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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.
Thyroid nodules
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Catherine McManus, Jennifer H. Kuo, James A. Lee
One important difference in the pediatric population is the evaluation of a diffusely enlarged thyroid gland. In children, papillary thyroid carcinoma can potentially present as a diffuse infiltrating disease that involves the entire lobe or gland. The majority of diffusely infiltrating PTC will have microcalcifications on ultrasound; thus, all children with a diffusely enlarged thyroid gland should undergo an ultrasound and subsequent biopsy if microcalcifications are noted (2).
Imaging of the Thyroid
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Papillary thyroid carcinoma accounts for 60%–70% of thyroid cancer [35–38]. It can be seen as a multicentric form and may be micro-nodular (<1 cm size nodule). It spreads along lymphatics to regional lymph nodes, and distant metastasis is commonly to lung and bone. Characteristic ultrasound features (Figures 4.20 through 4.22) are a solid or a mixed solid cystic hypoechoic or very hypoechoic mass lesion with punctate (Figure 4.23) echogenic foci within. The margins may be lobulated or irregular or ill-defined. Extrathyroidal extension and metastatic lymph nodes show features similar to primary lesions such as hypoechoic texture and punctate foci and cystic changes. On color Doppler, central heterogeneous vascularity is seen (Figures 4.24 through 4.26).
Clinical Efficacy of Intraoperative Ultrasound for Prophylactic Lymphadenectomy of the Lateral Cervical Neck in Stage CN0 Papillary Thyroid Cancer: A Prospective Study
Published in Journal of Investigative Surgery, 2023
Yi Shen, Xiaoen Li, Lingling Tao, Yupan Chen, Rongli Xie
The most prevalent thyroid cancer is a papillary thyroid carcinoma (PTC). Although the majority of PTC has a slow progression and a good prognosis, with a 10-year survival rate of more than 90% after surgical treatment, patients with PTC are prone to early lymph node metastasis (LNM), which can be as high as 20–90% in the neck [1–3] and 30–50% in the lateral cervical region (LCR) lymph node occult metastasis [4–6]. Thyroidectomy and thorough and rational lymph node dissection are recognized as the best options for the treatment of PTC [7–8]. The current standard procedure for PTC is thyroidectomy with central group lymph node dissection [9–10], but there is still a long-standing controversy at home and abroad about the need for prophylactic cervical lymph node dissection [11, 12], especially for patients with negative lymph nodes on preoperative imaging, there is no unanimous opinion on whether prophylactic LCR lymph node dissection is needed, as well as the extent and timing of dissection.
A preliminary study of microwave ablation for solitary T1N0M0 papillary thyroid carcinoma with capsular invasion
Published in International Journal of Hyperthermia, 2022
Jie Wu, Ying Wei, Zhen-Long Zhao, Li-Li Peng, Yan Li, Nai-Cong Lu, Ming-An Yu
The incidence of papillary thyroid carcinoma (PTC) has increased significantly in recent years, while disease-related mortality rates have not obviously changed [1,2]. Surgical resection is the classic treatment for PTC, while the specific method and scope of resection are distinct for different stages of PTC. PTC lesions extending to the thyroid capsule, perithyroidal soft tissue, or sternothyroid muscle are classified as a minimal extrathyroidal extension (mETE). The rate of extrathyroidal extension (ETE) in PTC is reported to be 22.7%, of which capsular invasion (CI) accounts for 4.7% [3]. CI is defined as a PTC nodule penetrating into the thyroid capsule without attaching to surrounding tissue [4]. The thyroid capsule is histologically defined as the connective tissue layer that is close to and envelops the thyroid gland. The thyroid capsule penetrates through the gland parenchyma, which includes blood vessels, lymphatics, and nerves, but does not include muscle components. The structure of the capsule provides an anatomical basis for the relatively higher incidence of lymph node metastasis (LNM) in PTC with CI. Previous studies have shown that CI is an independent risk factor for LNM in PTC patients [5,6].
Efficacy and safety of ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma: a systematic review and meta-analysis
Published in International Journal of Hyperthermia, 2022
JiaNan Xue, DengKe Teng, Hui Wang
Thyroid nodules (most of which are benign) are a common disease of the endocrine system, and malignant nodules account for 5–15% of all cases. Although the recommendations of the Korean guidelines for thyroid cancer screening published in 2015 do not routinely recommended thyroid ultrasonography for healthy subjects [1], according to the ATA guidelines [2], thyroid nodules can be classified into five categories using thyroid ultrasound (US): benign pattern (0% risk), very low suspicion pattern (<3% risk), low suspicion pattern (5–10% risk), intermediate suspicion pattern (10–20% risk) and high suspicion pattern (>70–90% risk). The most common type of malignant thyroid tumor is papillary thyroid carcinoma (PTC), which accounts for 85% of thyroid cancers [3]. In PTC, if the diameter of the tumor is less than or equal to 1 cm, then it can be defined as papillary thyroid microcarcinoma (PTMC), which has a better prognosis of low mortality and recurrence rate [4]. The current standard treatment for PTMC is surgery (e.g., thyroid lobectomy) and preventive or therapeutic lymph node dissection [5,6]. However, a variety of postoperative complications can occur, including hypothyroidism and injury of the parathyroid glands, which can affect patients’ quality of life and physical health [7,8]. Therefore, we must find treatments with fewer complications that give patients better quality of life and better cosmetic results.