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management of thyroid nodules

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https://www.readbyqxmd.com/read/28327204/lung-adenocarcinoma-with-thyroid-metastasis-a-case-report
#1
A Dao, H Jabir, A Taleb, N Benchakroun, Z Bouchbika, T Nezha, H Jouhadi, S Sahraoui, A Benider
BACKGROUND: The metastases of a primary lung cancer over the thyroid gland are extremely rare. We report on an unusual presentation of thyroid metastasis of lung cancer in order to improve the management of similar cases. CASE PRESENTATION: Three years ago, a Moroccan male 59-year-old was admitted for dyspnea, dry cough, and chest pain. He had smoked about 30 cigarette packs a year. Clinical examination revealed a right thyroid nodule. Chest and neck computed tomography (CT) scan showed a proximal left tumor in contact with the pulmonary artery and revealed a suspected nodule in the right lobe of the thyroid with homolateral neck node...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28326900/ultrasound-pathology-discordant-nodules-on-core-needle-biopsy-malignancy-risk-and-management-strategy
#2
Sae Rom Chung, Jung Hwan Baek, Hye Sun Park, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee
BACKGROUND: The reported malignancy rates of thyroid nodules that appear suspicious on ultrasound (US) but yield benign fine-needle aspiration (FNA) cytology results range from 13.6% to 56.6%. However, the malignancy risk of nodules that are discordant on US and core-needle biopsy (CNB) pathological findings has not been evaluated. This study evaluated the malignancy risk associated with thyroid nodules that are suspicious on US but yield benign CNB results. METHODS: Between July 2008 and November 2011, 1309 patients with 1313 thyroid nodules underwent US-guided CNB...
March 22, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28322617/clinicians-views-on-management-and-terminology-for-papillary-thyroid-microcarcinoma-a-qualitative-study
#3
Brooke Nickel, Juan P Brito, Alexandra Barratt, Susan Jordan, Ray Moynihan, Kirsten McCaffery
BACKGROUND: There is growing acceptance that the increase in thyroid cancer incidence is in part a result of overdiagnosis of small low-risk papillary microcarcinomas (PMCs) with indolent clinical course. Although surgery is the cornerstone treatment for patients with PMCs, recent management guidelines are shifting toward inclusion of more conservative treatments such as active surveillance. There is little evidence on clinicians' experience in managing PMC patients and their attitudes toward treatment options, including their willingness to accept a nonsurgical option...
March 21, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28283790/a-retrospective-study-of-ultrasound-and-fna-cytology-investigation-of-thyroid-nodules-working-towards-combined-risk-stratification
#4
Zi Wei Liu, Richard Fox, Samit Unadkat, Roy Farrell
The British Thyroid Association recommended in new guidelines on thyroid cancer treatment [Kwak et al. (Korean J Radiol 14:110-117, 2013)] that ultrasound grading of thyroid nodules should be incorporated into MDT management. A retrospective study was carried out to determine that the impact of US grading has had on MDT decision making in practice. The design used in the study is a retrospective review of case notes. The study was carried out in the hub hospital for thyroid cancer in the North west London Cancer network...
March 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28282233/dietary-management-of-hyperthyroidism-in-a-dog
#5
Andrea Looney, Joseph Wakshlag
An 8 yr old female spayed golden retriever presented for a routine exam during which ventral cervical soft tissue masses were identified. History included weight loss, increased activity and appetite, gagging, and occasional diarrhea. Exam findings included a body condition score of 4/9 and palpable ventral cervical nodules. A serum thyroxine (T4) value was 8.0 ug/dL (normal = 0.8-3.5ug/dL). Doppler systolic blood pressure readings ranged from 200-210 mmHg (normal systolic blood pressure <150 mmHg). The diagnosis was hyperthyroidism due to active thyroid masses...
