Annals of thyroid最新文献_第3页

Incidental diagnosis of ectopic thyroid in the work-up of metastatic esophageal cancer: a case report 转移性食管癌体检中偶然诊断甲状腺异位1例

Annals of thyroid Pub Date : 2022-03-01 DOI: 10.21037/aot-21-24

Sheryl T. Y. Htoo, Samuel J. Beaujean, Yousaf Mahmood, F. Alfonso

{"title":"Incidental diagnosis of ectopic thyroid in the work-up of metastatic esophageal cancer: a case report","authors":"Sheryl T. Y. Htoo, Samuel J. Beaujean, Yousaf Mahmood, F. Alfonso","doi":"10.21037/aot-21-24","DOIUrl":"https://doi.org/10.21037/aot-21-24","url":null,"abstract":"Ectopic thyroid occurs when the medial descent of the thyroid gland takes place inappropriately. Flurodeoxyglucose (FDG) uptake on the normal thyroid gland is rare. Etiologies for the FDG uptake include infection, inflammation, and malignancy. We report a rare case of ectopic thyroid which was suspected as metastatic lymph node on positron emission tomography-computerized tomography (PET-CT) scan during staging of esophageal adenocarcinoma. A 76-year-old man with no past notable chronic diseases was diagnosed with adenocarcinoma at the gastroesophageal (GE) junction. He was referred to the oncologist, who ordered FDG-PET-CT scan for the staging of cancer. On PET-CT scan, hypermetabolic focus measuring 2.2×2.1 cm with SUVmax 3.4 was present in the left supraclavicular region, which raised concerns for the metastatic disease to the lymph node. Fine-needle aspiration via ultrasound-guided approach was utilized to obtain biopsy, which resulted as benign thyroid tissue. To verify, repeat core biopsy was taken via CT-guided approach, the pathology again confirms benign thyroid tissue. No further intervention was proceeded on the ectopic thyroid. While past studies had shown FDG activity on thyroid lesions, prevalence of malignancy in these thyroid lesions is unclear. There is also no clear correlation between malignancy and SUVmax value. Therefore, we propose further studies are needed to understand the relationship between FDG uptake and thyroid lesions as well as to determine the follow-up algorithm for benign FDG avid lesions.","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41674337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hungry bone syndrome after thyrotoxicosis factitia complicated with thyroid storm: a case report 功能性甲状腺毒症合并甲状腺风暴后饿骨综合征1例

Annals of thyroid Pub Date : 2022-02-01 DOI: 10.21037/aot-21-18

C. Kaewkrasaesin, P. Srichomkwun

{"title":"Hungry bone syndrome after thyrotoxicosis factitia complicated with thyroid storm: a case report","authors":"C. Kaewkrasaesin, P. Srichomkwun","doi":"10.21037/aot-21-18","DOIUrl":"https://doi.org/10.21037/aot-21-18","url":null,"abstract":"other etiologies of hypocalcemia after thyrotoxicosis treatment are rare. We aimed to report the first case of persistent hypocalcemia after thyrotoxicosis factitia treatment. Case Description: A 56-year-old woman presented a thyroid storm at the Emergency Department of a referral hospital in Bangkok, Thailand. Thyrotoxicosis factitia was diagnosed due to a low thyroglobulin (Tg) level together with a history of using levothyroxine as an over-the-counter weight loss pill. Systemic glucocorticoid, together with comprehensive end-organ supportive therapy, was administered to achieve euthyroidism. During admission, the serum calcium level gradually decreased to as low as 6.25 mg/dL, whereas serum intact parathyroid hormone and the alkaline phosphatase (ALP) level considerably increased. Intravenous calcium gluconate, oral calcium carbonate, and vitamin D were administered aggressively to treat severe hypocalcemia. Oral administration of calcium carbonate, ergocalciferol, and alphacalcidol was successfully reduced and discontinued two months after the patient was discharged from the hospital. Conclusions: The abrupt discontinuation of exogenous levothyroxine in the thyrotoxicosis factitia led to an acceleration of the skeletal calcium uptake and resulted in hypocalcemia. Therefore, the close monitoring of the calcium and bone mineral metabolism in patients diagnosed with thyrotoxicosis factitia receiving treatment is recommended.","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44249546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beyond hypocalcemia: the impact of permanent post-operative hypoparathyroidism on patient quality of life—a narrative review 超越低钙:永久性术后甲状旁腺功能低下对患者生活质量的影响-叙述性回顾

Annals of thyroid Pub Date : 2022-01-01 DOI: 10.21037/aot-22-10

Vaninder K. Dhillon, K. F. Moseley

引用次数: 1

Thyroid cancer survivorship: the patient experience 甲状腺癌幸存者:患者的经历

Annals of thyroid Pub Date : 2022-01-01 DOI: 10.21037/aot-22-14

Marika D. Russell, Amanda Silver Karcioglu

引用次数: 0

Telemedicine as a new platform of care: assessing quality of care for the endocrine surgical patient—a narrative review 远程医疗作为一个新的护理平台:评估内分泌外科患者的护理质量-一篇叙述性综述

