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management of thyroid nodules

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https://www.readbyqxmd.com/read/29665745/heterogeneity-in-ppv-of-ras-mutations-in-cytologically-indeterminate-thyroid-nodules
#1
Fadi Nabhan, Kyle Porter, Mark Lupo, Gregory W Randolph, Kepal Narendra Patel, Richard T Kloos
BACKGROUND: RAS mutations are common in the available mutational analysis of cytologically indeterminate (Cyto-I) thyroid nodules. However, their reported positive predictive value (PPV) for cancer is widely variable. The reason for this variability is unknown and it causes clinical management uncertainty. We performed a systematic review evaluating the PPV for cancer in RAS mutation positive Cyto-I nodules and considered variables that might affect residual heterogeneity across the different studies...
April 18, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29649016/thyroid-cancer-management-from-a-suspicious-nodule-to-targeted-therapy
#2
Francesco Perri, Antonio Giordano, Salvatore Pisconti, Franco Ionna, Maria G Chiofalo, Francesco Longo, Davide Leopardo, Giuseppina Della Vittoria Scarpati, Luciano Pezzullo
Thyroid nodules are very common, and their frequency is four to five times higher in women than in men. Most of them are benign, with only a very little percentage revealing a malignant neoplasm. About 50% of thyroid nodules are detected by self-palpation of neck, whereas the other 50% are diagnosed by neck ultrasonography and following fine-needle aspiration. Management of thyroid nodules is very difficult, because benign nodules are prevalent, whereas thyroid carcinoma is uncommon, representing only 1% of all malignancies...
April 11, 2018: Anti-cancer Drugs
https://www.readbyqxmd.com/read/29626008/differences-between-ata-aace-ace-ame-and-acr-ti-rads-ultrasound-classifications-performance-in-identifying-cytological-high-risk-thyroid-nodules
#3
Angelo Lauria, Ernesto Maddaloni, Silvia Irina Briganti, Giuseppina Beretta Anguissola, Eleonora Perrella, Chiara Taffon, Andrea Palermo, Paolo Pozzilli, Silvia Manfrini, Anna Crescenzi
OBJECTIVE: Thyroid ultrasound is crucial for clinical decision in the management of thyroid nodules. In this study we aimed to estimate and compare the performance of ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications in discriminating nodules with high-risk cytology. DESIGN: Cross sectional study Methods 1077 thyroid nodules undergoing fine needle aspiration were classified according to ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications by an automated algorithm...
April 6, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29624786/impact-of-oncogene-panel-results-on-surgical-management-of-cytologically-indeterminate-thyroid-nodules
#4
Pablo Valderrabano, Laila Khazai, Zachary J Thompson, Marino E Leon, Kristen J Otto, Julie E Hallanger-Johnson, J Trad Wadsworth, Christine H Chung, Barbara A Centeno, Bryan McIver
BACKGROUND: The impact of oncogene panel results on the surgical management of indeterminate thyroid nodules (ITNs) is currently unknown. METHODS: Surgical management of 649 patients consecutively evaluated from October 2008 to April 2016 with a single nodule biopsied and indeterminate cytology (193 evaluated with and 456 without oncogene panels) was assessed and compared. Histological features of 629 consecutively resected ITNs (164 evaluated with and 465 without oncogene panels) were also characterized and compared...
April 6, 2018: Head & Neck
https://www.readbyqxmd.com/read/29608439/quantitative-analysis-of-the-benefits-and-risk-of-thyroid-nodule-evaluation-in-patients-%C3%A2-70-years-old
#5
Zhihong Wang, Chirag M Vyas, Olivia Van Benschoten, Matt A Nehs, Francis D Moore, Ellen Marqusee, Jeffrey F Krane, Matthew I Kim, Howard T Heller, Atul A Gawande, Mary C Frates, Peter M Doubilet, Gerard M Doherty, Nancy L Cho, Edmund S Cibas, Carol B Benson, Justine A Barletta, Ann Marie Zavacki, P Reed Larsen, Erik K Alexander, Trevor E Angell
BACKGROUND: In older patients, thyroid nodules are frequently detected and referred for evaluation, though usually prove to be benign disease or low-risk cancer. Therefore, management should be guided not solely by malignancy risk, but also by the relative risks of any intervention. Unfortunately, few such data are available for patients ≥70 years old. METHODS: All consecutive patients ≥70 years old assessed by ultrasound (US) and fine-needle aspiration (FNA) between 1995 and 2015 were analyzed...
