Objective: The purpose of this study was to investigate the effect of Hashimoto’s thyroiditis on efficacy of <sup>131</sup>I ablation in intermediate- and high-risk of thyroid papillary carcinoma patients...Objective: The purpose of this study was to investigate the effect of Hashimoto’s thyroiditis on efficacy of <sup>131</sup>I ablation in intermediate- and high-risk of thyroid papillary carcinoma patients. The findings will help to develop a personalized treatment plan for patients with thyroid papillary carcinoma complicated with Hashimoto’s thyroiditis. Material and Methods: From January 2016 to December 2020, patients who were diagnosed with intermediate- and high-risk PTC with lymph node metastasis were analyzed retrospectively, excluding patients with incomplete clinical data, distant metastasis, positive TGAb, TSH Results: A total of 525 patients (166 males and 359 females) were included in the study, including 368 patients in ER group (70.1%) and 157 patients in NER group (29.9%). Eleven factors including combining Hashimoto’s thyroiditis, pre-ablative Tg levels, sex, tumor diameter, extraglandular invasion, multifocal, bilateral lesions, central lymph node metastasis, lateral lymph node metastasis, lymph node metastasis rate, thyroglobulin were statistically different between ER group and NER group with significance at P Conclusion: Hashimoto’s thyroiditis, Ps-Tg level and lateral lymph node metastasis are potential predictors for short-term efficacy of <sup>131</sup>I treatment in intermediate- and high-risk thyroid papillary carcinoma. Hashimoto’s thyroiditis, high Ps-Tg level and increased number of lateral lymph node metastasis reduce the efficacy of <sup>131</sup>I therapy in patients with intermediate and high risk thyroid papillary carcinoma.展开更多
BACKGROUND Occult thyroid papillary carcinoma(OTPC)is typically characterized by initial presentation with cervical lymph node metastasis and can be detected through ultrasound.However,the initial and sole manifestati...BACKGROUND Occult thyroid papillary carcinoma(OTPC)is typically characterized by initial presentation with cervical lymph node metastasis and can be detected through ultrasound.However,the initial and sole manifestation was a submandibular solid-cystic mass.High-frequency ultrasound,enhanced multislice computed tomography(CT)scan,and thyroid function tests revealed no abnormalities,which is relatively uncommon.CASE SUMMARY A 24-year-old Chinese female,who studied at a university in Shandong Province,presented to the clinic in June 2019 with a right submandibular mass that she had noticed 2 mo earlier.Clinical examination revealed a 2-cm,nontender,movable solid-cystic mass in the submandibular region,with no palpable thyroid mass observed.Ultrasonography revealed a 2.0 cm×1.1 cm solid-cystic mass in the right submandibular region,and the thyroid gland showed no abnormalities.CT scan and 131I whole body follow-up scan showed that there were no abnormalities in the thyroid.However,cytology and pathology showed papillary tumor cell clusters,consistent with papillary thyroid carcinoma.Thus,we performed total thyroidectomy and right neck lymph node dissection.The pathology revealed the thyroid was detected as classical thyroid micropapillary carcinoma,and lymph nodes of levels VI central and levels II,III,IV,V on the right side showed no tumor metastasis.The patient was followed up for 2 years without significant recurrence.CONCLUSION The presentation of a submandibular solid-cystic mass as the primary and solitary indication of OTPC is relatively uncommon.Fine needle aspiration is advised for evaluating neck masses.展开更多
Objective: The purpose of this study is to evaluate the clinicopathologic characteristics and treatment outcomes of Papillary Thyroid Carcinomas (PTC) of the isthmus and to establish an appropriate surgical strategy. ...Objective: The purpose of this study is to evaluate the clinicopathologic characteristics and treatment outcomes of Papillary Thyroid Carcinomas (PTC) of the isthmus and to establish an appropriate surgical strategy. Methods: Thirty-four patients with PTC in isthmus are managed by surgery in National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences, Peking Union Medical College from 1985-2008. Demographic data, surgical procedures, pathological features, stages and outcomes are analyzed. Results: Seven patients were men and 27 were women. The median age was 41 years (range, 20 - 71). Twenty-five patients were treated with thyroid isthmusectomy or wide field isthmusectomy, five with hemithyroidectomy (lobectomy and isthmusectomy) and four with hemithyroidectomy and partial resection of the contralateral lobe. Twenty-eight patients had a pathologically T1 lesion (pT1);two patients had a pT2 lesion and four had a pT3 lesion. Five patients (14.7%) had papillary carcinoma detected in one of the pretracheal lymph nodes. Thirty-two patients had a solitary lesion confined to the thyroid isthmus. One patient had two lesions in the thyroid isthmus and another one had two lesions located in the thyroid isthmus and right lobe respectively. With a median follow-up of 94 months (range, 12 - 274), two patients had a recurrence and both survived after a re-operation. There was no regional lymph node or distant organ recurrences. No deaths occurred. Conclusions: Isthmusectomy or wide field isthmusectomy could be a sufficient treatment for PTC confined to the thyroid isthmus. We also recommend that pretracheal lymph node dissection be considered.展开更多
