SEARCH · PubMed Health

Results for “differentiated thyroid carcinoma”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMed1996

Surgical complications after total thyroidectomy and resections for differentiated thyroid carcinoma.

Differentiated thyroid carcinoma often has a favourable prognosis. However, there is no unanimity about the surgical procedure used. In this analysis we evaluated the surgical complications of 178 patients operated on for differentiated thyroid carcinoma during a 12-year period. 110 of the patients were operated in one session and 68 in two. Total thyroidectomy was performed in 106 patients and ipsilateral lobectomy together with contralateral subtotal resection in 72 patients. Tumour was bilateral or multicentric in 59 patients (33%). Hypoparathyroidism occurred in eight patients (4%), without differences between total thyroidectomies and lobectomy plus subtotal resections. Hypoparathyroidism tended to be more common after completion resection than after completion thyroidectomy (4/28 vs 1/40; P = 0.08). Accidental injury to the recurrent laryngeal nerve occurred in one patient (0.6%) during a contralateral resection. During a median follow-up of 4.5 years, tumour recurrence was detected in 22 patients (12%). In papillary carcinoma it was more common in patients who had underwent lobectomy plus contralateral resection than after total thyroidectomy (11/60 vs 3/88; P < 0.01). However, the median follow-up times were unequal. In conclusion, total thyroidectomy and even completion thyroidectomy is as safe as less radical lobectomy together with contralateral resection. Thus, total thyroidectomy should be offered to all patients with differentiated thyroid carcinoma until there is a reliable method to recommend for those patients who can be treated with less radical procedures.

Adenocarcinoma, Follicular↗

PubMed2004

[Prognostic factors in patients with differentiated thyroid carcinoma].

Differentiated thyroid carcinoma is a neoplasm with good prognosis. There is, however, a group of thyroid carcinoma patients with clearly unfavorable course. These patients should be selected soon after the diagnosis of the disease in order to introduce proper therapy as early as possible. The paper presents the main prognostic factors in patients with differentiated thyroid carcinoma.

Adult↗

PubMed1993

Recurrence-associated mortality in patients with differentiated thyroid carcinoma.

Differentiated thyroid carcinoma (DTC) is associated with prolonged natural history, and even recurrent tumor is not necessarily followed by increased mortality. Prognostic factors and different treatment strategies, therefore, are difficult to assess. One hundred and fifty-seven patients were followed in our clinic. In an attempt to predict mortality from this tumor, we evaluated the risk factors in 36 patients who presented with recurrent disease. Ten of these patients died. Age above 40 years at initial diagnosis was the predominant risk factor associated with 44% mortality after recurrence. Male sex, lack of radioiodine treatment, and distant site of initial recurrence were all associated with a trend towards increased mortality. Tumor histology and local invasion or extent of initial surgical treatment failed to affect mortality. In conclusion, this approach may be used to identify those patients who will die from their disease, despite currently available treatment. It remains to be seen, however, if new treatment protocols can be developed to improve the prognosis of these patients.

Adenocarcinoma↗

PubMed2000

The epidemiology and etiology of differentiated thyroid carcinoma.

Differentiated thyroid carcinoma (DTC) is a rare tumor with a relatively good prognosis, but in about 10% of cases it may be the cause of death. Papillary carcinoma is more frequent (about 70-80% of cases) and less aggressive than follicular cancer: the papillary/follicular ratio is increased in areas of high iodine intake. In recent years many genes have been found to be mutated in DTC, the most important of these being ras, ret, trk, and met. The relationship between radiation exposure and DTC is well recognized, especially in children. Since the Chernobyl nuclear accident, a high incidence of DTC has been found in children exposed to fallout.

Genes, p53↗

PubMedDate not supplied

[Differentiated thyroid carcinomas].

Differentiated thyroid carcinomas are TSH-dependent tumors induced by genetic and environmental factors. They may be found on 3-12% of single thyroid lesions. Females are more affected than males (F:M 3:1). The combined action of genetic and environmental factors induces the development of these tumors. The cornerstone of diagnostic evaluation is Fine Needle Aspiration (FNA). Size tumors > 2.5 cm and age > 45 aa are unfavorable prognostic factors. Radical surgery is the first choice therapy followed by hormone suppressive therapy and/or I131. Follow-up is based on WBS and serum Tg evaluation. Moreover recombinant TSH offers a new approach in the field of relapse diagnosis and therapy.