April 2, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29607563/investigation-of-thyroid-nodules-a-practical-algorithm-and-review-of-guidelines
#6
REVIEW
Jin Soo A Song, Adam A Dmytriw, Eugene Yu, Reza Forghani, Lorne Rotstein, David Goldstein, Colin S Poon
BACKGROUND: High resolution ultrasound has led to early detection of subclinical tumors and drastic increase in incidence of thyroid malignancy. To achieve a balance in appropriate investigation without perpetuating an overdiagnosis phenomenon, a concise set of evidence-based recommendations to stratify risk is required. METHODS: We sought to assemble an evidence-based diagnostic algorithm and accompanying pictorial review for workup of thyroid nodules that summarizes the most recent guidelines...
April 1, 2018: Head & Neck
https://www.readbyqxmd.com/read/29607233/preterm-parturient-with-polyhydramnios-and-pancreatitis-primary-presentation-of-hyperparathyroidism
#7
Esther S Han, Katherine Fritton, Phoebe Bacon, Martin K Slodzinski, Cynthia Argani
Objective: To report a case of severe hypercalcemia secondary to primary hyperparathyroidism in a late-preterm pregnant patient and review medical and surgical treatments as well as obstetric and neonatal outcomes. Background: Diagnosis of parathyroid disease during pregnancy can be difficult due to nonspecific presentation. Management decisions are complex and require multidisciplinary collaboration. Case: A 29-year-old G2P1001 woman at 35 weeks and 3 days' gestation presented with preterm contractions, polyhydramnios, pancreatitis, and severe hypercalcemia...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29605452/efficiency-of-the-bethesda-system-for-thyroid-cytopathology
#8
Ismael Mora-Guzmán, José Luis Muñoz de Nova, Cristina Marín-Campos, José Antonio Jiménez-Heffernan, Juan Julián Cuesta Pérez, Marcos Lahera Vargas, Emma Torres Mínguez, Elena Martín-Pérez
INTRODUCTION: Fine-needle aspiration biopsies are a key tool for preoperative assessment of thyroid nodules, and the Bethesda system is the preferred method to report cytological analysis. The purpose of this study is to assess the efficiency of the Bethesda system to identify the malignancy risk of thyroid nodules. METHODS: Patients who underwent thyroid surgery between June 2010 and June 2017 were included. Samples were classified into 6categories according to rates of malignancy associated with each diagnostic category...
March 28, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29596039/subclassification-of-bethesda-atypical-and-follicular-neoplasm-categories-according-to-nuclear-and-architectural-atypia-improves-discrimination-of-thyroid-malignancy-risk
#9
Joel Xue Yi Lim, Min En Nga, Dedrick Kok Hong Chan, Wee Boon Tan, Rajeev Parameswaran, Kee Yuan Ngiam
BACKGROUND: Although The Bethesda System for Reporting Thyroid Cytopathology has provided clinicians with a standardized classification scheme for the diagnosis of thyroid fine-needle aspiration cytology (FNAC) specimens, the indeterminate categories of Bethesda III (B3)-atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS)-and Bethesda IV (B4)-follicular neoplasm/suspicious for follicular neoplasm (FN/SFN)-continue to pose challenges with regards to ideal diagnostic and therapeutic management...
March 29, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29591914/the-bethesda-system-for-reporting-thyroid-cytopathology-explained-for-practitioners-frequently-asked-questions
#10
Massimo Bongiovanni, Georgios E Papadakis, Nathalie Rouiller, Laura Marino, Faiza Lamine, Bettina Bisig, Sonia Ziadi, Gerasimos P Sykiotis
The recent update of the Bethesda system for reporting thyroid cytology (TBSRTC) is a very important development in the evaluation of thyroid nodules. Clinical experience and scientific literature both show that practitioners performing thyroid FNA are accustomed to basing the clinical management of patients on reports using TBSRTC. Specifically, clinicians are familiar with the per cent risk of malignancy (ROM) corresponding to each TBSRTC diagnostic category (DC), as well as with the respective recommendation for clinical management...
