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Search Results: 1 - 10 of 1993 matches for " thyroid "
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Substernal Thyroid Masses
Mohamed A.H. Regal,Hazem M. Zakaria,Ahmed S. Ahmed,Yasser M. Aljehani
Oman Medical Journal , 2010,
Abstract: A thyroid mass, most often a non toxic colloid goiter or occasionally an adenoma, is not an unusual finding below the level of the thoracic inlet.1 In 1992 Creswell and Wells estimated that these tumors comprise 5.8% of all mediastinal lesions.1 There is no standard definition for thyroid glands extending below the thoracic inlet, but such masses descend from their original cervical location for more than 2 or 3 cm below the thoracic inlet, and are not truly primary tumors of the mediastinum. They preserve the connection between the thoracic and cervical portion and receive their blood supply from the neck.2,3 In 1940, the seminal report of Wakeley and Mulvany divided intrathoracic thyroid masses into 3 types; (1)”Small substernal extension” of a mainly cervical mass, (2) “Partial” intrathoracic, in which the major portion of the mass is situated within the thorax, and (3)”Complete” in which all of the mass lies within the thoracic cavity.
Early Detection of Thyroid Gland Disorders for Students in the Faculty of Applied Medical Sciences  [PDF]
Saeed Bafaraj, Ibrahim Abbas, Saddig Jastaniah, Hanan Abbas, Alamin Musa
Open Journal of Medical Imaging (OJMI) , 2015, DOI: 10.4236/ojmi.2015.51005
Abstract: In this study 70 male students were participated to determine the thyroid disorder through ultrasonography. Thyroid scan was done in 70 students prospectively with no indicative of thyroid disease (age of 19 - 23 yrs). Thyroid scan for students who participated the study took place in the department of Faculty of Applied Medical Sciences, King Abdulaziz University by using an IU 22 Philips ultrasound machine with a 5 - 12 MHz linear transducer. Among the total number of the subjects, 26% was found with abnormal ultrasound findings, 17% of them with cystic nodule, while solid and mixed nodule represented 4% for each. The high rate of abnormal findings of thyroid gland in the study suggested that screening using ultrasound scan was useful in detecting early thyroid disorders.
Angiosarcoma Thyroid: Case Report and Review of Literature  [PDF]
Aayush Mittal, Sunil Kumar, Yumlembem Brojendro Singh, Sunil Garg
Case Reports in Clinical Medicine (CRCM) , 2014, DOI: 10.4236/crcm.2014.33026
Abstract:

Objective: To describe a rare case of angiosarcoma thyroid in Indian subcontinent with its successful management. Case report: A 60-year-old male with swelling in neck for 20years with sudden increase in the size during last 3 months. Fine needle aspiration cytology suggested anaplastic carcinoma. The patient underwent total thyroidectomy with central and lateral neck dissection. On histopathology, the diagnosis of angiosarcoma was suspected. Immunohisto chemistry confirmed the diagnosis of angiosarcoma. Post-operative chemoradiation was given with no recurrence at 10 months of follow up. Conclusion: Though rare, angiosarcoma should be included as differential diagnosis in cases of long standing goiters with recent rapid increase in size. Immunohistochemistry is crucial for diagnosis and should be considered in these patients. Early and prompt diagnosis will help in providing curative treatment in such patients.

Management Approach to Thyroid Nodules  [PDF]
Rodrigo Arrangoiz, Fernando Cordera, David Caba, Eduardo Moreno, Enrique Luque de Leon, Manuel Mu?oz
International Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) , 2018, DOI: 10.4236/ijohns.2018.74023
Abstract: Thyroid nodules are a major health problem worldwide. The prevalence of palpable thyroid nodules in the general population is approximately 5% in women and 1% in men living in parts of the world with sufficient iodine. High resolution neck and thyroid ultrasound can detect thyroid nodules in a significant proportion of randomly selected individuals, with higher frequencies in women and the elderly population. The importance of thyroid nodules lies in the need to rule out cancer. The majority of thyroid nodules are benign, clinically irrelevant, and can be safely managed with a good surveillance program. The detection and diagnosis of differentiated thyroid cancer have evolved over the years with increased use of high resolution cervical and thyroid ultrasound, fine needle aspiration biopsy (FNAB), molecular testing, and thyroglobulin as a serum tumor marker. An algorithm that utilizes high resolution ultrasound and, when indicated, FNAB, and molecular testing for the diagnosis of thyroid nodules, facilitates a personalized, risk-based protocol that promotes high-quality care and minimizes cost and unnecessary testing. Our paper reviews the current, evidence-based management of newly diagnosed thyroid nodules.
