thyroid carcinoma

A thyroid carcinoma cell line, BHT-101, has been established in vitro from a metastatic lymph node deposit in a female patient with a non-hormone producing anaplastic, partly thyroglobulin-and thyroxine (T4)-positive papillary thyroid cancer. The cell population is heterogeneous, containing epithelial-like and fibroblast-like cells, and has a doubling time of 24 h. The cell line is polyploid with hypertetraploid predominance and the karyotype showed trisomies, tetrasomies, pentasomies as well as many marker chromosomes. The majority of the cells are negative or weakly positive for thyroglobulin and thyroxine and estrogen and progesterone receptors are present in the cells. BHT-101 cells produce tumours when injected into immunosuppressed CBA/Ca mice. The cells are sensitive to adriamycin, methotrexate and tamoxifen but not to methimazole (Favistan). The epithelial-like clone 1 and the fibroblastlike clone 3, isolated from the parental line, differed in drug sensitivity. This new cell line is suitable for studying the biology of thyroid carcinoma and for parallel in vivo and in vitro studies of drug activity against thyroid cancer.

While fairly complete and reliable incident data on childhood cancers are available from the registries in India, mortality and survival information is not. Information concerning the latter was obtained by the Bangalore cancer registry through active follow-up involving visits to homes of patients. Between 1982 and 1989, 617 cases of cancers in childhood were registered, giving an age-standardized incidence rate of 84.8 and 48.4 per million in male and female children, respectively. Active follow-up provided mortality/survival information in 532 or 86.2 percent of these cases. Overall, observed five-year survival was 36.8 percent (both genders combined) with a relative survival of 37.5 percent when childhood mortality in the general population was taken into account. The five-year relative survival was best for thyroid carcinoma (100 percent) followed by Hodgkin's disease (73 percent) and retinoblastoma (72.9 percent). Survival was comparatively low, being 9.9 percent in acute nonlymphatic leukemia and less than 20 percent in rhabdomyosarcoma and the category grouped as ‘other malignant neoplasms.’ Survival in Hodgkin's disease was influenced by clinical stage at presentation, but was not statistically significant possibly due to small numbers.

Introduction: Thyroid cancer is the most prevalent endocrine malignancy tumor, and its incidence is increasing. Chemotherapy drugs like Paclitaxel (PTX) are a common treatment for cancer; however, they have many adverse effects. Plants are a source of anticancer agents. The present study assessed the cytotoxic effects of hydro-alcoholic extract in comparison with those of paclitaxel on Papillary Thyroid Cancer (PTC) cell line.
Methods: PTC cell line was treated by different concentrations of extract and paclitaxel for 24, 48, and 72 h. Cytotoxicity was examined through Trypan blue and clonogenic assays. Acridine Orange/Ethidium Bromide (AO/EB) staining was used for detecting apoptotic cells. The observations were statistically tabulated and analyzed.
Results: The Trypan blue staining results suggested that hydro-alcoholic extract had a cytotoxic effect on PTC cells. Our results of AO/EB staining revealed that the hydro-alcoholic extract of Hull-Less Seed Pumpkin (HLSP) in the concentration of ≥100 μl/mL induced significant apoptosis in the PTC cultured cell (P<0.05). In addition, the AO/EB staining data suggested an increase in the number of apoptotic cells with increasing the concentration of extract and paclitaxel. The clonogenic assay results indicated a decrease in colonies by increasing the concentration. Comparing the groups treated by paclitaxel or HLSP extract, with the control group revealed significant differences between them (P<0.05).
Conclusion: The HLSP extract had a cytotoxic effect on the human PTC cell line. Based on the adverse effects of chemotherapy drugs, this extract can be considered as a beneficial agent for PTC treatment.

This study assessed the incidence of neoplasms, including malignant tumors, in lesions within the thyroid gland from which non-diagnostic biopsy aspirates were obtained. An auxiliary goal of the study was an evaluation of the diagnostic efficacy of repeated biopsy in cases when the first biopsy was non-diagnostic. Thus, results of 4603 fine-needle aspiration biopsies (FNABs) were submitted to histopathological verification. The verification revealed the rate of malignancy at 7.1% for non-diagnostic biopsies, i.e., significantly higher (p<0.001) than that in cases FNAB-diagnosed as benign lesions (2.1%). Repeated biopsy, performed when inadequate material has been collected, seems to be less effective than the first biopsy (non-diagnostic specimens; 14.4% vs 8.9%; p<0.01). The occurrence of neoplasms in the goiter was significantly higher (p < 0.0001) in patients with non-diagnostic first FNAB than in those with diagnostic one (50.7% vs 33.5%, p<0.001). And again, in patients with two non-diagnostic FNABs, the occurrence of neoplasms was higher than that in patients with the second diagnostic cytology (63% vs 41.2%, p<0.05). According to our data, patients with non-diagnostic FNAB results should be very carefully monitored, especially when the repeated biopsy is either non-diagnostic again or not performed at all.