Carcinoma↗

PubMed2001

[Should cervical lymph nodes be electively removed in differentiated thyroid carcinoma?].

Differentiated thyroid carcinomas (DTC; papillary and follicular) constitute merely 0.5-1% of all malignancies in the world. The proper extent of their surgical resection has been discussed for many years. Two different approaches predominate in the literature. One group claims, that elective, modified radical neck dissection (MRND) should be performed. That strategy is supported by high frequency (80%) of observed "occult", clinically not evident, micrometastases in regional lymph nodes on the neck. On the other hand, there have been no studies so far which would unquestionably confirm the prognostic value of neck lymph node involvement in DTC, or the favorable influence of elective lymph node dissection on long-term survival. Therefore, other authors do not recommend prophylactic lateral neck dissection. MRND, apart from its doubtful influence on prognosis, is connected with a higher complication rate and longer hospitalization. The authors of this review also share this opinion.

Adenocarcinoma, Follicular↗

PubMed2001

[Treatment with L-thyroxine for differentiated thyroid carcinoma].

Differentiated thyroid carcinoma (DTC) is one of malignant neoplasms with a very good prognosis and low mortality rate provided a proper therapy and its systematic monitoring is given. DTC treatment consists of surgery, radioiodine and L-thyroxine therapy. L-thyroxine therapy in DTC should be both substitutive and suppressive. Substitutive therapy consists in the removal of the lack of thyroid hormones symptoms so that the serum TSH is about 1 mU/l. Suppressive therapy consists in complete inhibition of TSH secretion by pituitary gland. This prevents from the regrowth and inhibition of carcinoma progress in patients with evident or residual neoplasmic disease. Although complete suppressive therapy (TSH less than 0.05 mU/l) is the most recommended one, in patients with low recurrence risk incomplete suppression can be used (TSH = 0.1-0.3 mU/l). Suppressive L-thyroxine doses may give side-effects such as: cardiac signs (arrhythmia, coronary or heart insufficiency), decrease in bone mineral density with osteopoenia or osteoporosis or subclinical hyperthyroidism. However, the side-effects of the suppressive L-thyroxine doses may be symptomatically treated (with beta-blockers, biphosphoniates).

Cardiovascular Diseases↗

PubMed2005

Bronchiectasis simulating pulmonary metastases on iodine-131 scintigraphy in well-differentiated thyroid carcinoma.

Differentiated thyroid cancer is an uncommon disease that carries a good prognosis when treated adequately. Radioiodine treatment is often used as an adjunct to surgery because this has been associated with increased survival, particularly in the presence of iodine-avid soft tissue metastases. Multiple different false-positive scans can occur in the absence of residual thyroid tissue or metastases. Recognition of these potential false-positive iodine-131 (I-131) scans is critical to avoid the unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine. We report a case of physiological uptake of radioactive iodine in the bronchiectatic bronchial tree bilaterally, potentially masquerading as pulmonary metastases.

Adult↗

PubMed1996

[CD26/dipeptidyl peptidase IV and thyroid peroxidase as molecular markers for differentiated thyroid carcinoma].

Differential expression of two enzymes, dipeptidyl peptidase IV (CD26/DPP IV) and thyroid peroxidase (TPO), in neoplastic thyroid tissues was studied by Northern blot analysis and histochemical analysis using 31 thyroid tissue specimens of various thyroid diseases. On Northern blot analysis, all 16 differentiated carcinomas (12 papillary and 4 follicular carcinomas) overexpressed CD26/DPP IV mRNA, whereas all 14 benign tissue specimens (4 normal thyroid, 4 Graves' disease, 2 adenomatous goiters and 4 follicular adenomas) showed faint expression of CD26/DPP IV mRNA. All 14 benign tissues expressed high levels of TPO mRNA, whereas all 12 papillary carcinomas strongly underexpressed TPO mRNA. A medullary carcinoma did not show any mRNA expression of either enzyme. TPO mRNA expression in differentiated carcinomas did not always correlate with mRNA expression of thyroglobulin, thyroid stimulating hormone receptor, and thyroid transcription factor-1. Northern blot analysis also revealed that CD26/DPP IV is a more specific marker of differentiated carcinoma than three proto-oncogenes previously reported to increase mRNA expression in thyroid carcinomas: c-met, c-erbB-2, and EGF-R. Histochemically, all 14 benign tissues were CD26/DPP IV negative and strongly TPO positive, while all 12 papillary carcinomas were strongly CD26/DPP IV positive and TPO negative. Three of 4 follicular carcinomas were histochemically positive for the two enzymes. These findings suggest that the differential expression of these two enzymes can be applied to study the thyroid tumorigenesis.

