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management of thyroid nodules

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https://www.readbyqxmd.com/read/28801882/patients-with-non-invasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features-are-unlikely-to-have-malignant-preoperative-cytology
#1
Richa Singh, Jorge Avila, Kahee Jo, Kevin T K Nguyen, Nika Roa Carrillo, Eric C Huang, Michael J Campbell
BACKGROUND: The newly termed tumor 'noninvasive follicular thyroid neoplasm with papillary-like nuclear features' (NIFTP) acts in an indolent manner and can likely be safely managed with a thyroid lobectomy. Preoperative fine-needle aspiration (FNA) is the cornerstone of surgical planning, but the ability of FNA to distinguish NIFTP from other variants of papillary thyroid carcinoma (PTC) has not been well-evaluated. METHODS: A 9-year retrospective review of the preoperative cytology and surgical pathology of PTC patients who underwent a thyroidectomy at our tertiary referral center...
August 11, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28795453/validation-of-the-modified-4-tiered-categorization-system-through-comparison-with-the-5-tiered-categorization-system-of-the-2015-american-thyroid-association-guidelines-for-classifying-small-thyroid-nodules-on-ultrasound
#2
Ji Hye Lee, Kyunghwa Han, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Vivian Y Park, Jin Young Kwak
BACKGROUND: The purpose of this study was to validate the modified 4-tiered categorization system and to compare stratification of malignancy risk in small thyroid nodules with the 2015 American Thyroid Association (ATA) management guidelines. METHODS: From January 2015 to December 2015, 737 thyroid nodules measured ≥ 1 cm and <2 cm were included in this study. Each nodule was assigned a category with the ultrasonographic patterns described by the 2015 ATA guidelines...
August 10, 2017: Head & Neck
https://www.readbyqxmd.com/read/28760234/thyroid-cancer-ultrasound-imaging-and-fine-needle-aspiration-biopsy
#3
REVIEW
Michelle Melany, Sardius Chen
Ultrasound is critical in detection, diagnosis, and management of thyroid nodules. Ultrasound detection of regional nodal metastatic disease is based on abnormal nodal morphology rather than size and is critical to initial surgical and long-term management of thyroid cancer. Fine-needle aspiration biopsy is the gold standard for malignancy diagnosis in thyroid cancer. Thyroglobulin assay of nodal aspirates improves accuracy in diagnosis of metastases. Reporting lexicons assign risk levels to thyroid nodules with the goal of improving and standardizing patient management...
September 2017: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/28718950/radiofrequency-ablation-for-the-management-of-thyroid-nodules-a-critical-appraisal-of-the-literature
#4
REVIEW
Roberto Cesareo, Andrea Palermo, Valerio Pasqualini, Roberto Cianni, Gianluigi Gaspa, Silvia Manfrini, Claudio Maurizio Pacella
The majority of benign thyroid nodules are asymptomatic, remain stable in size and do not require treatment. However, a minority of patients with growing nodules may have local symptoms or cosmetic concerns, and thus demand surgical therapy. The timely use of ultrasound-guided, minimally invasive thermal therapies has changed the natural history of benign, enlarging thyroid nodules (TNs). These procedures produce persistent shrinkage of TNs and an improvement of local symptoms. Among the various procedures, percutaneous ethanol injection represents the first-line treatment for thyroid cysts, while in solid cold nodules, laser and radiofrequency ablation (RFA) have proven to be very effective and safe techniques in producing significant volume reduction that remains stable over several years...
July 18, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28705700/incidental-primary-intradural-carcinoid-tumor-in-a-patient-with-lumbar-radiculopathy
#5
Stavros Koustais, Philip O'Halloran, Alfrazdaq Hassan, Francesca Brett, Steven Young
BACKGROUND: Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Central nervous system involvement is rare. The reported cases include metastases to brain or spinal cord, as well as primary skeletal or extradural disease resulting in compressive myelo-radiculopathy. There are two previously reported cases of primary intradural extramedullary carcinoid tumor, presenting with compressive symptoms. We report the first case of primary incidental intradural extramedullary carcinoid tumor...
July 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28703115/incidental-diagnosis-of-the-tall-cell-variant-of-the-papillary-microcarcinoma-of-the-thyroid-gland-requires-completion-lymphadenectomy-case-report
#6
I Bartella, F Meyer, K Frauenschläger, K Reschke, Th Wallbaum, B Buth, C Bruns, C Chiapponi
Papillary thyroid carcinoma is the most common neoplasm of the thyroid gland which is usually associated with a very good prognosis. The aim of this case report is to present the disease course of a rare tumor of the thyroid gland, which is worthwhile due to its extraordinary appearance and specific management. A 46-year-old patient presented with a pronounced right-sided, but bilateral, multinodular goiter, with a volume of approximately 80 mL, as assessed on ultrasonography. Surgical removal was indicated as scintigraphy showed a 4-cm cold nodule that almost completely took up the right thyroid lobe...
