Type Of Thyroid Malignancy Research Articles

Histopathological Characteristics and Incidence of Thyroid Carcinoma in a Tertiary Care Hospital of Pakistan - A retrospective study

Background: Thyroid cancer is the most frequently occurring cancer of endocrine organs. From the past few decades, the prevalence of thyroid carcinoma is increasing generally and this has aroused the great public concern.Papillary thyroid carcinoma is primarily responsible for this high prevalence.The cases of other types of thyroid malignancies have remained stable over time. Aim: To analyze our institution-based trends in histopathological characteristics and incidence of thyroid carcinoma. Study Design: Retrospective study Place and duration: Pathology Department of Rai Medical College, Sargodha, from July 2017 to June 2022. Methodology: This study comprised of 56 cases of thyroid neoplasm diagnosed on biopsy. The main histologic types of thyroid carcinoma include papillary, follicular, medullary and anaplastic. Results: Of 374 thyroid lesions reviewed, 56 cases were malignant. Among these, PTC constituted about 43(76.78%) cases. There were 6(10.71%) cases of follicular ca followed by 5(8.92%) cases of medullary and 1(1.78%) case of anaplastic carcinoma. Practical implication: Unfortunately, the frequency of thyroid cancer in Pakistan is on the increaseandthe incidence of thyroid cancer in our country is difficult to measure due to the limitations of epidemiological statistics. Information regarding the geographic distribution of thyroid cancer is of great value for formulating epidemiologic hypothesis and for understanding the concepts of its risk factors. Such info is also valuable for making worldwide comparisons. Conclusion: Thyroid cancer was six times more frequent in females (female-to-male ratio 6:1). Most cases of PTC, follicular carcinoma and medullary carcinoma were in patients in the fourth decade of life then in third and fifth decade. However, anaplastic carcinoma was seen between 60 to 69 years of age. Keywords: Thyroid Neoplasms, Thyroid Cancer, Papillary, Thyroid Carcinoma, Anaplastic

Papillary and medullary thyroid carcinomas coexisting in the same lobe, first suspected based on fine-needle aspiration cytology: a case report.

Because different types of thyroid malignancies have distinct embryological origins, coexisting tumors are rarely observed. We describe a coexisting papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC) first suspected by fine-needle aspiration cytology (FNAC). A 57-year-old female presented with an irregular mass in the right thyroid lobe. The cytopathologic findings of fine-needle aspiration showed two components: a papillary-like arrangement consisting of cells with pale enlarged nuclei indicative of PTC and loose clusters comprised of oval cells with granular chromatin indicative of MTC. The diagnosis of a coexisting PTC and MTC was initially confirmed by calcitonin immunocytochemistry and later after total thyroidectomy. Although some surgical case reports of PTC and MTC coexisting in either the same or different lobes have been documented, a case suspected by FNAC before the surgery has rarely been reported. Because appropriate treatment and prognosis of PTC and MTC are different, cytopathologists should be aware of this rare entity.

Impact of intensive multimodal treatment on the outcomes of patients with anaplastic thyroid cancer.

