National Cancer Institute®
Last Modified: May 1, 2002
UI - 11771049
AU - Dadas B; Uslu B; Cakir B; Ozdogan HC; Calis AB; Turgut S
TI - Intraoperative management of the thyroid gland in laryngeal cancer surgery.
SO - J Otolaryngol 2001 Jun;30(3):179-83
AD - Department of Otolaryngology and Head and Neck Surgery, Sisli Etfal Education and Research Hospital, Istanbul, Turkey.
OBJECTIVE: To determine if it is necessary to perform a hemithyroidectomy routinely with all total laryngectomies or if it should be reserved for selected cases. DESIGN: A retrospective analysis of 215 cases who had been operated on due to laryngeal cancer in our clinic between 1985 and 1999. SETTING: In only 182 cases, hemithyroidectomy and isthmectomy were performed together with laryngeal surgery. Of these, 98% were male. Their ages ranged between 42 and 70 years. The tumour was located in the supraglottic region in 93 (51%) and in the glottic region in 24 (13%) cases. In 65 cases (36%), the tumour was transglottic. Twenty cases of transglottic tumours (31%) and 3 cases of glottic tumours (12.5%) were found to have subglottic extension. METHODS: Total laryngectomy with unilateral or bilateral neck dissection and hemithyroidectomy on the tumour side plus isthmectomy were performed on all patients. On the pathologic specimens, subglottic extension was measured anteriorly and posteriorly from the free edges of the vocal cords. The specimens were stained with hematoxylin and eosin and examined under a light microscope. MAIN OUTCOME MEASURES: With glottic and transglottic carcinomas, the need for thyroidectomy may be based on the intraoperative assessment of the thyroid gland. In subglottic carcinomas, a hemithyroidectomy should routinely be performed. There may be no need to perform thyroidectomy in all total laryngectomy cases. RESULTS: The thyroid gland was invaded by squamous cell carcinoma in only 2 cases (1%). Both of these cases were transglottic tumours staged as T3 and T4 and had a subglottic extension more than 1 cm. CONCLUSIONS: We recommend routine hemithyroidectomy and isthmectomy during total laryngectomy only in cases with subglottic extensions more than 1 cm or thyroid cartilage invasion with tumour. In the other cases, assessment of extralaryngeal invasion and thyroid gland invasion by the tumour will determine whether thyroidectomy should be performed.
UI - 11865340
AU - Weber T; Amann K; Weckauf H; Lacroix J; Weitz J; Schonfuss T; Holting T;
TI - Klar E; Herfarth C; von Knebel Doeberitz M Detection of disseminated medullary thyroid carcinoma cells in cervical lymph nodes by cytokeratin 20 reverse transcription-polymerase chain reaction.
SO - World J Surg 2002 Feb;26(2):148-52
AD - Division of Molecular Diagnostics and Therapy, Department of Surgery, University of Heidelberg, Im Neuenheimer Feld110, 69120 Heidelberg, Germany. firstname.lastname@example.org
Local recurrence in differentiated and medullary thyroid carcinoma develops frequently from metastatic infiltration of cervical lymph nodes. Despite an aggressive surgical approach, postoperative calcitonin levels as biochemical evidence for residual cancer cells remain often elevated in patients with medullary thyroid carcinoma. In the present study, we compared the detection rates of disseminated medullary thyroid carcinoma cells in cervical lymph nodes by histopathology with reverse transcription-polymerase chain reaction (RT-PCR) amplification of cytokeratin 20 (CK20) transcripts as a more sensitive but still specific molecular parameter for residual thyroid cancer cells. Forty-two cervical lymph nodes obtained from 7 patients with CK20positive medullary thyroid carcinomas were cut into two halves, one used for conventional histology, the other subjected to RNA extraction and subsequent amplification of cytokeratin 20 transcripts. Matching results for CK20 RT-PCR and histopathology were found in 74% (31/42)of the examined lymph nodes (52% positive results, 48% negative results). Positive CK20 RT-PCR pointed to residual thyroid carcinoma cells in another 19% (8/42), in which no thyroid carcinoma cells were identified by histopathology. Histology and immunohistochemistry,however, identified tumor cells in 7% (3/42) of the analyzed lymph nodes, from which no CK20 transcript could be amplified (false-negative results). These data suggest that CK20 RT-PCR might be more sensitive to detect nodal involvement of CK20 positive medullary thyroid carcinomas than conventional histopathology. In combination with histology, it might help to identify patients with residual disease after surgery.
UI - 11865341
AU - Mishra A; Mishra SK; Agarwal A; Das BK; Agarwal G; Gambhir S
TI - Metastatic differentiated thyroid carcinoma: clinicopathological profile and outcome in an iodine deficient area.
SO - World J Surg 2002 Feb;26(2):153-7
AD - Department of Endocrine Surgery, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, India 226014.
