Cancer
Jahangir Moini, Matthew Adams, Anthony LoGalbo in Complications of Diabetes Mellitus, 2022
Thyroid cancer is one of the most common malignant endocrine tumors. It is subclassified as papillary, follicular, medullary and anaplastic carcinoma. Patients with diabetes are at a 1.34 times higher risk for thyroid cancer than those without diabetes. Thyroid cancer is most common between the ages of 20 and 50, and is three times more common in women than in men. Papillary carcinoma of the thyroid is a malignant epithelial tumor. Follicular carcinoma is the second most common type of thyroid carcinoma. It is encapsulated and has invasive growth. Medullary thyroid carcinoma (MTC) is the third most common of all thyroid tumors. Anaplastic thyroid carcinoma (ATC) is very aggressive and malignant. It is made up of undifferentiated follicular thyroid cells, which do not look like normal thyroid cells. Anaplastic carcinoma is considered to be a grade IV tumor.
Principles of thyroid cancer surgery and outcomes
Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner in Endocrine Surgery, 2017
More recently, the genetic landscape of papillary thyroid cancer was made clearer by the efforts of the Cancer Genome Atlas launched by the National Institutes of Health. The institute looked at almost 500 cases of papillary thyroid cancer and found a genetic lesion in more than 96% of the tumors. The most frequent mutations were in BRAF (~60%) and RAS (~13%). From these results, two subtypes of papillary thyroid cancer were able to be discerned. The papillary tumors that had a BRAF-type expression pattern had increased heterogeneity, more likely to be of the tall cell variant, and were less differentiated, whereas tumors that had a RAS-type expression pattern were well differentiated with a low likelihood of recurrence [57]. Although further investigation is required, it is easy to see how genetic investigations will continue to further modify our treatment approach to thyroid cancers in the future.
The Thyroid and the Parathyroid Glands
E. George Elias in CRC Handbook of Surgical Oncology, 2020
Papillary carcinoma is to be treated by a total thyroidectomy and palpation of the cervical lymph node with an excision of any enlarged lymph node. This is followed by a period of no therapy for 7 to 8 weeks to develop myxedema which is then treated by a therapeutic dose of radioactive iodine (100 mCi). This is followed by Synthroid of 0.2 mg daily. The reason for carrying out total thyroidectomy is its tendency to be multicentric in both lobes. The reason for sampling the cervical lymph nodes is that this disease tends to metastasize to the regional lymph nodes. The patient is then allowed to be without thyroid until he develops myxedema so that the ablative therapy will be more effective. It should be kept in mind that repeated administration of radioactive iodine may lead to leukemia.
HSP60 in cancer: a promising biomarker for diagnosis and a potentially useful target for treatment
Published in Journal of Drug Targeting, 2022
Bo Sun, Ganghui Li, Qing Yu, Dongchun Liu, Xing Tang
Papillary carcinoma (PC) is not only the most common malignant tumour of the thyroid, but also the most aggressive tumour of the entire endocrine system. However, there are few clinically useful biomarkers [70]. Researchers tested the exosomal HSP60 content in peripheral blood of PC and benign goitre (BG) patients and healthy people before and after ablation. HSP60 was detected in the plasma exosomes of PC and BG patients both before and after ablation, while the exosomal HSP60 levels in the PC group were higher than those in the BG group before ablation [70]. This indicates that HSP60 can be used as a diagnostic biomarker for PC. In addition, in vivo studies of CRC have shown that the exosomal HSP60 content in the peripheral blood of patients before surgery is significantly higher than those of patients after surgery [16], which shows that exosomal HSP60 can be used to evaluate the effect of tumour treatment. This evidence highlights the critical value of exosomal HSP60 in the diagnosis and assessment of cancer prognosis.
Nodular hidradenoma of the breast: A case report
Published in Alexandria Journal of Medicine, 2018
G.H. Ano-Edward, I.O. Amole, S.A. Adesina, O.A. Ajiboye, M.E. lasisi, R.K. Jooda
Nodular hidradenoma situated in the breast is very rare and it usually occurs in the nipple areolar area as one of the differentials diagnosis of breast neoplasms.1 When fine needle aspiration cytology (FNAC) is performed, cytological features are often inconclusive and as such it is rarely encountered in literature review of case reports.1,5 Nodular hidradenoma can be either superficial or deep within the breast. When it is deep, it is often located close to mammary ducts with extensions that mimic breast cancer.2 It has been reported that nodular hidradenoma can mimic conventional type renal cell carcinoma.6 This is not surprising as part of the consultation leading to the diagnosis of this tumour was diagnosis of papillary carcinoma by four pathologists. The patient on follow up has remained symptoms free in the last 2 yrs and as the time of writing this article. It is possible that the complete excision of the tumour with clear margins could have accounted for lack of recurrence of the tumour. Eventhough, Orsaria and Mariuzzi have reported a case of recurrent eccrine hidradenoma in a male breast.7
Hot and malignant – a case of invasive papillary carcinoma in hyperthyroid patient with hot nodules
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
Ramesh K. Pandey, Eliza Sharma, Sasmit Roy, Saroj Kandel, Sumit Dahal, Muhammad Rajib Hossain, Marie F. Schmidt, Zewge Shiferaw-Deribe
Our patient had hyper-functioning nodules on thyroid radionuclide scan with overt hyperthyroidism as evidenced by clinical symptoms, suppressed serum thyrotropin and elevated thyroxine. However, in the presence of cervical lymphadenopathy, the possibility of thyroid malignancy was entertained. The subsequent excisional biopsy of the lymph node and thyroidectomy proved the presence of invasive papillary carcinoma of thyroid. Multiple other cases of hyper-functioning malignant thyroid nodules have been reported [4,6–8]. In a review by Mirfakhraee et al., the prevalence of intra-nodular thyroid malignancy among hyper-functioning ‘hot’ nodules ranged from 0% to 12.5% in different case series with the weighted prevalence rate being 3.1% [6]. Similarly, there are increasing number of reports of co-existence of thyroid malignancy and hyperthyroidism [9–12]. In a review by Gabriele et al., the prevalence of thyroid malignancy in hyperthyroid patients was 1.65% [11]. Most of these malignancies were of the papillary carcinoma type [6]. While the exact pathophysiological mechanism has not been elucidated, mutations in TSH receptors and Ki-RAS play an important role in the hyper-functioning of the thyroid tumor and its carcinogenetic process [13,14].
Related Knowledge Centers
- Metastasis
- Recurrent Laryngeal Nerve
- Thyroglobulin
- Thyroid Cancer
- Sympathetic Nervous System
- Cellular Differentiation
- Asymptomatic
- Fine-Needle Aspiration
- Medical Ultrasound
- Tumor Marker