6082 Background: Anaplastic thyroid cancer (ATC) is a rare and aggressive type of thyroid malignancy with very poor prognosis and outcome despite therapy. The rarity of this disease and the poor functional status of ATC patients limit the ability to conduct clinical trials, thus there is a lack of large, controlled trials to guide treatment and evaluate the benefit of combined modality therapy. Methods: The National Cancer Database (NCDB) was queried for patients diagnosed with ATC at age 18 or older between 2004 and 2018. After excluding patients with unknown number of treatment modalities, Charlson-Deyo score of 3 or more and patients lost follow-up, we split the cohort into three groups according to the number of treatment modalities they received. Treatment modalities include surgery, radiation, and systemic therapy. Then, we evaluated the overall survival (OS) between the three groups. We studied the OS using Kaplan-Meier estimates and multivariate cox regression analyses to evaluate factors associated with OS. Additionally, propensity score matching (accounting for age, gender, race, Charlson-Deyo score, and clinical M stage) was used for more robust results. Results: A total of 3,460 patients with ATC were included in the analysis, of which 1,472 (42.5%) either received one type of therapy or did not receive any therapy (group1), 1,092 (31.6%) received bimodal therapy (group 2), and 896 (25.9%) received trimodal therapy (group 3). We found that group 3 had better OS compared to group 1 and group 2 (median OS 9.1 months vs 1.7 months and 4.9 months, respectively with P < 0.001 for all). Propensity score matching yielded 896 patients in each group. We found that group 3 had better OS compared to group 1 and group 2 (median OS 9.1 months vs 1.9 months and 5.2 months, respectively with P < 0.001 for all). Same trend was found in subgroup analysis when we split the cohort according to the metastatic status; in M0 group (median OS was 10.4 months vs 1.9 months and 6.1 months, respectively with P < 0.001 for all), in M1 group (median OS was 5.9 months vs 1.4 months and 3.7 months, respectively with P < 0.001 for all). On multivariate analysis, group 1 and group 2 were associated with worse OS compared to trimodal treatment (HR 2.721; 95% CI: 2.466 - 3.002 and HR 1.434; 95% CI: 1.299 - 1.582, P < 0.001 for all). Conclusions: Patients with ATC who were treated with intensive trimodal therapy had statistically significant improvement in OS compared to patients who received less intense therapy. This survival benefit was observed in both metastatic and non-metastatic groups. While we acknowledge the limitations of this retrospective analysis, our results showed the critical role of intensive therapy approach in this aggressive malignancy.

Abstract #1184083: Simultaneous Multifocal Medullary and Papillary Thyroid Carcinoma

Papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC) are two different types of thyroid malignancies with different cell origins, clinical and histological findings. PTC is the most common type of thyroid cancer accounting for 75–80% while MTC represents only 3-5%. Simultaneous occurrence of both disease entities is very rare representing < 1% of all thyroid malignancies. Moreover, the presence of synchronous multifocal MTC and PTC is even rarer, with only three cases reported in the literature to our knowledge.

Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study.

Introduction Thyroid cancer is the third most common cancer that occurs in children and adolescents. Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. Although the mortality rate of thyroid malignancy in children is usually low, the disease recurrence is higher in children with more severe clinical presentation than in adults. This study aimed to determine the demographic and clinicopathological characteristics and outcome of pediatric and adolescent patients with thyroid malignancy in Indonesia. Methods The retrospective study included all patients diagnosed with thyroid carcinoma aged <20 years, from January 1, 2015, to December 31, 2019. Twenty-nine subjects fulfilled the inclusion and exclusion criteria. We retrieved baseline characteristics, pathology features, TSH and fT4 status, radioactive iodine therapy data, and patients' outcomes. Then, data were analyzed using the chi-square or Fisher's exact method. Results We identified 29 eligible subjects, including 3 boys and 26 girls. The most common type of thyroid carcinoma was PTC (96.5%), and follicular type (31%) was the predominant variant of PTC. Lymph node involvement occurred in 24% of patients, while distant metastasis occurred in 17.2% of patients with PTC. Twenty-four (82.7%) patients had stage 1 disease. Disease recurrence was recorded in 31% of patients during the study period with a median follow-up time of 24 months. Conclusion PTC is the most frequent type of thyroid carcinoma among children and adolescents. This malignancy has a low mortality rate, but the recurrence rate remains high among younger patients than adults even during a short-term follow-up analysis. Distant metastasis and lymph node involvement are commonly found in this age group.

Promoter Methylation of Tumor Suppressors in Thyroid Carcinoma: A Systematic Review.

Background:The tumor suppressor genes play a critical role in cellular and molecular mechanisms such as cell cycle processes, cell differentiation and apoptosis. Aberrant DNA methylation of tumor suppressor genes and subsequent gene expression changes have shown to be involved in the initiation and progression of various malignancies including thyroid malignancies. In this review, we investigated what is known about the impact of promoter hypermethylation on the key tumor suppressor genes known to be involved in cell growth and/or apoptosis of thyroid cancer.Methods:The most important databases were searched for research articles until June 2020 to identify reported tumor suppressor genes that are modulated by methylation modulation changes in thyroid carcinoma. Following the inclusion and exclusion criteria, 26 studies were reviewed using the full text to meet the inclusion and exclusion criteria.Results:The tumor suppressor genes reviewed here are suggestive biomarkers and potential targetable drugs. Inactivation of RASSF1A, DAPK1, SLCFA8, and TSHR through aberrant epigenetic methylation could activate BRAF/MEK/ERK kinase pathways with potential clinical implications in thyroid cancer patients. RARβ2 and RUNX3 could suppress cell cycle and induce apoptosis in malignant cells. TIMP3 and PTEN could prevent angiogenesis and invasion through PIP3 pathway and arrest VEFG activity.Conclusion:The methylation status of key genes in various types of thyroid malignancies could be used in early diagnosis as well as differentiation of malignant and benign thyroid. This is valuable in drug repurposing and discovering alternative treatments or preventions in thyroid cancer.