Reports on metastatic differentiated carcinoma in endemic goiter regions are scarce. The aim of this study was to look into the clinicopathological profile and outcome of patients with metastatic differentiated thyroid carcinoma (DTC) of endemic origin. This was a retrospective study of 28 cases of metastatic DTC out of a total of 140 clinicopathological profile, operative and radioiodine ablation therapy details, and follow-up findings were noted. The overall incidence of distant metastases in our series was 20%. Mean age was 48.5 +/- 12.8 years (32.1%patients were < 45 years). Most metastases were detected synchronously (85.7%) and were multiple, with the skeletal system being the commonly affected site. Out of 22 cases having skeletal metastases, 6 patients were young (< 45 years). Though most patients with skeletal metastases had follicular carcinoma (FTC), 4 cases had papillary thyroid cancer (PTC). Near total or total thyroidectomy was done in 26 cases. Sixteen patients required regional lymph node dissection. Resection of metastases was performed in 9 cases.Histopathological diagnosis was PTC, FTC, and poorly differentiated carcinoma in 32.1%, 50.0%, and 17.9% of cases, respectively. Most patients had good symptomatic palliation following administration of I131 therapy. In 17.9% of cases there were locoregional recurrences. There was an overall 28.6% mortality. Two patients expired in the perioperative period. Six others died in follow-up (all within 3-9 months). In contrast to iodine sufficient regions, the incidence of metastases was high; the majority of cases had synchronous, symptomatic skeletal metastases. Skeletal metastases were not infrequent even in cases of PTC and in young patients. One-third of the cases were young. Though survival was poor despite aggressive management, significant symptomatic palliation could be achieved in most cases.
UI - 11223476
AU - Moppett J; Oakhill A; Duncan AW
TI - Second malignancies in children: the usual suspects?
SO - Eur J Radiol 2001 Feb;37(2):95-108
AD - Department of Paediatric Oncology, Bristol Royal Hospital for Sick Children, St. Michael's Hill, Bristol BS2 8BJ, UK.
The aim of this article is to provide an up to date review of second malignant neoplasms (SMN's) following treatment for childhood cancer, referring to their incidence, the role of genetic factors, and how the primary malignancy and treatment received influence the type, site and prognosis of SMN's. The role of genetic factors will be discussed as far as they impact upon a predisposition to later development of SMN's. The primary malignancies that have important associations with SMN's will then be discussed, in particular Hodgkin's disease, retinoblastoma and acute lymphoblastic leukaemia. The important second malignancies will be highlighted, including tumours of the CNS and thyroid, osteosarcoma, secondary acute myeloid leukaemia and melanoma. Emphasis will be put upon identifying which patients are most likely to suffer from these tumours. An important part of the article are case histories. These are provided in combination with illustrations as a useful adjunct to the text, with a particular emphasis on radiological features, diagnosis and screening. Finally, the important but different roles of causal agents, in particular chemotherapy and radiotherapy are highlighted.
UI - 11765046
AU - Rago T; Chiovato L; Aghini-Lombardi F; Grasso L; Pinchera A; Vitti P
TI - Non-palpable thyroid nodules in a borderline iodine-sufficient area: detection by ultrasonography and follow-up.
SO - J Endocrinol Invest 2001 Nov;24(10):770-6
AD - Department of Endocrinology and Metabolism, University of Pisa, Italy.
Thyroid ultrasonography was performed in 482 subjects, free of known thyroid disease and living in a borderline iodine-sufficient urban area, to assess the prevalence of non-palpable thyroid nodules and evaluation their evolute during a 3-yr follow-up. The mean (+/-SD) thyroid volume in the whole study group was 10.9+/-3.7 ml and was higher in males (12.9+/-3.6 ml) than in females (9.2+/-2.9 ml) (p<0.0001). Thyroid volume was correlated with body surface, height and weight, while no correlation was present with lean and fat body mass. Goiter was found in 5/256 females and in 13/226 males. Thyroid nodules were found in 27/482 subjects (18 females, 9 males). Single nodules were found in 17/464 subjects (3.66%) with a thyroid gland of normal volume and in 4/18 subjects (22.2%) with goiter (chi2=10.21; p=0.001). Multiple nodules were found in 3/464 subjects (0.6%) with a thyroid of normal volume and in 3/18 (16.6%) subjects with goiter (chi2=24.31; p<0.0001). The prevalence of thyroid nodules was significantly higher in females >35 yr than in those <34 yr (chi2=7.47; p=0.0062). A significant increase (>30%) of nodular volume was found in 5 subjects, while an increased number of nodules was found in 8. In conclusion, thyroid ultrasonography reveals the presence of thyroid nodules in a significant proportion of apparently thyroid disease-free subjects living in a borderline iodine-sufficient urban area. Incidentally discovered thyroid nodules are associated with goiter and are likely to progress in volume and number.
UI - 11202090
AU - Vini L; Harmer C
TI - Radioiodine treatment for differentiated thyroid cancer.
SO - Clin Oncol (R Coll Radiol) 2000;12(6):365-72
AD - Department of Clinical Oncology, Royal Marsden NHS Trust, London, UK. email@example.com
UI - 11940046
AU - Ouyang B; Knauf JA; Ain K; Nacev B; Fagin JA
TI - Mechanisms of aneuploidy in thyroid cancer cell lines and tissues: evidence for mitotic checkpoint dysfunction without mutations in BUB1 and BUBR1.
