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Juvenile thyroid malignancy  [cached]
Parelkar Sandesh,Joshi Milind
Indian Journal of Medical and Paediatric Oncology , 2009,
Abstract: Thyroid malignancy is an uncommon tumor of the pediatric population. Patients can present with asymptomatic thyroid nodule and it requires thorough work up to rule out the malignancy. Radiological and pathological procedures are a standard part of the management. A 10-year-old girl had asymptomatic thyroid nodule; the cytological examination and the frozen section and final histology of the nodule was different each time. The girl had to undergo total thyroidectomy on the basis of histology of the nodule which was well differentiated papillary carcinoma of thyroid and is under regular follow-up for last two years on thyroid supplementation.
Radionuclide therapy in the treatment of thyroid malignancy
Male?evi? Milica ?.
Archive of Oncology , 2003, DOI: 10.2298/aoo0303179m
Abstract: In this paper we presented the principles of performance of radionuclide therapy, its adverse effect, together with mentioned complications obligation to use it only according to directions and the success of the therapy, which is seen through the length of a patient's survival rate. All types of thyroid malignancies are primary cured surgically, by the total or near-total thyreoidectomy, together with lymph node dissection of the neck and with a long-term suppressive- therapy or only substitutive L-thyroxin therapy. Radionuclide therapy is used only for the types of thyroid malignancies where a radionuclide was detected, beta emitter which is distinguished by its selective entering into the primary tumor and metastatic tissue. This therapy is used for patients with differentiated papillary and follicular thyroid carcinoma (DTC) and patients with medullary thyroid carcinoma (MTC). By the means of 131-I we additionally cure patients with DTC, by MIBG-131-I we treat patients with MTC, but we also try to cure this malignancy by the specific monoclonal antibodies, marked by 131-I or 90-Y, which is still a part of clinical trial studies. It is very likely that the radioimmune therapy will be the means of cure for malignant thyroid lymphoma (MLT), since this therapy is successful in healing the lymphomas in other locations.
Predictive value for malignancy of the thyroid nodule macroscopically  [cached]
Dedivitis, Rogério Aparecido,Couto Netto, Sergio Dias do,Castro, Mario Augusto Ferrari de,Pfuetzenreiter Junior, Elio Gilberto
International Archives of Otorhinolaryngology , 2010,
Abstract: Introduction: The fine needle aspiration (FNA) is a method of high accuracy in the preoperative diagnosis of thyroid nodules, but the "follicular" remains a factor of failure. Furthermore, the usefulness of intraoperative examination of freezing is controversial. Macroscopic aspects of thyroid nodules may increase the diagnostic accuracy of preoperative and intraoperative FNA biopsy and freezing. Objective: To evaluate the macroscopic aspects of the surgical specimen in the decision facing the nodular disease of thyroid gland. Methods: During 2007, 85 patients underwent surgical treatment for thyroid nodular diseases were evaluated by prospective and macroscopic aspects of 125 nodules were compared with histopathological findings. Results: We found that the pattern of recent growth, the presence of adhesions of the thyroid, absence of hemorrhage, necrosis and poor demarcation of the nodule had statistical significance in the outcome of malignant disease. Conclusion:Pattern of growth, thyroid adhesions, necrosis and poor demarcation of the nodule are predictors of malignancy, while the presence of hemorrhage is a protective factor.
The Professional Medical Journal , 2010,
Abstract: To determine frequency of malignancy in solitary thyroid nodule. Design: Case-series study. Place and Durationof Study: The study was conducted at Department of Surgery, Combined Military Hospital Rawalpindi, from April 2002 till April 2003. Patientsand Methods: Sixty patients with clinical solitary thyroid nodule fulfilled the selection criteria and were included in the study. Thyroid functiontests, ultrasonography and thyroid scanning was done. Finally FNAC and histopathology were done in all the operated cases and record wasevaluated. Results: Out of 60 cases studied, 8 (13.33%) were found to have malignant lesions. The remaining 52 (86.67%) cases had benignpathology. Male patients with solitary thyroid nodule showed a higher incidence of malignancy 17.65% as compared to females 11.63%.Maximum malignant cases (50%) were found between the ages of 31 to 40 years. Papillary carcinoma was the most common malignancy (50%)found in our study. Conclusions: The incidence of malignancy in solitary thyroid nodule is quite high (13.33%). So people should be educated toattend thyroid clinics for early diagnosis and adequate treatment.