Pancreatic metastasis from papillary thyroid carcinoma: Case report and literature review.

Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. Papillary thyroid carcinoma generally spreads locally to the cervical lymph nodes, but distant metastases are seen in 5%-7% of cases. Most distant metastases occur in the bone, lung, and brain. Pancreatic metastases of PTC are extremely rare. Herein we present a patient with PTC treated with total thyroidectomy and two rounds of radioactive iodine (RAI) ablation that was subsequently found to have a pancreaticmetastasis detected on fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) imaging 3 years from the initial diagnosis.

Malignant teratoid tumor of the thyroid gland: an aggressive primitive multiphenotypic malignancy showing organotypical elements and frequent DICER1 alterations\u2014is the term \u201cthyroblastoma\u201d more appropriate?

Primary thyroid teratomas are exceedingly rare. Mature and immature variants recapitulate their gonadal counterparts (predilection for infants/children, triphasic germ layer differentiation, and favorable outcome). On the other hand, the so-called malignant teratomas affect predominantly adults and elderly, are highly aggressive, and, according to a few published cases, harbor DICER1 mutations. We describe three highly aggressive sporadic malignant teratoid thyroid tumors in 2 females (17 and 45 years) and one male (17 years). Histology showed triphasic neoplasms composed of solid nests of small primitive monomorphic cells embedded in a cellular stroma with primitive immature rhabdomyosarcoma-like (2) or pleomorphic sarcoma-like (1) phenotype. The third component was represented by TTF1+/PAX8+ primitive teratoid epithelial tubules reminiscent of primitive thyroid follicles and/or Wilms tumor, admixed with scattered respiratory- or enteric-type tubules, neuroepithelial rosettes, and fetal-type squamoid nests. Foci of cartilage were seen in two cases, but none contained mature organoid adult-type tissue or skin adnexa. SALL4 was expressed in the small cell (2) and stromal (1) component. Other germ cell markers were negative. Molecular testing revealed a known “hotspot” pathogenic DICER1 mutation in two cases. In addition, case 1 had a missense TP53 variant. This type of thyroid malignancy is distinct from genuine teratomas. The immunoprofile suggests primitive thyroid- or branchial cleft-like differentiation. Given that “blastoma” is a well-accepted terminology in the spectrum of DICER1-associated malignancies, the term “thyroblastoma” might be more convenient for these malignant teratoid tumors of the thyroid gland. Relationship of thyroblastoma to the DICER1 syndrome remains to be addressed.

Carcinoma of the Thyroid Gland: Insights into Etiology, Pathogenesis, Diagnosis and Possible Lines of Management

Thyroid carcinoma is one of the most common malignancies of the endocrine system worldwide. Over the recent years, there has been a significant increase in the newly reported cases of thyroid cancer which may be attributed to the wide use of imaging techniques in the diagnosis and treatment of a wide range of human diseases. Papillary thyroid cancer is the most common type of thyroid malignancies. Lines of treatment include total thyroidectomy, radioactive iodine therapy, and molecular-targeted therapies. Prognosis of thyroid carcinoma depend on many factors including age of the patient, the tumor type and its stage at the time of diagnosis of the disease. This review sheds light on carcinoma of the thyroid gland in view of the recent trends regarding its prevalence, risk factors, types, clinical picture, methods of diagnosis and possible lines of management.