Background: Thyroid cancer is a rare disease yet the most common endocrine malignancy in pediatrics. Unlike adult patients, children with thyroid nodules typically don’t complain of pain, soreness, or difficulty swal...Background: Thyroid cancer is a rare disease yet the most common endocrine malignancy in pediatrics. Unlike adult patients, children with thyroid nodules typically don’t complain of pain, soreness, or difficulty swallowing. Additionally, using the recommended therapy for adults to treat paediatrics is not appropriate. There is an unmet need for updated unique guidelines for the management of papillary thyroid carcinoma (PTC) in paediatrics and adolescents. Case Report: A 12-year-old girl had an atypical presentation of metastatic PTC in lymph nodes. She was treated initially with hemi-thyroidectomy, followed by total thyroidectomy. A multidisciplinary team followed her up till successful results were found. Conclusion: Due to the difference in pathophysiology between thyroid tumors in children and adults, a unique approach to PTC management is to be implemented. Further trials are required for a better understanding of risk factors, the likelihood of recurrence, and the long-term side effects of the chosen management plan.展开更多
Objective: To clarify the inhibitory mechanism of Haizao Yuhu Decoction on BRAFV600E mutation-driven papillary thyroid carcinoma cells. Methods: Prepare seaweed Yuhu Decoction medicated serum, select human normal thyr...Objective: To clarify the inhibitory mechanism of Haizao Yuhu Decoction on BRAFV600E mutation-driven papillary thyroid carcinoma cells. Methods: Prepare seaweed Yuhu Decoction medicated serum, select human normal thyroid cells Nthy-ori3-1 as the normal control group, and PLX4032 as the positive control drug. The experiment was divided into normal control group, model control group, PLX4032 group, Haizao Yuhu Decoction group (referred to as HYD group), Haizao Yuhu Decoction group + PLX4032 (referred to as HYD+PLX4032 group), and high iodine water group, at 8h and 24h respectively. At 72h, the cell proliferation of each group was detected by MTT method;at 24h, the expression of ERK and p-ERK protein in each group was detected by Western blot. Results: The longer the time, the more obvious the inhibitory effect of Haizao Yuhu Decoction-containing serum on the proliferation activity of BCPAP cells: Compared with the normal control group, the BCPAP cell proliferation activity of the model control group was significantly enhanced at 24h and 72h (P <0.05);At 24h, the PLX4032 group, HYD group, and HYD+PLX4032 group all showed a tendency to inhibit the proliferation of BCPAP cells, but there was no statistical difference;at 72h, compared with the model control group, the PLX4032 group The cell proliferation activity of the HYD group and HYD+PLX4032 group was significantly inhibited (P <0.05), and there was no difference between the high iodine water group and the model control group (P>0.05). In inhibiting the proliferation of BCPAP cells, the medicated serum of Shanghai Zaoyuhu Decoction has a synergistic effect with PLX4032 (F=10.87, P=0.005). Western blot results showed that there was no difference in the expression of ERK1/2 protein between the groups, but there were significant differences in the expression of p-ERK1/2 protein between the groups: Compared with the normal control group, the expression of p-ERK1/2 protein in the model group increased significantly (P < 0.05);Compared with the model control group, the expression of p-ERK1/2 protein in the PLX4032 group, the HYD group, and the HYD+PLX4032 group decreased significantly (P <0.05), and there was no difference between the high iodine water group and the model control group (P> 0.05). Conclusion: The medicated serum of Haizao Yuhu Decoction has an inhibitory effect on the proliferation of BCPAP cells, and its mechanism may be inhibiting the proliferation of BCPAP cells by inhibiting ERK1/2 protein phosphorylation, a protein post-translational modification process;the medicated serum of Haizao Yuhu Decoction may have Help enhance the effect of PLX4032 curative effect.展开更多
Objective: To analyze the correlation between Val66Met gene of brain-derived neurotrophic factor (BDNF) and papillary thyroid carcinoma (PTC) complicated with depression. To evaluate the clinical value of papillary th...Objective: To analyze the correlation between Val66Met gene of brain-derived neurotrophic factor (BDNF) and papillary thyroid carcinoma (PTC) complicated with depression. To evaluate the clinical value of papillary thyroid carcinoma. Methods: Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess the correlation of BDNF in the blood of patients with depressive disorder of thyroid papillary carcinoma using polymerase chain reaction PCR. The relationship between BDNF gene polymorphism and the incidence of thyroid papillary carcinoma was analyzed, and the susceptibility factors of thyroid papillary carcinoma complicated with depression were explored. Results: Compared with normal control group, T3 and T4 of PTC in non-depressed group were decreased, while TSH and TPOAb were increased (P < 0.05). Compared with normal control group, T3, T4 and TPOAb were increased and TSH was decreased in PTC depression group (P < 0.05). PTC depression score was higher than that of healthy control group (P < 0.05), and PTC combined depression score was higher than that of normal control group (P < 0.05). The depression rate of PTC combined with depression was 86.7%, which was higher than that of other groups (P < 0.05). The distribution of RS6265 locus genotype of BDNF gene was significantly different between PTC with depression group and PTC without depression group (P Conclusion: There is a significant difference between PTC with depression and PTC without depression, which is related to SNP rs6265 of BDNF gene. AG and GG are both risk sites of PTC with depression, and GG type is more prone to PTC with depression.展开更多
