- Cancer Types
Information about risk, prevention, screening, symptoms, diagnosis, treatment, and support for all cancers Cancer A to Z - Cancer Treatment
Cancer Treatment
Information about cancer treatment, including surgery, chemotherapy, radiation therapy, clinical trials, proton therapy, complementary medicine, and cutting edge technologies.
- Risk and Prevention
- Cancer Drugs
- Support
Support
Ways for cancer patients and caregivers to cope with cancer, side effects, nutrition, general cancer support issues, grief/end of life issues, and shared survivor's experiences.
- Healthcare Professionals
- Clinical Trials
My Patient Treatment Binder
OncoLink Blogs
What's My Cancer Risk?
OncoPilot: Navigating Your Cancer Journey
Community Events Calendar
OncoLink eNews
Abramson Cancer CenterNCI CANCERLIT® Search: Thyroid Cancer - February 2002
National Cancer Institute®
Last Modified: February 1, 2002
Table of Contents
1
UI - 11778561
AU - Yin Y; Xu Z; Tang P
TI -
[Management of the neck for patients with thyroid papillary carcinoma]
SO - Zhonghua Zhong Liu Za Zhi 2000 Jul;22(4):321-3
AD - Department of Head and Neck Surgery, Cancer Institute (Hospital),
Chinese Academy of Medical Sciences, Peking Union Medical College,
Beijing 100021, China.
OBJECTIVE: To search an optimal management of the neck for patients with
thyroid papillary carcinoma. METHODS: Clinical data of 424 cases with
thyroid papillary carcinoma treated in our hospital from Jan, 1965 to
Jan, 1987 were analyzed retrospectively. Patients with positive cervical
lymph nodes (N+) were treated with radical excision of the primary tumor
and neck dissection. For patients without cervical lymph node
involvement (N0), neck dissection was spared. On follow-up, whenever
cervical lymphatic node metastasis occurred, neck dissection was
performed. All patients were followed up for more than 10 years.
RESULTS: The 5- and 10-year survival rate of the 258 N+ patients was
84.3% and 80.4% respectively, and that of the 166 N0 patients was 94.1%
and 91.3% respectively. Twenty-three N0 cases later developed cervical
lymph node metastasis. Their 5- and 10-year survival rate was 91.4% and
82.2% respectively after neck dissection. CONCLUSION: Since only 13.9%
of N0 thyroid papillary carcinoma patients who did not receive neck
dissection develop cervical lymph node metastases later, and their
survival rate was just as good where neck dissection is postponed until
metastases occur, prophylactic neck dissection seems unnecessary.
2
UI - 11778562
AU - Gong J; Zhang R; Chen H
TI -
[Childhood thyroid carcinoma: an analysis of 14 cases]
SO - Zhonghua Zhong Liu Za Zhi 2000 Jul;22(4):324-6
AD - Department of General Surgery, Jiangsu Cancer Hospital, Nanjing 210009,
China.
OBJECTIVE: To reveal the clinical characteristics, causes of
misdiagnosis, treatment and prognosis of thyroid carcinoma in children.
METHODS: Fourteen patients under 14 years of age with thyroid carcinoma
were retrospectively reviewed. RESULTS: According to UICC's clinical and
histopathologic classification (1989), there were 12 cases of papillary
carcinomas (83.3%), 2 cases of follicular carcinomas (16.7%). All but
one case were in stage I. Cervical lymph node metastasis was found in 12
cases (85.7%). Diagnosis was incorrect in 7 cases. All patients were
operated, including unilateral neck dissection in 11 and bilateral neck
dissection in 2. One patient received palliative subthyroidectomy and
postoperative 131I treatment. In the follow-up period of 2 to 13 years
(mean 6 years), no patient died. CONCLUSION: Thyroid cancer in children
are mostly papillary carcinomas with good prognosis, regardless of high
frequency of cervical lymph node metastases. Early cases can be picked
up if misdiagnosis be avoided.
3
UI - 11774396
AU - Ulanovski D; Feinmesser R; Cohen M; Sulkes J; Dudkiewicz M; Shpitzer T
TI -
Preoperative evaluation of patients with parathyroid adenoma: role of
high-resolution ultrasonography.
SO - Head Neck 2002 Jan;24(1):1-5
AD - Department of Otolaryngology-Head and Neck Surgery, Rabin Medical
Center, Beilinson Campus, Petah Tikva 49100, Israel. Ulanovski@yahoo.com
BACKGROUND: Unilateral parathyroid exploration with adenoma removal and
identification of a normal parathyroid gland is a controversial surgical
approach to the treatment of primary hyperparathyroidism. The aim of
this study was to evaluate the ability of high-resolution
ultrasonography to localize adenomas preoperatively and to assess the
effect of such localization on operative time. METHODS: One hundred
twenty consecutive previously non-operated patients with primary
hyperparathyroidism underwent ultrasonography before surgery, which
consisted of unilateral neck exploration. The procedure was changed to
bilateral exploration when justified by the surgical findings. RESULTS:
The sensitivity and positive predictive value of the ultrasonographic
examinations were 89% and 98%, respectively. These results were obtained
regardless of the size of the adenoma. No significant difference was
found in the presence of thyroid multinodular disease (p =.2). A
positive sonographic examination decreased the operative time to an
average of 59 minutes. The average size of the adenomas was 19 mm
(range, 4-55 mm). A positive and highly statistically significant
correlation was found between adenoma size and both preoperative calcium
level (p =.01) and parathyroid hormone level (p =.0001). CONCLUSIONS: In
experienced hands, high-resolution ultrasonography can be a
cost-effective means of localizing parathyroid adenomas when unilateral
neck exploration is considered the acceptable surgical approach.
Copyright 2002 John Wiley & Sons, Inc.
4
UI - 11815959
AU - Leboulleux S; Travagli JP; Caillou B; Laplanche A; Bidart JM;
TI -
Schlumberger M; Baudin E
Medullary thyroid carcinoma as part of a multiple endocrine neoplasia
type 2B syndrome: influence of the stage on the clinical course.