Zerumbone Reduces the Level of MAPK1 by Upregulating Mir-758-3p to Inhibit the Survival of Thyroid Papillary Cancer Cells

Thyroid papillary carcinoma is the most common type of thyroid malignancy. The mitogen-activated protein kinase signaling cascade is the major pathway involved in thyroid papillary carcinoma and may be regulated by small molecules and transcription factors. Zerumbone is a bioactive compound with multiple pharmacological properties. This study investigated the effects of zerumbone on survival and proliferation of thyroid papillary carcinoma-1 cells with an emphasis on the level of microRNA-758-3p and its target gene, mitogen-activated protein kinase-1. Zerumbone exhibited dose-dependent inhibitory effects on the viability and proliferation of thyroid papillary carcinoma-1 cells. It also gradually elevated the level of microRNA-758-3p but decreased mitogen-activated protein kinase-1 expression in these cells. Mitogen-activated protein kinase-1 has been suggested as a downstream target of microRNA-758-3p and confirmed by dual-reporter luciferase assay. The downregulation of microRNA-758-3p in thyroid papillary carcinoma-1 cells via the transfection with microRNA-758-3p inhibitor reversed the inhibitory effect of zerumbone on mitogen-activated protein kinase-1 expression. Furthermore, the transfection of thyroid papillary carcinoma-1 cells with lentiviral vector overexpressing mitogen-activated protein kinase-1 eliminated the protective effects of zerumbone on thyroid papillary carcinoma progression as compared to the group delivered with control vector. In conclusion, this study demonstrated that zerumbone inhibited survival and proliferation of thyroid papillary carcinoma-1 cells via suppressing the expression of mitogen-activated protein kinase-1 through microRNA-758-3p. These data suggest the therapeutic potential of zerumbone in thyroid papillary carcinoma treatment.

Thyroid Nodule Size and Prediction of Cancer: A Study at Tertiary Care Hospital in Saudi Arabia.

BackgroundThyroid noduleshave become relatively common in clinical practice,and their prevalence increases with age. The majority of thyroid nodules are benign, with 5-15% being malignant. There are a number of well-established predictors of malignancy in thyroid nodules, but thyroid nodule size has been a cause for concern for many researchers and results of the studies are still controversial about their probability of malignancy. Up to the current knowledge, there is no published study that evaluates if thyroid nodule size is associated with the risk of malignancy in Saudi Arabia, so in this study, we aim to find that.MethodsThis is a retrospective study of 987 patients who underwent thyroid nodule fine-needle aspiration (FNA) and subsequent thyroidectomy for thyroid nodules measuring ≥ 1 cm.ResultsThyroid cancer was more prevalent in males than females, and in patients who were older than or equal to 45 years. Nodular size of 1 - 1.9 cm was more prevalent among cancer patients than in benign cases (p<0.001).ConclusionsThe highest malignancy risk was observed in nodules <2 cm and no increase in malignancy risk for nodules >2 cm. Nevertheless, when examined by type of thyroid malignancy, the rate of follicular carcinoma and other rare malignancy increased with increasing nodule size.

SUN-608 A Rare Miliary Tuberculosis-Like Presentation of Papillary Thyroid Cancer: A Case Report with Literature Review

Papillary thyroid cancer (PTC) is the most common thyroid cancer with a very favorable prognosis [1]. It commonly presents as a palpable thyroid nodule or an incidental finding of thyroid nodule(s) seen on imaging. The most common site of metastases in PTC is lung, however, the incidence is very low. Presence of metastasis can drastically affect the prognosis of PTC [2]. We discuss here a case of an asymptomatic 34-year-old male, who initially presented with positive tuberculin skin test and was found to have diffuse micronodular pulmonary disease on chest imaging. Initially being diagnosed with pulmonary TB, he received 6 months of empiric anti-tuberculous therapy, although, repeated sputum and blood cultures for acid-fast bacilli remained negative. However, patient had no improvement of pulmonary lesions on interval imaging. Another interesting incidental finding, seen on lung CT, was the presence of multinodular appearance of the thyroid gland which prompted further imaging of the neck. CT scan of the neck showed multiple enhancing necrotic masses in the right thyroid gland with similar lesions in cervical lymph nodes. Considering the patient’s preliminary diagnosis of pulmonary TB, these lesions were thought to be secondary to tuberculosis. However, given that different types of thyroid malignancies can have a similar presentation, further workup was initiated. Subsequent FNA was positive for PTC on the right thyroid nodule. A total thyroidectomy with neck dissection was performed and confirmed the presence of a 2 cm PTC with cervical lymph node metastases. Post-operative non-stimulated thyroglobulin was very high at 2858. Thyroglobulin antibody was negative. The post radioactive iodine therapy (RAI) whole body scan (WBS) showed impressive bilateral lung uptake. Widespread pulmonary nodules, similar to that seen in miliary TB, is a rare initial presentation of PTC. However, as our case highlights, the added presence of thyroid nodules should prompt further investigation to rule out PTC as the cause of pulmonary lesions. 1. Aschebrook-Kilfoy, B., et al., Thyroid cancer incidence patterns in the United States by histologic type, 1992-2006. Thyroid, 2011. 21(2): p. 125-34. 2. Lang, B.H., et al., Staging systems for papillary thyroid carcinoma: a review and comparison. Ann Surg, 2007. 245(3): p. 366-78.