Background: Central lymph node dissection (CLND) for papillary thyroid carcinoma (PTC) allows correct pathologic staging of lymph nodes and planning of postoperative management. The purpose of this study was to determ...Background: Central lymph node dissection (CLND) for papillary thyroid carcinoma (PTC) allows correct pathologic staging of lymph nodes and planning of postoperative management. The purpose of this study was to determine the number of the lymph nodes in the CLND and the relationship to presence of chronic lymphocytic thyroiditis (CLT) and thymic tissue (TT). Methods: Total thyroidectomy and CLND materials from 153 patients with PTC were included in this study. Two histopathologic features (presence of CLT and TT) were evaluated for their value in adequacy of CLND. Results: Histopathologic examination revealed CLT and TT in CLND materials in 70 (46%) and 63 (41%) patients, respectively. Total number of lymph nodes in CLND materials was significantly higher in CLT (+) and TT (+) groups (p Conclusions: Our study demonstrates that presence of CLT in thyroid gland has been associated with higher number of central lymph nodes mainly due to increased number of benign hyperplastic lymph nodes. It may be possible to conclude that upper limit of lymph nodes for satisfactory CLND would be higher to correctly evaluate central lymph node status in existing staging systems if specimens have CLT. Results of this study also show that the presence of TT in surgical materials may represent the adequacy of CLND.展开更多
Papillary thyroid carcinoma with metastasis to the skull is extremely rare.We report a case of unsuspected papillary thyroid carcinoma with skull metastasis.A 48-year-old female patient presenting with painless,pulsat...Papillary thyroid carcinoma with metastasis to the skull is extremely rare.We report a case of unsuspected papillary thyroid carcinoma with skull metastasis.A 48-year-old female patient presenting with painless,pulsatile,progressively increasing swelling in the occipitoparietal region of the scalp approached for an X-ray of the skull.Ultrasound of palpable swelling in the neck revealed a heteroechoic lesion with increased vascularity.Foci of calcification were seen involving both lobes of the thyroid.Ultrasound of scalp showed a destructive mass in the skull with increased vascularity.Biopsy of thyroid lesions revealed branching papillae having a dense fibrovascular core covered by cuboidal epithelial cells with nuclei having a clear ground glass appearance.This case illustrates how isolated extensive skull metastasis can be found in papillary carcinoma patients without causing significant morbidity.Therefore,in the clinical course of thyroid papillary carcinoma,skull metastasis should be considered,and the patients should be meticulously investigated and followed up.展开更多
AA amyloidosis is often secondary to chronic inflammatory diseases but can rarely occur in patients with malignant neoplasms. A 33 years old woman with papillary carcinoma of thyroid was hospitalized in our department...AA amyloidosis is often secondary to chronic inflammatory diseases but can rarely occur in patients with malignant neoplasms. A 33 years old woman with papillary carcinoma of thyroid was hospitalized in our department of Nephrology for nephrotic syndrome. Renal histology finds AA amyloidosis. To our knowledge, this is the first report of a patient with papillary carcinoma of thyroid and secondary (AA) amyloidosis with amyloid deposition in the kidneys causing nephrotic syndrome.展开更多
The central nervous system plays an important role in regulating thyroid hormone homeostasis. 5-HT is one of the important neurotransmitters involved in energy balance regulation. 5-HT transporters affect 5-HT functio...The central nervous system plays an important role in regulating thyroid hormone homeostasis. 5-HT is one of the important neurotransmitters involved in energy balance regulation. 5-HT transporters affect 5-HT function by regulating SERT protein expression and transcriptional activity. Based on the biological correlation between thyroid hormone and thyroid tumors, 5-HTTLPR is associated with thyroid tumors under stress. Animal models of thyroid disease have shown that some of the transmitters in the brain’s monoaminergic nervous system have changed, and when the monoamine transporter gene expression is altered, it is found that this disorder is more pronounced. This article discusses whether thyroid papillary carcinoma patients are associated with 5-HTTLPR and whether the mechanism of thyroid papillary carcinoma “gene x environment” has an effect. Briefly describe the role of 5-HTTLPR in the development of patients with papillary thyroid carcinoma, and provide a basis for clinical diagnosis and treatment of papillary thyroid cancer.展开更多
