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Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
This patient appears to be suffering from the consequences of hyperthyroidism. The finding of a single enlarged nodule suggests this may be a toxic thyroid adenoma. This may also be Graves’ disease, though exopthalmos and pretibial myxoedema are usually present. On examination, only a single nodule was palpable, but this may also be a toxic multinodular goitre.
Endocrine Imaging
Published in D. A. Scullion, G. Cook, R. Allan, D. A. Cunningham, MCQs in Clinical Nuclear Medicine, 2020
D. A. Scullion, G. Cook, R. Allan, D. A. Cunningham
The commonest causes of a solitary thyroid nodule are: Thyroid adenomaColloid cystPrimary thyroid carcinoma
Radiation Carcinogenesis: Human Model
Published in Kedar N. Prasad, Handbook of RADIOBIOLOGY, 2020
From the data on the survivors of atomic bomb, it was estimated that a dose of 50 rads or more produces thyroid tumors. Recent studies101,102 estimate that a dose of 6.5–7 rads may produce thyroid cancer. The BEIR report26 estimates that the risk of thyroid cancer is about 1.6–9.3 cases per 106/year/rad. The X-irradiation is 10–80 times more effective than β-irradiation.103 This estimate is based on animal studies. However, β-irradiation is more effective in inducing hyperthyroidism. Radiation-induced thyroid cancers are mostly the papillary and follicular types.103–104 The BEIR report26 suggests that females are 2.3 times more sensitive than males. The incidence among females of Jewish heritage may be 17 times higher than non-Jewish females. There is no relation between lower doses and the latent period. The latent period may vary from 10 years to over 35 years after irradiation.26 Age was initially considered an important factor in radiation-induced thyroid cancer, but the BEIR report indicates that age may be a weak influence.26 Thyroid adenoma may have a higher incidence than thyroid carcinoma with smaller doses of radiation.26 The incidence of thyroid adenoma is about 12 cases per 106/year/rad, which is about three times higher than that of thyroid carcinoma.100
Lever-elevating vs. liquid-isolating maneuvers during microwave ablation of high-risk benign thyroid nodules: a prospective single-center study
Published in International Journal of Hyperthermia, 2019
Huaxiang Yang, Yanjun Wu, Jie Luo, Xiaoliang Yang, Jing Yan
This study enrolled a total of 174 eligible cases (Figure 1). These 174 patients were randomly assigned to the liquid-isolating method group (LIM group) or the lever-elevating method group (LEM group). The LIM group included 87 patients (35 males and 52 females, aged 22–63 years; mean age, 44.5 ± 10.8 years). The mean number of thyroid nodules was 3.4 ± 0.8. Mean thyroid nodule diameter was 2.52 ± 1.38 cm. The LIM group included 83 cases of nodular goiter and 4 cases of thyroid adenoma. The LEM group included 87 patients (39 males and 48 females, aged 20–65 years; mean age, 42.3 ± 11.6 years). The mean number of thyroid nodules was 3.2 ± 0.5. Mean thyroid nodule diameter was 2.46 ± 1.07 cm. The LEM group included 85 cases of nodular goiter and 2 cases of thyroid adenoma. There was no significant difference in clinical data between groups (all p > .05), as shown in Table 1.
miR-146b measurement in FNA to distinguish papillary thyroid cancer from benign thyroid masses
Published in British Journal of Biomedical Science, 2018
F Yang, H Zhang, X Leng, F Hao, L Wang
Histological diagnoses were primary PTC (n = 246), benign thyroid nodules (n = 90). The clinicopathological characteristics of the patients are shown in Table 1. Of the PTC patients, 192 were at TNM stage I/II, 50 were at TNM stage III/IV. Of patients with benign thyroid nodules, 62 had a thyroid adenoma and 28 had a classical nodular goiter. PTCs and benign thyroid nodules patients were age (49.7 years [16.4–70.4] and 49.3 [19.4–78.4], p = 0.439) and sex (M:F = 54:192 and M:F = 28:62, P = 0.215) matched. Relative expression of miR-146b compared to the general U6 mRNA level was significantly higher in malignant lesions compared with benign lesions (194.3 [IQR 1.4–392.4] vs. 18.7 [0.9–113.6 ng/mL] p = 0.0013). Levels of miR146b were significantly higher in PTCs with advanced TNM stage, lymph node metastasis and distant metastasis (Table 1).
Diagnosis and management of hurthle cell carcinoma, a rare case report
Published in Acta Oto-Laryngologica Case Reports, 2020
Marlinda Adham, Ferucha Moulanda, Agnes Harahap, Krishna Pandu, Em Yunir
Significant age differences were observed between Hurthle cell thyroid adenoma (HCA) and Hurthle cell thyroid carcinoma (HCC) in which patients with HCC were 12 years older and had a larger initial tumor size (26 mm versus 40 mm). Ultrasonography (USG) and Fine Needle Aspiration (FNA) were considered as the main procedure to diagnose thyroid malignancy, but the application of these procedures is still challenging in terms of differentiating benign and malignancy cases of follicular neoplasm. A thorough investigation of the tumor with the discovery of trans capsular and/or vascular invasion is required. Diagnostic procedure is challenging and often require hemithyroidectomy and total thyroidectomy (second surgery) in patients suspected with malignancy [2,3].