• Title/Summary/Keyword: Medullary Thyroid Carcinoma

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RET Proto Oncogene Mutation Detection and Medullary Thyroid Carcinoma Prevention

  • Yeganeh, Marjan Zarif;Sheikholeslami, Sara;Hedayati, Mehdi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2107-2117
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    • 2015
  • Thyroid cancer is the most common endocrine neoplasia. The medullary thyroid carcinoma (MTC) is one of the most aggressive forms of thyroid malignancy,accounting for up to 10% of all types of this disease. The mode of inheritance of MTC is autosomal dominantly and gain of function mutations in the RET proto-oncogene are well known to contribute to its development. MTC occurs as hereditary (25%) and sporadic (75%) forms. Hereditary MTC has syndromic (multiple endocrine neoplasia type 2A, B; MEN2A, MEN2B) and non-syndromic (Familial MTC, FMTC) types. Over the last two decades, elucidation of the genetic basis of tumorigenesis has provided useful screening tools for affected families. Advances in genetic screening of the RET have enabled early detection of hereditary MTCs and prophylactic thyroidectomy for relatives who may not show any symptom sof the disease. In this review we emphasize the main RET mutations in syndromic and non syndromic forms of MTC, and focus on the importance of RET genetic screening for early diagnosis and management of MTC patients, based on American Thyroid Association guidelines and genotype-phenotype correlation.

Cytopathologic Analysis on Fine Needle Aspiration Cytologic Misdiagnoses of the Thyroid (갑상선의 세침흡인 세포학적 오진에 대한 세포병리학적 분석)

  • Park, Chan-Pil;Keum, Joo-Seob;Lee, Won-Mi;Park, Moon-Hyang;Lee, Jung-Dal
    • The Korean Journal of Cytopathology
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    • v.9 no.2
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    • pp.169-180
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    • 1998
  • Fine needle aspiration cytology(FNAC) has been used effectively as the initial modality in evaluating various thyroid lesions. We correlated cytologic and histopathologic features to investigate the diagnostic pitfalls of FNAC of the thyroid. A total of 1,593 FNACs of the thyroid were diagnosed at the Department of Pathology, Hanyang University Hospital, from January 1993 to December 1997 There were 963 cytologically benign cases(60.5%), 97 suspicious cases(6.1%), and 75 malignant cases(4.71%). The remaining 458 cases(28.8%) were unsatisfactory. Subsequent surgical resection was done in 192 cases. Seventy-two cases(37.5%) were cytologically diagnosed as benign, 45 cases(23.4%) suspicious, 56 cases(29.2%) malignant, and 19 cases(9.9%) unsatisfactory. Histopathologically, 101 cases were benign(11 thyroidites, 52 adenomatous hyperplasias, 34 follicular adenomas, and four Hurthle cell adenomas), and 91 cases malignant(72 papillary carcinomas, 16 follicular carcinomas, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor). After excluding 19 unsatisfactory cases, 63 were misdiagnosed. They included 17 benign(three thyroidites and 14 adenomatous hyperplasias), 27 suspicious(10 follicular adenomas, four Hurthle cell adenomas, and seven follicular carcinomas), and 19 malignant(16 papillary carcinoma, one medullary carcinoma, one anaplastic carcinoma. and one granular cell tumor) lesions. The accuracy rates in the benign, suspicious, and malignant categories were 54.9%, 49.8%, & 92.8%, respectively. The cytological pitfalls were as follows: (1) background, (2) crowded follicular cell clusters indistinguishable between follicular neoplasia and adenomatous hyperplasia, (3) papillary structure, irregular nuclear membrane and pleomorphism mimicking those of papillary carcinoma, (4) indistinct eosinophilia in follicular epithelial cells, (5) unusual cellular components not commonly seen in FNACS of the thyroid.

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Paraganglioma of the Thyroid Gland Mimicking Medullary Thyroid Carcinoma (갑상선 수질암으로 오인된 갑상선 부신경절종 1예)

  • Lee, Sang Yeon;Lee, Won Yong;Jeong, Woo-Jin;Ahn, Soon-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.2
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    • pp.149-152
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    • 2012
  • Paraganglioma of the thyroid is a neuroendocrine tumor originating from the neural crest. To our knowledge, only 32 cases of thyroid paraganglioma(TP) have been reported to date. TP is difficult to distinguish from medullary thyroid cancer(MTC), hence correct diagnosis is seldom obtained preoperatively. Although immunohistochemistry is helpful for confirmation of TP, these markers are not specific for differential diagnosis between TP and MTC. Therefore, an index of suspicion is important when encountered with MTC with unusual features, or given pathology with neuroendocrine features and unusual immunohistochemical findings. The authors report a case of TP misdiagnosed as MTC at preoperative work-up and intraoperative frozen section analysis, with a review of the literature. The case depicts various immunohistochemical characteristics of the tumor.