This review aimed to describe the inculpation of microRNAs(miRNAs)in thyroid cancer(TC)and its subtypes,mainly medullary thyroid carcinoma(MTC),and to outline web-based tools and databases for bioinformatics analysis ...This review aimed to describe the inculpation of microRNAs(miRNAs)in thyroid cancer(TC)and its subtypes,mainly medullary thyroid carcinoma(MTC),and to outline web-based tools and databases for bioinformatics analysis of miRNAs in TC.Additionally,the capacity of miRNAs to serve as therapeutic targets and biomarkers in TC management will be discussed.This review is based on a literature search of relevant articles on the role of miRNAs in TC and its subtypes,mainly MTC.Additionally,web-based tools and databases for bioinformatics analysis of miRNAs in TC were identified and described.MiRNAs can perform as oncomiRs or antioncoges,relying on the target mRNAs they regulate.MiRNA replacement therapy using miRNA mimics or antimiRs that aim to suppress the function of certain miRNAs can be applied to correct miRNAs aberrantly expressed in diseases,particularly in cancer.MiRNAs are involved in the modulation of fundamental pathways related to cancer,resembling cell cycle checkpoints and DNA repair pathways.MiRNAs are also rather stable and can reliably be detected in different types of biological materials,rendering them favorable diagnosis and prognosis biomarkers as well.MiRNAs have emerged as promising tools for evaluating medical outcomes in TC and as possible therapeutic targets.The contribution of miRNAs in thyroid cancer,particularly MTC,is an active area of research,and the utility of web applications and databases for the biological data analysis of miRNAs in TC is becoming increasingly important.展开更多
Background:To observe the changes in serum calcitonin levels after application of different surgical methods for primary medullary thyroid microcarcinoma(MTMC)and explore a more reasonable surgical method.Methods:A re...Background:To observe the changes in serum calcitonin levels after application of different surgical methods for primary medullary thyroid microcarcinoma(MTMC)and explore a more reasonable surgical method.Methods:A retrospective analysis of 36 patients with MTMC,16 in group A and 20 in group B,was performed.In group A,tumors were single and confined to the thyroid lobe,and thyroid lobectomy with isthmusectomy was performed.In group B,tumors were in the isthmus or invaded the thyroid gland,or there were multiple foci in bilateral lobes,and patients with primary foci underwent total thyroidectomy.The median follow-up time was 3.6 years.Clinical and pathological characteristics and changes in serum calcitonin(CTn)and carcinoembryonic antigen levels after the surgery were compared between the 2 groups.Results:The difference in the biochemical cure rate after surgery was statistically significant between patients with preoperative serum calcitonin levels<150 pg/mL and≥150 pg/mL(P<0.01).No significant differences in the biochemical cure rates and serum calcitonin levels were noted at different time points after surgery between group A and group B(P>0.05).One recurrence and metastasis were observed in each group after surgery.Conclusions:After performing different surgical methods for the primary foci of MTMC,the changes in serum calcitonin and carcinoembryonic antigen levels are similar.Especially for patients with single foci confined to the thyroid lobe without lateral cervical lymph node metastasis and with serum calcitonin levels<150 pg/mL,the unilateral thyroid lobectomy with isthmectomy can achieve the same therapeutic effect and biochemical cure rate as total thyroidectomy.展开更多
Thyroid cancer is the most common endocrine malignancy.While there has been no appreciable increase in the observed mortality of well-differentiated thyroid cancer,there has been an overall rise in its incidence world...Thyroid cancer is the most common endocrine malignancy.While there has been no appreciable increase in the observed mortality of well-differentiated thyroid cancer,there has been an overall rise in its incidence worldwide over the last few decades.Patients with papillary thyroid carcinoma(PTC)and clinical evidence of central(cN1)and/or lateral lymph node metastases require total thyroidectomy plus central and/or lateral neck dissection as the initial surgical treatment.Nodal status in PTC patients plays a crucial role in the prognostic evaluation of the recurrence risk.The 2015 guidelines of the American Thyroid Association(ATA)have more accurately determined the indications for therapeutic central and lateral lymph node dissection.However,prophylactic central neck lymph node dissection(pCND)in negative lymph node(cN0)PTC patients is controversial,as the 2009 ATA guidelines recommended that CND“should be considered”routinely in patients who underwent total thyroidectomy for PTC.Although the current guidelines show clear indications for therapeutic CND,the role of pCND in cN0 patients with PTC is still debated.In small solitary papillary carcinoma(T1,T2),pCND is not recommended unless there are high-risk prediction factors for recurrence and diffuse nodal spread(extrathyroid extension,mutation in the BRAF gene).pCND can be considered in cN0 disease with advanced primary tumors(T3 or T4)or clinical lateral neck disease(cN1b)or for staging and treatment planning purposes.The role of the preoperative evaluation is fundamental to minimizing the possible detrimental effect of overtreatment of the types of patients who are associated with low disease-related morbidity and mortality.On the other hand,it determines the choice of appropriate treatment and determines if close monitoring of patients at a higher risk is needed.Thus,pCND is currently recommended for T3 and T4 tumors but not for T1 and T2 tumors without high-risk prediction factors of recurrence.展开更多