SO - Clin Endocrinol (Oxf) 2002 Mar;56(3):341-50
AD - Division of Endocrinology and Metabolism, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0547, USA.
OBJECTIVE: Thyroid follicular adenomas (FA) and carcinomas (FC) have a high prevalence of aneuploidy. We examined the contribution of mitotic checkpoint dysfunction and mutations of BUB1 or BUBR1, components of the spindle assembly checkpoint pathway, to chromosomal instability in thyroid cancer. DESIGN: The integrity of the mitotic checkpoint was studied in 8 aneuploid thyroid tumour cell lines. All cell lines as well as 9 FA, 9 FC, and 1 aneuploid papillary carcinoma were screened for mutations of BUB1 by SSCP and direct sequencing. Cell lines were also examined for mutations of BUBR1. RESULTS: Neither FRO, NPA nor WRO cells arrested in mitosis after treatment with nocodazole, whereas other aneuploid cell lines paused appropriately following microtubule disruption. One FC had a 2-bp somatic deletion (G2480/A2481) of BUB1 leading to a frameshift, and one FC had a silent polymorphism at nucleotide 1049 (TGT-TGC). There was a silent polymorphism of BUBR1 (G1271A) in one sample. CONCLUSION: Some, but not all thyroid cancer cell lines with aneuploidy have an abnormal mitotic checkpoint, indicating that chromosomal instability may arise through alternative cell cycle defects. Moreover, mutations of BUB1 or BUBR1 are infrequent in follicular neoplasms, and do not account for aneuploidy in thyroid cancer.
UI - 11940050
AU - Zettinig G; Fueger BJ; Passler C; Kaserer K; Pirich C; Dudczak R;
TI - Niederle B Long-term follow-up of patients with bone metastases from differentiated thyroid carcinoma -- surgery or conventional therapy?
SO - Clin Endocrinol (Oxf) 2002 Mar;56(3):377-82
AD - Department of Nuclear Medicine, University of Vienna, Austria. firstname.lastname@example.org
OBJECTIVE: Surgery of bone metastases from differentiated thyroid carcinoma seems indicated in individual patients. This study was performed (1) to analyse retrospectively patients with bone metastases from differentiated thyroid carcinoma and (2) to evaluate the impact of surgery of bone metastases on survival. PATIENTS AND DESIGN: We analysed 41 consecutive patients with bone metastases from differentiated thyroid carcinoma who had undergone thyroid surgery at Vienna University Hospital since 1966. The median follow-up time was 12 years. There were 24 females and 17 males with a mean age of 60 +/- 12 years. Primary tumour histology was follicular in 35 and papillary in six patients. Radioiodine treatment was performed in 32 with a mean administered activity of 27 +/- 24 GBq 131I. Metastases restricted to the skeleton were found in 22 whereas in 19 individuals additional extraskeletal distant metastases were seen. Twenty-seven patients had multiple bone metastases. In 21 individuals, up to five bone metastases were surgically removed with the intention of cure. RESULTS: Univariate analysis identified total thyroidectomy (P = 0.003), lymph node surgery (P = 0.001), radioiodine therapy (P = 0.036), and the absence of extraskeletal distant metastases (P = 0.017) as significant predictors of survival. Multivariate analysis failed to identify significant prognostic factors. In the subgroup of patients with distant metastases limited to the bones, univariate analysis identified, in addition to thyroid and lymph node surgery, the surgical extirpation of the bone metastases as a significant prognostic factor associated with improved survival (P = 0.025). CONCLUSIONS: These findings indicate that in patients without additional extraskeletal distant metastases, the radical surgical extirpation of bone metastases from differentiated thyroid carcinoma might be associated with improved survival.
UI - 11859206
AU - Erickson LA; Jin L; Papotti M; Lloyd RV
TI - Oxyphil parathyroid carcinomas: a clinicopathologic and immunohistochemical study of 10 cases.
SO - Am J Surg Pathol 2002 Mar;26(3):344-9
AD - Department of Laboratory Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Oxyphil parathyroid carcinomas are uncommon neoplasms, and the clinicopathologic features of these tumors are largely unknown. We evaluated the clinicopathologic features of oxyphil parathyroid carcinomas and the expression of cytokeratin 14 (CK14), the high-affinity glucose transporter-4 (Glut-4), as well as the cell cycle proteins p27 and Ki67 and compared these with oxyphil parathyroid adenomas and chief cell parathyroid adenomas and carcinomas. Formalin-fixed, paraffin-embedded archival tissues from primary (n = 6) and recurrent (n = 4) oxyphil carcinomas were analyzed and compared with chief cell parathyroid carcinomas (n = 12), oxyphil parathyroid adenomas (n = 38), and chief cell parathyroid adenomas (n = 17) by immunohistochemistry for CK14, Glut-4, p27, and Ki67 using the avidin-biotin peroxidase system. Patients with primary oxyphil and chief cell carcinoma presented with high levels of serum calcium (n = 15.5 and 13.7 mg/dL, respectively). Approximately half the patients in each group died of disease. The Ki67 labeling index was higher (4.9 vs 1.9) and the p27 index lower (23 vs 66) in primary oxyphil carcinoma compared with primary oxyphil adenomas. CK14 was expressed in most oxyphil adenomas (35 of 38 cases) but not in oxyphil carcinomas (0 of 10 cases). Glut-4 was more commonly expressed in both groups of adenomas compared with carcinomas. These results show that oxyphil parathyroid carcinomas are functional malignancies similar to chief cell carcinomas and are associated with hypercalcemia, recurrence, and death. Expression of CK14 is very different in oxyphil adenomas compared with carcinomas. Although distinction between parathyroid adenomas and carcinomas can only be made by histopathologic and clinical findings, these results suggest that immunostaining for CK14, p27, and Ki67 may provide additional information to help distinguish between difficult cases of parathyroid adenomas and carcinomas. These findings also indicate that the same histopathologic features should be used to diagnose oxyphil and chief cell parathyroid carcinomas.