LncRNA ENST00000539653 acts as an oncogenic factor via MAPK signalling in papillary thyroid cancer

BackgroundPapillary thyroid cancer (PTC) is the most frequent type of thyroid malignancy. In this study, we investigated the mechanisms whereby long non-coding RNAs (lncRNAs) are associated with PTC pathogenesis.MethodsMicroarray analysis was used to determine differentially expressed lncRNAs between paired PTC tissues and normal adjacent thyroid tissues. Quantitative RT-PCR was used for validation in 86 PTC cases. Small interfering RNA (siRNA) transfection assays were then performed to assess how a novel lncRNA affected key proliferation and cell death pathways in IHH4 PTC cells.ResultsWe identified 1878 differentially expressed lncRNAs versus matched control samples (fold change ≥2.0, P < 0.05), of which 429 were upregulated and 1449 were downregulated. ENST00000539653.1 (ENS-653), one of the top hits in this microarray, was selected for further study. Higher ENS-653 expression was observed in PTC tissue samples versus adjacent normal tissues, and was associated with a larger tumor size and a more advanced clinical stage. In the Cancer Genome Atlas (TCGA) PTC cohort, higher ENS-653 expression was correlated with more frequent BRAF (V600E) mutation and poorer disease-free survival. Furthermore, ENS-653 downregulation reduced the proliferation of PTC cells and led to G1-S arrest, but had no impact on apoptosis. ENS-653 downregulation also inactivated ERK1/2 and ERK5, causing partial MAPK cascade suppression.ConclusionENS-653 exhibits oncogenic properties in PTC, and could be a diagnostic and/or prognostic PTC biomarker, in addition to possibly being a future target for therapy.

MALIGNANT THYROID DISEASE;

Objectives: To determine frequency of Transient &amp; permanent hypocalcemiaafter Thyroid Surgery for Malignant thyroid disease. Study Design: Observational study.Setting: Public &amp; Private Sector Hospitals of Hyderabad. Period: December 2008 to April 2016.Materials and Methods: All patients of Thyroid pathology who fulfilled the inclusion criteriawere admitted in the ward. They were evaluated preoperatively &amp; surgery was performed.Postoperatively patients were assessed clinically &amp; biochemically for Hypocalcaemia. Patient’sdata was recorded &amp; analyzed for variables like age, sex, diagnosis of thyroid disease on FNAC,Type of thyroid Malignancy, type of thyroid surgery, Transient &amp; permanent hypocalcemia inrelation to type of type of thyroid surgery performed &amp; the hospital stay. Results: Total 254patients were operated for different thyroid pathologies. It includes 91(35.82%) male &amp; and163 (64.17%) female patients making ratio of 1: 1.79. Mean age was 37.29 ±7.4 years.Amongst them 33 patients were diagnosed as Malignant Thyroid diseases. Most commontype of thyroid malignancy detected was papillary carcinoma in 48.48% patients followed byfollicular carcinoma in 42.42% patients. Most common surgical procedures performed includescompletion thyroidectomy in 57.57% patients with 01(3.03%) of them underwent cervicalneck dissection followed by total thyroidectomy in 36.36% patients with 02(6.06%) of themunderwent cervical neck dissection. Postoperative hypocalcemia was noted in 45.45% patientswith 36.36% patients developed hypocalcemia within 24 hours of operation, 6.06% within 24to 48 hours &amp; 3.03% patients after 48 hours of surgery. Transient hypocalcemia was noticed in13/33 (39.39%) cases &amp; permanent hypocalcemia in 02/33(6.06%) patients. Mean hospital staywas 4.13± 0.32 days. Conclusion: Hypocalcaemia was noted in 15(45.45%) patients operatedfor thyroid Malignancy. Revision surgery &amp; cervical lymph node dissection were noted as riskfactors.

