Annals of thyroid最新文献_第4页

Welcome to this special edition of AOT: The Management of Thyroid Tumors in 2021 and Beyond! 欢迎收看本期《AOT：2021年及以后甲状腺肿瘤的治疗》特别版！

Annals of thyroid Pub Date : 2021-06-01 DOI: 10.21037/AOT-21-14

J. Richmon, J. Russell

引用次数: 0

Isolated medullary thyroid carcinoma: a case report 孤立性甲状腺髓样癌1例报告

Annals of thyroid Pub Date : 2021-05-20 DOI: 10.21037/AOT-21-4

A. Chaudhry, Krishdeep Khosla, Caroline Muriuki

{"title":"Isolated medullary thyroid carcinoma: a case report","authors":"A. Chaudhry, Krishdeep Khosla, Caroline Muriuki","doi":"10.21037/AOT-21-4","DOIUrl":"https://doi.org/10.21037/AOT-21-4","url":null,"abstract":"Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor, derived from parafollicular C-cell origin, which occurs in two forms; sporadic and familial. Diagnostic evaluations are done through ultrasound, radionuclide thyroid scans, fine needle biopsies, and a thorough physical examination all of which play a pivotal role in treating disease. Factors such as size, location, affected organs, and the disease’s onset determine the prognosis of this tumor. Our case covers a sporadic MTC with no relation to traditional multiple endocrine neoplasia (MEN) syndrome and its confounding diseases such as pheochromocytoma or parathyroid hyperplasia. This case focuses on the importance of recognizing and evaluating the related symptoms to ensure proper treatment/resection of cancer while also covering potential ethical issues that may arise governing medical treatment, and decisions regarding familial disclosure. It brings attention to important biochemical markers often used that aid with detection, maintenance and prognosis of the disease. Long term maintenance therapy outcomes as well as possible adverse outcomes are covered to ensure proper disposal of knowledge regarding treatment procedures. This case also highlights the significance of the rare form of MTC which can present with a wide array of symptoms while also emphasizing the importance of diagnostic tools, punctuality and treatment measures needed to minimize adverse outcomes, ensuring a","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41554873","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

Surgical management of parathyroid cancer during the COVID-19 pandemic: experience from a tertiary referral centre (a case series) COVID-19大流行期间甲状旁腺癌的手术治疗:来自三级转诊中心的经验(病例系列)

Annals of thyroid Pub Date : 2021-05-10 DOI: 10.21037/AOT-21-7

K. Greene, J. Ramsingh

引用次数: 0

Parathyroidectomy in a patient treated with denosumab: a case report denosumab治疗的甲状旁腺切除术1例报告

Annals of thyroid Pub Date : 2021-04-16 DOI: 10.21037/AOT-20-64

Ved A Tanavde, Brian M Hondorp, J. Russell

{"title":"Parathyroidectomy in a patient treated with denosumab: a case report","authors":"Ved A Tanavde, Brian M Hondorp, J. Russell","doi":"10.21037/AOT-20-64","DOIUrl":"https://doi.org/10.21037/AOT-20-64","url":null,"abstract":": Primary hyperparathyroidism (PHPT) is most common in postmenopausal women, with parathyroidectomy considered to be the only definitive treatment. The risk of osteoporosis is increased in postmenopausal women and osteoporosis may be a sequela of long-term PHPT. Denosumab, a novel human monoclonal antibody, is a Food and Drug Administration-approved treatment for osteoporosis in postmenopausal women at high risk of fracture. Multiple reports in the literature have observed markedly elevated parathyroid hormone (PTH) after one dose of denosumab. We report our experience of parathyroidectomy in a patient who received a single dose of denosumab two weeks prior to surgery. In that time, the patient’s uncorrected calcium level decreased from 10.6 to 8.5 mg/dL and PTH increased from 209 to 465 pg/mL. On ultrasound immediately prior to surgery, a 1 cm hypoechoic focus was identified at the left thyrothymic ligament, suspicious for parathyroid adenoma. A 402 mg mass was removed at this site, with parathyroid tissue confirmed on frozen pathology review. Following removal, intraoperative PTH declined rapidly before plateauing at 200 pg/mL. After discussion of potential denosumab-induced hyperparathyroidism in the setting of multiglandular parathyroid disease, the remaining glands were explored. Removal of two glands on the right yielded a reduction in PTH to 82 pg/mL, with PTH eventually settling at 53 pg/mL postoperatively. Given the difficulty of interpreting intraoperative PTH kinetics in the setting of denosumab-induced hyperparathyroidism, we recommend administration of denosumab be delayed until after parathyroidectomy and that surgeons factor in its effects before deciding to operate on patients who have already received a dose.","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47452214","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

Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid gland: first Australasian case report 甲状腺硬化性黏液表皮样癌伴嗜酸性粒细胞增多:澳大利亚首例报告

Annals of thyroid Pub Date : 2021-01-01 DOI: 10.21037/aot-21-17

Chelsea L Heaven, S. Shetty, Julian G. de Beer

引用次数: 0

Regression of papillary thyroid cancer using metformin: a case report 二甲双胍治疗甲状腺乳头状癌1例

Annals of thyroid Pub Date : 2020-12-01 DOI: 10.21037/aot-18-67

D. Reznick, M. Policarpio-Nicolas, E. Moore, E. Berber

{"title":"Regression of papillary thyroid cancer using metformin: a case report","authors":"D. Reznick, M. Policarpio-Nicolas, E. Moore, E. Berber","doi":"10.21037/aot-18-67","DOIUrl":"https://doi.org/10.21037/aot-18-67","url":null,"abstract":": Metformin is a medication that has been used for almost a century for the treatment of type II diabetes. Relatively recent studies have discovered metformin to have utility for the treatment and prevention of number malignancies. Metformin has demonstrated in population studies to reduce papillary thyroid cancer however, the specific effect of metformin on papillary thyroid cancer in humans has not been previously reported. Herein we present the first clinical evidence of anti-tumor effect of metformin on papillary thyroid cancer resulting in clinical regression. This was found in a 35-year-old female who noticed a lump in her neck and was found to have a thyroid nodule. On biopsy, her nodule was proven to be papillary thyroid carcinoma. The patient chose to take metformin in lieu of surgical removal of her thyroid. Repeated monitoring demonstrated clinical regression of her carcinoma, with the size of her nodule decreasing from 1.4×1.1×1.2 to 0.66×0.52×0.67 cm 3 , or an 88% reduction in volume. There was also no evidence of any progression to her lymph nodes. This opens a potentially new treatment modality for papillary thyroid cancer which traditionally has had the mainstay treatment options of surgery and radioactive iodine, however more work is needed to be done to confirm the generalizable results for this one case.","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47300707","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

Transoral endoscopic thyroidectomy-vestibular approach: starting a program in an inner-city hospital 经口内窥镜甲状腺切除术-前庭入路:在市中心医院启动一个项目

Annals of thyroid Pub Date : 2020-09-01 DOI: 10.21037/aot-2019-mtt-11

V. Banuchi, Kerri-Anne Vlaming

引用次数: 3

Active surveillance for low-risk papillary thyroid microcarcinomas 主动监测低风险甲状腺乳头状微癌