A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She under...A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She underwent a right salpingo-oophorectomy in May 2022. The anatomical pathology result is in favor of a papillary carcinoma developed on stroma ovarii. No adjuvant treatment was necessary since the tumor was well limited, without capsular rupture, stage IA. The thyroid test was normal. The patient is currently being monitored. There is no sign of recurrence 20 months after surgery.展开更多
Objective:To study the correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion.Methods:A total of 128 patients with thyroid papillary carcinoma who received surgical...Objective:To study the correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion.Methods:A total of 128 patients with thyroid papillary carcinoma who received surgical treatment in the hospital between May 2013 and May 2016 were collected, CEUS was used to make clear the peak intensity (PI) and area under the curve (AUC) of tumor tissue and surrounding normal tissue, and the median of PI and AUC was referred to further divide the patients into high PI group and low PI group as well as high AUC group and low AUC group, 64 cases in each group. Fluorescent quantitative PCR was used to determine proliferation and invasion gene mRNA expression in tumor tissues.Results: PI and AUC levels in tumor tissue were lower than those in surrounding normal tissue;proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low PI group were higher than those of high PI group, and invasion gene Ki-67 mRNA expression was higher than that of high PI group while P53 and MRP-1 mRNA expression were lower than those of high PI group;proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low AUC group were higher than those of high AUC group, and invasion gene Ki-67 mRNA expression was higher than that of high AUC group while P53 and MRP-1 mRNA expression were lower than those of high AUC group.Conclusion: Thyroid papillary carcinoma CEUS parameters PI and AUC levels can quantifiably reflect the cancer cell proliferation and invasion activity.展开更多
BACKGROUND The gold standard treatment for papillary thyroid carcinoma is total thyroidectomy and indications for microwave thermal ablation for primary thyroid cancers have not yet been clearly established However,so...BACKGROUND The gold standard treatment for papillary thyroid carcinoma is total thyroidectomy and indications for microwave thermal ablation for primary thyroid cancers have not yet been clearly established However,some patients refuse surgery and others have no indication for it,for example patients under palliative care as in this case,or cannot undergo surgery,based on their comorbidities.These indications are described in the most recent Korean,North American and European guidelines.Laser ablation,radiofrequency ablation,and microwave ablation are similarly safe and effective,so the choice should be based on the specific competences and resources of the pertaining centers.These indications are Percutaneous minimally-invasive techniques;they can be useful to stop disease progression and as an alternative to surgery in patients with contraindication or who refuse surgery.We present a case of a thyroid papillary carcinoma with 17 mm effectively treated with microwave thermal ablation and without recurrence after one year of follow up.CASE SUMMARY The authors present a case of a 71-years-old patient with a left lobe papillary thyroid carcinoma with 13 mm×17 mm×13 mm,with no indication for thyroid surgery given the context of another cancer in palliative treatment.Microwave thermoablation was performed on December 2021.Four months later he repeated computed tomography(CT)scan,which showed that the tumor had disappeared.Six months after ablation he underwent a positron emission tomography/CT-fluorodeoxyglucose scan,which didn’t show any evidence of hypermetabolic tumor lesions.CONCLUSION This case shows microwave thermoablation can be a safe and effective alternative to surgery in patients with no conditions to undergo surgery or when they refuse it.By treating the tumor,with this minimally invasive technique,we are stopping its growth and avoiding disease progression.展开更多