Contribution of scintigraphy and ultrasonography to the prediction of malignancy in thyroid nodules with indeterminate cytology
Rosário, Pedro Weslley;Salles, Daniela Santos;Bessa, Breno;Purisch, Saulo;
Arquivos Brasileiros de Endocrinologia & Metabologia , 2010, DOI: 10.1590/S0004-27302010000100010
Abstract: objective: to evaluate the contribution of 131i scintigraphy and ultrasonography to the prediction of malignancy in thyroid nodules with indeterminate cytology in euthyroid patients. subjects and methods: the sample consisted of 102 patients with thyroid nodules, submitted to fnac and presenting an indeterminate cytological diagnosis (follicular neoplasm). results: malignancy was observed in 19/25 (76%) nodules with suspicious ultrasonographic characteristics versus 5/77 (6.5%) without suspicious findings. when 131i scintigraphy showed a cold or hot nodule, the chance of malignancy was 38.5% and 2.5%, respectively. this exam was inconclusive in 10% of the patients. conclusions: surgery is indicated when a thyroid nodule with indeterminate cytology exhibits suspicious ultrasonographic characteristics. otherwise, 131i scintigraphy can exclude thyroidectomy when reveals uptake in the nodule, which is observed in half the cases.
Galectin-3: A promising marker of thyroid malignancy
Cveji? Dubravka S.,Savin-?egarac Svetlana B.,Paunovi? Ivan R.,Tati? Svetislav B.
Archive of Oncology , 2003, DOI: 10.2298/aoo0303186c
Abstract: Background: Galectin-3 is an endogenous beta-galactoside binding lectin implicated in neoplastic transformation and tumor progression. High levels of this lectin have recently been found in malignant thyroid tumors, but not in normal or benign thyroid tissue, suggesting galectin-3 as a promising presurgical marker of thyroid malignancy. Methods: We analyzed immunohistochemically galectin-3 expression in thyroid tissue using a monoclonal antibody. The total of 108 tissue specimens included 55 cases of thyroid carcinoma (30 papillary, 15 follicular, and 10 anaplastic type), 15 samples of follicular adenoma, 15 samples of normal thyroid tissue, and 23 thyroid tissue specimens from human fetuses (16 to 37 weeks of intrauterine life). Results: The results showed galectin-3 expression in 20/30 papillary carcinomas, 11/15 follicular carcinomas, 10/10 anaplastic carcinomas, and 4/15 follicular adenomas. Thyroid follicular cells in normal adult and fetal tissue were negative. Conclusions: These results further confirm that galectin-3 expression is a feature of malignant thyroid cells, and that immunohistochemical detection of galectin-3 could be useful in thyroid carcinoma diagnostics. The absence of galectin-3 in thyroid cells during fetal development suggests that galectin-3 is expressed de novo during malignant transformation of thyroid epithelium, thus it should not be considered an oncofetal antigen.