March 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28280507/fine-needle-aspiration-of-thyroid-nodules-using-the-bethesda-system-for-reporting-thyroid-cytopathology-an-institutional-experience-in-a-rural-setting
#6
Aili Guo, Yuuki Kaminoh, Terra Forward, Frank L Schwartz, Scott Jenkinson
Background. Fine needle aspiration (FNA) remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC) to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28279554/a-case-of-coexistence-of-tsh-gh-secreting-pituitary-tumor-and-papillary-thyroid-carcinoma-challenges-in-pathogenesis-and-management
#7
Phatharaporn Kiatpanabhikul, Shanop Shuangshoti, Kraisri Chantra, Patpong Navicharern, Kanaungnit Kingpetch, Natnicha Houngngam, Thiti Snabboon
Co-existence of thyrotropin/growth hormone-secreting pituitary adenoma with differentiated thyroid carcinoma is exceedingly rare, with less than 15 cases having been reported. Its clinical presentation and treatment strategy are challenging. We report a case of pituitary macroadenoma, with clinical syndromes of acromegaly and hyperthyroidism, and a thyroid nodule, with cytologically confirmed to be a papillary thyroid carcinoma. Clinical implications, focusing on the strategy for proper management, and possible pathogenesis were discussed...
March 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28273370/features-of-papillary-thyroid-microcarcinoma-associated-with-lateral-cervical-lymph-node-metastasis
#8
Min Ji Jeon, Mi Sun Chung, Hyemi Kwon, Mijin Kim, Suyeon Park, Jung Hwan Baek, Dong Eun Song, Tae-Yon Sung, Suck Joon Hong, Tae Yong Kim, Won Bae Kim, Young Kee Shong, Jeong Hyun Lee, Won Gu Kim
OBJECTIVES: Papillary thyroid microcarcinoma (PTMC) has an excellent prognosis with an indolent disease course. However, some PTMCs have an aggressive course with lateral cervical lymph node (LCLN) metastasis or distant metastasis. This study aimed to evaluate the preoperative features of PTMC associated with LCLN metastasis. DESIGN AND PATIENTS: This retrospective cohort study with a nested, matched case-control design included 199 PTMC patients with LCLN metastasis at initial surgery (N1b group) and 196 PTMC patients without any LN metastasis or persistent disease (N0 NED group) as controls; primary tumour sizes were matched...
March 8, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28242987/renal-metastasis-and-dual-18-f-fluorodeoxyglucose-and-131-i-avid-skeletal-metastasis-in-a-patient-with-papillary-thyroid-cancer
#9
Prashanth Kulkarni, Pobbi Setty Radhakrishna Gupta Rekha, Meghana Prabhu, Sunil Hejjaji Venkataramarao, Nalini Raju, Naveen Hedne Chandrasekhar, Subramanian Kannan
Differentiated thyroid carcinoma (DTC) though usually behaves in an indolent manner, can have unusual metastatic presentation. Initial presentation of metastatic disease has been reported in 1-12% of DTC being less frequent in papillary (~2%) than in follicular (~10%) thyroid carcinoma. Renal metastasis from DTC is very rare. To our knowledge, only about 30 cases have been reported in the English literature to date. To make clinicians aware that management of such high-risk thyroid cancer frequently requires novel multimodality imaging and therapeutic techniques...
January 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/28242165/rare-thyroid-malignancies-an-overview-for-the-oncologist
#10
D B Spielman, A Badhey, S Kadakia, J C Inman, Y Ducic
Anaplastic thyroid cancer, medullary thyroid cancer, primary thyroid lymphoma and primary thyroid sarcoma are rare thyroid cancers that comprise 5-10% of all thyroid malignancies. Unlike well-differentiated thyroid cancers, these malignancies have few treatment options and carry a worse prognosis. The literature surrounding these pathologies is limited, but remains an area of active research. Despite the rarity of these conditions, they remain an important part of the differential diagnosis for any thyroid nodule...
February 24, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28222720/birt-hogg-dub%C3%A3-syndrome-a-literature-review-and-case-study-of-a-chinese-woman-presenting-a-novel-flcn-mutation
#11
Shengyu Hao, Fei Long, Fenglan Sun, Teng Liu, Daowei Li, Shujuan Jiang
BACKGROUND: The Birt-Hogg-Dubé (BHD) syndrome is a very rare autosomal dominant form of genodermatosis caused by germline mutations in the folliculin (FLCN) gene, which is mapped to the p11.2 region in chromosome 17. BHD commonly presents cutaneous fibrofolliculomas, pulmonary cysts, renal cell carcinoma, and recurrent pneumothoraxes. The disease is easily ignored or misdiagnosed as pneumothorax, pulmonary lymphangiomyomatosis (LAM), or emphysema. Follow-up and guidelines for managing recurrent pneumothoraxes in these patients are lacking...