SO - Cancer 2002 Jan 1;94(1):44-50
AD - Service de Cancerologie Endocrinienne et de Medecine Nucleaire, Institut
Gustave-Roussy, Villejuif, France.
BACKGROUND: Multiple endocrine neoplasia type 2B (MEN 2B) is an
exceptional syndrome, for which the optimal age of thyroidectomy is
poorly established and the course of medullary thyroid carcinoma (MTC)
is ill-defined. PATIENTS: All the 18 patients with a MEN 2B syndrome
examined at the Institut Gustave Roussy were included in a single-center
retrospective study. RESULTS: There were 9 men and 9 women with a mean
age of 13 years (range, 2-27 years) at diagnosis. The diagnosis of MTC
was based on the presence of a thyroid nodule or involved neck lymph
nodes and on dysmorphic features of MEN 2B in 60% and 40% of the cases,
respectively. The classic M918T mutation in exon 16 was found in the 16
patients in whom it was investigated. At diagnosis, 2 patients had Stage
I MTC, 15 patients had Stage III, and 1 patient had Stage IV disease. T1
MTC was found in 4 patients aged 2.1-3.7 years. However, two of these
patients already had N1 disease. One patient with Stage I MTC, aged 3.4
years and 2 patients with Stage III disease, aged 14 and 25 years, had
undetectable basal calcitonin (CT) after initial surgery. During
follow-up, basal CT became detectable in one of three patients. Among
the 15 other patients with an elevated postoperative CT level,
metastases were demonstrated in 5 patients after a mean follow-up of 2
years. Five patients died, three of MTC, one of the MEN 2B syndrome, and
one of intercurrent disease. Five- and 10-year overall survival rates
were 85% and 75%, respectively. CONCLUSIONS: This study confirms the
need for early treatment of MTC in patients with the MEN 2B syndrome,
preferably within the first 6 months of life. The phenotype of MTC
occurring in the MEN 2B syndrome was not more aggressive than sporadic
MTC or MTC occurring in other familial syndromes. Copyright 2002
American Cancer Society.
5
UI - 11747225
AU - Nguyen GK; Akin MR
TI -
Cytopathology of insular carcinoma of the thyroid.
SO - Diagn Cytopathol 2001 Nov;25(5):325-30
AD - Department of Laboratory Medicine and Pathology, University of Alberta
Hospitals, Edmonton, Alberta, Canada. knguyen@cha.ab.ca
Four pure insular carcinomas (IC) and one IC with focal anaplastic
carcinoma (AC) of the thyroid with cytologic evaluation by fine-needle
aspiration (FNA) were reviewed. The needle aspirates from the four pure
ICs revealed abundant monomorphic follicular cells present singly, in
small, loose aggregates, and in cohesive trabecular and acinar clusters.
Tumor cells showed fragile, ill-defined, granular cytoplasm and oval
nuclei with conspicuous or inconspicuous nucleoli. The case of IC with
focal AC yielded, in addition to the follicular cells as seen in the FNA
of the 4 cases of pure IC, large pleomorphic malignant cells with
prominent nucleoli that were characteristic for an AC, giant-cell type.
No intact insulae of tumor cells were identified in any of the 5 cases.
Thus, a thyroid IC may be suspected if abundant cohesive and dyshesive
monomorphic follicular cells are present in the tumor FNA. However, a
firm diagnosis of thyroid IC can only be made by histologic examination
of the excised tumor. Copyright 2001 Wiley-Liss, Inc.
6
UI - 10905237
AU - Bartolazzi A
TI -
Improving accuracy of cytology for nodular thyroid lesions.
SO - Lancet 2000 May 13;355(9216):1661-2
AD - Cellular and Molecular Tumor Pathology, Cancer Centre Karolinska,
Karolinska Hospital, Stockholm, Sweden.
7
UI - 11554638
AU - Violet J; Nutting C; Plowman PN; Britton KE
TI -
123Imaging in the follow-up of differentiated thyroid cancer.
SO - Clin Oncol (R Coll Radiol) 2001;13(4):313-4
8
UI - 11554639
AU - Fenwick JD; Mallick UK; Perros P
TI -
123I imaging in the follow-up of differentiated thyroid cancer.
SO - Clin Oncol (R Coll Radiol) 2001;13(4):314
9
UI - 11776629
AU - Li Z; Tang P; Huang Y
TI -
[The role of surgery in the management of thyroid lymphoma]
SO - Zhonghua Zhong Liu Za Zhi 1999 Nov;21(6):464-6
AD - Department of Head and Neck Surgery, Cancer Hospital, Peking Union
Medical College, Chinese Academy of Medical Science, Beijing 100021.
OBJECTIVE: To evaluate the role of surgery in the management of thyroid
lymphoma. METHODS: A retrospective analysis was performed of 14 patients
with thyroid lymphoma treated at the Cancer Hospital, Peking Union
Medical College, Chinese Academy Medical Science from 1964 to March
1998. There were 5 males and 9 females, with a median age of 54 years
(range 15-75). There were 4 cases in stage IEA, 9 in stage IIEA, 1 in
stage II EB. Fine needle aspiration biopsy was performed in 1 case,
excision biopsy in 4, thyroid lobectomy in 8, and total thyroidectomy in
1. Radiotherapy was used alone in 4 patients, chemotherapy alone in 2,
radiotherapy combined with chemotherapy in 7, no postoperative treatment
in 1. RESULTS: All but 1 patients were histopathologically diagnosed as
non-Hodgkin's lymphoma. It was of B cell origin in 11 cases, T cell
origin in 2. Seven patients were alive without evidence of recurrent
disease at follow-up, ranging from 5 to 112 months. Three patients died
of lymphoma, 1 died of treatment complication, 2 died of other diseases,
and 1 lost from follow-up. The major surgical resection did not
appreciably affect survival. CONCLUSION: Radiotherapy or chemotherapy,
alone or in combination, is the treatment of choice for thyroid
lymphoma. Surgical resection combined with radiotherapy or chemotherapy
may be beneficial to survival in patients with intrathyroid lymphoma. It
is otherwise limited to make a tissue diagnosis.