June 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28701827/malignancy-rate-in-thyroid-nodules-categorized-as-atypia-of-undetermined-significance-or-follicular-lesion-of-undetermined-significance-an-institutional-experience
#7
Smita Chandra, Harish Chandra, Sampan S Bisht
INTRODUCTION: Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) of Bethesda system for reporting thyroid cytopathology has emerged as most controversial category due to its heterogeneity and inconsistent usage. Initially associated risk of malignancy was estimated to be about 5-15%, but eventually different results have been obtained across institutions due to variable follow-ups and interpretation. The present study was conducted to evaluate the rate of malignancy along with appropriate management in this category...
July 2017: Journal of Cytology
https://www.readbyqxmd.com/read/28699306/strategies-for-building-a-successful-ultrasound-guided-fna-practice-in-department-of-pathology-experience-at-a-university-hospital
#8
Maoxin Wu, Kenneth R Shroyer
INTRODUCTION: Although pathology services focused on fine needle aspiration (FNA) biopsy of superficial palpable masses with on-site cytological evaluation are available in a wide range of clinical and academic settings, the addition of ultrasound (US) guidance into FNA practice by a cytopathologist group can be challenging. An US-FNA service provided by a cytopathologist in the department of Pathology is a relatively new practice in the field of medicine. This report summarizes our experience and strategies in achieving this objective and our successful preliminary results...
July 11, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28697907/the-contemporary-utility-of-intraoperative-frozen-sections-in-thyroid-surgery
#9
Samuel J Trosman, Rohith Bhargavan, Brandon L Prendes, Brian B Burkey, Joseph Scharpf
PURPOSE: To determine the accuracy of intraoperative frozen section analysis on thyroidectomy specimens stratified by the Bethesda classification scheme and its utility for intraoperative decision-making. STUDY DESIGN: Retrospective chart review. METHODS: A retrospective review was performed on all patients who underwent thyroidectomy or thyroid lobectomy with intraoperative frozen sections at a tertiary care academic center from 2009 to 2015...
July 5, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28695819/role-of-ultrasound-in-the-management-of-thyroid-nodules-and-thyroid-cancer
#10
Ruyu Liu, Bo Zhang
The management of thyroid nodules can be classified into narrow-and broad-sense levels. The broad-sense procedures are used for special population and include screening,risk assessment of thyroid nodules,follow-up of benign thyroid nodules,surgical operation,post-operative follow-up,and assessment and treatment of recurrence and/or metastasis of thyroid cancer. The narrow-sense procedures are for individual patients and the whole process includes the assessment,supervision,treatment,and reassessment of thyroid lesion...
June 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28692457/the-thyroid-cancer-epidemic-2017-perspective
#11
Benjamin R Roman, Luc G Morris, Louise Davies
PURPOSE OF REVIEW: Thyroid cancer incidence and mortality trends have been identified as being consistent with overdiagnosis, and several recent efforts have been made to mitigate this problem. RECENT FINDINGS: Major guidelines for thyroid nodule management recommend against general biopsy of nodules less than 1 cm in size. Data supporting the safety of active surveillance of low-risk thyroid cancers is now recognized. Tumors previously labeled as encapsulated follicular variant papillary thyroid cancers are now recommended to be called noninvasive follicular thyroid neoplasm with papillary-like nuclear features...
July 7, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28689321/underestimated-risk-of-cancer-in-solitary-thyroid-nodules-%C3%A2-3%C3%A2-cm-reported-as-benign
#12
Sohail Bakkar, Anello Marcello Poma, Caterina Corsini, Mario Miccoli, Carlo Enrico Ambrosini, Paolo Miccoli
BACKGROUND: The study aims to assess the risk of cancer in solitary thyroid nodules ≥30 mm in size reported as Bethesda II, and its implications. METHOD: The clinical records of 202 patients, who underwent thyroid lobectomy for solitary nodules measuring ≥30 mm, reported as Bethesda II on preoperative FNAC between Jan 2015 and Apr 2016 were reviewed. Data collected included nodule size and consistency, and final histopathology results. The risk of cancer and the recommended management according to ATA guidelines were the outcomes of interest...
July 8, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28649084/malignancy-rate-of-focal-thyroid-incidentaloma-detected-by-fdg-pet-ct-results-of-a-prospective-cohort-study
#13
Philippe Thuillier, Nathalie Roudaut, Geneviève Crouzeix, Marie Cavarec, Philippe Robin, Ronan Abgral, Véronique Kerlan, Pierre-Yves Salaun
OBJECTIVE: To evaluate the malignancy rate of focal thyroid incidentaloma (fTI) in a population of patients undergoing a 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) for a non-thyroid purpose. DESIGN: We conducted a prospective cohort study from January 2013 to November 2014. All consecutive patients referred for a FDG PET-CT were prospectively screened. Patients with known neoplastic thyroid disease were excluded from the analysis...
August 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28639967/ras-positive-thyroid-nodules
#14
Trevor E Angell
PURPOSE OF REVIEW: The current review focuses on the uncertainty regarding the management of rat sarcoma viral oncogene homolog RAS-positive thyroid nodules. The application of oncogene testing has been heralded for improving risk assessment for indeterminate cytology thyroid nodules and has grown in clinical use. RAS mutations are historically considered oncogenic. However, RAS mutation detection in thyroid nodules has proven problematic, as these mutations are found in benign and malignant lesions...