February 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28222584/ultrasonographic-imaging-of-papillary-thyroid-carcinoma-variants
#12
Jung Hee Shin
Ultrasonography (US) is routinely used to evaluate thyroid nodules. The US features of papillary Epub ahead of print thyroid carcinoma (PTC), the most common thyroid malignancy, include hypoechogenicity, spiculated/microlobulated margins, microcalcifications, and a nonparallel orientation. However, many PTC variants have been identified, some of which differ from the classic type of PTC in terms of biological behavior and clinical outcomes. This review describes the US features and clinical implications of the variants of PTC...
January 12, 2017: Ultrasonography
https://www.readbyqxmd.com/read/28217964/is-fine-needle-aspiration-really-not-necessary-in-patients-with-thyroid-nodules%C3%A2-%C3%A2-%C3%A2-1-cm-with-highly-suspicious-features-on-ultrasonography-and-candidates-for-active-surveillance
#13
Pedro Weslley Rosario, Alexandre Lemos Silva, Maria Regina Calsolari
BACKGROUND: The low rate of progression associated with the potential complications of thyroidectomy makes active surveillance an increasingly recommended management in low-risk papillary microcarcinomas of the thyroid (PMT). The objective of this study was to report the results of fine needle aspiration (FNA) of nodules ≤ 1 cm with highly suspicious appearance on ultrasonography (US) in patients who are potential candidates for active surveillance. METHODS: We revised thyroid nodules ≤ 1 cm with highly suspicious appearance on US in patients without known distant metastases, suspicion of extrathyroid extension, or suspicious lymph nodes on US...
April 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28201927/histologic-findings-and-cytological-alterations-in-thyroid-nodules-after-radioactive-iodine-treatment-for-graves-disease
#14
Siba El Hussein, Yumna Omarzai
Unlike the well-documented relation between radiation to the neck and development of papillary thyroid carcinoma, a causal association between radioactive iodine treatment for Graves' disease and development of thyroid malignancy is less defined. However, patients with a background of thyroid dysfunction presenting with clinically palpable thyroid nodules are followed more closely than the average population, and fine needle aspiration is recommended in such circumstances. Cytological examination of aspirates, and histologic examination of tissue provided from patients with a known history of Graves' disease, managed by radioactive iodine therapy can create a diagnostic dilemma, as the distinction between radiation effect and a malignant primary thyroid neoplasm can be very challenging...
February 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28194993/preoperative-prediction-of-papillary-thyroid-microcarcinoma-via-multiparameter-ultrasound
#15
Hui Juan Ma, Jing Chun Yang, Zhen Peng Leng, Ying Chang, Hua Kang, Liang Hong Teng
Background Accurate diagnosis of papillary thyroid microcarcinoma (PTMC) is important for further management. Ultrasound (US) is the most frequently used imaging modality for PTMC. Purpose To evaluate the diagnostic value of conventional US, contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) for patients with PTMC. Material and Methods In total, 135 patients with subcentimeter thyroid nodules who underwent conventional US, CEUS, and RTE before surgery were enrolled. A multivariate logistic regression analysis was performed to assess the independent predictors of PTMC...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28192631/thyroid-cytology-nuclear-versus-architectural-atypia-within-the-atypia-of-undetermined-significance-follicular-lesion-of-undetermined-significance-bethesda-category-have-significantly-different-rates-of-malignancy
#16
Tiffany Rui Xuan Gan, Min En Nga, Jeffrey Huey Yew Lum, Wendy Meihua Wong, Wee Boon Tan, Rajeev Parameswaran, Kee Yuan Ngiam
BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology is the most widely used classification system for the reporting of thyroid fine-needle aspiration cytology (FNAC) specimens. However, the "atypical" category ("atypia of undetermined significance" [AUS] or "follicular lesion of undetermined significance" [FLUS]) continues to cause diagnostic and therapeutic dilemmas. The objectives of this study were to describe the differential malignancy rates of FNACs diagnosed as AUS/FLUS based on nuclear or architectural atypia and to assess the significance of demographic and ultrasonographic features in predicting malignancy in this category...