Diagnosis and Treatment of Anaplastic Thyroid Carcinoma  [PDF]
Patorn Piromchai, Teeraporn Ratanaanekchai, Pornthep Kasemsiri
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.31016
Abstract: Anaplastic thyroid carcinoma (ATC) is a poorly differentiated thyroid cancer. It cannot uptake iodine or synthesis thyroglobulin. The incidence is low; about 2% - 5% of thyroid cancer. The peak age incidence is 60 - 70 years and it is more common in females (55% - 77% of all patients). In recent years, the incidence has declined; however, it may be higher in areas of endemic goiter. ATC may occur with a coexisting carcinoma and may represent transformation of a well-differentiated thyroid cancer. Patients typically present with a rapidly growing anterior neck mass and aggressive symptoms. The most reliable tool in detecting thyroid malignancies is fine-needle aspiration cytology (FNAC). Sensitivity of FNAC for thyroid malignancy ranged from 61% to 97.7%. Fine-needle aspiration can diagnose ATC by the demonstration of spindled or giant cells, bizarre neoplastic cells that may be multinucleated, or atypical cells with high mitotic activity. A syncytial pattern is the predominant cellular pattern of anaplastic thyroid carcinoma. Other laboratory tests, including tumor markers (cytokeratin, vimentin, and carcinoembryogenic antigen) are helpful in diagnosis and follow-up of the patients. Multimodality therapy (surgery, external beam radiation, and chemotherapy) is the recommended treatment and it seems to have slightly improved outcomes. The prognosis is not as bad in younger patients with smaller tumors. The most common cause of death is lung metastasis. The mean survival time is less than 6 months from the time of diagnosis. The prompt diagnosis and aggressive treatment are essential modality to achieve optimal outcomes.
Measurement of shear wave velocities coupled with an evaluation of elasticity using ARFI elastography in diagnosis of papillary thyroid carcinoma  [PDF]
Ryuhei Okada, Masami Suzuki, Koji Takeuchi, Hiroyuki Horikoshi, Atsunobu Tsunoda
Open Journal of Clinical Diagnostics (OJCD) , 2013, DOI: 10.4236/ojcd.2013.34033
Abstract: This study aimed to evaluate the diagnostic value of measuring the shear wave velocities (Vs) of thyroid nodules in diagnosis of the thyroid carcinoma. Using Virtual Touch Tissue Quantification (VTTQ) of acoustic radiation force impulse (ARFI) elastography (ACUSON S2000®, Siemens Medical Solutions, Mountain View, CA, USA), we measured the Vs of thyroid nodules in 39 nodules from 34 patients (four males and 30 females) before surgery. Elasticity itself was also estimated by VTTI (Virtual Touch Tissue Imaging) using ARFI. The average Vs of normal thyroid tissue was 2.24 ± 0.68 m/s. Twenty-three out of 39 nodules showed an average 2.52 ± 1.33 m/s. However, 16 other nodules showed “X.XX m/s”. These 16 nodules showed either “black” or “honeycomb” patterns of elasticity in VTTI. This value suggested that the Vs of these nodules were too fast or heterogenous to measure by this device. After the surgery, the pathologies of these nodules were revealed to be papillary carcinoma (21 cases), adenomatous goiter (11), follicular carcinoma (4), follicular adenoma (2) and follicular lymphoma (1). Five papillary carcinomas were found within adenomatous goiters. Nodules from four follicular carcinomas showed average Vs of 1.92 ± 0.48 m/s, while two follicular adenomas and follicular lymphoma showed 2.19 ± 0.06 and 2.34 m/s respectively. Nodules of adenomatous goiter showed 2.14 ± 0.60 m/s. On the other hand, nodules from five out of 21 papillary carcinomas showed average Vs of 4.00 ± 2.37 m/s. In the nodules of 16 papillary carcinomas, Vs were measured as “X.XX m/s” and this value was only observed in nodules of papillary carcinoma. These data reflected high and/or heterogenous elasticity of papillary carcinoma, in other words, the tissue of papillary carcinoma was hard and/or heterogenous. It was notable that the Vs value of “X.XX m/s” strongly suggested papillary carcinoma.
Comprehensive Review of Thyroid Embryology, Anatomy, Histology, and Physiology for Surgeons  [PDF]
Rodrigo Arrangoiz, Fernando Cordera, David Caba, Manuel Mu?oz, Eduardo Moreno, Enrique Luque de León
International Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) , 2018, DOI: 10.4236/ijohns.2018.74019
Abstract: Emil Theodor Kocher and Theodor Billroth pioneered the surgical management of thyroid disease. Their surgical techniques, knowledge of thyroid anatomy, embryology, histology, physiology, and antisepsis practices transitioned a life-threatening operation to one with acceptable morbidity. The modern head and neck surgeon should have a meticulous surgical technique, combined with a thorough understanding of thyroid embryology and anatomy that is central to the understanding and treatment of the different disease processes of the thyroid gland and the consequences of thyroid gland surgery. In this manuscript we will be examining thyroid gland embryology, anatomy, histology, and physiology that is essential to the practicing thyroid surgeon.
