Radiation Carcinogenesis: Human Model
Kedar N. Prasad in 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
Neoplasia
C. Simon Herrington in Muir's Textbook of Pathology, 2020
Despite their name these are not always harmless. As they remain localized at their site of origin, the effects fall into three broad categories: The presence of a palpable lump, often painless, but occasionally causing discomfort.The effects of substances produced by a tumour. The cells of a benign tumour are well differentiated and often retain the function of the tissue of origin, such as production of hormones. This is usually outwith the normal feedback mechanisms and overactivity may result, e.g. a thyroid adenoma may lead to hyperthyroidism.The effects on adjacent tissues due to pressure from expansion of the tumour. This is seen particularly when the tumour arises in a confined area, e.g. within the cranial cavity. Thus, a pituitary adenoma may cause hypopituitarism by compressing the surrounding normal glandular tissue. The distortion of the uterine cavity by a fibroid (leiomyoma) often results in heavy menstrual blood loss, whereas a benign tumour may block a hollow viscus, e.g. by causing intussusception in the intestine (see Chapter 10).
Thyroid Gland
Joseph Kovi, Hung Dinh Duong in Frozen Section In Surgical Pathology: An Atlas, 2019
In a patient with adenomatous goiter there are multiple nodules in the thyroid palpable. Thyroid adenoma presents as a solitary nodule. Adenomatous goiter must also be differentiated from thyroid carcinoma. Carcinoma, as benign adenoma usually manifests as a single nodule. It must be pointed out, however, that carcinoma may also develop in adenomatous goiter. The incidence of carcinoma in adenomatous goiter is higher in patients less than 50 years of age and in men.138 The frequency of carcinoma in solitary non-toxic (cold) nodular goiter has been reported to be 15.6% to 24.4%.144
The Value of Preoperative and Intraoperative Ultrasound in the Localization of Intrathyroidal Parathyroid Adenomas
Published in Journal of Investigative Surgery, 2022
Wei Zhao, Ruigang Lu, Li Yin, Bojun Wei, Mulan Jin, Chun Zhang, Ruijun Guo, Xiuzhang Lv
Primary hyperparathyroidism (PHPT) is a common endocrine disease with an incidence of 0.1%-0.7% in the population.1 The diagnostic criteria of classic PHPT is elevated plasma calcium levels, accompanied with high or improperly high parathyroid hormone (PTH) levels, after excluding other causes of hyperparathyroid hypercalcemia. Once the diagnosis of PHPT confirmed, the accurate location of the abnormal glands becomes a top priority. Due to the characteristics of parathyroid embryonic development, the position of parathyroid gland varies a lot.2 A small number of cases have reported that the intrathyroidal parathyroid adenoma(IPA) is a rare disease, the incidence of which ranges from 1% to 6%, and the diagnosis is difficult, which may complicate the treatment.3,4 The color doppler ultrasound may be a better method to identify IPA because Sestamibi-SPECT features may overlap with nodular thyroid disease.5 Previous studies have described the role of ultrasound in the diagnosis of IPAs, and defined IPA as “the combination of hypoechogenicity and high vascularization on US along with absence of an echogenic plane between the parathyroid lesion and the thyroid gland.”6 However, these ultrasonographic features may overlap with thyroid adenoma or medullary thyroid carcinoma (MTC) to a great extent. The purpose of this study was to explore the characteristic ultrasonographic findings of IPA and to identify the value of preoperative and intraoperative ultrasound in localization and management of IPAs.
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.
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].
Related Knowledge Centers
- Benign Tumor
- Histopathology
- Hyperthyroidism
- Mutation
- Thyroid Hormones
- Neoplasm
- Thyroid
- Hyperplasia
- Hürthle Cell Neoplasm
- Goitre