10
UI - 11802050
AU - Steurer M; Passler C; Denk DM; Schneider B; Niederle B; Bigenzahn W
TI -
Advantages of recurrent laryngeal nerve identification in thyroidectomy
and parathyroidectomy and the importance of preoperative and
postoperative laryngoscopic examination in more than 1000 nerves at
risk.
SO - Laryngoscope 2002 Jan;112(1):124-33
AD - Department of Otorhinolaryngology-Head and Neck Surgery, Vienna Medical
School, General Hospital Vienna, Waeringer Guertel 18-20, A-1090 Vienna,
Austria. martin.steurer@akh-wien.ac.at
OBJECTIVES/HYPOTHESIS: Recurrent laryngeal nerve palsy (RLNP) is a major
obstacle in thyroid and parathyroid surgery. Therefore, methods that
reduce the number of temporary and, especially, permanent recurrent
laryngeal nerve palsies are of great interest. One promising way to
ensure the integrity of the recurrent laryngeal nerve (RLN) is to
identify the nerve always. The first question raised in the present
study was whether RLN preparation reduces the number of recurrent
laryngeal nerve palsies or whether it introduces additional risks.
Second, from former cases we know that the absence of postoperative
hoarseness does not exclude RLNP, nor does postoperative hoarseness
exclusively imply RLNP. Besides, misdiagnosis is not uncommon.
Therefore, preoperative and postoperative laryngoscopic examination was
given attention. STUDY DESIGN: Patients were investigated 1 to 7 days
before and 3 to 7 days after surgery. When an RLNP was identified,
patients were followed up in a 2-week rhythm the first few times and
every 6 to 8 weeks thereafter until RLNP resolved or it was considered
permanent after 2 years. METHODS: We prospectively investigated 608
surgical patients with 1080 nerves at risk. Because different diseases
might have different rates of postoperative RLNP, we analyzed benign
thyroid disease (680 nerves at risk), thyroid malignoma (321 nerves at
risk), and hyperparathyroidism (79 nerves at risk) separately. Patients
undergoing primary surgery (no prior thyroid surgery) and secondary
interventions (there were one or more thyroid operations before this
intervention) were evaluated separately. RESULTS: We found 3.4%, 7.2%,
and 2.5% of temporary recurrent laryngeal nerve palsies per nerve in the
benign thyroid disease, thyroid malignoma, and hyperparathyroidism
groups, respectively. The prevalence of recurrent laryngeal nerve
palsies in these groups was 0.3%, 1.2%, and 0%, respectively. Conforming
with other studies, the total number of recurrent laryngeal nerve
palsies (temporary and permanent) was not increased compared with cases
with no RLN preparation, whereas the number of permanent recurrent
laryngeal nerve palsies was markedly reduced. An RLN was always
identifiable. Astonishingly, the restitution of an RLNP was up to 2
years in duration; however, most restitutions occurred within the first
6 months. Thirty cases of hoarseness appeared or were intensified after
surgery and were not caused by RLNP. Eleven cases of postoperative RLNP
had no detectable hoarseness. CONCLUSIONS: Besides indirect
laryngoscopy, videostroboscopy should be performed in all cases with no
evident bilateral normal laryngeal function or normal voice. Otherwise,
the incidence of false-positive or false-negative diagnosis of RLNP is
likely to be increased.
11
UI - 11788631
AU - Thieblemont C; Mayer A; Dumontet C; Barbier Y; Callet-Bauchu E; Felman
TI -
P; Berger F; Ducottet X; Martin C; Salles G; Orgiazzi J; Coiffier B
Primary thyroid lymphoma is a heterogeneous disease.
SO - J Clin Endocrinol Metab 2002 Jan;87(1):105-11
AD - Service d'Hematologie, Centre Hospitalier Lyon-Sud, 69495 Pierre-Benite,
France. catherine.thieblemont@chu-lyon.fr
We retrospectively analyzed 26 patients with thyroid lymphoma (TL).
Patients were mostly females, with a median age of 59 yr, presenting a
rapidly growing nodular goiter with or without cervical adenopathy,
without symptoms related to lymphoma for 81% and hypothyroidism in 61%.
A previous history of Hashimoto thyroiditis was observed in 11 patients.
Six different subtypes of lymphoma were observed: 13 of 26 (50%) had
diffuse large B cell lymphoma, 6 (23%) mucosa- associated lymphoid
tissue (MALT) lymphoma, 3 (12%) had follicular lymphoma, 2 (7%) had
Hodgkin's disease, 1 (4%) had small lymphocytic lymphoma, and 1 (4%) had
Burkitt's lymphoma. Diffuse large B cell lymphoma patients presented a
compressive multinodular goiter, cervical adenopathy (66%), disseminated
disease (50%), and poor performance status, with a poor prognosis (5-yr
survival at 44%) despite a treatment based on a multidrug regimen. MALT
lymphoma arose in patients with previous history of Hashimoto disease,
was localized in all but 1, and was biologically associated with
hypothyroidism and a high level of serum antithyroid antibodies. With
total thyroidectomy, prognosis was good (5-yr survival at 100%). We did
not find any routine clinical or biological parameters that could
predict the evolution from Hashimoto's thyroiditis to MALT lymphoma. In
conclusion, we confirmed the histological heterogeneity of TL
corresponding to different clinical presentations and different
prognoses.
12
UI - 11788654
AU - Vella V; Pandini G; Sciacca L; Mineo R; Vigneri R; Pezzino V; Belfiore A
TI -
A novel autocrine loop involving IGF-II and the insulin receptor
isoform-A stimulates growth of thyroid cancer.
