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Thyroid nodule management

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
Alfredo Campennì, Salvatore Giovinazzo, Salvatore Antonio Pignata, Francesca Di Mauro, Domenico Santoro, Lorenzo Curtò, Francesco Trimarchi, Rosaria Maddalena Ruggeri, Sergio Baldari
Parathyroid carcinoma is a rare malignancy, which usually occurs as a sporadic disease, and less frequently in the setting of genetic syndromes. Despite the association of parathyroid and thyroid disorders being quite common, the coexistence of parathyroid carcinoma and thyroid disease is rare. We reviewed the pertinent literature. The terms "parathyroid carcinoma" and "thyroid disease, hyperthyroidism, thyrotoxicosis, hypothyroidism, thyroid nodule(s), Graves' disease, autonomously functioning thyroid nodules" were used both separately and in reciprocal conjunction to search MEDLINE for articles published from January 2007 to March 2016...
October 15, 2016: Endocrine
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
Sophia S Yu, Lindsay A Bischoff
Owing to the young median age of diagnosis, thyroid cancer in women can coincide with pregnancy and affect its management. The evaluation of a thyroid nodule in pregnant women is similar to that in nonpregnant women, but special consideration must be taken for the impact of a cancer diagnosis and its sequelae in pregnancy. The initial comprehensive exam for pregnant and nonpregnant women includes evaluation of the biochemical function and structure of the thyroid gland, and then fine-needle aspiration biopsy of any suspicious nodule...
October 14, 2016: Seminars in Reproductive Medicine
Bryan R Haugen
Thyroid nodules are very common, and thyroid cancer is currently the fifth leading cancer diagnosis in women. The American Thyroid Association has led the development and revision of guidelines for the management of patients with thyroid nodules and differentiated thyroid cancer (DTC). The most current revision was published in the January 2016 issue of the journal Thyroid. The current guidelines have 101 recommendations, with 8 figures and 17 tables that are hopefully helpful to those treating patients with thyroid nodules and cancer...
October 14, 2016: Cancer
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
Tommaso Bizzarro, Maurizio Martini, Sara Capodimonti, Patrizia Straccia, Celestino Pio Lombardi, Alfredo Pontecorvi, Luigi Maria Larocca, Esther Diana Rossi
BACKGROUND: Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) represents a challenge for the diagnosis and management of thyroid carcinoma. Some authors have proposed histological criteria that are able to distinguish NIFTPs from invasive follicular variant of papillary thyroid carcinoma (I-FVPTC). Hence, NIFTPs may have repercussions in the diagnostic categories on fine-needle aspiration. In the current study, the authors evaluated the criteria for NIFTPs on liquid-based cytology samples...
October 2016: Cancer
Kwang Hwi Lee, Dong Wook Kim, Jin Wook Baek, Yoo Jin Lee, Hye Jung Choo, Young Jun Cho, Sun Joo Lee, Young Mi Park, Soo Jin Jung, Hye Jin Baek
BACKGROUND: To date, appropriate management for Bethesda IV thyroid nodules is controversial, and no specific features of follicular neoplasm and nodular hyperplasia on ultrasonography, computed tomography (CT), or other imaging modalities have been reported. This study aimed to compare CT features of follicular neoplasm and nodular hyperplasia and to determine the specific CT features that could be used to distinguish follicular neoplasm from nodular hyperplasia. METHODS: In 122 patients who underwent preoperative CT of the neck and thyroid surgery, 59 follicular neoplasms and 65 nodular hyperplasias were included...
October 3, 2016: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Travis M Cotton, Jing Xin, John Sandyhya, Roy Lirov, Barbara S Miller, Mark S Cohen, Paul G Gauger, David T Hughes
BACKGROUND: The utility of frozen section (FS) for indeterminate thyroid nodules is controversial. In 2009, the Bethesda System for Reporting Thyroid Cytopathology was established to further subcategorize indeterminate fine-needle aspiration results (follicular lesions, FL) into Bethesda category 3 (BC3) and Bethesda category 4 (BC4). We hypothesize that FS will have less utility in the evaluation of BC3 lesions when compared to BC4. MATERIALS AND METHODS: A total of 479 patients who underwent thyroid lobectomy from January 2008 to July 2014 were retrospectively reviewed...