July 20, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28626115/reappraisal-of-cyst-fluid-only-on-thyroid-fine-needle-aspiration-cytology
#15
Nami Takada, Mitsuyoshi Hirokawa, Ayana Suzuki, Miyoko Higuchi, Seiji Kuma, Akira Miyauchi
According to the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), cyst fluid only (CFO) cases are classified in the non-diagnostic category. To date, no large study focusing on CFO has been conducted. To reassess the diagnostic significance of CFO, we compared CFO nodules with non-diagnostic nodules excluding CFO (ND-other). We reviewed the conventional thyroid smears of 715 CFO and 766 ND-other nodules. We compared the timing of and findings at re-aspiration, the histology of resected specimens, and the proportion of malignant nodules between the two groups...
June 13, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28603866/utility-of-intraoperative-frozen-sections-for-thyroid-nodules-with-prior-fine-needle-aspiration-cytology-diagnosis
#16
Sudarshana Roychoudhury, Fabiola Souza, Cecilia Gimenez, Ryan Glass, Rubina Cocker, Karen Chau, Nina Kohn, Kasturi Das
INTRODUCTION: The objective of this study was to evaluate the role of intraoperative frozen section (IFS) in determining the course of surgery in thyroid nodules with a prior fine needle aspiration (FNA) biopsy diagnosis. In addition, reliability of FNA interpretation to guide surgical management without IFS was investigated. MATERIAL AND METHODS: This is a retrospective study of all patients who had a FNA biopsy, IFS, and final pathology performed on a thyroid nodule over a 9 month period...
September 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28589088/a-2016-italian-survey-about-guidelines-and-clinical-management-of-thyroid-nodules
#17
Roberto Negro, Roberto Attanasio, Franco Grimaldi, Andrea Frasoldati, Rinaldo Guglielmi, Enrico Papini
BACKGROUND: While thyroid nodules are frequent in endocrine clinical practice, patients are often asymptomatic and euthyroid, and death is rare in cases of malignancy. OBJECTIVES: To evaluate the perception of current international guidelines regarding thyroid nodule management among Italian endocrinologists, and to compare daily clinical practice with suggested recommendations. METHODS: Italian Association of Clinical Endocrinologists (AME) members were invited to participate in a Web-based survey...
April 2017: European Thyroid Journal
https://www.readbyqxmd.com/read/28589087/nodular-thyroid-disease-and-thyroid-cancer-in-the-era-of-precision-medicine
#18
REVIEW
Carles Zafon, Juan J Díez, Juan C Galofré, David S Cooper
The management of thyroid nodules, one of the main clinical challenges in endocrine clinical practice, is usually straightforward. Although the most important concern is ruling out malignancy, there are grey areas where uncertainty is frequently present: the nodules labelled as indeterminate by cytology and the extent of therapy when thyroid cancer is diagnosed pathologically. There is evidence that the current available precision medicine tools (from all the "-omics" to molecular analysis, fine-tuning imaging or artificial intelligence) may help to fill present gaps in the future...
April 2017: European Thyroid Journal
https://www.readbyqxmd.com/read/28588772/ultrasound-guided-core-needle-biopsy-for-differential-diagnosis-of-thyroid-nodules-a-systematic-review-and-meta-analysis
#19
Na Liu, Zhaowei Meng, Qiang Jia, Xianghui He, Weijun Tian, Jian Tan, Yujie Zhang, Xue Li, Tianpeng Hu, Pingping Zhou, Sen Wang, Arun Upadhyaya
Ultrasound-guided core needle biopsy (US-CNB) of thyroid nodules is a relatively new technique used in surgical workup. However, no systematic review of this method has yet been performed. In the present meta-analysis, literature databases consisting of Cochrane Library, Medline, Embase, Scopus and Google Scholar were searched. Following eligibility assessments of the studies, quality appraisals were performed on the included studies using the Quality Assessment Tool for Diagnostic Accuracy Studies-2 method...
June 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28581673/the-role-of-thyroid-fna-cytology-in-pediatric-malignant-lesions-an-overview-of-the-literature
#20
REVIEW
Esther Diana Rossi, Maurizio Martini, Tonia Cenci, Sara Capodimonti, Luigi Maria Larocca
When one is dealing with pediatric thyroid lesions, fine-needle aspiration is the first diagnostic tool for the correct characterization of these nodules. Despite the apparent infrequency of thyroid cancers in children, recent data from the National Cancer Institute prove that the incidence has been increasing, especially in adolescents. With the same data, a higher prevalence of well-differentiated cancers can be estimated, with 90% diagnosed as papillary thyroid cancer. Nonetheless, some publications have demonstrated that some specific malignant variants are more frequent in children and have a more aggressive behavior that justifies the increased number of surgical procedures...
June 5, 2017: Cancer
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