BACKGROUND Papillary thyroid carcinoma(PTC)is regarded as a fairly common endocrine malignancy,which can be divided into different multiple variants due to wide morphologic differences.The majority of PTC variants hav...BACKGROUND Papillary thyroid carcinoma(PTC)is regarded as a fairly common endocrine malignancy,which can be divided into different multiple variants due to wide morphologic differences.The majority of PTC variants have been reported,but PTC with nodular fasciitis-like stroma(NFS)is a rare pathological variant and has been infrequently reported in the relevant literature.This condition involves abundant reactive stromal components rich in spindle cells,which may account for 60%-80%of the tumor along with a typical papillary carcinoma.CASE SUMMARY A 44-year-old man presented with a 4-mo history of a palpable mass over the anterior aspect of the left neck,the tumor demonstrated gradual enlargement but was painless during the 4 mo prior to discovery.Thyroid function test results were normal.Physical examination showed an enormous and firm nodular mass in the left lobe of the thyroid gland extending to the level of the hyoid bone.Ultrasonography of the neck revealed a well-defined heterogeneous lesion measuring around 5.0 cm×4.0 cm with a hypoechoic complex nodule,decreased vascularity and speckles of microcalcification.The patient underwent left thyroidectomy with central compartment lymph node dissection.Final histopathological examination confirmed the diagnosis of PTC with extensive fibromatosis-like stroma combined with typical PTC.The patient was asymptomatic at the 3-mo follow-up.CONCLUSION PTC-NFS is a rare pathological variant and its diagnosis and prognosis may be similar to typical papillary carcinoma.展开更多
Ovarian goiter is a form of single tissue teratoma of the ovary, accounting for 2% - 3% of mature ovarian teratomas. Malignant transformation may occur in rare cases. Papillary thyroid-type carcinoma represents the mo...Ovarian goiter is a form of single tissue teratoma of the ovary, accounting for 2% - 3% of mature ovarian teratomas. Malignant transformation may occur in rare cases. Papillary thyroid-type carcinoma represents the most common type of malignant struma ovarii, followed by follicular carcinoma. Malignant struma ovarii is commonly seen in women in the fifth decade. The diagnosis is often made post-operatively after histological examination. Histology also helps assess tumor aggressiveness (mitoses, necrosis, poorly differentiated subtype, etc.). Given the rarity of these lesions, no therapeutic consensus or prognostic value had yet been formally established. We report herein, the case of a 76-year-old woman with a cystic tumor of the right ovary and a nodular lesion of the bladder. The clinical symptomatology is nonspecific, associating abdomino-pelvic pain and a right latero-uterine mass on abdominal palpation. After total hysterectomy with bilateral adnexectomy, the diagnosis of papillary carcinoma arising from struma ovarii and extending into the bladder was made. Through this observation, we suggest to discuss the anatomoclinical particularities of this rare pathological entity.展开更多
Introduction: The impact of pregnancy on the prognosis of papillary thyroid carcinoma (PTC) has been debated for several decades;however, no definitive conclusions have been reached. The main objective of this study i...Introduction: The impact of pregnancy on the prognosis of papillary thyroid carcinoma (PTC) has been debated for several decades;however, no definitive conclusions have been reached. The main objective of this study is to demonstrate the short-term influence of pregnancy on the evolution and prognosis of PTC. Materials and Methods: A prospective descriptive and analytical study was conducted in the Endocrinology and Diabetology Department at the Hassan II University Hospital in Fez, including patients followed for papillary thyroid carcinoma presenting with a pregnancy during the year 2019 and 2020. The follow-up of these patients was continued until 1 year postpartum. We studied the clinical, paraclinical and therapeutic factors that could influence the prognosis of the disease. Results: We included 26 patients. Our study showed a significant correlation between recurrence and the presence of unfavorable histological signs (p = 0.02) as well as the initial Tg level (0.01). However, pregnancy was not an influencing factor (p = 0.41). Conclusion: Pregnancy does not seem to be a factor aggravating the prognosis of differentiated thyroid cancers.展开更多
Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this stu...Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.展开更多
文摘Objective: The purpose of this study was to investigate the effect of Hashimoto’s thyroiditis on efficacy of <sup>131</sup>I ablation in intermediate- and high-risk of thyroid papillary carcinoma patients. The findings will help to develop a personalized treatment plan for patients with thyroid papillary carcinoma complicated with Hashimoto’s thyroiditis. Material and Methods: From January 2016 to December 2020, patients who were diagnosed with intermediate- and high-risk PTC with lymph node metastasis were analyzed retrospectively, excluding patients with incomplete clinical data, distant metastasis, positive TGAb, TSH Results: A total of 525 patients (166 males and 359 females) were included in the study, including 368 patients in ER group (70.1%) and 157 patients in NER group (29.9%). Eleven factors including combining Hashimoto’s thyroiditis, pre-ablative Tg levels, sex, tumor diameter, extraglandular invasion, multifocal, bilateral lesions, central lymph node metastasis, lateral lymph node metastasis, lymph node metastasis rate, thyroglobulin were statistically different between ER group and NER group with significance at P Conclusion: Hashimoto’s thyroiditis, Ps-Tg level and lateral lymph node metastasis are potential predictors for short-term efficacy of <sup>131</sup>I treatment in intermediate- and high-risk thyroid papillary carcinoma. Hashimoto’s thyroiditis, high Ps-Tg level and increased number of lateral lymph node metastasis reduce the efficacy of <sup>131</sup>I therapy in patients with intermediate and high risk thyroid papillary carcinoma.