Adenocarcinoma, Follicular↗

PubMedDate not supplied

Chemosensitivity of anaplastic thyroid carcinoma and poorly differentiated thyroid carcinoma.

BACKGROUND: The prognosis of anaplastic thyroid carcinoma (ATC) and poorly differentiated thyroid carcinoma (PDTC) is very poor because of their resistance to chemotherapy. MATERIALS AND METHODS: We retrospectively evaluated the response to chemotherapy of 14 patients with ATC and examined the in vitro chemosensitivity of primary cultures of one ATC and five PDTCs from six recent patients. RESULTS: As assessed at one month after treatment, one patient had a partial remission (PR), 3 had no change (NC), and the other 10 progressed (PD). The mean survival of all 14 patients was 3.4 months (PD; 2.3 months, PR or NC; 6 months). Five of the tumors (one ATC and four PDTCs) were resistant to all drugs examined: adriamycin, cisplatin, cyclophosphamide, etoposide, and carboplatin; cells from one PDTC were sensitive to adriamycin alone. Although five patients had administration of anti-cancer agents, none showed a response to chemotherapy. CONCLUSION: most ATCs and PDTCs are very resistant to anti-cancer agents. In vitro chemosensitivity testing may prevent the administration of ineffective chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1986

Is the EORTC prognostic index of thyroid cancer valid in differentiated thyroid carcinoma? Retrospective multivariate analysis of differentiated thyroid carcinoma with long follow-up.

The European Organization for Research on Treatment of Cancer (EORTC) Thyroid Cancer Cooperative Group presented a prognostic index in 1979 that included all histologic groups of thyroid carcinomas, and was based on a multivariate analysis of 507 patients with a median follow-up of 40 months. The current report not only uses a multivariate analysis to study the clinical validity and reproducibility of this index on case material consisting of 226 differentiated thyroid carcinomas with a considerably long follow-up (11 years), but also it investigates possible prognostic factors, other than those proposed by the EORTC. Three EORTC variables could be reproduced as important: age at diagnosis, locally advanced disease, and distant metastases. Of the additional histopathologic variables tested, microscopic tumor invasion beyond thyroid capsule (pT4) and marked cellular atypia (MCA) proved to be significant. When the effect of the age-correlated tumor factors pT4 and MCA of differentiated thyroid carcinomas were taken into consideration, age alone lost its prognostic importance as a guide for treatment.

Adult↗

PubMed1984

Thyroglobulin may be undetectable in the serum of patients with metastatic disease secondary to differentiated thyroid carcinoma. Follow-up of differentiated thyroid carcinoma.

To assess the value of serum thyroglobulin (Tg) levels in the follow-up of differentiated thyroid carcinoma after ablative therapy simultaneous Tg estimations and radioiodine (131I) scans were performed on patients during an 18-month follow-up period. In this study, 287 scans were performed on 200 patients who were not receiving Thyroxine (T4) replacement at the time, i.e., off T4. Wherever possible, Tg was also estimated while the patient was receiving T4. All sera were screened for Tg autoantibodies which were detected on 67 occasions in 44 patients (22%). Of the 220 sera without Tg autoantibodies (156 patients), 17 were accompanied by scan evidence of functioning thyroid tissue, although Tg was undetectable (less than 5 micrograms/l) either on or off T4. Serum Tg was only detectable off T4 in a further five patients (six scans) who simultaneously had scan evidence of functioning thyroid tissue. In seven patients the finding of detectable Tg preceded scan evidence of recurrence. Thus, serum Tg is useful in the follow-up of differentiated thyroid cancer after ablative therapy. However, some patients with recurrence or metastasis will be missed if Tg alone is relied on, particularly if thyroxine treatment is continued.