Definition of retrosternal thyroid growth  [PDF]
Ernst G. Eising, Sandra Rosenbaum-Krumme, Walter Jentzen, Alfred G?decke, Andreas Bockisch
Open Journal of Clinical Diagnostics (OJCD) , 2012, DOI: 10.4236/ojcd.2012.22007
Abstract: The diagnosis of a retrosternal thyroid growth (RTG) causes extended surgical exploration and a different surgical treatment planning (partial sternotomy, thoracotomy) and is usually made by the help of thyroid scintigraphy and ultrasonography. But both examinations have problems in determining the retrosternal thyroid extend in the complex anatomy of sternal bone and often pathologically altered manubrioclavicular joints (MCJ). This study evaluates the variation of anatomical structures in the upper sternal region, the position of the sternal markers during scintigraphy, and the frequency of enhanced bone metabolism of the MCJs. For this aim, the positions of the upper edges of the MCJs were measured by X-ray fluoroscopy in 50 consecutive patients. To prove the exactness of an external marker as used in thyroid scintigraphy, the variation of the marker position was also determined. The activity in the MCJs was measured semiquantitatively with bone scintigraphy in further 100 patients (mean age: 62.3 yrs, SD: 14.2 yrs). As results, the upper edges of the medial clavicular edges exceed the upper margin of the sternal edge up to 2.7 cm. The distance between the medial clavicular edges ranged from 2.3 - 5.6 cm. The position of the sternal marker was correct in the horizontal deviation (mean: 0.1 cm, SD: 0.48 cm) but too high in the vertical position (mean: 2.2 cm, SD: 0.67 cm). During bone scintigraphy, the MCJs showed no enhanced activitity in 75/200 joints, medium activity in 96/200 joints, and strong enhanced activity in 29/200 joints. In consequence, a high variability in the position of the anatomical structures has to be considered together with a high amount of degenerative alterations. The position of the sternal marker was inappropriate in the vertical direction and overestimated a possible retrosternal growth.
Treatment Outcome of Papillary Carcinoma Confined to the Thyroid Isthmus  [PDF]
Hui Huang, Shao-Yan Liu, Song Ni, Zong-Min Zhang, Xiao-Lei Wang, Zhen-Gang Xu
Journal of Cancer Therapy (JCT) , 2016, DOI: 10.4236/jct.2016.712093
Abstract: Objective: The purpose of this study is to evaluate the clinicopathologic characteristics and treatment outcomes of Papillary Thyroid Carcinomas (PTC) of the isthmus and to establish an appropriate surgical strategy. Methods: Thirty-four patients with PTC in isthmus are managed by surgery in National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences, Peking Union Medical College from 1985-2008. Demographic data, surgical procedures, pathological features, stages and outcomes are analyzed. Results: Seven patients were men and 27 were women. The median age was 41 years (range, 20 - 71). Twenty-five patients were treated with thyroid isthmusectomy or wide field isthmusectomy, five with hemithyroidectomy (lobectomy and isthmusectomy) and four with hemithyroidectomy and partial resection of the contralateral lobe. Twenty-eight patients had a pathologically T1 lesion (pT1); two patients had a pT2 lesion and four had a pT3 lesion. Five patients (14.7%) had papillary carcinoma detected in one of the pretracheal lymph nodes. Thirty-two patients had a solitary lesion confined to the thyroid isthmus. One patient had two lesions in the thyroid isthmus and another one had two lesions located in the thyroid isthmus and right lobe respectively. With a median follow-up of 94 months (range, 12 - 274), two patients had a recurrence and both survived after a re-operation. There was no regional lymph node or distant organ recurrences. No deaths occurred. Conclusions: Isthmusectomy or wide field isthmusectomy could be a
Investigating the Association of Smoking with Thyroid Volume and Function  [PDF]
Saddig Jastaniah, Amer Abed Alhazmi, Hassan Alabdullah, Faisal Fawzi Selamee, Waleed Khalid Barahim, Mohammad Wazzan, Mohamed Yousef, Shyma M. Alkhateeb
Health (Health) , 2017, DOI: 10.4236/health.2017.913133
Abstract: This study was conducted to explore possible correlation between smoking habit and thyroid volume and function in Jeddah. A total of 226 volunteers i.e. 128 male and 98 female were screened at Radiology Department King Abdul-Aziz University Hospital. They were categorized as smokers and non- smokers; the number of smokers was 99 cases i.e. 48 Cigarette smokers and 51 Shisha smokers, and the non-smokers were 127 cases. The information was gathered via a questionnaire distributed at the radiology department. Ultrasonography of thyroid and thyroid function test were performed for 166 participants; and data were analyzed Using SPSS version 22 and Microsoft excel. The study was carried out based on random selection and findings revealed that most of the cases were in the age group between 20 to 30 years old, high body mass index (BMI) was 33.1 kg/m2 in persons above 60 years old and the highest percentage smokers in the age group from 20 to 30 years (40.02%). Ultrasonography of thyroid showed 96 (58%) normal cases, 46 (28%) abnormal “solid” cases and 24 (14%) abnormal “cyst” cases. A lower proportion of cigarette and shisha smokers (15.4% and 5.6% respectively) had an enlarged thyroid gland compared to no cigarettes or shisha smokers (47.9% and 47.3% respectively). The difference between these frequencies was statistically significant (Chi-square = 9.446 and 11.424, p = 0.002 and p = 0.001 for cigarette and shisha smoking respectively). Consequently, it can be concluded from this research that there are no direct significant values correlating smoking habit to thyroid volume or function. However, it is always recommended not smoke due to other well-known threats.
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