文摘BACKGROUND Occult thyroid papillary carcinoma(OTPC)is typically characterized by initial presentation with cervical lymph node metastasis and can be detected through ultrasound.However,the initial and sole manifestation was a submandibular solid-cystic mass.High-frequency ultrasound,enhanced multislice computed tomography(CT)scan,and thyroid function tests revealed no abnormalities,which is relatively uncommon.CASE SUMMARY A 24-year-old Chinese female,who studied at a university in Shandong Province,presented to the clinic in June 2019 with a right submandibular mass that she had noticed 2 mo earlier.Clinical examination revealed a 2-cm,nontender,movable solid-cystic mass in the submandibular region,with no palpable thyroid mass observed.Ultrasonography revealed a 2.0 cm×1.1 cm solid-cystic mass in the right submandibular region,and the thyroid gland showed no abnormalities.CT scan and 131I whole body follow-up scan showed that there were no abnormalities in the thyroid.However,cytology and pathology showed papillary tumor cell clusters,consistent with papillary thyroid carcinoma.Thus,we performed total thyroidectomy and right neck lymph node dissection.The pathology revealed the thyroid was detected as classical thyroid micropapillary carcinoma,and lymph nodes of levels VI central and levels II,III,IV,V on the right side showed no tumor metastasis.The patient was followed up for 2 years without significant recurrence.CONCLUSION The presentation of a submandibular solid-cystic mass as the primary and solitary indication of OTPC is relatively uncommon.Fine needle aspiration is advised for evaluating neck masses.
文摘Objective: The purpose of this study is to evaluate the clinicopathologic characteristics and treatment outcomes of Papillary Thyroid Carcinomas (PTC) of the isthmus and to establish an appropriate surgical strategy. Methods: Thirty-four patients with PTC in isthmus are managed by surgery in National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences, Peking Union Medical College from 1985-2008. Demographic data, surgical procedures, pathological features, stages and outcomes are analyzed. Results: Seven patients were men and 27 were women. The median age was 41 years (range, 20 - 71). Twenty-five patients were treated with thyroid isthmusectomy or wide field isthmusectomy, five with hemithyroidectomy (lobectomy and isthmusectomy) and four with hemithyroidectomy and partial resection of the contralateral lobe. Twenty-eight patients had a pathologically T1 lesion (pT1);two patients had a pT2 lesion and four had a pT3 lesion. Five patients (14.7%) had papillary carcinoma detected in one of the pretracheal lymph nodes. Thirty-two patients had a solitary lesion confined to the thyroid isthmus. One patient had two lesions in the thyroid isthmus and another one had two lesions located in the thyroid isthmus and right lobe respectively. With a median follow-up of 94 months (range, 12 - 274), two patients had a recurrence and both survived after a re-operation. There was no regional lymph node or distant organ recurrences. No deaths occurred. Conclusions: Isthmusectomy or wide field isthmusectomy could be a sufficient treatment for PTC confined to the thyroid isthmus. We also recommend that pretracheal lymph node dissection be considered.
文摘Background: Thyroid cancer is a rare disease yet the most common endocrine malignancy in pediatrics. Unlike adult patients, children with thyroid nodules typically don’t complain of pain, soreness, or difficulty swallowing. Additionally, using the recommended therapy for adults to treat paediatrics is not appropriate. There is an unmet need for updated unique guidelines for the management of papillary thyroid carcinoma (PTC) in paediatrics and adolescents. Case Report: A 12-year-old girl had an atypical presentation of metastatic PTC in lymph nodes. She was treated initially with hemi-thyroidectomy, followed by total thyroidectomy. A multidisciplinary team followed her up till successful results were found. Conclusion: Due to the difference in pathophysiology between thyroid tumors in children and adults, a unique approach to PTC management is to be implemented. Further trials are required for a better understanding of risk factors, the likelihood of recurrence, and the long-term side effects of the chosen management plan.