UI - 11938121
AU - Verger P; Hubert P; Bard D
TI - [What epidemiologic surveillance after a radiation accident? Lessons from Chernobyl]
SO - Rev Epidemiol Sante Publique 2002 Jan;50(1):93-103
AD - Observatoire Regional de la Sante PACA, 23 rue Stanislas Torrents, 13006 Marseille.
UI - 11943128
AU - Yamashita H; Watanabe S; Koike E; Ohshima A; Uchino S; Kuroki S; Tanaka
TI - M; Noguchi S Video-assisted thyroid lobectomy through a small wound in the submandibular area.
SO - Am J Surg 2002 Mar;183(3):286-9
AD - Noguchi Thyroid Clinic and Hospital Foundation, 6-33 Noguchi-Nakamachi, 874-0932, Beppu Oita, Japan. email@example.com
BACKGROUND: Endoscopic thyroidectomy has not gained wide acceptance because of the expertise required, the long operation time, the wide dissection, and the extra cost of specialized instruments. We developed a video-assisted hemithyroidectomy procedure that requires only one small incision at the upper neck. METHODS: Hemithyroidectomy was performed through a 25 to 30 mm transverse incision made in the upper lateral neck for the treatment of benign thyroid nodule. No gas or external lift dissection was needed. RESULTS: The mean age of 39 patients was 33.8 years. The tumor size ranged from 1.9 to 5.5 cm (mean 3.1 cm). All patients underwent total lobectomy without conversion to traditional cervicotomy. The mean operation time was 56 minutes (range 36 to 90). Follicular adenoma was the final pathologic diagnosis in 25 patients and adenomatous goiter in 14. Transient recurrent laryngeal nerve palsy was seen in 1 patient. CONCLUSIONS: Our technique is safe, minimally invasive, less time consuming, and cosmetically excellent.
UI - 11485606
AU - LiVolis VA
TI - Thyroid papillary carcinoma in lateral neck cyst: missed primary tumour or ectopic thyroid carcinoma within a branchial cyst?
SO - J Laryngol Otol 2001 Jul;115(7):614-5
UI - 11157996
AU - Shane E
TI - Clinical review 122: Parathyroid carcinoma.
SO - J Clin Endocrinol Metab 2001 Feb;86(2):485-93
AD - Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
UI - 11762710
AU - Lacroix L; Nocera M; Mian C; Caillou B; Virion A; Dupuy C; Filetti S;
TI - Bidart JM; Schlumberger M Expression of nicotinamide adenine dinucleotide phosphate oxidase flavoprotein DUOX genes and proteins in human papillary and follicular thyroid carcinomas.
SO - Thyroid 2001 Nov;11(11):1017-23
AD - Department of Clinical Biology, Institut Gustave-Roussy, Villejuif, France.
Duox2, and probably Duox1 are glycoflavoproteins involved in the thyroid H2O2 generator functionally associated to thyroperoxidase (TPO). We investigated both DUOX1 and DUOX2 gene expressions using quantitative reverse transcription-polymerase chain reaction (RT-PCR) in 47 thyroid carcinomas, including 10 paired normal/tumoral tissues. In carcinomas, variations of DUOX1 and DUOX2 mRNA levels were parallel, indicating that control mechanisms of both gene expressions operate in tumors as well as in normal thyroid tissues; DUOX1 expression was in the normal range in 20, was decreased up to 50-fold in 8, and increased up to 7-fold in 19 samples. DUOX2 expression was in the normal range in 15, was decreased up to 200-fold in 10, and increased up to 5-fold in 22 samples. In the 10 paired samples, variations of DUOX and TPO gene expressions were not correlated. We analyzed Duoxl/2 protein expression in 86 tumor samples using an antipeptide antiserum reacting with both Duox proteins. In normal tissue, Duox proteins are localized at the apical pole of thyrocytes, with 40% to 60% of thyrocytes being stained. In the 86 cancer tissues, immunostaining was absent in 19 samples, was low in 32, and normal or even slightly increased in the other 35 samples. The expression of Duox proteins was related to tumor differentiation, being more frequently found in neoplastic tissues that were able to pick up radioiodine, and in those with a detectable expression of sodium iodide symporter (NIS), pendrin and TPO.
UI - 11762717
AU - Merhy J; Driscoll HK; Leidy JW; Chertow BS
TI - Increasing incidence and characteristics of differentiated thyroid cancer in Huntington, West Virginia.
