MRND) encompassing levels II - V is generally recommended. However, routine level V dissection is controversial because of the low incidence of metastasis/recurrence in level V and the increased morbidities associated with level V dissection. METHODS: We retrospectively reviewed 646 N1b PTC patients who underwent unilateral MRND between January 1997 and June 2015...
October 20, 2016: Thyroid: Official Journal of the American Thyroid Association
Soo Yeon Hahn, Jung Hee Shin, Hyun Kyung Lim, So Lyung Jung, Young Lyun Oh, In Ho Choi, Chan Kwon Jung
BACKGROUND: A recent concept was proposed that the non-invasive encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) reclassified as "non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is benign. Our aim was to identify the differences between NIFTP and non-NIFTP preoperatively. METHODS: This retrospective study included a total of 208 patients with 208 FVPTCs that were surgically confirmed at 3 university hospitals from 2008 through 2014...
October 19, 2016: Clinical Endocrinology
Kazuhiko Yoshimatsu, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Masaya Satake, Yasufumi Yamada, Shunichi Shiozawa, Takeshi Shimakawa, Takao Katsube, Shungo Endo, Hiroyuki Kato, Yoshihiko Naritaka
A 57-year-old woman had been diagnosed with sigmoid colon cancer at surgery for ovarian cancer, and underwent simultaneous radical resection. Because of the pathological diagnosis of sigmoid cancer with ovarian metastasis, adjuvant chemotherapy was scheduled, with Leucovorin(LV)25 mg. This was immediately followed with 5-fluorouracil(5-FU)500 mg, via a 2-hour systemic intravenous infusion daily for 5 consecutive days, with courses repeated at 5 weeks, followed by maintenance once every 1 or 2 weeks for 2 years...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
X Chen, F X Dou, X B Cheng, A T Guo, H Y Shi
Objective: To study the clinicopathologic features of thyroid-like follicular renal cell carcinoma. Methods: Clinical data were collected in 5 cases of thyroid-like follicular renal cell carcinoma. HE staining and immunohistochemistry were carried out in surgically-removed specimen to analyze the clinical and pathological features with review of the literatures. Results: The patients aged 20-55 years, with one male and four females; the tumor occurred in the left kidney in three cases and right kidney in two cases...
October 8, 2016: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Tian-Run Liu, Zhi-Wen Xiao, Hai-Neng Xu, Zhen Long, Fan-Qin Wei, Shi-Min Zhuang, Xiao-Mei Sun, Liang-En Xie, Jia-Sheng Mu, An-Kui Yang, Guan-Ping Zhang, Yi Fan
INTRODUCTION: Although anaplastic thyroid carcinoma (ATC) is rare, it is one of the most aggressive human cancers. The optimal multimodal therapy policy of ATC is still debated, and a standardized treatment strategy remains to be established. This study aimed to evaluate the management aspect and prognosis of ATC. MATERIALS AND METHODS: The data were analyzed retrospectively for 50 patients with ATC to evaluate the clinical characters, management and factors influencing survival...
2016: PloS One
James C Lee, Paula Chang, Simon Grodski, Meei Yeung, William Johnson, Jonathan Serpell
BACKGROUND: The American Thyroid Association (ATA) management guidelines for thyroid cancer were revised in 2009. The aim of this study was to determine if management of thyroid cancer in our institution has changed in accordance with the introduction of the revised ATA guidelines (ATA(2009) ), and to compare the characteristics and management of thyroid cancer in a Melbourne endocrine surgery unit over a 7-year period. METHODS: All patients treated by the Monash University Endocrine Surgery Unit for thyroid cancer between 2007 and 2013 were divided into two groups - the pre-ATA(2009) group (2007-2010) and the post-ATA(2009) group (2011-2013)...
October 18, 2016: ANZ Journal of Surgery
Stephanie Rutledge, Michele Harrison, Martin O'Connell, Tadhg O'Dwyer, Maria M Byrne
BACKGROUND: We report the case of a giant intrathyroidal parathyroid adenoma weighing 59 g in a young woman presenting acutely with severe hypercalcemia requiring correction and adequate preoperative management prior to surgery. Parathyroid adenomas account for 85 % of cases of primary hyperparathyroidism. Those weighing more than 3.5g are classified as giant parathyroid adenomas. There are only 25 cases of parathyroid adenomas weighing over 30g reported in the literature. With the wide availability of biochemical screening tests in Western countries, mildly elevated calcium levels are often discovered incidentally...
October 19, 2016: Journal of Medical Case Reports
Alborz Jooya, Joe Saliba, Audrey Blackburn, Michael Tamilia, Michael P Hier, Alex Mlynarek, Véronique-Isabelle Forest, Louise Rochon, Anca Florea, Hangjun Wang, Richard J Payne
BACKGROUND: Management decisions are not straightforward when the Ultrasound Guided Fine Needle Aspiration (USFNA) demonstrates a Bethesda score of either category III or IV, and a diagnostic hemi-thyroidectomy or a repeat USFNA (r-USFNA) could be performed. The aim of this study is to assess the effectiveness of r-USFNA in the management of indeterminate thyroid nodules by evaluating the likelihood of obtaining a definite diagnosis. METHODS: We reviewed the medical records of all patients with thyroid nodules between 2011 and 2015 at the Jewish General Hospital (Montreal, Canada)...