SO - J Clin Endocrinol Metab 2002 Jan;87(1):245-54
AD - Istituto di Medicina Interna e di Malattie Endocrine e del Metabolismo,
Cattedra di Endocrinologia, University of Catania, Ospedale Garibaldi,
95123 Catania, Italy.
The insulin receptor (IR) occurs in two isoforms (IR-A and IR-B)
resulting from alternative splicing of exon 11 of the gene. The IR-A
isoform is predominantly expressed in fetal tissues and malignant cells
and binds IGF-II with high affinity. We previously observed that IRs are
overexpressed in thyroid cancer cells; now we evaluated whether these
cells preferentially express IR-A and produce IGF-II, which would
activate a growth-promoting autocrine loop. The IR content ranged
6.0-52.6 ng/100 microg cell membrane protein in thyroid cancer primary
cultures (n = 8) and permanent cell lines (n = 6) vs. 1.2-1.7 in normal
thyroid cells (n = 11 primary cultures; P < 0.0001). IR-A isoform
relative abundance ranged from 36-79% in cancer cells (with the highest
values in undifferentiated cancers) vs. 27-39% in normal cells. Similar
results were obtained in normal vs. cancer thyroid tissue specimens.
IGF-II caused IR autophosphorylation with an ED(50) of 1.5-40.0 nM in
cancer cells vs. more than 100 nM in normal cells; IGF-II affinity
correlated with the relative abundance of IR-A (r = 0.628; P < 0.0001).
IGF-II was expressed in all cancer cells, highly expressed in anaplastic
cells, and less expressed in normal cells. In conclusion, malignant
thyrocytes, especially when poorly differentiated, produce IGF-II and
overexpress IR, predominantly as IGF-II-sensitive isoform A. A
growth-promoting autocrine loop is activated, therefore, and may affect
thyroid cancer biology.
13
UI - 11788662
AU - Saller B; Feldmann G; Haupt K; Broecker M; Janssen OE; Roggendorf M;
TI -
Mann K; Lu M
RT-PCR-based detection of circulating calcitonin-producing cells in
patients with advanced medullary thyroid cancer.
SO - J Clin Endocrinol Metab 2002 Jan;87(1):292-6
AD - Division of Endocrinology, Department of Internal Medicine, University
of Essen, 45122 Essen, Germany. bernard.saller@uni-essen.de
In patients with medullary thyroid carcinoma (MTC) the clinical course
of disease ranges from rapid tumor progression to long-lasting stable
disease. The purpose of the present study was to investigate whether
circulating tumor cells can be detected in the peripheral blood of
patients with MTC by RT-PCR targeted to calcitonin (CT) mRNA and whether
the results of this method are correlated with disease manifestation and
metastatic potential. Blood samples from 19 consecutive patients with
MTC and elevated CT levels were analyzed. Four had newly diagnosed MTC,
and 15 patients had undergone total thyroidectomy. Six of 19 patients
had detectable CT mRNA by RT-PCR. CT levels in the CT mRNA-positive
patients were significantly higher than those in CT mRNA-negative
patients [2,239-265,313 pg/ml; median 80,921 pg/ml (n = 6) vs. 70-46,787
pg/ml; median, 932 pg/ml (n = 13); P = 0.006]. CT mRNA was detectable in
5 of 8 patients with distant metastases, in 1 of 6 patients with
local/regional lymph node metastases, but in none of the patients with
newly diagnosed, organ-confined MTC (n = 2) or surgically treated MTC
without tumor manifestation by various imaging studies (n = 3). In
peripheral blood from 10 healthy volunteers and 21 patients with benign
thyroid nodules, no CT RNA could be detected. In conclusion, an
RT-PCR-based procedure was established to detect circulating
CT-producing cells in the peripheral blood of patients with MTC. RT-PCR
results seem to reflect tumor spread and aggressiveness and thus may
help with early identification of patients with disseminated and rapidly
progressive disease.
14
UI - 11788674
AU - Tonacchera M; Viacava P; Agretti P; de Marco G; Perri A; di Cosmo C; de
TI -
Servi M; Miccoli P; Lippi F; Naccarato AG; Pinchera A; Chiovato L; Vitti
P
Benign nonfunctioning thyroid adenomas are characterized by a defective
targeting to cell membrane or a reduced expression of the sodium iodide
symporter protein.
SO - J Clin Endocrinol Metab 2002 Jan;87(1):352-7
AD - Dipartimento di Endocrinologia e Metabolismo, Univerita di Pisa, Italy.
mtonacchera@hotmail.com
Nodular thyroid disease is the most common endocrine disorder.
Nonfunctioning thyroid nodules are identified by their low radioiodide
uptake compared with the normal extranodular tissue, which, at thyroid
scintiscan, produces the typical picture of a cold thyroid nodule.