Die chirurgische Therapie der Schilddrüsenkarzinome hat in den letzten Jahren aufgrund verfeinerter Techniken und Nachsorgekonzepte weltweit erhöhte Aufmerksamkeit gefunden. Wegen der tumorbiologischen Besonderheiten der 5 Haupttypen der Schilddrüsenkarzinome und der hiermit in Verbindung stehenden unterschiedlichen adjuvanten (Radiojodtherapie) bzw. additiven (Radiojodtherapie, externe Strahlentherapie, Chemotherapie) Therapieverfahren steht der primäre Karzinomtyp im Mittelpunkt der chirurgischen Therapiestratifizierung. Abhängig von der Ausdehnung des Primärtumors (extrathyreoidal vs. intrathyreoidal) und vom lokoregionären Lymphknotenbefall kann ein erhebliches lokoregionäres Rezidivrisiko bestehen. Aufgrund der zwar reduzierten, aber trotz Rezidiv auch im Langzeitverlauf nicht ungünstigen Prognose ist bei Fehlen einer progredienten Fernmetastasierung insbesondere bei differenzierten und medullären Karzinomen grundsätzlich die Indikation zur Rezidivresektion gegeben. Die Diagnostik von Primärtumoren und Rezidiven konnte insbesondere durch Sonographie und PET/CT wesentlich verbessert werden und hat dadurch nicht nur zu einer früheren Diagnosestellung, sondern auch zu einem differenzierten Verständnis der Tumorbiologie beigetragen. In recent years surgical therapy of thyroid carcinoma has received increased attention worldwide due to refined techniques and postoperative concepts. Due to the biological characteristics of the five main types of thyroid carcinoma and the corresponding different adjuvant (radioiodine therapy) and additive (radioiodine therapy, external radiation therapy and chemotherapy) therapeutic procedures, the type of primary carcinoma is the focus of surgical therapy stratification. There can be a substantial locoregional risk of recurrence depending on the spread of the primary tumor (extrathyroidal versus intrathyroidal) and the locoregional lymph node infestation. Due to the reduced but despite recurrence not unfavorable prognosis even in the long-term, the indications for resection of recurrences are given by a lack of progressive distant metastization especially for differentiated and medullary carcinomas. The diagnostics of primary tumors and recurrences have been substantially improved especially by sonography and PET-CT and have led not only to an earlier diagnosis but also to a differentiated understanding of tumor biology.

We conducted a prospective evaluation of somatostatin receptor scintigraphy (SRS) for the diagnosis of recurrent vesicular or papillary thyroid carcinoma in 16 patients with no detectable iodine uptake. SRS was performed 1, 4 and 24 h after intravenous injection of 137–200 MBq of indium-111 pentetreotide. Results were interpreted in terms of assumed presence of tumoral tissue: there were three true-positives (19%), one false-positive (6%) and 12 false-negatives (75%). The three true-positive patients had multiple lesions visible on computerized tomography. SRS was negative in all patients with a high thyroglobulin level alone. In addition, we analyzed the consequences of interpretative criteria and somatostatin receptor expression variability for SRS positivity as well as the risk of false-positives. We conclude that when iodine uptake cannot be demonstrated in patients with suspected recurrence of differentiated thyroid carcinoma, SRS would not appear to contribute to diagnosis, and that interpretative criteria commonly used for tumours with a high receptor density may be too restrictive for tumours with a low receptor density.