Frequency of Malignancy in Solitary Thyroid Nodule in a Tertiary Level Hospital of Bangladesh  [PDF]
Md Shazibur Rashid, Najnin Akhter, Md Shafiqur Rahman, Jahangir Alam Majumder, A. H. M. Delwar, Md Golam Mustafa
International Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) , 2019, DOI: 10.4236/ijohns.2019.84015
Abstract: Objectives: To determine the frequency of thyroid malignancy in clinically and sonographically solitary thyroid nodule in patients undergoing thyroidectomy in Comilla Medical College Hospital. Methods: A cross sectional study was carried out at the Department of Otolaryngology and Head Neck Surgery of Comilla Medical College Hospital during the period from January 2016 to January 2019. This study includes all patients admitted and undergoing surgery with solitary thyroid nodule. Results: Out of 188 patients 146 patients were female and 42 patients were male with female:male ratio of 3.4:1. Out of 188 patients 24 patients were found histologically thyroid malignancy. Among them 14 patients were male and 10 patients were female. Papillary carcinoma was found in all cases. Conclusions: Follicular carcinoma is rare in our country. Histopathological examiners may not efficiently be doing their job to differentiate carcinoma from adenoma.
Venous obstruction of thyroid malignancy origin: the Antoine Lacassagne Institute experience
Pierre-Yves Marcy, Juliet Thariat, Alex Bozec, Gilles Poissonnet, Danielle Benisvy, Olivier Dassonville
World Journal of Surgical Oncology , 2009, DOI: 10.1186/1477-7819-7-40
Abstract: Clinical data were collected from the thyroid unit database of the Antoine Lacassagne Institute.Of 1171 patients with thyroid cancer treated at our institution over the last 18 years, we retrospectively identified nine patients (0.8%), three women and six men, aged 34–81 years (median age: 70 years) presenting with malignant thyroid tumor of median diameter 45 mm (range: 23–87) having venous obstruction of thyroid malignancy origin. Two patients underwent multimodal therapy. All other patients underwent external beam radiation therapy alone ± chemotherapy or palliative care. Ultrasound (US) provided particularly useful information on venous involvement characteristics. Median survival was 7 months and median progression-free survival was 6 months. Survival in our series was worse than that of previously reported series despite diagnosis of vein involvement at an early stage in 2/3 cases using US.Despite small numbers of patients, it seems that aggressive treatment modalities including surgery are required to improve survival. In our experience, US was a useful non-invasive method to describe tumor extensions to great veins of the neck (invasion versus compression, tumor thrombus versus blood clot) and should be recommended to depict early venous invasion in cases of suspected thyroid malignancy.Superior vena cava (SVC) obstruction is associated with lung cancer, malignant lymphoma and mediastinal metastases. In less than 1% of the cases, SVC syndrome (SVCS) is due to massive invasion into the great veins or compression of the SVC by a thyroid cancer [1]. Only 29 cases have been reported in the literature so far. We hereby report on the Antoine Lacassagne Institute's experience and provide additional data on neck Ultrasonography (US) and patient outcomes in our series, in which most of patients could not undergo curative treatment. Clinical features, tumor size, histological types, and outcomes to therapy are presented.From 1991 to 2008, clinical and radiological dat
Thyroid Malignancy Association with Cortical & Subcortical Brain SPECT Changes In Patients Presenting with a Myalgic Encephalomyelitis / Chronic Fatigue Syndrome.  [cached]
Byron, Hyde; MD,Jean, Leveille; MD,Sheila, Vaudrey,Tracy, Green
Alasbimn Journal , 2007,
Abstract: Thyroid malignancy in ME/CFS patients greatly exceeds the normal incidence of thyroid malignancy in any known subgroup. The thyroid malignancy incidence in the ME/CFS group may exceed 6,000 / 100,000. As part of their investigation, Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) patients should be examined by thyroid ultrasound for evidence of thyroid pathology and malignancy. Thyroid pathology may be missed in this group of patients if investigation relies only upon serum testing for TSH, FT3, FT4, microsomal and thyroglobulin antibodies, which are usually normal. Thyroid uptake scans tend also to be normal and may also miss malignant lesions. A newly recognized syndrome may exist in ME/CFS patients characterized by: (a) thyroid malignancy, (b) persistent abnormal cortical and subcortical SPECT brain scans (NeuroSPECT), (c) failure of thyroidectomy surgery and hormone replacement to correct the fatigue syndrome, and (d) an unusual high incidence of cervical vertebrae osteoarthritic changes. ME/CFS patients with treated non-malignant thyroid disease and abnormal NeuroSPECT scans may also fail to improve despite adequate thyroid hormone replacement. A brief summary of the differences between ME and CFS is discussed.Lee, Hur and Ahn [1] stated that thyroid malignancy is said to be an infrequent occurrence found in 0.5 to 3 patients per 100,000 in the general population. They noted that in a subgroup of patients booked for mammography, a thyroid ultrasound was also performed. In this group, they found thyroid malignancy frequency was as high as 3 per 100,000. It is not known if their subgroup was at a higher risk for malignancy. Mittelstaedt [2] in the Globe and Mail states that thyroid malignancy was 15 per 100,000, In the past 100 patients whom I have investigated for (ME/CFS)[3], with or without associated Fibromyalgia Syndrome (FS), I have found that 6% of these patients had thyroid malignancy. In each of these patients the diagnosis was made by ultrasonography and needle biopsy under ultrasonography. This was followed by surgical removal of the thyroid, and each case the malignancy was confirmed. These findings would suggest that 6% of the ME/CFS patients seen, or 6,000 cases per 100,000, had a confirmed thyroid malignancy. Unfortunately, these figures may be conservative since we are in the process of obtaining needle biopsies on six further cases of these first 100 patients. In addition, we have not yet performed thyroid ultrasound on all 100 cases. We are in the process of further investigation of those patients who had not yet been
Malignancy Risk Assessment in Patients with Thyroid Nodules Using Classification and Regression Trees  [PDF]
Shokouh Taghipour Zahir,Fariba Binesh,Mehrdad Mirouliaei,Elias Khajeh,Sina Noshad
Journal of Thyroid Research , 2013, DOI: 10.1155/2013/983953
Abstract: Purpose. We sought to investigate the utility of classification and regression trees (CART) classifier to differentiate benign from malignant nodules in patients referred for thyroid surgery. Methods. Clinical and demographic data of 271 patients referred to the Sadoughi Hospital during 2006–2011 were collected. In a two-step approach, a CART classifier was employed to differentiate patients with a high versus low risk of thyroid malignancy. The first step served as the screening procedure and was tailored to produce as few false negatives as possible. The second step identified those with the lowest risk of malignancy, chosen from a high risk population. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) of the optimal tree were calculated. Results. In the first step, age, sex, and nodule size contributed to the optimal tree. Ultrasonographic features were employed in the second step with hypoechogenicity and/or microcalcifications yielding the highest discriminatory ability. The combined tree produced a sensitivity and specificity of 80.0% (95% CI: 29.9–98.9) and 94.1% (95% CI: 78.9–99.0), respectively. NPV and PPV were 66.7% (41.1–85.6) and 97.0% (82.5–99.8), respectively. Conclusion. CART classifier reliably identifies patients with a low risk of malignancy who can avoid unnecessary surgery. 1. Introduction Thyroid nodules are common findings in clinical practice. It is estimated that 4% to 7% of adults in the Unites States have palpable nodules upon examination [1]. With the advent of ultrasonographic (US) techniques for assessment of the thyroid gland, it is now believed that a nodule can be detected in as many as 67% of the normal population [2]. The first and foremost obstacle for the clinician is to determine whether the nodule is of a benign or malignant nature, albeit malignant nodules are quite rare, comprising approximately 5% of all nodules [1]. Fine needle aspiration (FNA) of the thyroid nodule has become the standard procedure for evaluation of nodule histopathology and is recommended as the main diagnostic strategy in several guidelines and published consensus agreements [3]. Nevertheless, FNA has multiple drawbacks inherent in the procedure itself [4], including the technique employed and the experience of the physician performing the aspiration [5, 6]. In an analysis of 4 703 FNAs performed in centers in New York and Texas, 10.4% of the FNAs were considered unsatisfactory, and another 17.4% were reported as either suspicious or indeterminate [7]. A considerable number of patients with equivocal findings
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