Previous in vitro studies demonstrated that the majority of
nonfunctioning thyroid nodules have a specific defect in iodide
transport that accounts for their failure to accumulate radioactive
iodide in vivo. A defect in the expression or structure of the sodium
iodide symporter (NIS) gene has been hypothesized as a possible cause of
the impaired iodide trapping in nonfunctioning thyroid nodules. We
studied 22 patients who were submitted to surgery for a solitary
nonfunctioning thyroid nodule that originated in an otherwise normal
gland. Thyroid scintigraphy was performed at 1, 2, 3, 4, 6, and 24 h
after the oral administration of a tracer dose of 131I (iodine). All
patients showed absence of 131I uptake in the nodule, with normal uptake
in the extranodular tissue and in the contralateral thyroid lobe. Eight
patients with toxic adenomas who underwent lobectomy were also included
in the study. We first studied the expression of human NIS (hNIS)
protein by immunohistochemistry in paraffin-embedded tissue sections
using a specific anti-hNIS monoclonal antibody. Subsequently, we
searched for somatic mutations of hNIS gene in nonfunctioning thyroid
nodules. The level of hNIS expression was determined in both the nodules
and the normal tissue from the same thyroid gland. In all functioning
thyroid nodules (toxic adenomas), a high expression of hNIS protein was
detected with respect to normal surrounding tissue. Similar to the
normal thyroid tissue, follicular cells of toxic thyroid adenomas showed
an exclusive expression of hNIS protein at the cell membrane. Fifty-four
percent of benign nonfunctioning thyroid nodules overexpressed hNIS
protein compared with the normal surrounding tissue, but in these
nodules the hNIS protein failed to target the cell membrane, being
mostly localized inside the cytoplasm. hNIS protein was not detected by
immunohistochemistry in 46% of nonfunctioning nodules, whereas it was
expressed in the surrounding unaffected thyroid tissue. Direct
sequencing of the hNIS gene in all of the nonfunctioning nodules did not
reveal major genetic alterations. A silent polymorphism (GCC/GCG codon
544, exon 13) was found in one nodule. In conclusion, the results
obtained in this study show that two mechanisms contribute to the
reduced radioiodide uptake typical of benign nonfunctioning thyroid
nodules: 1) reduced expression of the hNIS protein, and 2) defective
targeting of hNIS to the cell membrane.
15
UI - 11788675
AU - Specht MC; Tucker ON; Hocever M; Gonzalez D; Teng L; Fahey TJ 3rd
TI -
Cyclooxygenase-2 expression in thyroid nodules.
SO - J Clin Endocrinol Metab 2002 Jan;87(1):358-63
AD - Departments of Surgery, New York Presbyterian Hospital and Weill Medical
College of Cornell University, New York, New York 10021, USA.
Factors contributing to the development of thyroid neoplasia remain
poorly understood. Recent evidence indicates that overexpression of the
inducible cyclooxygenase, COX-2, is important in the pathogenesis of
epithelial carcinomas. These studies were undertaken to evaluate whether
COX-2 is up-regulated in human thyroid neoplasia. Benign (n = 14), and
malignant (n = 14) thyroid nodules were analyzed for expression of COX-2
mRNA by quantitative RT-PCR. Immunoblotting and immunohistochemistry
were performed on representative samples. Three human thyroid cancer
cell lines were similarly analyzed for COX-2 expression. Levels of COX-2
mRNA were significantly increased in thyroid nodule samples compared
with adjacent thyroid tissue in the malignant specimens but not in the
benign specimens. Additionally, COX-2 mRNA levels were significantly
increased in malignant nodule samples compared with benign nodule
samples. COX-2 protein expression was higher in 8 of 10 thyroid nodules
compared with the adjacent tissue. Immunohistochemical analysis
localized expression of COX-2 to the malignant epithelial cells.
Immunofluorescence demonstrated COX-2 protein expression in all three
thyroid cell lines. Finally, COX-2 expression could be detected by
RT-PCR in fine needle aspiration specimens of thyroid nodules. These
data indicate that COX-2 is up-regulated in human thyroid cancer, but
not in benign thyroid nodules, and suggest that COX-2 expression may
serve as a marker of malignancy in thyroid nodules.
16
UI - 11788677
AU - Chiappetta G; Toti P; Cetta F; Giuliano A; Pentimalli F; Amendola I;
TI -
Lazzi S; Monaco M; Mazzuchelli L; Tosi P; Santoro M; Fusco A
The RET/PTC oncogene is frequently activated in oncocytic thyroid tumors
(Hurthle cell adenomas and carcinomas), but not in oncocytic
hyperplastic lesions.
SO - J Clin Endocrinol Metab 2002 Jan;87(1):364-9
AD - Istituto Nazionale dei Tumori di Napoli, Fondazione Senatore Pascale,
80131 Napoli, Italy.
Hurthle cell adenomas and carcinomas, characterized by the presence of
oncocytic cells, are unusual thyroid neoplasms, the treatment of which
is still controversial. We analyzed specimens from 49 patients with
oncocytic cell nodular lesions including 20 adenomas, 19 carcinomas, and
10 hyperplasias for RET/PTC (papillary thyroid carcinoma) activation,
which is the most frequent genetic alteration in PTCs. RET/PTC
activation was detected in a significant number of cases of Hurthle cell
adenomas and carcinomas, but in 0 of 10 patients with hyperplastic
nodules. In particular, the RET/PTC1 isoform was found in 7 of 12
adenomas and 4 of 7 carcinomas. These results would indicate that
RET/PTC is a genetic event common to papillary carcinomas and to Hurthle
cell neoplasias.
17
UI - 11788678
AU - Santoro M; Papotti M; Chiappetta G; Garcia-Rostan G; Volante M; Johnson
TI -
C; Camp RL; Pentimalli F; Monaco C; Herrero A; Carcangiu ML; Fusco A;
Tallini G
RET activation and clinicopathologic features in poorly differentiated
thyroid tumors.
SO - J Clin Endocrinol Metab 2002 Jan;87(1):370-9
AD - Centro di Endocrinologia ed Oncologia Sperimentale del Consiglio
Nazionale delle Ricerche, Dipartimento di Biologia e Patologia Cellulare
e Molecolare, Universita di Napoli Federico II, 80131 Naples, Italy.
Poorly differentiated carcinoma of the thyroid gland (PDC) represents an
heterogeneous group of epithelial neoplasms with morphologic features
and clinical characteristics intermediate between well differentiated
and anaplastic (undifferentiated) carcinomas. Unlike well differentiated
tumors, PDCs are associated with significant morbidity and mortality.
