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Hyperthyroidism
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
The risk of thyroid neoplasms in children is greatest with exposure to low-level external radiation (0.1–25 Gy; ~0.09–30 uCi/g) and not with the higher activities used to treat GD. At present, we are not aware of any cases of thyroid cancer that developed in pediatric patients treated with >150 uCi of 131I per gram of thyroid tissue for childhood GD that can be attributed to 131I therapy.
The endocrine system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Follicular adenomas are benign encapsulated lesions with follicular patterns of growth but lacking invasion and the nuclear features of papillary carcinoma. These are common thyroid neoplasms, presenting in young to middle aged females, as painless thyroid lumps (see Case History 18.2). They are usually solitary, encapsulated lesions containing haemorrhage, degeneration, and fibrosis, histologically they contain follicular epithelial cells arranged in a wide variety of architectural patterns The cells lack the nuclear features of papillary carcinoma and no invasion of blood vessels or capsule is seen. Distinguishing between an adenoma and an adenomatous nodule can at times be difficult but is of limited clinical significance. Follicular adenomas show mutations in RAS and PAX8/PPARG gene rearrangements. TSHR and GNAS mutations may also be seen.
The thyroid gland
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Clinical history and examination continue to be the cornerstone of diagnosis of thyroid neoplasms. As previously mentioned, radiation exposure and family history should be discussed. Examination of the central neck and regional lymphatics should be combined with assessment of vocal cord function. Biochemical assessment of thyroid function should also be considered in this first encounter, if not already performed.
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
Major vessel invasion by thyroid cancer: a comprehensive review
Published in Expert Review of Anticancer Therapy, 2019
Michael S. Xu, Jennifer Li, Sam M. Wiseman
Literature searches were performed using PubMed and MEDLINE databases to identify relevant studies published in English between 1940 and 2018. A preliminary search was performed for articles identified with searches using the keywords ‘thyroid neoplasms’ and ‘thyroid cancer’ cross-referenced with terms: ‘papillary,’ ‘follicular,’ ‘differentiated,’ ‘anaplastic,’ ‘medullary,’ or ‘poorly-differentiated’ in the title and/or abstract. The search results were then cross-referenced for abstracts containing the words: ‘vascular,’ ‘invasive,’ ‘invasion,’ ‘extrathyroidal,’ ‘aggressive,’ or ‘locally advanced.’ Abstracts then were further narrowed down to those that contained the words: ‘arteries,’ ‘veins,’ ‘internal jugular,’ and ‘superior vena cava.’
Controversies in the pharmacological treatment of Graves’ disease in children
Published in Expert Review of Clinical Pharmacology, 2018
Filippo De Luca, Mariella Valenzise
RAI is widely used in children but still viewed as controversial by some practitioners owing primarily to concern over cancer risks. Although there are sparse clinical data relating to RAI use in children with GD and subsequent thyroid cancer, it is known that risks of thyroid cancer after external irradiation are highest in children <5 years of age, and they decline with advancing age. For this reason RAI is contraindicated in children under 5 years, for pre-pubescent children and for large goiters over 80 g in mass. The risk is due to the sensitivity of tissues to radiation. In comparison, activities of RAI used with contemporary therapy are not known to be associated with an increased risk of thyroid neoplasm in children.