Medullary Thyroid Carcinoma in a Maltese Dog (말티즈 개에서 발생한 갑상선수질암)

  • Hyun, Hee-Jin;Jung, Soo-Kyo;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.435-438
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    • 2014
  • An 11-year-old, 2.67 kg female Maltese dog with 3 weeks history of palpable cervical mass near trachea was submitted to a local animal hospital. Radiography and ultrasonography showed radiopaque mass adjacent trachea and vagus nerve. Surgically excised mass was solitary and approximately $3.5{\times}2{\times}0.8cm$ in size. Histopathologically, there were large neoplastic foci admixed with normal thyroid tissues. These neoplastic foci were composed of small to large packets of the neoplastic cells with plasmacytic morphology, and these packets were divided by fine fibrovascular septa. Immunohistochemically, most neoplastic cells in the thyroid mass showed positive reactions for cytokeratin (AE1/AE3), chromogranin A, neuron specific enolase (NSE) and the negative reaction for vimentin. Based on the gross, histopathologic and immunohistochemical characteristics, this dog was diagnosed as medullary thyroid carcinoma.

A Case of Thyroid Hyalinizing Trabecular Tumor Mistaken for Papillary Carcinoma in Aspiration Cytology (흡인 세포검사에서 유두상 암종으로 오인된 갑상선 유리질 소주형 종양 1예)

  • Hong, Seok Jung;Kim, Eun Ju;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.33-36
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    • 2018
  • Hyalinizing trabecular tumor (HTT) of the thyroid gland is a rare neoplasm and only less than 100 cases have been reported so far. It is characterized by hyalinizing stroma with trabecular growth pattern and has an indolent clinical course. Because of its histologic features, it is frequently misdiagnosed as papillary or medullary carcinoma in fine needle aspiration cytologic findings. The tumor is benign or low malignant potential and thyroid lobectomy is recommended for adequate treatment. We recently experienced a case of thyroidal HTT in a 57-year-old man, who presented with a right thyroid nodule that was suspicious of papillary carcinoma in aspiration cytology. We report the unique and rare disease entity with brief literature review.

The Role of PET in Thyroid Cancer (갑상선암에서 PET의 역할)

  • Yeo, Jeong-Seok
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.147-154
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    • 2002
  • The role of PET in the diagnosis and management of thyroid cancer is discussed. The major role of F-18 FDG PET is on patients with discordant negative I-131 scan and a positive serum thyroglobulin values. F-18 FDG PET scan localized metastatic sites in I-131 scan-negative thyroid carcinoma patients with high accuracy. F-18 PET is also valuable in medullary thyroid cancer with high calcitonin level. Focal thyroid uptake in patients with non-thyroidal diseas has high likelihood of thyroid cancer.

The Surgical Management of Pediatric Thyroid Nodule (소아 갑상선 결절의 수술)

  • Oh, Heung-Kwon;Kim, Hyun-Young;Park, Kwi-Won;Jung, Sung-Eun;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.183-191
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    • 2006
  • Thyroid nodules are less common in children than in adults and their management is still controversial. The clinical presentations, operations, complications, histopathologic findings, and postoperative progressions of 34 pediatric patients that underwent thyroidectomy for palpable thyroid nodule at the Department of Surgery, Seoul National University Children Hospital between 1986 and 2003 were studied retrospectively by reviewing medical records and telephone interviews. The mean age of the patients was 11.8 years old. There were 23 females (67.6 %) and 11 males (32.4 %). Surgical indications were clinical need of histological confirmation (n=15), unresponsiveness to thyroxin replacement therapy (n=10), suggestion of the carcinoma on fine needle aspiration cytology (n=5), cosmetic purpose-a huge benign nodule (n=2), completion thyroidectomy for medullary thyroid carcinoma (n=1), and prophylactic thyroidectomy in a MENIIpatient (n=1). Unilateral Lobectomy was performed in 20 patients (57.1 %), subtotal thyroidectomy in 8 (22.9 %), total thyroidectomy in 5 (14.7 %), and completion thyroidectomy in 1 (2.9 %). Lymph node dissection was performed in 9 cases. Benign tumor was found in 23 patients (67.6 %), adenomatous goiter (n=18) and follicular adenoma (n=5). Malignant tumor was found in 11 children (32.4 %), 9 papillary carcinomas (26.5 %), and 2 medullary carcinomas (5.9 %). Of the 9 papillary carcinomas, 7 cases (77.8 %) had lymph node metastasis. No lymph node metastasis was found in 2 medullary carcinomas. Complications developed in 5 cases - transient hypocalcaemia (n=2), and temporary hoarseness (n=3). There was no mortality. Median follow-up period was 7.4 years (0.5-18 years). One patient showed recurrence in cervical lymph nodes 10 years after surgery and modified radical neck dissection was performed. Because of the high incidence of malignancy and advanced stage at initial presentation, more meticulous diagnostic work up is necessary for children with thyroid nodule, and more radical surgical treatment should be performed when malignant nodule is suggested.

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