Annals of thyroid Pub Date : 2022-01-01 DOI: 10.21037/aot-22-7

Jerica L Podrat, F. Zheng

引用次数: 0

Radiofrequency ablation of thyroid nodules: a narrative review and perspective on the patient experience and quality of life 甲状腺结节的射频消融:对患者体验和生活质量的叙述回顾和观点

Annals of thyroid Pub Date : 2022-01-01 DOI: 10.21037/aot-22-12

Julia E. Noel, Zoe H Fullerton

引用次数: 0

A narrative review of molecular testing for indeterminate thyroid nodules: living with the results 不确定甲状腺结节分子检测的叙述性综述：与结果共存

Annals of thyroid Pub Date : 2022-01-01 DOI: 10.21037/aot-22-13

V. Sant, M. Livhits

{"title":"A narrative review of molecular testing for indeterminate thyroid nodules: living with the results","authors":"V. Sant, M. Livhits","doi":"10.21037/aot-22-13","DOIUrl":"https://doi.org/10.21037/aot-22-13","url":null,"abstract":"Background and Objective: By age 50, the majority of Americans will have one or more thyroid nodules incidentally discovered. Thyroid nodules may be biopsied via fine-needle-aspiration (FNA), and nearly 100,000 nodules are graded cytologically indeterminate every year in the US, yielding a diagnostic dilemma. Molecular testing has emerged as a modality to aid in risk stratifying these indeterminate thyroid nodules to avoid unnecessary diagnostic surgery. To date, few studies have investigated quality of life (QOL) associated with molecular testing for indeterminate thyroid nodules. Our aim in this review is to discuss the findings, implications, and limitations of these studies. Methods: A literature review was performed using PubMed to search all original articles published in the English language over the last 30 years that assessed QOL in patients undergoing molecular testing for indeterminate thyroid nodules. Key Content and Findings: The two most relevant studies assessed QOL in patients with indeterminate cytology who underwent molecular testing followed by observation or surgery, both at an initial timepoint and then longitudinally. Patients with benign cytology and a benign molecular test result experienced similar QOL. Patients with malignant cytology had increased impairment of daily life but otherwise no other differences in QOL, compared to those with a suspicious molecular test. A suspicious molecular test was associated with worse initial QOL compared to a benign molecular test. Patients who underwent surgery for suspicious molecular test reported improved QOL after surgery compared to before. The small subset of patients opting for active surveillance after receiving a suspicious molecular test reported similar QOL as those with a benign molecular test. Conclusions: While there was some loss to follow up, these studies may provide reassurance that patients view a benign molecular test similarly to benign cytology. A suspicious molecular result may initially be associated with worse QOL compared to a benign molecular result, but QOL differences seem to disappear at early follow up, likely reflecting the large proportion of patients with suspicious molecular testing who undergo surgery and subsequently report improvement in nearly all QOL domains compared to their baseline.","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48482143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of surgeon-performed ultrasound usage amongst Australian and New Zealand Endocrine Surgeons 评估外科超声在澳大利亚和新西兰内分泌外科医生中的应用

Annals of thyroid Pub Date : 2022-01-01 DOI: 10.21037/aot-22-8

Jessica Wong, J. A. Miller, Ian Bennett

{"title":"Evaluation of surgeon-performed ultrasound usage amongst Australian and New Zealand Endocrine Surgeons","authors":"Jessica Wong, J. A. Miller, Ian Bennett","doi":"10.21037/aot-22-8","DOIUrl":"https://doi.org/10.21037/aot-22-8","url":null,"abstract":"Background: Surgeon-performed ultrasound (US) is increasingly embraced by surgeons worldwide as an integral part of patient assessment. Its usage within Australian and New Zealand Endocrine Surgeons (ANZES) is not well documented. This study aims to evaluate current usage patterns and to determine suitable future training models. Methods: An online survey was sent to members of ANZES between August and September 2021, with emphasis on practice demographics, access and usage of US, US training and accreditation. Results: Of 125 surveys sent, 52 were returned (42%). Most respondents were metropolitan based (90%), worked in both public and private sectors (81%) and practiced both breast and endocrine surgery, with some general surgery (38%). A preponderance of surgeons had access to US equipment (73%) and 42% believed US is essential for best practice in endocrine surgery. Thirty-seven percent of surgeons performed more than 20 US per month, and 40% of respondents perform US guided fine needle aspiration biopsy (FNAB). Ultrasounds were also used in theatre as an adjunct for parathyroid (73%), thyroid (38%) and cervical lymph node surgery (44%). Most surgeons underwent formal training post Fellowship (81%) and 38% have Australasian Society for Ultrasound in Medicine Certificate in Clinician Performed Ultrasound (ASUM CCPU) accreditation. Surgeons strongly favoured post fellowship US training for future endocrine surgical trainees (88%). Conclusions: The survey demonstrates that surgeon-performed US is significantly embraced by endocrine surgeons, with 80% of respondents overall and 92.9% of those with access to US, indicating that surgeon-performed US is essential or at least very important for best practice. US is used frequently in the office and theatre settings. There is an important need for the development and formalization of endocrine US training courses from the SET/Registrar level through to the post-Fellowship environment.","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42231126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Narrative review of neck reinterventions for medullary thyroid carcinoma: indications and outcomes 甲状腺髓样癌颈部再介入治疗的回顾性分析:适应症和结果