Annals of thyroid Pub Date : 2020-08-28 DOI: 10.21037/aot-2020-rcmtt-06

Yasuhiro Ito, A. Miyauchi

{"title":"Active surveillance for low-risk papillary thyroid microcarcinomas","authors":"Yasuhiro Ito, A. Miyauchi","doi":"10.21037/aot-2020-rcmtt-06","DOIUrl":"https://doi.org/10.21037/aot-2020-rcmtt-06","url":null,"abstract":": The active surveillance of low-risk papillary thyroid microcarcinomas (PTMCs) was started at Kuma Hospital (Kobe, Japan) in 1993 and was then adopted widely, especially after the publication of the 2015 guidelines by the American Thyroid Association (ATA). The data collected at Kuma Hospital indicate that at the 10-year observations, the incidence of enlargement ≥ 3 mm was only 8.0% and that of the novel appearance of node metastasis was 3.8%. None of the patients showed distant metastasis or died of thyroid carcinoma. A portion of the patients underwent conversion surgery for various reasons, including disease progression, but no patients showed life-threatening recurrence/metastasis or died of thyroid carcinoma not only when they underwent active surveillance but also after they received conversion surgery. In contrast to clinical papillary thyroid carcinoma (PTC), PTMCs of elderly patients were less progressive than those of middle-aged and young patients, indicating that elderly patients are ideal candidates for active surveillance. PTMCs in young patients are the most progressive, but based on the estimated lifetime probability, >50% and >75% of patients in their 20s and 30s, respectively would not require conversion surgery during their lifetime, indicating that young patients can be candidates for active surveillance. Several studies from other institutions [including Cancer Institute Hospital (Tokyo) and foreign institutions] have been published, and all of them reported very favorable patient outcomes. Active surveillance can avoid the adverse events of immediate surgery and is more economical than immediate surgery (at least in Japan and Hong Kong). We can therefore conclude that active surveillance is suitable for the first-line management of PTMCs. 12","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43789346","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: 1

Management of medullary thyroid carcinoma 甲状腺髓样癌的治疗

Annals of thyroid Pub Date : 2020-08-20 DOI: 10.21037/aot-20-41

F. Torresan, C. Armellin, M. Iacobone

{"title":"Management of medullary thyroid carcinoma","authors":"F. Torresan, C. Armellin, M. Iacobone","doi":"10.21037/aot-20-41","DOIUrl":"https://doi.org/10.21037/aot-20-41","url":null,"abstract":"Medullary thyroid carcinoma (MTC) is a rare malignancy arising from parafollicular C-cells and accounts for 3–10% of all thyroid malignancies. MTC occurs mostly as a sporadic disease, but in at least 30% of cases is hereditary, caused by RET germline mutations. In this setting, different germline RET mutations lead to distinct clinical phenotypes of hereditary MTC such as familial MTC and multiple endocrine neoplasia 2A and 2B. RET genetic screening should be performed in all new discovered cases of MTC since about 4–10% of patients with apparently sporadic MTC have RET germline mutations and therefore an inheritable disease. Calcitonin (CT) is the most reliable marker of MTC for both diagnosis and follow-up after thyroidectomy. In sporadic MTC, a routine determination of CT in patients with nodular goiter has been correlated to a lower rate of advanced tumor stages. Surgery is the only curative treatment. Since the relatively high risk of multifocal and bilateral disease and the early spread to cervical lymph nodes, total thyroidectomy and central neck lymph node dissection is the standard initial treatment. Lateral neck lymph node dissection might be considered according to imaging results and CT levels. The potential benefit of neck reiterative surgery for persistent or recurrent MTC should be balanced against the increased surgical morbidity in a scarred operative field. The treatment of locally advanced MTC that is not amenable to surgery or metastatic MTC benefits of tyrosine kinase inhibitors that have shown some effects on disease progression. External radiotherapy and cytotoxic chemotherapy have demonstrated little benefit. Prognosis strictly depends on stage of disease at diagnosis, with lower survival and cure rate for stage IV disease. The purpose of this review is to describe the management and treatment of patients with MTC, focusing on biochemical and imaging diagnostic tools, preoperative work-up, treatment and prophylactic surgery for hereditary variants.","PeriodicalId":92168,"journal":{"name":"Annals of thyroid","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/aot-20-41","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45444731","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

Patient satisfaction and telemedicine in thyroid and parathyroid diseases: a review 甲状腺和甲状旁腺疾病的患者满意度和远程医疗：综述

Annals of thyroid Pub Date : 2020-05-22 DOI: 10.21037/AOT-19-52

Estelle Chang, Christopher J. Britt

引用次数: 0