Expression and function of CXCL12/CXCR4/CXCR7 in thyroid cancer.

The contribution of CXCL12/CXCR4/CXCR7 axis to cancer progression has been increasingly recognized. However, its role in thyroid cancer development remains unclear. The present study aimed to examine the expression and function of CXCL12 and its receptors in thyroid cancer. The expression of CXCL12/CXCR4/CXCR7 in human tissue specimens of papillary, follicular, medullary, and anaplastic thyroid carcinoma, follicular adenoma, Hashimoto's thyroiditis and nodular goiter were examined by immunohistochemistry using a tissue microarray. CXCR4 and CXCR7 were over-expressed in human thyroid cancer cells K1 by transduction of recombinant lentivirus. The effect of overexpression of CXCR4 and CXCR7 on K1 cell proliferation and invasion and the molecular mechanism underlying the effect were investigated. CXCL12 was exclusively expressed in papillary thyroid carcinoma tissue but absent in other types of thyroid malignancies and benign lesions. CXCR7 was widely expressed in the endothelial cells of all types of malignancy but only occasionally detected in benign lesions. CXCR4 was expressed in 62.5% of papillary thyroid carcinoma tissue specimens and in 30–40% of other types of malignancy, and it was either absent or weakly expressed in benign lesions. CXCL12 stimulated the invasion and migration of K1 cells overexpressing CXCR4, but did not affect K1 cells overexpressing CXCR7. K1 cell proliferation was not affected by overexpression of CXCR4 or CXCR7. Overexpression of CXCR4 in K1 cells significantly increased AKT and ERK phosphorylation and markedly induced the expression and activity of matrix metalloproteinase-2 (MMP-2). Thus, CXCL12 may be an effective diagnostic marker for papillary thyroid carcinoma, and CXCL12/CXCR4/CXCR7 axis may contribute to thyroid cancer development by regulating cancer cell migration and invasion via AKT and ERK signaling and MMP-2 activation.

Papillary thyroid cancer with bilateral adrenal metastases

Background: Papillary thyroid cancer is the most common type of thyroid malignancy and has an excellent prognosis. Distant organ metastasis is rare. Bilateral adrenal metastases with iodine uptake has not been described before. Patient Findings: A 47-year-old woman presented for evaluation because of severe right upper arm pain and weakness. Magnetic resonance imaging of the thoracic spine showed a compression fracture at the third thoracic vertebra associated with a soft tissue mass. Computed tomography (CT)-guided biopsy of the mass showed metastatic papillary thyroid carcinoma. Ultrasonography of the neck showed an enlarged right thyroid lobe with cervical lymphadenopathy. A high-resolution CT scan of the chest showed multiple bilateral pulmonary nodules. Treatment included total thyroidectomy and lymph node dissection, external beam radiation to the thoracic spine, and 131I therapy. Initial whole body 131I scintigraphy showed faint uptake in the right upper abdomen, interpreted as a sign of physiologi...

Detection of metabolites discriminating subtypes of thyroid cancer: Molecular profiling of FFPE samples using the GC/MS approach

One of the critical issues in thyroid cancer diagnostic is differentiation between follicular adenoma, follicular carcinoma and the follicular variant of papillary carcinoma, which in some cases is not possible based on histopathological features only. In this paper we performed molecular profiling of thyroid tissue aiming to identify metabolites characteristic for different types of thyroid cancer. FFPE tissue specimens were analysed from 5 different types of thyroid malignancies (follicular, papillary/classical variant, papillary/follicular variant, medullary and anaplastic cancers), benign follicular adenoma and normal thyroid. Extracted metabolites were identified and semi-quantified using the GC/MS approach. There were 28 metabolites identified, whose abundances were significantly different among different types of thyroid tumours, including lipids, carboxylic acids, and saccharides. We concluded, that multi-component metabolome signature could be used for classification of different subtypes of follicular thyroid lesions. Moreover, potential applicability of the GC/MS-based analysis of FFPE tissue samples in diagnostics of thyroid cancer has been proved.