Adenocarcinoma↗

PubMed2025

High Prevalence of Potential Molecular Therapeutic Targets in Poorly Differentiated Thyroid Carcinoma.

Poorly differentiated thyroid carcinoma (PDTC) is a rare thyroid cancer with aggressive clinical course and peculiar clinical/pathological characteristics but lacking effective therapeutic options, when surgery is not curative. We aimed at the molecular characterization of PDTC with a specific focus on the identification of potential therapeutic targets. A series of PDTC cases was selected from a multi-institutional network. Fifty-nine samples underwent wide targeted DNA and RNA next-generation sequencing (NGS) testing and immunohistochemical analysis for mismatch repair (MMR) proteins. Gene fusion analysis was enriched by 25 additional samples. Prevalence of MMR protein loss was 11.9%. The most prevalent mutations were in NRAS (25%) and TP53 (25%), mutually exclusive. TERT promoter (TERTp) mutations were detected in 19.6% of cases (10/51). NRAS-mutated cases were enriched for mutations in genes belonging to the same pathway. TP53-mutated samples lacked TERTp co-mutations, but were associated with mutations in PTEN and in genes related to MMR system and/or loss of MMR proteins. TERTp mutations were the most prevalent alterations (28%, 7/25) in a third group that lacked NRAS or TP53 mutations. Four cases harbored gene fusions, including two cases harboring the TBL1XR1::PIK3CA fusion that has never been reported in thyroid cancer, so far. In conclusion, PDTC may be genomically segregated in subgroups with specific molecular characteristics. Overall, targetable gene fusions have a prevalence of 9% (4/42). Moreover, 47% of cases are potential candidates for individualized target therapies since they harbor mutations in genes coding for potentially targetable molecules and/or have defects in the MMR system.

Humans↗

PubMed2003

Acute toxicity of adjuvant radiotherapy in locally advanced differentiated thyroid carcinoma. First results of the multicenter study differentiated thyroid carcinoma (MSDS).

BACKGROUND AND PURPOSE: The indication for adjuvant postoperative radiotherapy in patients with differentiated thyroid carcinoma (DTC) extending beyond the thyroid capsule has been an issue of controversy during the past 2 decades. No randomized studies evaluating the benefit of radiotherapy have been published so far. In the Multicenter Study Differentiated Thyroid Carcinoma (MSDS), a randomization has been performed concerning external-beam radiotherapy in patients with DTC extending beyond the thyroid capsule (pT4 pN0/1/x cM0, TNM classification, 5th edition, 1997) following surgery and radioiodine therapy. Radiation-associated toxicity has been prospectively evaluated. PATIENTS AND METHODS: Radiotherapy was performed with 50.4 Gy (pN0) or 54.0 Gy (pN1/x) to the cervical, supraclavicular and upper mediastinal lymph nodes. A total dose of 59.4 Gy (R0 resection) or 66.6 Gy (R1) was used to treat the tumor bed. Conventional fractionation was used with 1.8 Gy/d. At the time of the analysis, 36 patients were randomized or allocated to treatment arm A (with external-beam radiotherapy). Of these, 22 were treated with radiotherapy, and documentation of acute toxicity was available. Toxicity was evaluated prospectively according to the RTOG/EORTC criteria. RESULTS: The maximal acute toxicity observed during radiotherapy was grade I in four patients, grade II in 16 patients, and grade III in two patients (9.1%; 95% confidence interval [95% CI] 1.1-29.2%). Toxicity was mainly observed at the pharynx, larynx, and skin. In 19 patients, residual toxicity within 100 days following radiotherapy was evaluated. No residual toxicity was observed in two patients. Maximal residual toxicity was grade I in 13 patients and grade II in four. No further grade III toxicity could be observed. CONCLUSION: The majority of patients experience mild to moderate side effects from adjuvant external-beam radiotherapy. At the first follow-up examination, most side effects have subsided. Acute toxicity is tolerable in these patients.

Adenocarcinoma, Follicular↗

PubMed2005

Hepatic metastasis of differentiated thyroid carcinoma.