October 2016: Journal of Surgical Research
Maria Papaleontiou, Megan R Haymart
No abstract text is available yet for this article.
September 15, 2016: Endocrine Practice
Martina Rossi, Sabrina Lupo, Roberta Rossi, Paola Franceschetti, Giorgio Trasforini, Stefania Bruni, Federico Tagliati, Mattia Buratto, Giovanni Lanza, Luca Damiani, Ettore Degli Uberti, Maria Chiara Zatelli
Indeterminate thyroid nodules include heterogeneous lesions that could benefit from a differential management. Our aim is to better define the management of the Bethesda System for Reporting Thyroid Cytopathology class III and IV nodules, by identifying cytological subcategories among Bethesda System for Reporting Thyroid Cytopathology class III associated with different clinical risk, by means of ultrasound, repeated FNAB, and BRAFV600E molecular analysis. We also evaluated the outcome of nodules not operated, over a 5-year follow-up...
September 13, 2016: Endocrine
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
Paolo Del Rio, Chiara Montana Montana, Giulia Mingardi, Giovanna Piva, Mario Sianesi, Luigi Corcione
BACKGROUND: The incidence of thyroid carcinoma goes from 0.5 to 10 cases on 100.000, depending on the country, the context and purpose of the study. The high incidence of differentiated thyroid tumor is continuously growing. While most malignant pathologies affect the adults, a proportion of 1-2 % of paediatric population is affected by solitary nodule, of which some are malignant cancers. Studying thyroid malignant cancer, the most sensitive and accurate imaging technique is the colorDoppler ultrasounds...
September 2, 2016: Minerva Endocrinologica
Faouzi Ben Slimène, Aida Mhiri, Moez Ben Ali, Hédia Slimène, Nouzha Ben Raies, Esma Karboua, Martin Schlumberger
The management of nodules and thyroid cancer is evolving. The aim is to individualize the treatment, decreasing aggression in the forms low risk and instead seeking new therapeutic options in advanced disease. This update shows the main recent advances in this field.
March 2016: La Tunisie Médicale
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
Saul Levy-Blitchtein, Stefany Plasencia-Rebata, Domingo Morales Luna, Juana Del Valle Mendoza
Papillary thyroid cancer (PTC) represents 80-85% of thyroid cancer and its prevalence has been rising in the last decades. Primary thyroid lymphoma (PTL) accounts for 3% of extranodal lymphomas and about 5% of thyroid malignancies, having a prevalence of one or two cases per million people. Mucosa-Associated Lymphoid Tissue lymphoma represents approximately 30% of PTL. Both entities have an indolent course and a very good prognosis. Diagnosis is made by ultrasound and fine needle aspiration (FNA) or surgery specimen pathology...
August 2016: Asian Pacific Journal of Tropical Medicine
Sarah J Sternlieb, Celine Satija, David T Pointer, Byron E Crawford, Lacey Sullivan, Emad Kandil
Struma ovarii is a rare type of ovarian teratoma comprised of at least 50% thyroid tissue. While most are benign, 70% of malignant cases are diagnosed as papillary carcinoma. Management of patients with thyroid nodules following gynecologic surgery remains controversial and variable. Historically, the treatment of choice has been surgical removal to rule out ovarian carcinoma. Thyroid follow-up and further treatment options are guided by tumor characteristics. The patient in this case presented to the endocrine surgeon with multiple thyroid nodules, dysphagia and a history of struma ovarii that was surgically treated at an outside hospital...
August 2016: Gland Surgery
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
T Danielle Samulski, Virginia A LiVolsi, Lawrence Q Wong, Zubair Baloch
BACKGROUND: The gene expression classifier (GEC; Afirma-Veracyte) has proven to be an effective triage modality in the management of thyroid nodules. We evaluate our institutional experience with GEC, specifically examining performance as a first line testing strategy versus in conjunction with repeat fine needle aspiration (FNA), usage trends based on clinical setting, and performance related to diagnostic categories of The Bethesda System for Reporting Thyroid Cytology (TBSRTC). METHODS: All nodules undergoing GEC analysis from 1/2011 to 12/2015 at the Hospital of the University of Pennsylvania were identified using electronic database search methods...
November 2016: Diagnostic Cytopathology
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