Familial Non-Medullary Thyroid Carcinoma
Dongyou Liu in Handbook of Tumor Syndromes, 2020
The thyroid gland lies in the lower anterior neck and consists of two lateral lobes joined by an isthmus which usually overlies the second and third tracheal rings. It contains many follicular and parafollicular cells (Figure 55.2). The former cells store the thyroid hormones thyroxine and triiodothyronine following their production from iodine. These hormones, often referred to as the major metabolic hormones, regulate processes in nearly every cell in the body. The latter cells secrete calcitonin and are thus also known as C cells. Thyroid carcinoma refers to cancers that originate from these cells, and it is the most common endocrine tumor [1]. There have been many terms used to describe and classify thyroid carcinomas, some of which are still in use today. For simplicity and clarity, thyroid carcinomas are often grouped into three broad categories (Figure 55.1) [2].
Clinical Aspects on the Role of Prolactin in Human Breast Cancer
Nagasawa Hiroshi in Prolactin and Lesions in Breast, Uterus, and Prostate, 2020
The endocrine tumor-host interaction is of preeminent significance in human breast cancer, not the least because it can be used therapeutically. The first indication that the apparently autonomous growth of breast cancer is influenced by the host endocrine system came from Beatson2 in 1896 when he reported on the regression of a metastasizing tumor after ovariectomy. In recent years, adoption of the estrogen receptor concept in the pathophysiology of hormonally regulated tumors by Jensen3 has led to a better understanding of the interaction of steroid hormones and the tumor cell. About one third of all breast cancers display estrogen or progesterone receptors. The growth of breast cancers with a high steroid receptor content can be inhibited in up to 80% of cases by therapies interfering with steroid metabolism, e.g., by antiestrogens. According to the generally accepted view, the main effect of such endocrine therapies consists of abolition of the stimulation of the tumor cell by host steroids. However, the steroid hormones constitute only part of the hormonal environment in which breast cancers are situated.
Peptide Receptor Therapy with 90Y-Dotatoc: The Emerging Experience in Chile
Marco Chinol, Giovanni Paganelli in Radionuclide Peptide Cancer Therapy, 2016
A 55-year-old man suffering from metastatic pancreatic tumor with portal vein thrombosis and portal hypertension syndrome was declared non-operable five years ago after a surgical exploration assuming an adenocarcinoma. After four years of evolution the patient presented a relative stable disease, but symptomatic with severe abdominal pain and diarrhea. Due to the atypical progression of the disease a biopsy was indicated. This revealed a pancreatic endocrine tumor. The 111In-Octreotide showed a strongly positive tumor uptake of the radiopharmaceutical. Therefore, the patient received 5 cycles of 90Y-DOTATOC, with a total cumulative activity of 14.54 GBq (393 mCi) at 8 to 10 week intervals. The patient showed a marked reduction of the primary and metastatic foci and is now clinically asymptomatic. Comparative whole body images acquired 24 hours after the first and fifth administration of 90Y-DOTATOC using the Bremsstrahlung radiation from the β particles (Fig. 1) demonstrated the almost complete disappearance of both the primary pancreatic tumor and liver metastases.
Evaluating the safety and efficacy of microwave ablation in treatment of cervical metastatic lymph nodes of papillary thyroid carcinoma compared to repeat surgery
Published in International Journal of Hyperthermia, 2022
Wanqing Tang, Wenhai Sun, Xiaoyan Niu, Xufu Wang, Xinya Wang, Mingzhu Zhang, Rongling Wang, Wenbin Jiang, Danni Jiang, Cheng Zhao
Thyroid cancer is the most common form of endocrine tumor [1]. Papillary thyroid carcinoma (PTC) accounts for approximately 85% of all cases of thyroid cancer [2,3]. PTC has a favorable prognosis with low mortality rates [4] and a good response to conventional treatments, including thyroidectomy, radioiodine ablation (RAI), and thyrotropin (TSH) suppression therapy [5,6]. However, recurrence and metastasis rates as high as 20–30% postsurgery have been reported [7–9]. Repeat surgery and RAI are the mainstream treatments for metastatic lymph nodes (MLNs) of PTC in postoperative patients [8,10,11]. However, distortion of the neck structures secondary to tissue fibrosis and scar formation makes reoperation challenging and increases complication rates [12]. Furthermore, small MLNs may be difficult to identify without ultrasound guidance, thereby limiting the effectiveness of reoperation. Repeat surgery is the preferred treatment for MLNs of PTC in postoperative patients. However, given the associated risk, the American Thyroid Association guidelines [13] recommend active surveillance (AS) as an option for small MLNs. Several studies [13–15] support managing small MLNs with AS. However, the number/volume of MLNs may increase dramatically during the follow-up period. Furthermore, living with an untreated tumor can cause considerable anxiety for patients. Therefore, they could benefit from a minimally invasive treatment [16].
Surgical Outcomes and Efficacy of Isthmusectomy in Single Isthmic Papillary Thyroid Carcinoma: A Preliminary Retrospective Study
Published in Journal of Investigative Surgery, 2021
Hee Won Seo, Chang Myeon Song, Yong Bae Ji, Jin Hyeok Jeong, Hye Ryoung Koo, Kyung Tae
Differentiated thyroid cancer is the most common malignancy of the endocrine tumor, accounting for about 33% of all head and neck malignant tumors.1 The annual prevalence of differentiated thyroid cancer has been rapidly increasing over the last 20 years, with a female-to-male ratio of 3:1.2 Papillary thyroid carcinoma (PTC) is the most common histologic type of differentiated thyroid cancer, which accounts for 80-85% of cases and has an excellent prognosis with a 10-year survival exceeding 90%.1,3 Although the majority of PTC occurs in the thyroid lobes, approximately 1% to 9% is limited to the thyroid isthmus.4–6 The thyroid isthmus is the central part of the thyroid gland that connects the bilateral thyroid lobes. It is located just anterior to the trachea and just posterior to the strap muscles and skin. Lesions of the thyroid isthmus are known to have a higher incidence of multifocality and local invasion compared to lesions presenting in the thyroid lobes.7
Catecholamine-induced cardiomyopathy and multiple organ failure in pheochromocytoma
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Joel Thekekara, Atchayaa Gunasekharan, Young Kwon, Niaz Memon, Joe N Hackworth
This patient had cardiomyopathy, pulmonary edema, acute kidney injury, acute liver injury, hyperglycemia without a history of diabetes, and elevated lactic acid. This presentation of cardiomyopathy in the setting of multiple organ failure is an extremely rare presentation for pheochromocytoma. She was initially considered to have three separate diagnoses of STEMI, hyperglycemia, and sepsis. Normal coronary vessels on cardiac angiography with cardiomyopathy and unexpected improvement in clinical symptoms over a short time period suggested that a functioning endocrine tumor could be the underlying etiology for her clinical presentation. An incidental finding of an adrenal mass on CTPA was crucial in suspecting the final diagnosis of pheochromocytoma.
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