SO - Thyroid 2001 Nov;11(11):1063-9
AD - Department of Medicine, Joan C. Edwards School of Medicine at Marshall University and Medical Service, Veterans Affairs Medical Center, Huntington, West Virginia 25701, USA.
Since 1985, we have observed an increasing number of differentiated thyroid cancer cases in Huntington, West Virginia. We describe tumor incidence, patient and tumor characteristics, treatment modalities, and tumor recurrence and death. One hundred seventeen patients with differentiated thyroid cancer were identified between 1976 and 1999. Data were collected from patient records in our practice and the tumor registries at the three hospitals serving our community. The annual incidence of differentiated thyroid cancer increased significantly from fewer than 3 cases per 100,000 prior to 1996 to 9.4 cases per 100,000 in 1999. The median age at diagnosis was 49 years (range, 16-80). The median tumor size was 2.5 cm (range, 1.2-10). Forty-seven percent of the patients had bilateral disease, 28% had three or more tumors, 44% had thyroid capsular invasion, and 16% had gross extrathyroid invasion at surgery. Twenty-two percent had cervical lymph node involvement and 9% had distant metastases at diagnosis. During 1-month to 23-year follow-up, 11% had recurrence, and 5% died of thyroid cancer. In summary, differentiated thyroid cancer has increased dramatically in our community. The tumors appear to be aggressive at diagnosis as reflected by the high percentage of tumors with bilateral, multicentric, and locally invasive disease.
UI - 11762722
AU - Sequeira MJ; Morgan JM; Fuhrer D; Wheeler MH; Jasani B; Ludgate M
TI - Thyroid transcription factor-2 gene expression in benign and malignant thyroid lesions.
SO - Thyroid 2001 Nov;11(11):995-1001
AD - Department of Medicine, University of Wales College of Medicine, Cardiff, United Kingdom.
Thyroid transcription factor-2 (TTF-2) is a recently cloned thyroid-specific gene and is central to the development and differentiation of the thyroid follicular cell. Information regarding transcript levels in normal and diseased adult human thyroids is lacking. We have investigated TTF-2 gene expression in various thyroid pathologies and assessed its potential in preoperative diagnosis of thyroid nodular disease, which is a common clinical problem. We have used reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridization (ISH) and detected TTF-2 transcripts in 60% of 125 samples of adult human thyroids tested by RT-PCR (64% of 35) or ISH (59% of 90). In normal thyroid tissues TTF-2 transcript levels are low, 18 of 36 were weakly positive and 18 of 36 negative when tested by ISH. In the benign lesions, TTF-2 transcripts were detected either by RT-PCR or ISH in 8 of 8 Graves disease; 3 of 7 Hashimoto's; 2 of 2 follicular hyperplasia; 15 of 21 follicular adenoma; 11 of 13 multinodular goiters and 0 of 1 hyalinizing trabecular adenoma. In the malignant thyroid lesions, TTF-2 transcripts were detected in 8 of 18 follicular cancers; 0 of 2 anaplastic carcinoma, and 11 of 17 papillary cancers. Compared with normal thyroids, transcripts were more abundant in 24% of thyroid lesions tested by ISH. In conclusion, we report for the first time on TTF-2 gene expression in normal and diseased adult human thyroids.
UI - 11903601
AU - Coli A; Bigotti G; Zucchetti F; Negro F; Massi G
TI - Galectin-3, a marker of well-differentiated thyroid carcinoma, is expressed in thyroid nodules with cytological atypia.
SO - Histopathology 2002 Jan;40(1):80-7
AD - Department of Pathology, Catholic University of Sacred Heart, Largo F. Vito 1, 00168 Rome, Italy.
AIMS: The distribution of galectin-3, a widely recognized marker of well-differentiated thyroid carcinoma, was investigated in 95 thyroid lesions including nodules with foci of cytoarchitectural atypia. METHODS AND RESULTS: Twenty-eight papillary carcinomas, five follicular carcinomas, one Hurthle cell carcinoma, three poorly differentiated carcinomas, one anaplastic carcinoma, 25 nodular hyperplasias and 27 follicular adenomas, including nodules with atypical features, three neoplasms of undetermined malignant potential and two thyroiditis cases were examined. By immunohistochemistry, galectin-3 was consistently found in carcinomas; otherwise benign nodules exhibited galectin-3-positive clusters of cells with poorly developed features of differentiated carcinoma (mainly of papillary type) such as nuclear chromatin clearing, nuclear clefting, pseudoinclusions, which, in each case, were not histologically sufficient to warrant a definitive diagnosis of malignancy. In other nodules galectin-3 staining was negative. The latter were either clearly benign or showed constantly a minor degree of chromatin clearing and of other atypical features when compared with galectin-3-positive cases. CONCLUSIONS: Galectin-3, a reliable marker of differentiated thyroid carcinoma as confirmed in our series of malignant neoplasms, appears expressed in nodules with an overall benign appearance but with focal areas suspicious for malignancy. The significance of such findings needs to be further investigated.