BACKGROUNDThe mechanisms of local and distant metastases are imperfectly understood. The goal of the current study was to add to the body of knowledge regarding local and distant metastases of thyroid malignancies.The mechanisms of local and distant metastases are imperfectly understood. The goal of the current study was to add to the body of knowledge regarding local and distant metastases of thyroid malignancies.METHODSThe authors performed multivariate analysis of 573 patients who underwent surgery between November 1994 and May 2002 for follicular (FTC; n = 100), papillary (PTC; n = 236), or medullary thyroid carcinoma (MTC; n = 237) at a university hospital.The authors performed multivariate analysis of 573 patients who underwent surgery between November 1994 and May 2002 for follicular (FTC; n = 100), papillary (PTC; n = 236), or medullary thyroid carcinoma (MTC; n = 237) at a university hospital.RESULTSIn multivariate analysis, extrathyroidal extension consistently evolved as the key risk factor for both lymph node metastasis and distant metastasis. This correlation was most pronounced in MTC and least pronounced in FTC. The risk of lymph node metastasis also increased with reoperative status in patients with MTC and with primary tumor diameter in patients with MTC (tumor diameter > 10 mm) and patients with PTC (tumor diameter > 20 mm). In the PTC group, lymph node metastasis was more common among patients younger than age 45. In the MTC group, extrathyroidal growth and distant metastasis were associated exclusively with lymph node metastasis. Lymph node metastasis was the only secondary risk factor for distant metastasis. In the analysis of risk factors for distant metastasis in the FTC and PTC groups, no interaction was found between extrathyroidal growth and lymph node metastasis. This finding suggests that extrathyroidal growth and lymph node metastasis of FTC and PTC, and presumably also MTC, represent separate mechanisms and routes of distant metastasis.In multivariate analysis, extrathyroidal extension consistently evolved as the key risk factor for both lymph node metastasis and distant metastasis. This correlation was most pronounced in MTC and least pronounced in FTC. The risk of lymph node metastasis also increased with reoperative status in patients with MTC and with primary tumor diameter in patients with MTC (tumor diameter > 10 mm) and patients with PTC (tumor diameter > 20 mm). In the PTC group, lymph node metastasis was more common among patients younger than age 45. In the MTC group, extrathyroidal growth and distant metastasis were associated exclusively with lymph node metastasis. Lymph node metastasis was the only secondary risk factor for distant metastasis. In the analysis of risk factors for distant metastasis in the FTC and PTC groups, no interaction was found between extrathyroidal growth and lymph node metastasis. This finding suggests that extrathyroidal growth and lymph node metastasis of FTC and PTC, and presumably also MTC, represent separate mechanisms and routes of distant metastasis.CONCLUSIONSScreening for both local residual disease and distant metastases should be intensified in the high-risk population of patients whose primary tumors exhibit large diameters, extrathyroidal growth, or lymph node metastasis. Cancer 2003;98:712–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11581Screening for both local residual disease and distant metastases should be intensified in the high-risk population of patients whose primary tumors exhibit large diameters, extrathyroidal growth, or lymph node metastasis. Cancer 2003;98:712–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11581

Supposedly, thyrocyte-specific transcripts such as thyroglobulin (Tg) and thyroid-stimulating hormone receptor (TSH-R) were proposed to be useful for the diagnosis of circulating tumour cells in patients suffering from differentiated thyroid carcinoma (DTC). However, several research groups reported blood-borne Tg transcripts in healthy individuals. This study determines in particular the origin of Tg mRNA in nucleated blood cells and analyses whether

In an attempt to advance and improve the characterization of the so-called diffuse follicular variant of papillary thyroid carcinoma (diffuse FVPTC) we studied a series of 59 thyroid carcinomas consecutively treated in a specialized center. The clinicopathologic and some of the immunohistochemical characteristics (uPA-R, Lewis X, Sialyl Lewis X, and MIB-1) of ten cases of FVPTC displaying a multinodular or diffuse pattern of growth, and histologic features similar to those previously described in diffuse FVPTC, were compared with those of common papillary thyroid carcinoma (PTC, 25 cases) and common FVPTC (8 cases). Cases of diffuse FVPTC differed significantly from common PTC and FVPTC in targeting younger patients and in exhibiting a prevalence of multicentricity, extrathyroid extension, nodal metastasis, and vascular invasion. Immunohistochemically, diffuse FVPTC cases were characterized by the overexpression of uPAR and sialyl Lewis X. No differences were observed regarding MIB 1 immunoreactivity. Regardless of the term used to designate the multicentric, invasive form of FVPTC (diffuse or multinodular FVPTC) it is crucial to acknowledge the existence of cases of FVPTC with a guarded prognosis that should be distinguished from the classic, uninodular form of FVPTC.