Annals of thyroid Pub Date : 2021-06-01 DOI: 10.21037/aot-21-12

J. L. M. D. Nova, Álvaro Valdés de Anca, Emma Torres Mínguez, E. Martín-Pérez

{"title":"Narrative review of neck reinterventions for medullary thyroid carcinoma: indications and outcomes","authors":"J. L. M. D. Nova, Álvaro Valdés de Anca, Emma Torres Mínguez, E. Martín-Pérez","doi":"10.21037/aot-21-12","DOIUrl":"https://doi.org/10.21037/aot-21-12","url":null,"abstract":"Objective: To discuss the cervical recurrence risk factors of medullary thyroid carcinoma (MTC) and the indications, recommended surgical strategy and outcomes of cervical reintervention. Background: Unlike differentiated thyroid carcinoma, MTC is not sensitive to radioactive iodine, thus making surgery the cornerstone of the treatment of these patients. Initial surgery consists of total thyroidectomy with bilateral central compartment (level VI) lymph node dissection, being lateral lymphadenectomy indicated whenever macroscopic cervical lymph node metastases are present. However, up to 50% of patients with presumed curative surgery have persistent elevated serum calcitonin levels, in most of the cases due to inadvertent residual malignant tissue or metastases, and 10–25% develop cervical recurrence. Nodal disease is the main form of structural recurrence, with a median time until diagnosis of 4 years since initial surgery. Both serum calcitonin levels and the evidence of macroscopic recurrence/persistence should be used to guide the indication for reoperation. If biochemical cure has not been achieved and there is no evidence of structural disease, a watch-and-wait approach might be adopted. However, surgery is indicated in the presence of structural recurrence or after a sub-optimal initial procedure. Metastatic workup is necessary before reoperation as the extent of the disease will guide the surgical strategy. This metastatic workup consists mainly in imaging techniques [computed tomography (CT)-scan, magnetic resonance imaging (MRI), bone scintigraphy and neck-ultrasound (US)], nuclear medicine techniques [positron emission tomography (PET)/CT] or invasive procedures such as diagnostic laparoscopy. Neck reintervention is associated with a higher risk of complications than during primary surgery, mainly recurrent laryngeal nerve injury, permanent hypoparathyroidism, and thoracic duct leak, and therefore reintervention should be carefully planned and performed by experienced endocrine surgeons. Reintervention can be planned either with a curative intent or as a palliative procedure. If planned with a curative intent, a compartment-oriented lymph-node dissection is the recommended surgical strategy, and the goal should be achieving biochemical cure. Methods: Narrative review of articles published between 1990 and 2021. An additional review of the articles referenced in the bibliography of the included articles was performed. The search was conducted in PubMed and Web of Science. Conclusions: Reintervention, even if associated with a higher morbidity, does not imply a worse overall prognosis if biochemical cure is achieved. On the contrary, it can be planned as a palliative procedure aimed at minimizing complications derived from compromise of vital cervical structures such as airway, esophagus, or major vessels.","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41640598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

All roads lead to the thyroid gland: review of two popular “scarless” thyroidectomy approaches 条条大路通甲状腺:回顾两种流行的“无疤痕”甲状腺切除术方法

Annals of thyroid Pub Date : 2021-06-01 DOI: 10.21037/AOT-20-47

Marissa Mencio, G. Fernández-Ranvier, W. Inabnet, H. Suh

{"title":"All roads lead to the thyroid gland: review of two popular “scarless” thyroidectomy approaches","authors":"Marissa Mencio, G. Fernández-Ranvier, W. Inabnet, H. Suh","doi":"10.21037/AOT-20-47","DOIUrl":"https://doi.org/10.21037/AOT-20-47","url":null,"abstract":"Thyroidectomy is the most common procedure performed in endocrine surgery. The standard surgical approach is via the anterior neck using a Kocher incision. Over the past two decades, minimally invasive and remote endoscopic approaches to thyroid surgery have emerged as surgeons attempt to improve the cosmesis of the surgery and move towards “scarless” approaches. Remote access techniques utilize strategically hidden incisions removed from the highly visible anterior neck. Rapidly emerging data shows these have comparable outcomes to the conventional open approach and result in high patient satisfaction and improved quality of life in thyroidectomy patients. The transoral endoscopic vestibular approach (TOETVA) and the robotic bilateral axillo-breast approach (BABA) are the two most common remote access approaches to date. In TOETVA, three incisions within the vestibular mucosa are used to access the thyroid. The use of standard laparoscopic instruments and a slightly less steep learning curve compared to other techniques have led to a successful adoption in North America. The robotic BABA technique uses 4 small, widely spaced incisions to provide ideal triangulation of instruments with a familiar midline view of the thyroid. Due to the robotic platform, it has a steeper learning curve but has seen great success in Asia. This article will review these two techniques, offering a comparison and highlighting the clinical trend and future","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44371283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0