October 18, 2016: Journal of Otolaryngology—Head & Neck Surgery
Verena Merki, Juliane Pichler, Roland Giger, Georgios Mantokoudis
BACKGROUND: Chylothorax is a very rare but major complication in thyroid surgery and should be apparent to clinicians in this field. CASE PRESENTATION: We report a case with chylothrax after thyroid surgery in our department that drew our attention. METHODS: Systematic review of the literature to evaluate the incidence and the contributing factors of chylothorax after thyroid surgery. Database (PubMed) and hand searches to identify patients with thyroid surgery and postoperative chylothorax...
October 18, 2016: Journal of Otolaryngology—Head & Neck Surgery
Ho-Sheng Lin, David J Terris
PURPOSE OF REVIEW: Recurrent laryngeal nerve (RLN) injury is one of the most common and serious complications associated with thyroid and parathyroid surgery. Although routine visual identification of the RLN is considered the current standard of care, the role of intraoperative neuromonitoring (IONM) of the RLN is more controversial. RECENT FINDINGS: Despite initial enthusiasm that IONM might substantially reduce the rate of RLN injury, most studies failed to show a significant difference in the rate of RLN injury when the use of IONM was compared with visualization of the RLN alone...
October 14, 2016: Current Opinion in Oncology
Clara Ugolini, Nicla Borrelli, Cristina Niccoli, Rossella Elisei, David Viola, Paolo Vitti, Paolo Miccoli, Fulvio Basolo
CONTEXT: Yes-associated protein-1 (YAP-1) is a player of the Hippo pathway and is involved in regulating cell proliferation. YAP-1 is overexpressed in papillary and anaplastic thyroid cancers. However, a correlation between YAP-1 expression and outcome in thyroid carcinoma has not been conclusively demonstrated. OBJECTIVE: This study was designed to clarify whether YAP-1 may be considered a marker of worse prognosis and outcome in thyroid cancer. DESIGN: A large series of cases of thyroid cancer with a long follow-up were investigated for YAP-1 expression...
October 7, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
Rijul S Kshirsagar, Zachariah Chandy, Hossein Mahboubi, Sunil P Verma
OBJECTIVES/HYPOTHESIS: To evaluate the impact of resident involvement during thyroid surgery on 30-day postoperative complications. STUDY DESIGN: Retrospective cohort study. METHODS: All patients who underwent thyroid surgery in 2011 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Patient demographics, perioperative details, resident involvement in surgery, and 30-day postoperative complications were extracted...
October 18, 2016: Laryngoscope
Brian H Lang, Tony Shek, Angel On-Kei Chan, C Y Lo, Koon Yat Wan
Background To balance the risk of disease progression, morbidity and efficacy of reoperative central neck dissection (RCND) in papillary thyroid carcinoma, the latest clinical guidelines recommend early surgery over surveillance when the largest diseased node is >8 mm in its smallest dimension. However, the evidence remains scarce. To determine an appropriate size for first-time RCND, we examined the relationship between size of largest diseased central node, morbidity and response-to-therapy following RCND...
October 17, 2016: Thyroid: Official Journal of the American Thyroid Association
Ke Jiang, Jianyong Lei, Wenjie Chen, Yanping Gong, Han Luo, Zhihui Li, Rixiang Gong, Jingqiang Zhu
The preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are known to be prognostic factors in several cancers. However, no previous investigation has been performed to evaluate the significance of the NLR and PLR in medullary thyroid carcinoma (MTC).The aim of this study was to identify the ability of the preoperative NLR or PLR to predict lymph node metastasis and recurrence in patients with MTC. Data from all patients with MTC who had undergone surgery at our institution from May 2009 to May 2016 were retrospectively evaluated...
October 2016: Medicine (Baltimore)
Kim To, Iain J Nixon
In recent decades, our understanding of thyroid cancer has improved significantly with the recognition that differentiated thyroid cancer (DTC) has good survival and oncological outcomes. Along with the recent rise in the detection of otherwise subclinical tumours due to improved diagnostics, there has been much debate on how aggressive one should be when performing thyroid and lymph node surgery. The use of risk stratification to categorize patients into low, intermediate and high risk has led to a more tailored approach to treating differentiated thyroid cancer...
June 2016: Indian Journal of Medical Research
H D Rashmi, H K Komala
BACKGROUND: The procedures in anesthesia such as laryngoscopy and endotracheal intubation are the most important skills to be mastered by an anesthesiologist. However, they produce marked cardiovascular responses such as hypertension and tachycardia. Various drugs have been used to suppress this response. One of those is a novel centrally acting α2 agonist - dexmedetomidine. It has numerous uses in anesthesia as it is having sedative, analgesic, hypnotic, and opioid sparing effects. It is also known to suppress the hemodynamic response to laryngoscopy and intubation...
September 2016: Anesthesia, Essays and Researches
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
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