Follicular thyroid carcinoma in a child presenting as autonomously functioning thyroid nodule

Thyroid nodules are uncommon in children (1.5%). However, the incidence of thyroid carcinoma in childhood thyroid nodules (26.4%) is 3-4 folds higher than in adults. Autonomously functioning thyroid nodules (AFTN) or hot nodules account for less than 3% of hyperthyroidism in children and carry a small risk of malignancy (2-5%). The majority of malignant hot nodules are papillary thyroid carcinoma (57.1%) with follicular carcinoma reportedly comprising 36.4% of cases. A search of MEDLINE identified 7 paediatric cases of AFTN harbouring carcinoma. Here we report a child, presenting with hyperthyroidism and subsequently diagnosed with follicular thyroid carcinoma. An 11 year old girl presented with a palpable right sided thyroid nodule and symptoms of hyperthyroidism consisting of tachycardia and anxiety. A thyroid ultrasound showed a solitary, minimally heterogenous nodule on the right, measuring 2.5x1.9x1.6 centimetres. It was hyperechoic to the remainder of thyroid gland and had increased intralesional and perilesional vascularity. A radionuclide scan demonstrated the nodule as hyperfunctioning “hot” nodule with no radiotracer uptake in the rest of thyroid. An ultrasound guided FNAC was performed and features consistent with a follicular neoplasm were identified. She underwent right hemi-thyroidectomy and histopathology was consistent with angioinvasive follicular thyroid carcinoma. No evidence of carcinoma was found in the rest of the thyroid following completion thyroidectomy. Additionally, her head circumference was >98th percentile, a lipoma was present over her sacrum and MRI suggested avascular hamartoma over her right ankle, together raising the possibility of Cowden syndrome. FNAC is warranted in all cases of solid thyroid nodules in children including hot nodules to help define the pathology. If inconclusive, surgical excision of lesion for histopathology should be considered. Familial cancer syndromes, which can include a hamartoma/tumour phenotype such as Cowden syndrome and other PTEN hamartoma/tumour syndromes, DICER1 syndrome and MEN2 are also possible, depending on the type of thyroid malignancy. Written informed consent was obtained from the patient's parent or guardian for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.

Prevalence and types of thyroid malignancies among thyroid enlarged patients in Gondar, Northwest Ethiopia: a three years institution based retrospective study.

BackgroundThyroid carcinoma is the leading cause of death among endocrine cancers second to carcinoma of the ovary. Now a day, the incidence of thyroid malignancy is increasing more rapidly than any other malignancy. But data on the prevalence of thyroid malignancy among thyroid enlarged patients were very limited in the study area. Therefore, this study was aimed to determine the prevalence of thyroid malignancies among thyroid enlarged patients.MethodsData of 846 thyroid enlarged patients registered from January 2010 to February 2013 were collected from fine needle aspirate cytology and histology (for inconclusive and the neoplastic cases) log books. It was entered and analyzed using SPSS version 20. Odds ratio was calculated to assess the presence and strength of association between the outcome variable and the explanatory variables. P-values less than 0.05 were considered statistically significant.ResultsAmong the 846 thyroid enlarged patients, 62(7.3%) were confirmed to have malignancy. Among malignancies papillary thyroid carcinoma was the leading, 28 (45.2%), followed by follicular thyroid carcinoma, 18 (29%), and the least type of thyroid malignancies were medullary thyroid carcinoma and hurtle cell carcinoma, each accounts 1 (1.6%). Severe form of thyroid malignancy, undifferentiated thyroid carcinoma, was also accounted significant proportion, 12.9%. Older patients having an age of greater than 60 years and patients with solitary thyroid enlargement were more affected by malignancy compared to the reference age group, 11–20 years and diffused type of enlargement respectively (AOR: 10.96 (3.15-38.1; AOR: 8.82 (3.49-22.32) respectively).ConclusionsThe prevalence of thyroid malignancy was significantly high and the leading type of malignancy was papillary thyroid carcinoma followed by follicular thyroid carcinoma. Thyroid malignancy was found to have statistically significant association with type of enlargement and age.

The utility of ultrasonographic features on the accuracy of diagnosing individual types of thyroid malignancies

The utility of ultrasonographic features on the accuracy of diagnosing individual types of thyroid malignancies