UI - 11996789
AU - Hemmer S; Wasenius VM; Haglund C; Zhu Y; Knuutila S; Franssila K;
TI - Joensuu H Alterations in the suppressor gene PPP2R1B in parathyroid hyperplasias and adenomas.
SO - Cancer Genet Cytogenet 2002 Apr 1;134(1):13-7
AD - Department of Oncology, Haartmaninkatu 4, P.O. Box 180, FIN-00029 HUS, Helsinki, Finland.
Deletion of chromosome 11q23 is a common alteration in parathyroid adenomas and hyperplasias. A new potential suppressor gene PPP2R1B encoding the beta isoform of the A subunit of the serine/threorine protein phosphatase 2A was recently identified and localized to chromosome 11q23. We performed polymerase chain reaction-based single-strand conformation polymorphism and direct sequencing on six parathyroid hyperplasias and 12 adenomas to evaluate the role of PPP2R1B in the pathogenesis of parathyroid lesions. A previously identified germline G-A transition (GGC-GAC) in codon 90, changing glycine (Gly) to aspartic acid (Asp), was detected in one adenoma. Both the common Gly allele and the variant Asp allele were detected by direct sequencing in the patient's somatic cells. We conclude mutations of PPP2R1B are not frequent in parathyroid lesions, and that other genes located at 11q23 may be more closely associated with pathogenesis of parathyroid hyperplasia and adenoma.
UI - 11130016
AU - Kondi-Pafiti A; Smyrniotis V; Frangou M; Papayanopoulou A; Englezou M;
TI - Deligeorgi H Immunohistochemical study of ceruloplasmin, lactoferrin and secretory component expression in neoplastic and non-neoplastic thyroid gland diseases.
SO - Acta Oncol 2000;39(6):753-6
AD - Department of Pathology, Athens University, School of Medicine, Areteion Hospital, Greece.
The expression of lactoferrin (LF), ceruloplasmin (CP) and secretory component (SC) in various thyroid diseases was investigated using an immunohistochemical method. LF is an iron-binding protein overexpressed in certain human adenocarcinomas. CP is implicated in carcinogenesis and SC is part of the local immune defense system. Sections of 15 follicular adenomas, 5 follicular carcinomas (FC), 16 papillary carcinomas (PC), 15 goitres and 2 cases of lymphocytic thyroiditis were re-examined and investigated immunohistologically by a streptavidin-biotin method. A positive immunostain reaction for CP and LF was observed in all cases of PC and FC. A positive immunostain reaction for SC was observed in 13/16 cases of PC and 4/5 cases of FC. A negative immunostain reaction for CP, LF and SC was observed in medullary cancers, in follicular adenomas and in the cases with goitre. We conclude that the immunostain expression of LF, CP and SC is a valuable diagnostic aid in the differential diagnosis between benign and malignant thyroid tumors. The expression of SC indicates the presence of a local immunodefensive system.
UI - 11859989
AU - Tuccari G; Barresi G
TI - Comments to the article 'Immunohistochemical study of ceruloplasmin, lactoferrin and secretory component expression in neoplastic and nonneoplastic thyroid gland diseases' by A. Kondi-Pafiti et al. in Acta Oncologica 2000; 39 (6) 753-6.
SO - Acta Oncol 2001;40(7):875-6
UI - 11937995
AU - Michels JJ; Delcambre C; Marnay J; Denoux Y; Peny AM; Chasle J
TI - [Primary thyroid lymphomas: clinicopathologic study of 30 cases and review of the literature]
SO - Ann Pathol 2002 Feb;22(1):10-7
AD - Service d'Anatomie Pathologique, Centre Francois Baclesse, 14076 Caen Cedex, France.
During a both retrospective and prospective study of thyroid cancers treated in the Basse Normandie between 1960 and 1999, we have identified 32 patients with thyroid lymphoma. The correct diagnosis was made initially in 69% of all cases. In the other cases, the diagnosis was secondarily corrected after review of the pathological material. According to the REAL classification, 7 (21%) corresponded to low grade MALT lymphomas, 2 to low grade lymphomas, 10 to high grade MALT Lymphomas and 10 (31%) to high grade lymphomas, one plasmocytoma and two unclassified lymphomas. According to the Ann Arbor classification, stage was IE for 56%, IIE for 19%, IIIE for 3% and 9% for IV. Median survival was 28 months with a mean at 61 months. 20 patients died (62%), 12 from the lymphoma and 8 from intercurrent causes. The overall survival at 5 years was 36% (9 5% CI 16 54%). A comparison of our results with those of the literature was performed.
UI - 11950855
AU - Lesueur F; Corbex M; McKay JD; Lima J; Soares P; Griseri P; Burgess J;
TI - Ceccherini I; Landolfi S; Papotti M; Amorim A; Goldgar DE; Romeo G Specific haplotypes of the RET proto-oncogene are over-represented in patients with sporadic papillary thyroid carcinoma.
SO - J Med Genet 2002 Apr;39(4):260-5
AD - International Agency for Research on Cancer, Lyon, France.