BACKGROUND: Differentiated thyroid cancers (DTC) often form metastases in neck lymph nodes, lungs and bones. Other metastases--to the brain, kidneys, skin and liver are rare. Liver metastases of DTC occur in the terminal phase of the disease and predominantly do not accumulate radioiodine. Functional (accumulating radioiodine) metastases are very rare. MATERIAL AND METHODS: In an 85 year old patient with DTC of the follicular type after removal of the thyroid and lymph nodes metastases on the neck and after the elimination of thyroid remnants by radioiodine, a functional metastasis in the liver was detected by combination of whole-body scintigraphy following administration of 131I and liver scintigraphy by using 99mTc-colloid, supplemented by bone scintigraphy after administration of 99mTc-MDP. At first, the high thyroglobulin serum level was falsely negative after repeated radioiodine treatment. The patient was treated for this hepatic accumulating metastasis eight times by 59.2 GBq total dose of radioiodine. Radioiodine treatments were repeated for 7 years, the patient died at the age of 92 years. CONCLUSIONS: It is necessary to distinguish between diffuse and focal radioiodine accumulation in a liver. Only a focal accumulation is characteristic for functional liver metastasis in which thyroxin synthesis is preserved. The correspondence of focal accumulation of radioiodine on whole-body scintigraphy with "cold" area on liver scintigraphy is specific for diagnosis of this metastasis. At the same time, it confirms the fact that radioiodine therapy can be both promising and successful, as we can see in the case of our patient.

Aged↗

PubMed1980

Thyroid carcinoma.

Differentiated thyroid carcinoma was studied with regard to mode of presentation, initial findings, treatment and survival. The classic signs, symptoms, physical and scan findings were found to be present in approximately 70% of the patients. Thirty percent of the patients had either unusual presentations or findings. Prognosis was found to be dependent on age of presentation more than any other factor. The effects of neck metastasis, extracapsular invasion and recurrent laryngeal nerve involvement on long-term survival are studied in detail. patients with prior exposure to radiation were found to have more extensive disease and require more extensive surgery but ultimately had the same prognosis for 15-year cure. Treatment for distant metastatic disease by surgery, radioactive iodine and external radiation all resulted in long-term survival in certain cases.

Adenocarcinoma↗

PubMed2002

[Unusual metastasis of differentiated thyroid carcinoma].

Distant metastases of differentiated thyroid cancer are usually localised in the lung and bone; less common sites of metastases are the brain, liver, and skin. To find it in other sites it is exceptional. This work shows the clinical, histological and therapeutical characteristic of primary tumour in three cases of non-typical distant metastases of differentiated thyroid cancer. Follicular thyroid carcinoma was displayed in two cases, the first presented one metastases in right adrenal gland and the second in left kidney. Both cases were initially treated only with hemithyroidectomy, without posterior radioiodine. In one case, elevated serum thyroglobulin did not receive radioiodine treatment because Whole-Body Scintigraphy was negative. The thirst case was a papillary thyroid carcinoma treated with total thyroidectomy, ablative radioiodine and suppressor therapy with levothyroxine. However, posterior evolution was unfavourable and tumour presented metastases in common and less common sites like choroid. Histological study showed tall cell variant of papillary thyroid carcinoma. In summary, when the initial treatment of well-differentiated thyroid carcinoma it is inaccurate, it is possible to find common and less common sites metastases. Some variants of papillary thyroid carcinoma, like tall cell, have a worse prognosis and they can present metastases in less common sites.

Adenocarcinoma, Follicular↗

PubMedDate not supplied

Differentiated thyroid carcinoma in childhood.

Differentiated thyroid carcinoma is rare in childhood and shows different characteristics as compared to thyroid carcinoma in adults. The male/female ratio is different, it has a higher aggressiveness, locoregional and distant metastases are frequent, response to surgery and 131I radioiodine therapy is optimal. A better knowledge of these characteristics has resulted in the understanding of some relevant aspects of the pathogenesis and natural history of the disease, the suitability of the therapeutic approach and the incidence of adverse side-effects. The increased incidence of differentiated thyroid carcinoma in childhood following the Chernobyl nuclear accident of April 1986 renewed the interest of the scientific community and the public opinion and allowed an in-depth study of some important aspects correlated with the carcinogenic effect of ionizing radiation.

Adolescent↗