February 13, 2017: Cancer
https://www.readbyqxmd.com/read/28188700/how-suspicious-is-that-nodule-review-of-suspicious-afirma-gene-expression-classifier-in-high-risk-thyroid-nodules
#17
Sudarshana Roychoudhury, Melissa Klein, Fabiola Souza, Cecilia Gimenez, Alice Laser, Rubina Shaheen Cocker, Karen Chau, Kasturi Das
BACKGROUND: The Afirma gene expression classifier (GEC) is being increasingly utilized to confirm the benign nature of indeterminate FNA cytology results thus avoiding unnecessary surgical procedures. However the "suspicious" result of the Afirma GEC does not classify these indeterminate nodules further in determining appropriate management. This study investigated the outcome of the thyroid nodules deemed to be "suspicious" by the Afirma GEC in a high risk population. METHODS: The pathology database was searched for all thyroid nodules with Afirma test results over a three year period, 2013-2015...
April 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28182068/evaluation-of-thyroid-nodules-classified-as-bethesda-category-iii-on-fnac
#18
Shiwani Garg, Leena P Naik, Kanchan S Kothari, Gwendolyn C Fernandes, Mona A Agnihotri, Jagruti C Gokhale
BACKGROUND: The Bethesda (BSRTC) category III has been ascribed a malignancy rate of 5-15%, however, the probability of malignancy remains variable. AIM: To evaluate category III with respect to its rate and risk of malignancy and substratify it. SETTINGS AND DESIGN: Atypia of undetermined significance/Follicular lesion of undetermined significance (AUS/FLUS) percentage, cytohistological correlation, and risk of malignancy were analyzed and substratification was done...
January 2017: Journal of Cytology
https://www.readbyqxmd.com/read/28178124/anaplastic-thyroid-carcinoma-and-foscarnet-use-in-a-multitarget-treatment-documented-by-18f-fdg-pet-ct-a-case-report
#19
Elisa Giannetta, Andrea M Isidori, Cosimo Durante, Cira Di Gioia, Flavia Longo, Vincenzo Tombolini, Nadia Bulzonetti, Chiara Graziadio, Riccardo Pofi, Daniele Gianfrilli, Antonella Verrienti, Raffaella Carletti, Sebastiano Filetti, Andrea Lenzi, Alberto Baroli
RATIONALE: The case reported the rapid remission of disease recurrence achieved adding foscarnet, a DNA polymerase inhibitor that interacts with fibroblast growth factor 2, to low molecular weight heparin and sunitinib for the first time in a patient with an anaplastic thyroid cancer (ATC). PATIENT CONCERNS: A 65-year-old woman with a multinodular goiter referred for a rapid enlargement of a nodule. Histological examination revealed an ATC with a little area of papillary thyroid cancer (PTC)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28175931/determining-patient-preferences-for-indeterminate-thyroid-nodules-observation-surgery-or-molecular-tests
#20
Daniel Joonil Lee, Jason J Xu, Dale H Brown, Ralph W Gilbert, Patrick J Gullane, Jonathan C Irish, Lorne E Rotstein, David P Goldstein, John R de Almeida
BACKGROUND: Gene-expression classifiers (GEC) and genetic mutation panels (GMP) have been shown to improve preoperative diagnostic evaluations of indeterminate thyroid nodules. Despite the improvement, uncertainty regarding the proper management exists. Patient preferences may better inform the management of these indeterminate thyroid nodules. METHODS: Hypothetical scenarios were administered to two groups of patients: those with previous FNA-confirmed indeterminate thyroid nodules (Group A, n = 50) and those presenting to a general otolaryngology clinic for other reasons (Group B, n = 50)...
February 7, 2017: World Journal of Surgery
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