BACKGROUND: Papillary thyroid carcinoma (PTC), which may be sporadic (95%) or familial (5%), has a prevalence adjusted for age in the general population of 1:100 000. Somatic rearrangements of the RET proto-oncogene are present in up to 66% of sporadic tumours, while they are rarely found in familial cases. PURPOSE: In order to determine if some variants of this gene, or a combination of them, might predispose to PTC, we looked for an association of RET haplotype(s) in PTC cases and in controls from four countries matched for sex, age, and population. METHODS: Four single nucleotide polymorphisms (SNPs) across the RET coding sequence were typed and haplotype frequencies were estimated. Genotype and haplotype distributions were compared among these cases and controls. RESULTS: Ten haplotypes were observed, the seven most frequent of which have been previously described in sporadic Hirschsprung patients and controls. The single locus analyses suggested association of exon 2 and exon 13 SNPs with sporadic PTC. The haplotype analysis showed over-representation of one haplotype in French and Italian sporadic PTC, whereas a different haplotype was significantly under-represented in French familial PTC. CONCLUSIONS: Our data suggest that some variants of RET and some specific haplotypes may act as low penetrance alleles in the predisposition to PTC.
UI - 11916545
AU - Rubino C; Cailleux AF; De Vathaire F; Schlumberger M
TI - Thyroid cancer after radiation exposure.
SO - Eur J Cancer 2002 Mar;38(5):645-7
AD - INSERM U 521 and Department of Nuclear Medicine and Endocrine Tumors, Institut Gustave Roussy, 94805 Villejuif, France.
UI - 11993691
AU - Baloch ZW; LiVolsi VA
TI - Neuroendocrine tumors of the thyroid gland.
SO - Am J Clin Pathol 2001 Jun;115 Suppl():S56-67
AD - Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
The neuroendocrine lesions of the thyroid are few in number and include C-cell lesions (C-cell hyperplasia and medullary carcinoma), mixed C-cell and follicular-derived tumors, paraganglioma, intrathyroidal parathyroid adenoma, and metastasis to the thyroid from neuroendocrine carcinoma arising elsewhere. However, some follicular-derived lesions of the thyroid can show trabecular and nesting growth patterns characteristic of neuroendocrine tumors. These lesions should also be included in the differential diagnosis of primary and secondary neuroendocrine tumors of the thyroid.
UI - 11914930
AU - Hubbard JG; Sebag F; Maweja S; Henry JF
TI - Primary hyperparathyroidism in MEN 1--how radical should surgery be?
SO - Langenbecks Arch Surg 2002 Mar;386(8):553-7
AD - Department of Endocrine Surgery, University Hospital La Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 5, France.
Primary hyperparathyroidism is the most common manifestation of MEN 1 syndrome. The management of these patients is complex due to the underlying disease process, which predisposes patients to persistent and recurrent disease. The surgical treatment of patients with MEN 1 and hyperparathyroidism can therefore be considered to be palliative in nature. The basic principles of surgery include (1) obtaining and maintaining normocalcaemia for the longest time possible, avoiding persistent/recurrent hypercalcaemia, (2) avoiding surgically induced hypocalcaemia, and (3) facilitating future surgery for recurrent disease. Two approaches have been described as the best practice for patients with hyperparathyroidism in MEN 1: subtotal parathyroidectomy, leaving a remnant of no more than 60 mg in the neck, and total parathyroidectomy with immediate autotransplantation of 10-20 1 mm(3) pieces of parathyroid tissue. Both approaches should be combined with efforts to exclude supernumerary glands and ectopic parathyroid tissue by including resection of fatty tissue from the central neck compartment and thymectomy in all patients. Cryopreservation of parathyroid tissue should be performed whenever facilities are available. In patients with persistent or recurrent disease, an attempt to obtain total elimination of cervical parathyroid tissue is justified, combined with cryopreservation of parathyroid tissue. As radical as surgery is for hyperparathyroidism in MEN 1, the surgeon must take steps to avoid permanent hypoparathyroidism, which in young patients may be worse than the disease itself.
UI - 11989299
AU - Biermann M; Schober O; Multizentrische Studie Differenziertes
TI - Schilddrusenkarzinom Studiengruppe [How many high-risk patients with differentiated thyroid cancer need a "Tumor Center" per year?]
SO - Nuklearmedizin 2002 Apr;41(2):61-2
UI - 12001695
AU - Korem S; Kraiem Z; Shiloni E; Yehezkel O; Sadeh O; Resnick MB
TI - Increased expression of matrix metalloproteinase-2: a diagnostic marker but not prognostic marker of papillary thyroid carcinoma.
SO - Isr Med Assoc J 2002 Apr;4(4):247-51
AD - Endocrine Research Unit, Carmel Medical Center and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
BACKGROUND: Matrix metalloproteinases are proteolytic enzymes that degrade extracellular matrix components. Numerous studies have demonstrated that individual MMPs play a crucial role in tumor invasion and metastasis. OBJECTIVE: To examine the expression of MMPs and their inhibitor TIMP-2 in neoplastic and normal thyroid tissues. METHODS: We examined 33 cases of thyroid tumor (papillary, follicular and medullary carcinoma, follicular adenoma and multinodular goiter). MMP protein content and activity were measured by enzyme-linked immunosorbent assay and gel zymography. Immunohistochemistry was also performed. RESULTS: The thyroid tissues examined secreted MMP-2 and 9 as well as TIMP-2, but only MMP-2 was significantly higher in papillary carcinoma cases compared to the adjacent normal tissue or to the other tumor entities. Increased MMP-2 immunohistochemical staining was demonstrated in the neoplastic papillary epithelial component. No significant difference was seen between papillary carcinomas with lymph node metastases and those without. CONCLUSIONS: Increased MMP-2 expression may be useful as a diagnostic marker to differentiate papillary carcinoma from other thyroid neoplasms, but it cannot serve as a useful prognostic marker.