March 28, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29590358/gene-expression-classifier-versus-targeted-next-generation-sequencing-in-the-management-of-indeterminate-thyroid-nodules
#11
Masha J Livhits, Eric J Kuo, Angela M Leung, Jianyu Rao, Mary Levin, Michael L Douek, Katrina R Beckett, Kyle A Zanocco, Dianne S Cheung, Yaroslav A Gofnung, Stephanie Smooke Praw, Michael W Yeh
Context: Molecular testing has reduced the need for diagnostic hemithyroidectomy for indeterminate thyroid nodules. No studies have directly compared molecular testing techniques. Objective: Compare diagnostic performance of Afirma Gene Expression Classifier (GEC) and ThyroSeq v2 next-generation sequencing assay. Design: Parallel randomized trial, monthly block randomization of patients with Bethesda III / IV cytology to GEC or ThyroSeq v2...
March 23, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29581701/thyroid-nodule-management-thyroid-stimulating-hormone-ultrasound-and-cytological-classification-system-for-predicting-malignancy
#12
Mohamed Abdulaziz Al Dawish, Asirvatham Alwin Robert, Mohammed A Thabet, Rim Braham
Background/objectives: Thyroid nodule (TN) is a common thyroid disorder globally, and the incidence has been increasing in recent decades. The objective of this study was to determine the contribution of thyroid-stimulating hormone (TSH), ultrasound (US), and cytological classification system for predicting malignancy among the surgically excised nodules. Design and methods: A retrospective analysis was performed between January 2012 and December 2014, using data drawn from 1188 patients (15-90 years), who had 1433 TN and fine-needle aspiration in Prince Sultan Military Medical City, Saudi Arabia...
2018: Cancer Informatics
https://www.readbyqxmd.com/read/29566452/analysis-of-circulating-tumor-dna-does-not-improve-the-clinical-management-of-patients-with-locally-advanced-and-metastatic-papillary-thyroid-carcinoma
#13
Vincenzo Condello, Elisabetta Macerola, Clara Ugolini, Luigi De Napoli, Cristina Romei, Gabriele Materazzi, Rossella Elisei, Fulvio Basolo
BACKGROUND: Circulating cell-free tumor DNA (ctDNA) in plasma is a promising noninvasive instrument for cancer monitoring. Detection of BRAFV600E on ctDNA of patients with papillary thyroid carcinoma (PTC) may represent an indicator of tumor aggressiveness and progression. METHODS: Eighty-three plasma samples were collected from 70 patients with thyroid nodules undergoing surgery and from 13 patients with PTC causing distant metastases. A total of 59 PTCs from both groups were evaluated for BRAF mutation on tumor tissue and on ctDNA from plasma samples by real-time polymerase chain reaction (PCR) and digital PCR...
March 22, 2018: Head & Neck
https://www.readbyqxmd.com/read/29532140/a-prospective-comparative-study-on-improvement-of-hyperthyroid-cardiovascular-dysfunction-in-patients-undergoing-total-thyroidectomy-versus-medical-management
#14
S Muthukumar, K Ravikumar, S Dhalapathy, T Gomathy, S Umadevi, D Maruthupandian
INTRODUCTION: Cardiovascular dysfunction (CVD) is a well-recognized complication in patients with hyperthyroidism and is the major cause of mortality. Very few studies have compared the outcome of CVD following different treatment modalities. In this study we intended to compare treatment modalities (antithyroid drugs vs surgery) for reversal of CVD. MATERIALS AND METHODS: Patients with newly detected hyperthyroidism were grouped into, Group I [n = 123, age <60 years, undergoing total thyroidectomy], Group II [n = 42, age <60 years, treated with antithyroid medications] were evaluated with 2D echocardiography, serum N terminal pro brain natriuretic peptide (NT-pro-BNP) at the time of diagnosis (Point A), after achieving euthyroidism (Point B) with antithyroid drugs and 6 months after surgery/continuation of antithyroid medications (Point C)...
March 12, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29531571/classification-of-thyroid-fine-needle-aspiration-cytology-into-bethesda-categories-an-institutional-experience-and-review-of-the-literature
#15
Safa Alshaikh, Zainab Harb, Eman Aljufairi, S Ali Almahari
Background: Fine-needle aspiration cytology (FNAC) of thyroid is the initial screening test for thyroid nodules. The Bethesda system classifies thyroid FNAC into six categories. Each category is linked to a malignancy risk and has a recommended clinical management. The aim of this study is to analyze the thyroid cytology smears by Bethesda system and to correlate the diagnosis of cytopathology with histopathology, whenever surgery was done. Materials and Methods: This study presents our experience with the Bethesda system in 681 thyroid FNAs from 632 patients in the period between January 2013 and December 2016...