The general prevalence of RET/PTC rearrangement in thyroid PDC and its
impact on patient outcome are unknown. To address these issues and to
identify prognostically relevant clinicopathologic parameters, we have
investigated a series of 62 PDCs. RET/PTC rearrangement, analyzed by
RT-PCR and immunohistochemistry using antibodies specific for the
tyrosine kinase and juxtamembrane portions of the RET protein, was
identified in 8/62 (12.9%) PDCs. RET/PTC was more common in cases with
histologic evidence indicating coexistence with or possible evolution
from a well differentiated papillary carcinoma (5 of 25 tumors, 20%) but
did not correlate with other clinicopathologic parameters. The
relatively low prevalence of RET activation in PDCs argues against a
major role for RET/PTC in the progression from well to poorly
differentiated thyroid tumor phenotypes. Survival analysis demonstrates
that poor survival in PDC is associated with old age, male sex, invasion
of extrathyroidal soft tissues, coexistence in the same tumor of
oncocytic features with insular growth pattern, and distant metastases
but not RET activation.
18
UI - 11788682
AU - Menko FH; van der Luijt RB; de Valk IA; Toorians AW; Sepers JM; van
TI -
Diest PJ; Lips CJ
Atypical MEN type 2B associated with two germline RET mutations on the
same allele not involving codon 918.
SO - J Clin Endocrinol Metab 2002 Jan;87(1):393-7
AD - Department of Clinical Genetics and Human Genetics, Vrije Universiteit
Medical Center, 1007 MB Amsterdam, The Netherlands.
fh.menko.humgen@med.vu.nl
A kindred was diagnosed with atypical MEN type 2B characterized by
medullary thyroid cancer and mucosal neurilemmomas in multiple family
members. Mutation analysis revealed a double RET germline mutation,
Val804Met and Ser904Cys, in affected individuals. The clinical
phenotype, the functional effect of the mutations, and the clinical
implications of our findings are discussed.
19
UI - 11801940
AU - Watanabe A; Kawabori S; Osanai H; Taniguchi M; Hosokawa M
TI -
Preoperative computed tomography diagnosis of non-recurrent inferior
laryngeal nerve.
SO - Laryngoscope 2001 Oct;111(10):1756-9
AD - Department of Otolaryngology, Keiyukai Sapporo Hospital, Sapporo,
Hokkaido, Japan. akihito-watanabe@hokkaido.med.or.jp
OBJECTIVE: The non-recurrent inferior laryngeal nerve (NRILN) is a nerve
anomaly that is associated with the developmentally aberrant subclavian
artery. Thus, it is possible to predict NRILN by preoperative diagnosis
of an aberrant subclavian artery. Preoperative recognition of the NRILN
should be advantageous in the prevention of intraoperative nerve damage.
The purpose of this study was to assess the possibility of diagnosis of
an aberrant subclavian artery by computed tomography (CT) of the neck,
which is often performed before thyroid surgery. METHODS: We
retrospectively studied the preoperative CT films from 594 thyroid or
patients, and a right recurrent inferior laryngeal nerve (RILN) was
observed in 588 of these patients. We evaluated whether the
brachiocephalic artery could be identified on the CT scan and classified
the positional relationship between the right subclavian artery and the
tracheoesophagus into three types. RESULTS: The brachiocephalic artery
was identified on the CT films in 158 cases, all of which were cases of
RILN. The right subclavian artery was detected on the ventral side of
the membranous wall of the trachea in all 588 RILN cases, whereas it was
detected on the dorsal side in all 6 NRILN cases. CONCLUSIONS: It was
possible to predict an aberrant subclavian artery by identifying the
brachiocephalic artery and position of the right subclavian artery on
the CT film of the neck. When an anomaly of the subclavian artery is
thus preoperatively detected, NRILN can be preoperatively predicted,
which likely will enable prevention of vocal cord paralysis.
20
UI - 11769392
AU - Szybinski P; Nowak W
TI -
[Thyroid carcinoma--contemporary diagnostic principles and treatment]
SO - Przegl Lek 2001;58(7-8):809-13
AD - I Katedra i Klinika Chirurgii Ogolnej i Gastroenterologicznej Collegium
Medicum Uniwersytetu Jagiellonskiego w Krakowie.
Thyroid cancer, which is a rare neoplasm, is still controversial issue.
References approved in Poland in 1995 caused unification of the
extension of thyroid surgery to total resection of thyroid gland in case
of cancer. For many surgeons such a radical treatment is still doubtful.
On the other hand thyroid cancer is an object of many studies because of
its heterogenous clinical course and prognosis depending of histological
type. This article focuses on modern principles of diagnosis, treatment
and follow-up according to obligatory references in Poland. The authors
show current epidemiological data, prognosis according to histological
type of cancer and explain pathogenesis of the disease. Preoperative
diagnostic model has been described including role of ultrasound
examination, biopsy, cytology and histology examination. Special
interest was taken to follow-up patients after total thyroidectomy
emphasising the role of thyreglobin in early detection of cancer
recurrence. It is also important to observed patients for the rest of
their life because cancer recurrences have been reported even 40 years
after surgery. Preoperative diagnosis and treatment is a typical example
of multi-disciplinary procedure which should be held in specialistic
centres with proper equipment and experience.
21
UI - 11575855
AU - Mai KT; Vaccani JP; Thomas J; Odell PF
TI -
Immunostaining for ret oncogene proteins in papillary thyroid carcinoma:
a correlation of ret immunoreactivity and potential of lymph node
metastasis.
SO - Thyroid 2001 Sep;11(9):859-63
AD - Department of Pathology and Laboratory Medicine, Ottawa Hospital and
University of Ottawa, Ontario, Canada. ktmai@civich.ottawa.on.ca
Ret oncogenes, particularly Ret/PTC, have been associated with the
potential of local invasion of papillary thyroid carcinoma (PTC). The
purpose of this study was to investigate the correlation between the Ret
oncogene expression and the potential of lymph node metastasis of PTC. A
total of 107 PTC were microscopically reviewed to identify areas of
infiltrating carcinoma (IC). IC was defined as tumor cells disposed in a
haphazard pattern and in lobules, nests, follicles, or single cells
within a desmoplastic or sclerotic stroma. All cases were submitted to
immunostaining for Ret oncogene. There were 36 noninfiltrating PTC with
lymph node metastasis in 1 case and 71 infiltrating PTC with lymph node
metastasis in 40 cases. For non-PTC, the positive immunoreactivity was
often weak to moderate and focal. For infiltrating PTC with IC, the IC
displayed strong immunoreactivity. The noninfiltrating component of PTC
with IC usually showed stronger reactivity than PTC without an
infiltrating component. Furthermore, 36 of 40 metastatic PTC in lymph
node were immunoreactive. Three follicular adenomas with areas of scar
caused by fine-needle aspiration biopsy were not immunoreactive for Ret.
