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Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Exposure to ionizing radiation is the main cause of papillary thyroid carcinoma. Risk factors may include genetics, alcohol consumption, diabetes mellitus, dietary nitrites, excessive dietary iodine, obesity, and smoking. The actual causes of follicular thyroid carcinoma are unknown, but inadequate dietary iodine is a significant risk factor. Genetic factors are considerable for follicular thyroid carcinomas. The cause of MTC is not known, and there is no relationship to external ionizing irradiation of the head and neck. Often, the tumor develops along with Hashimoto’s thyroiditis, but this is not fully understood. The etiology of ATCs is unclear. Risk factors include inherited cancer syndromes, including Cowden’s syndrome, Carney complex, Werner’s syndrome, and familial adenomatous polyposis.
Imaging in head and neck surgery
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Differentiated thyroid carcinoma includes the histological subtypes of papillary, follicular and follicular variant of papillary carcinoma. The imaging for these follows the fundamental principles of the BTA guidelines for nodule evaluation [8]. As well as primary lesion evaluation, ultrasound has the advantage of histological evaluation with fine needle aspiration. Further to this, ultrasound also allows assessment of nodal metastatic spread. This is essential for subsequent management plans discussed in the MDT meeting.
The Thyroid and the Parathyroid Glands
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
The prognosis of thyroid carcinoma depends largely on the cell type. Papillary carcinoma has the best prognosis of all the malignant tumors of the thyroid gland.4 However, this tumor is multicentric and total thyroidectomy gives better results in large tumors. However, tumors of 1 cm or less in diameter can be treated by a lobectomy giving the same results.5 Follicular carcinoma has a similarly good prognosis as papillary carcinoma as long as there is no blood vessel invasion. The presence of blood vessel invasion in follicular carcinoma carries a poor prognosis, with a high risk of distant metastasis. However, such metastasis frequently responds to radioactive iodine therapy with a positive effect on survival.
Thyroid paraganglioma – a rare entity
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
K Naidu, V Saksenberg, MF Suliman, B Bhana
Neuroendocrine tumours of the thyroid are rare and include medullary thyroid carcinoma, C-cell hyperplasia, mixed C-cell and follicular derived tumours, paraganglioma, intrathyroidal parathyroid adenoma and secondary metastases.1 Most thyroid neoplasms arise from thyroid follicular cells, with papillary thyroid carcinoma being the commonest histologic subtype. The approximate incidence of extra-adrenal paragangliomas (PG) is 1 per 1 million persons.3 PGs of the head and neck region arise from the parasympathetic nervous system and are usually non-functional (±1–3% are secretory) and are rarely malignant (±4–16%).4 Parasympathetic PGs are usually only found in the head and neck area.5,6 The most prevalent head and neck PG is a carotid body tumour, followed by glomus tympanicum and vagal paraganglioma.7 Rare sites include the orbits, para-nasal sinuses, larynx, thyroid and parathyroid glands. The thyroid gland is one of the rarest locations for an extra-adrenal PG.8
The pathogenesis and treatment differences between differentiated thyroid carcinoma and medullary thyroid carcinoma
Published in Current Medical Research and Opinion, 2022
Jingyang Su, Yue Fu, Menglei Wang, Jiang Yan, Shengyou Lin
It is worth noting that distinguishing differentiated thyroid carcinoma (DTC) from medullary thyroid carcinoma (MTC) is necessary. Although these two forms of thyroid cancer share certain similarity in the selection of multi-target tyrosine kinase inhibitors (TKIs), the pathogenesis followed by treatment varies. Thyroid cancer can be divided into three main histological types: DTC, MTC as well as anaplastic thyroid carcinoma (ATC); the last type is not included in the discussion here. DTC accounts for approximately 90% of all thyroid cancers, the pathogenesis of which is related to targets like vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor (PDGFR), fibroblast growth factor receptor (FGFR), involving rearranged during transfection (RET)-RAS-RAF-mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase (PI3K)-Akt -mammalian target of rapamycin (mTOR) signalling pathways. RET/PTC translocations along with BRAFV600E mutation in papillary thyroid carcinoma2, and RAS mutation in follicular and poorly DTC are the most common genetic variant. MTC is a neuroendocrine tumour originating from parafollicular thyroid cells, which can be classified into sporadic and hereditary types. Hereditary MTC is primarily associated with RET mutation, where transmitting an abnormal signal by an encoded protein affects growth, survival, invasion, metastasis of tumour cells. Therefore, MTC has a poorer prognosis than DTC.
Thyroid gland involvement in secondary syphilis: a case report
Published in Acta Clinica Belgica, 2022
Thomas Strypens, Gudrun Alliet, Greet Roef, Linsey Winne
The differential diagnosis with an anaplastic thyroid carcinoma should be made due to the rapidly progressive increase in volume of the thyroid swelling as well as its ultrasonically ill-defined boundaries with embedded microcalcifications and the slimy aspect of the puncture fluid. However, associated uveitis and inflammatory laboratory results do not fit this diagnosis. Tuberculosis should also be included in the differential diagnosis. Tuberculosis of the thyroid gland is a rare condition with a reported incidence rate of 0.1–0.3% [16]. Concomitant disorders of the thyroid in tuberculosis of the thyroid are rare [16,17], but hyperthyroidism and hypothyroidism have been reported [16]. The majority of these cases had a primary focus elsewhere in the body with hematogenous spread. Other possible differential diagnoses are sarcoidosis, subacute granulomatous thyroiditis, other bacterial thyroid abscess and lymphoma but were excluded due to the positive test results for T. pallidum.