2018: CytoJournal
https://www.readbyqxmd.com/read/29527855/thyroid-disease-in-pregnancy-a-clinical-survey-among-endocrinologists-gynecologists-and-obstetricians-in-israel
#16
Ronit Koren, Yifat Wiener, Karen Or, Carlos A Benbassat, Shlomit Koren
OBJECTIVES: To study the current practices in the management of subclinical hypothyroidism (SCH) and thyroid nodules during pregnancy of obstetricians/gynecologists (OB/GYNs) and endocrinologists in Israel. METHODS: An electronic questionnaire was sent by email to all members of the Israeli Endocrine Society and the Israel Society of Obstetrics and Gynecology. Questionnaires included demographic data and clinical scenarios with questions regarding the screening and management of pregnant women with SCH, hypothyroxinemia, and a palpable thyroid nodule...
March 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29522149/patient-reported-dysphagia-after-thyroidectomy-a-qualitative-study
#17
Brittany N Krekeler, Elizabeth Wendt, Cameron Macdonald, Jason Orne, David O Francis, Rebecca Sippel, Nadine P Connor
Importance: It is important that clinicians understand consequences of thyoridectomy on swallowing from the patient perspective to better care for this population. Objective: Using rigorous qualitative methodology, this study set out to characterize the effect of swallowing-related symptoms after thyroidectomy on patient quality of life and swallowing-related outcomes. Design, Setting, and Participants: Prospective, grounded theory analysis of interviews with 26 patients at 3 time points after thyroidectomy (2 weeks, 6 weeks, and 6 months) Data were collected from an ongoing clinical trial (NCT02138214), and outpatient interviews were conducted at the University of Wisconsin Hospital and Clinics...
March 8, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29520656/reasons-associated-with-total-thyroidectomy-as-initial-surgical-management-of-an-indeterminate-thyroid-nodule
#18
Trevor E Angell, Chirag M Vyas, Justine A Barletta, Edmund S Cibas, Nancy L Cho, Gerard M Doherty, Atul A Gawande, Brooke E Howitt, Jeffrey F Krane, Ellen Marqusee, Kyle C Strickland, Erik K Alexander, Francis D Moore, Matthew A Nehs
BACKGROUND: Diagnostic hemithyroidectomy (HT) is the most widely recommended surgical procedure for a nodule with indeterminate cytology; however, additional details may make initial total thyroidectomy (TT) preferable. We sought to identify patient-specific factors (PSFs) associated with initial TT in patients with indeterminate thyroid nodules. METHODS: Retrospective analysis of all patients with a thyroid nodule ≥ 1 cm and initial cytology of atypia of undetermined significance or suspicious for follicular neoplasm between 2012 and 2015 who underwent thyroidectomy...
March 8, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29509871/the-diagnosis-and-management-of-thyroid-nodules-a-review
#19
REVIEW
Cosimo Durante, Giorgio Grani, Livia Lamartina, Sebastiano Filetti, Susan J Mandel, David S Cooper
Importance: Thyroid nodules are common, being detected in up to 65% of the general population. This is likely due to the increased use of diagnostic imaging for purposes unrelated to the thyroid. Most thyroid nodules are benign, clinically insignificant, and safely managed with a surveillance program. The main goal of initial and long-term follow-up is identification of the small subgroup of nodules that harbor a clinically significant cancer (≈10%), cause compressive symptoms (≈5%), or progress to functional disease (≈5%)...
March 6, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29503150/improved-quality-of-thyroid-ultrasound-reports-after-implementation-of-the-acr-thyroid-imaging-reporting-and-data-system-nodule-lexicon-and-risk-stratification-system
#20
Andrew S Griffin, Jason Mitsky, Upma Rawal, Abraham J Bronner, Franklin N Tessler, Jenny K Hoang
PURPOSE: The aim of this study was to compare the description and management recommendations for thyroid nodules before and after implementing a structured reporting template based on the ACR Thyroid Imaging Reporting and Data System (TI-RADS). METHODS: Thyroid ultrasound reports for seven private practice radiologists were analyzed in three phases. In phase 1, radiologists dictated in a free-text format. In phase 2, they used a structured reporting template based on the ACR TI-RADS lexicon, but without the ACR TI-RADS recommendations for nodule management...
March 1, 2018: Journal of the American College of Radiology: JACR
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