In view of the high potential of infiltrating PTC for lymph node
metastasis, distinction of this type of carcinoma from its
noninfiltrating form is clinically important. Because immunoreactivity
for Ret is usually positive in areas of infiltrating PTC and is often
negative or focally positive in noninfiltrating PTC, immunostaining for
Ret is helpful to identify infiltrating PTC and distinguish it from
changes caused by fine-needle aspiration biopsy in benign thyroid
lesions.
22
UI - 11575858
AU - Pacini F; Elisei R; Capezzone M; Miccoli P; Molinaro E; Basolo F; Agate
TI -
L; Bottici V; Raffaelli M; Pinchera A
Contralateral papillary thyroid cancer is frequent at completion
thyroidectomy with no difference in low- and high-risk patients.
SO - Thyroid 2001 Sep;11(9):877-81
AD - Department of Endocrinology and Metabolism, University of Pisa, Italy.
fpacini@endoc.med.unipi.it
Total (or near-total) thyroidectomy (TT) is considered by many as the
most adequate treatment for papillary thyroid carcinoma (PTC). In
patients who have undergone lobectomy, the necessity of performing a
completion thyroidectomy (CT) is still discussed. The aim of this
retrospective study was to evaluate tumor bilaterality in patients
initially treated with partial thyroidectomy for PTC and who then
underwent CT. We studied 182 patients treated with CT after lobectomy
and/or isthmectomy for PTC diagnosed from 1969-1998. Mean age at
diagnosis was 40+/-14.5 years and mean interval between partial
thyroidectomy and CT was 19.8+/-56.8 months. At CT, 80 of 182 patients
(44%) had one or more foci of tumor in the remaining thyroid lobe,
always of the same papillary histotype, associated with ipsilateral
lymph node metastases in 22 cases. In addition, 10 patients with no
tumoral foci in the thyroid specimen had evidence of lymph node
metastases. The rate of bilateral tumor was not different when patients
were analyzed according to the classification of "low-" or "high-risk."
Among several clinical features, the presence of lymph node metastases
at the first surgical treatment and time interval between first
treatment and CT were correlated with higher frequency of bilaterality
(p = 0.033 and p = 0.044, respectively). The postsurgical 131I
whole-body scan revealed the presence of persistent lymph node
metastases or diffuse micronodular lung metastases in 7 and 6 patients,
respectively. In conclusion, PTC was frequently bilateral in our series
and this bilaterality was independent from the "low-" or "high-risk"
classification. On these bases, we believe that PTC should be treated
with TT when diagnosed before surgery and submitted to CT, if partial
surgery was the initial intervention.
23
UI - 11801967
AU - Gross ND; Weissman JL; Talbot JM; Andersen PE; Wax MK; Cohen JI
TI -
MRI detection of cervical metastasis from differentiated thyroid
carcinoma.
SO - Laryngoscope 2001 Nov;111(11 Pt 1):1905-9
AD - Department of Otolaryngology-Head and Neck Surgery, Oregon Health
Sciences University, Portland, Oregon 97201, USA.
BACKGROUND: With the advent of the use of serum thyroglobulin as a
marker for the recurrence of well-differentiated thyroid cancer (WDTC)
after total thyroidectomy, clinicians are increasingly faced with the
diagnostic dilemma of detecting the site of recurrence in
thyroglobulin-positive patients with normal clinical examinations. The
high protein content of this thyroglobulin may make it specifically
detectable by magnetic resonance (MR) imaging. OBJECTIVE: To determine
the ability of MR imaging to detect the presence of metastatic WDTC in
cervical lymph nodes. STUDY DESIGN: Retrospective cohort. METHODS:
Blinded review by two independent head and neck radiologists of 34 head
and neck MR scans obtained from 26 patients with thyroid cancer (12 with
primary disease and 14 with recurrent disease) all of whom subsequently
underwent surgical removal of the lymph nodes considered at risk by
imaging. RESULTS: The average overall percent sensitivity, specificity,
positive predictive value (PPV), negative predictive value (NPV), and
accuracy of MR imaging were 95%, 51%, 84%, 78%, and 83%, respectively.
The concordance between the two radiologists was 69%. There was no
overall difference in the ability of the MR scan to detect the presence
of disease in the upper jugular, lower jugular, or paratracheal nodal
stations. However, it was more useful for papillary carcinoma (PPV 86%,
accuracy 85%) than for follicular carcinoma or the follicular variant of
papillary carcinoma (PPV 63%, accuracy 67%). CONCLUSION: MR imaging is a
sensitive and accurate technique for the detection of WDTC, particularly
papillary carcinoma, metastatic to cervical lymph nodes. However, the
lower specificity of this modality precludes its use as a screening
tool.
24
UI - 11790980
AU - Weiss RE; Lado-Abeal J
TI -
Thyroid nodules: diagnosis and therapy.