UI - 11716041
AU - Frasoldati A; Flora M; Pesenti M; Caroggio A; Valcavil R
TI - Computer-assisted cell morphometry and ploidy analysis in the assessment of thyroid follicular neoplasms.
SO - Thyroid 2001 Oct;11(10):941-6
AD - Unita Operativa di Endocrinologia, Centro Interdipartimentale per le Malattie della Tiroide, Azienda Ospedaliera di Reggio Emilia, Arcispedale S. Maria Nuova-Reggio Emilia, Italy.
Conventional cytology cannot discriminate between benign and malignant follicular neoplasms. Our study evaluated the diagnostic role of computer-assisted image analysis in the presurgical assessment of thyroid follicular neoplasms. Fifty-eight patients (14 males, 44 females, age range, 45-75 years) who underwent surgery for cytologic diagnosis of thyroid follicular neoplasm were studied. All patients were first evaluated on clinical grounds and assigned a high/low suspicion of malignancy on the basis of gender, age, and nodule size. Cell image analysis was subsequently performed using a Cytometrica BYK Gulden microscope image processor on Feulgen-stained thyroid cytologic smears. A different population of 50 benign and 50 malignant, histologically evaluated nodules was studied in order to establish image analysis criteria suggestive of thyroid malignancy. Ploidy histogram, proliferation index (PI), nuclear area coefficient of variation (NACV), and anisocariosis ratio (AR) were studied. Thyroid cancer was diagnosed in 16 of 58 follicular neoplasms. Only 7 of these lesions were clinically suspicious (43.7%), whereas 14 of 16 (87.5%) malignant tumors were identified by image analysis. Positive and negative predictive values of image analysis versus clinical evaluation were 46.6% versus 30.4% and 92.8% versus 74.3%, respectively. The distribution of ploidy pattern was different in benign versus malignant follicular neoplasms (chi2 8.25, p = 0.016), malignant lesions showing an increased frequency of heteroclonal aneuploid DNA content (37.5% vs. 7.1%). Increased PI (mean +/- standard deviation (SD) = 11.3 +/- 5.7 vs. 7.1 +/- 6.1; p < 0.01) and NACV (mean +/- SD = 25.28 +/- 1.89 vs. 20.14 0.91; p < 0.01) levels were also observed in malignant follicular neoplasms. In conclusion, computer-assisted image analysis may profitably support clinical evaluation in the assessment of thyroid follicular neoplasms.
UI - 11716043
AU - Voutilainen PE; Multanen MM; Leppaniemi AK; Haglund CH; Haapiainen RK;
TI - Franssila KO Prognosis after lymph node recurrence in papillary thyroid carcinoma depends on age.
SO - Thyroid 2001 Oct;11(10):953-7
AD - Department of Surgery, Helsinki University Central Hospital, Finland. firstname.lastname@example.org
Papillary thyroid carcinoma (PTC) is a malignancy that has good prognosis especially among patients up to 45 years of age; about half of the patients are female and of childbearing age. Lymph node recurrence (LNR) occurs in 10%-14% of patients but is considered to be associated with relatively good prognosis. The purpose of this study was to estimate the association between patient age at primary operation, and the behavior of the disease after LNR. Between 1967 and 1994, 495 patients underwent surgery for primary PTC at the Department of Surgery, Helsinki University Central Hospital. There were 391 (79.0%) women and 104 (21.0%) men with a mean age of 44.5 years (range, 10.8-85.4 years). Fifty-eight patients in whom LNR was the first clinical sign of persistent disease after complete clinical response to primary treatment were included in this series. At the time of primary operation, 37 (64.3%) of the 58 patients who developed LNR were younger than 45 years of age and 21 patients were older. The mean times to LNR in these groups were 42.0 months (range, 3.0-194.5 months) and 49.0 months (range, 3.6-209.0 months) respectively. Carcinoma-specific 5-year survival after LNR was 100% (95% confidence interval [CI] 88.8%-100.0%) in patients ages up to 45 years and 61.1% (40.5%-82.8%) in older patients; 10-year survival rates were 100%, and 41.3% (p < 0.0001), respectively. Relative survival at 10 years was 98.6% for patients ages up to 45 years and 42.6% for older patients (p = 0.0014). Using the Cox model it was shown that development of LNR after primary treatment has an independent highly significant negative effect on survival (p < 0.001) in patients over 45 years of age. Prognosis of PTC even after LNR on patients ages up to 45 years at the time of the primary operation is almost parallel to the normal reference population, but in patients over 45 years of age the prognosis is relatively poor.