Die chirurgische Therapie der Schilddrüsenkarzinome hat in den letzten Jahren aufgrund verfeinerter Techniken und Nachsorgekonzepte weltweit erhöhte Aufmerksamkeit gefunden. Wegen der tumorbiologischen Besonderheiten der 5 Haupttypen der Schilddrüsenkarzinome und der hiermit in Verbindung stehenden unterschiedlichen adjuvanten (Radiojodtherapie) bzw. additiven (Radiojodtherapie, externe Strahlentherapie, Chemotherapie) Therapieverfahren steht der primäre Karzinomtyp im Mittelpunkt der chirurgischen Therapiestratifizierung. Abhängig von der Ausdehnung des Primärtumors (extrathyreoidal vs. intrathyreoidal) und vom lokoregionären Lymphknotenbefall kann ein erhebliches lokoregionäres Rezidivrisiko bestehen. Aufgrund der zwar reduzierten, aber trotz Rezidiv auch im Langzeitverlauf nicht ungünstigen Prognose ist bei Fehlen einer progredienten Fernmetastasierung insbesondere bei differenzierten und medullären Karzinomen grundsätzlich die Indikation zur Rezidivresektion gegeben. Die Diagnostik von Primärtumoren und Rezidiven konnte insbesondere durch Sonographie und PET/CT wesentlich verbessert werden und hat dadurch nicht nur zu einer früheren Diagnosestellung, sondern auch zu einem differenzierten Verständnis der Tumorbiologie beigetragen. In recent years surgical therapy of thyroid carcinoma has received increased attention worldwide due to refined techniques and postoperative concepts. Due to the biological characteristics of the five main types of thyroid carcinoma and the corresponding different adjuvant (radioiodine therapy) and additive (radioiodine therapy, external radiation therapy and chemotherapy) therapeutic procedures, the type of primary carcinoma is the focus of surgical therapy stratification. There can be a substantial locoregional risk of recurrence depending on the spread of the primary tumor (extrathyroidal versus intrathyroidal) and the locoregional lymph node infestation. Due to the reduced but despite recurrence not unfavorable prognosis even in the long-term, the indications for resection of recurrences are given by a lack of progressive distant metastization especially for differentiated and medullary carcinomas. The diagnostics of primary tumors and recurrences have been substantially improved especially by sonography and PET-CT and have led not only to an earlier diagnosis but also to a differentiated understanding of tumor biology.

Purpose Postoperative lymphatic leakage following thyroid surgery represents a management problem with considerate potential morbidity, psychological, and economical impact. Conservative and surgical management strategies for high- and low-output lymph fistulas are inconsistent. Reliable criteria to predict outcome of conservative versus surgical treatment in clinically evident lymph fistula are lacking. Material and methods A retrospective single-center chart review of consecutively quality-control-documented thyroid surgeries from January 1998 to December 2009 was performed to identify reported postoperative lymph fistulas. Documentation of surgical procedures, drainage, medical, and nutritional management was analyzed to identify risk factors for occurrence and criteria for management of evident lymph fistulas. Results There were 29 patients identified with postoperative clinical evidence of lymph fistulas following thyroid surgery; incidence was 0.5%. Indication to surgery comprised benign nodular goiter, recurrent nodular goiter, and thyroid carcinoma or local and lymphonodal carcinoma recurrences. There were 12 (41%) primary and 17 (59%) redo surgeries performed. Surgical procedures performed included thyroidectomy, completion thyroidectomy, and primary and redo central and lateral systematic microdissection of lymphatic compartments. All patients were initially submitted to fasting diet and medical treatment, successfully in 19 (66%), whereas ten (34%) patients underwent surgical intervention for fistula closure after failure of conservative treatment. Complications were one wound infection and fistula recurrence in five (26%) patients in the conservative group and two (20%) in the surgical group. Hospital stay was exceedingly prolonged in both groups with a median of 21 and 11 versus 6 days in patients with regular postoperative course following thyroid surgery. Conclusions Data of this series support definition of the two categories of high- and low-output fistulas according to drainage collection with >300 versus

Introduction  Nodular lesions within the neck may origin from several structures. A misdiagnosed origin may expose the surgeon to inappropriate procedures. These lesions are paradoxically frequent in high specialised centre for endocrine surgery. Patients and methods  In the year 2006, three patients were first admitted to our department with a diagnosis of thyroid nodule (1) or lymphatic metastases of thyroid carcinoma (2).

Page 1. NACB: Practice Guidelines And Recommendations For Use Of Tumor Markers In The Clinic Monoclonal Gammopathies (Section 3K) 1 National Academy of Clinical Biochemistry Guidelines for the Use of Tumor Markers in Monoclonal Gammopathies ...

We report a 57-year-old female with a history of migraine without aura in her early adulthood who complained about new migraine attacks after being free of them for 30 years. As a possible trigger, an intracranial metastasis of a thyroid cancer was found which also caused elevated serum prolactin. The mechanism of a para- or endocrinal effect of the tumour is discussed, showing the relevance of intracranial tumours as a human headache model. The recurrence of a primary headache syndrome after long latency should result in the exclusion of a pathological cause.