SO - Curr Opin Oncol 2002 Jan;14(1):46-52
AD - Department of Medicine, University of Chicago, Chicago, Illinois 60613,
USA. rweiss@medicine.bsd.uchicago.edu
Less than 1% of all cancers are present in the thyroid, yet thyroid
nodules are found in 4 to 10% of the adult population. Because thyroid
nodules are relatively common, the diagnostic dilemma is to distinguish
between a more common benign nodule, which usually does not require
specific treatment, and a malignant nodule, which requires thyroidectomy
and further treatment. Thyroid nodules usually are an incidental finding
on a routine examination by a primary care physician. When patients seek
treatment for symptomatic nodules, a more serious problem may be
indicated, and thyroid cancer is suggested. However, additional studies
have demonstrated the use of genetic markers and immunohistochemistry in
the diagnosis of thyroid nodules, which may lead to a more rational
approach to the treatment. This article reviews literature published in
the last 12 months pertaining to the pathogenesis, diagnosis, and
treatment of thyroid nodules.
25
UI - 11803633
AU - Triponez F; Simon S; Robert J; Andereggen E; Ussel M; Bouchardy C; Orrit
TI -
J; Meier CA; Burger A; Spiliopoulos A
[Thyroid cancers: the Geneva experience]
SO - Ann Chir 2001 Dec;126(10):969-76
AD - Clinique de chirurgie thoracique, departement de chirurgie, hopitaux
universitaires de Geneve, rue Micheli-du-Crest 24, 1211 Geneve 14,
Suisse. frederic.triponez@hcuge.ch
AIM OF THE STUDY: To study the survival of patients with thyroid cancer
operated in the same centre from 1978 to 1999. PATIENTS AND METHOD: This
retrospective study included 218 patients operated on for thyroid
carcinoma from january 1978 to december 1999. Modified neck dissection
was performed only in the presence of one or more suspected lymph nodes.
The stage of the cancer was defined according to the last TNM
classification (1997). Survival data were taken from the Geneva Tumour
Registry (168 patients = 77% of the series, 109 papillary carcinomas, 37
follicular, 14 undifferentiated and 8 medullary carcinomas). RESULTS:
The overall 5, 10 and 15-year survival rates were respectively 88%, 84%
and 80%. Papillary carcinoma was associated with the best survival at 5,
10 and 15 years (99%, 97% and 93%), despite a recurrence rate of 20%
treated mainly by surgery often associated with radioiodine therapy.
Follicular carcinoma had a survival rate of 83% at 5 years and 75% at 10
years. Undifferentiated carcinoma had a median survival rate of 56 days.
None of the 8 patients with medullary carcinoma had died from that
cancer in this series. CONCLUSION: Thyroid carcinoma carries such a good
prognosis (except for undifferentiated carcinoma) that invasive surgery
at first operation, like radical neck dissection, is not justified,
despite a high rate of recurrence.
26
UI - 11803634
AU - Wu Y
TI -
[Differentiated carcinoma of the thyroid in children and adolescents]
SO - Ann Chir 2001 Dec;126(10):977-80
AD - Service de chirurgie cervicofaciale, centre anticancereux de Shanghai,
Republique populaire de Chine.
AIM OF THE STUDY: Evaluation of resection "a la demande" for
differentiated thyroid carcinoma in young patients. PATIENTS AND
METHODS: From 1963 to 1996, 70 differentiated thyroid carcinomas were
observed in young patients (mean age: 16 years, range: 9-19 years).
Three had pulmonary metastases. Resections were 39 extra-capsular
lobo-isthmectomies (56%), 11 total lobo-isthmectomies with contra
lateral subtotal lobectomies (16%), and 20 total thyroidectomies "de
necessite" (28%). Lymph node resection was unilateral in 41 cases (58%),
bilateral in 23 (33%), and more extended in 5 (7%). In tracheal (n = 8),
esophageal (n = 4) or bilateral inferior laryngeal nerve involvement (n
= 6), the visceral extension was preserved and surgery completed with
postoperative external radiotherapy. In patients with pulmonary
metastases surgery was completed with I131. Two patients were lost of
follow-up. The others were evaluated from 5 years to 28 years later.
RESULTS: There were no postoperative deaths, no laryngeal palsy except
those existing before surgery. In 6 patients, resection was complicated
by permanent hypoparathyroidism. In the follow-up, the death of two
patients was not correlated with the thyroid carcinoma. Five patients
who had a recurrence were reoperated and were alive without any sign of
recurrence. All the patients were alive. CONCLUSION: These results
suggest that in children and adolescent patients, without previous
irradiation, a surgical procedure "a la demande" is justified.
Preservation of tracheal, esophageal or laryngeal involvement, followed
by postoperative radiotherapy was associated with good results.
Cancer Types
Bone Cancer
Brain Tumors
Breast Cancer
Carcinoid Tumors
Endocrine System Cancers
Gastrointestinal Cancers
Gynecologic Cancers
Head and Neck Cancers
Leukemia
Lung Cancers
Lymphomas
Myelomas
Pediatric Cancers
Penile Cancer
Prostate Cancer
Sarcomas
Skin Cancers
Testicular Cancer
Thyroid Cancer
Urinary Tract Cancers
OncoLink Vet
Cancer Treatment
Biologic Therapy
Bone Marrow Transplants
Chemotherapy
Clinical Trials
Complementary Medicine
Gene Therapy
General Treatment Concerns
Hormone Therapy
PDT Center
Proton Therapy
Radiation Oncology
Surgical Oncology
Targeted Therapies
Vaccine Therapies
Cancer Support
Caregivers
Hospice Care and Bereavement
Nutrition and Cancer
Sexuality & Fertility
Side Effects
Support
Survivorship
Exercise and Cancer
Cancer Resources
Cancer News
OncoLink University
Nurses' Notes
Conferences
Newly Diagnosed Patients
Causes and Prevention
Legal and Financial Information for Patients
LGBT Resources
NCI Resources
Global Resources
Cancer Resource List
Resources for Young Adults
OncoLink Media Library
OncoLink TV
Book, Music and Video Reviews
Ask the Experts
Brown Bag Chat
Tracy's Corner
About OncoLink
About OncoLink
Giving to OncoLink
Contact Information
Usage Policy
Editorial Board
How to Partner with OncoLink
Link to OncoLink
Mission Statement