基金Fund Project:General Program of Natural Science Foundation of Liaoning Province(No.2015020390)General Program of National Natural Science Foundation of China(No.81874441)。
文摘Objective: To clarify the inhibitory mechanism of Haizao Yuhu Decoction on BRAFV600E mutation-driven papillary thyroid carcinoma cells. Methods: Prepare seaweed Yuhu Decoction medicated serum, select human normal thyroid cells Nthy-ori3-1 as the normal control group, and PLX4032 as the positive control drug. The experiment was divided into normal control group, model control group, PLX4032 group, Haizao Yuhu Decoction group (referred to as HYD group), Haizao Yuhu Decoction group + PLX4032 (referred to as HYD+PLX4032 group), and high iodine water group, at 8h and 24h respectively. At 72h, the cell proliferation of each group was detected by MTT method;at 24h, the expression of ERK and p-ERK protein in each group was detected by Western blot. Results: The longer the time, the more obvious the inhibitory effect of Haizao Yuhu Decoction-containing serum on the proliferation activity of BCPAP cells: Compared with the normal control group, the BCPAP cell proliferation activity of the model control group was significantly enhanced at 24h and 72h (P <0.05);At 24h, the PLX4032 group, HYD group, and HYD+PLX4032 group all showed a tendency to inhibit the proliferation of BCPAP cells, but there was no statistical difference;at 72h, compared with the model control group, the PLX4032 group The cell proliferation activity of the HYD group and HYD+PLX4032 group was significantly inhibited (P <0.05), and there was no difference between the high iodine water group and the model control group (P>0.05). In inhibiting the proliferation of BCPAP cells, the medicated serum of Shanghai Zaoyuhu Decoction has a synergistic effect with PLX4032 (F=10.87, P=0.005). Western blot results showed that there was no difference in the expression of ERK1/2 protein between the groups, but there were significant differences in the expression of p-ERK1/2 protein between the groups: Compared with the normal control group, the expression of p-ERK1/2 protein in the model group increased significantly (P < 0.05);Compared with the model control group, the expression of p-ERK1/2 protein in the PLX4032 group, the HYD group, and the HYD+PLX4032 group decreased significantly (P <0.05), and there was no difference between the high iodine water group and the model control group (P> 0.05). Conclusion: The medicated serum of Haizao Yuhu Decoction has an inhibitory effect on the proliferation of BCPAP cells, and its mechanism may be inhibiting the proliferation of BCPAP cells by inhibiting ERK1/2 protein phosphorylation, a protein post-translational modification process;the medicated serum of Haizao Yuhu Decoction may have Help enhance the effect of PLX4032 curative effect.
文摘Objective: To analyze the correlation between Val66Met gene of brain-derived neurotrophic factor (BDNF) and papillary thyroid carcinoma (PTC) complicated with depression. To evaluate the clinical value of papillary thyroid carcinoma. Methods: Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess the correlation of BDNF in the blood of patients with depressive disorder of thyroid papillary carcinoma using polymerase chain reaction PCR. The relationship between BDNF gene polymorphism and the incidence of thyroid papillary carcinoma was analyzed, and the susceptibility factors of thyroid papillary carcinoma complicated with depression were explored. Results: Compared with normal control group, T3 and T4 of PTC in non-depressed group were decreased, while TSH and TPOAb were increased (P < 0.05). Compared with normal control group, T3, T4 and TPOAb were increased and TSH was decreased in PTC depression group (P < 0.05). PTC depression score was higher than that of healthy control group (P < 0.05), and PTC combined depression score was higher than that of normal control group (P < 0.05). The depression rate of PTC combined with depression was 86.7%, which was higher than that of other groups (P < 0.05). The distribution of RS6265 locus genotype of BDNF gene was significantly different between PTC with depression group and PTC without depression group (P Conclusion: There is a significant difference between PTC with depression and PTC without depression, which is related to SNP rs6265 of BDNF gene. AG and GG are both risk sites of PTC with depression, and GG type is more prone to PTC with depression.
文摘Background: Central lymph node dissection (CLND) for papillary thyroid carcinoma (PTC) allows correct pathologic staging of lymph nodes and planning of postoperative management. The purpose of this study was to determine the number of the lymph nodes in the CLND and the relationship to presence of chronic lymphocytic thyroiditis (CLT) and thymic tissue (TT). Methods: Total thyroidectomy and CLND materials from 153 patients with PTC were included in this study. Two histopathologic features (presence of CLT and TT) were evaluated for their value in adequacy of CLND. Results: Histopathologic examination revealed CLT and TT in CLND materials in 70 (46%) and 63 (41%) patients, respectively. Total number of lymph nodes in CLND materials was significantly higher in CLT (+) and TT (+) groups (p Conclusions: Our study demonstrates that presence of CLT in thyroid gland has been associated with higher number of central lymph nodes mainly due to increased number of benign hyperplastic lymph nodes. It may be possible to conclude that upper limit of lymph nodes for satisfactory CLND would be higher to correctly evaluate central lymph node status in existing staging systems if specimens have CLT. Results of this study also show that the presence of TT in surgical materials may represent the adequacy of CLND.
文摘Papillary thyroid carcinoma with metastasis to the skull is extremely rare.We report a case of unsuspected papillary thyroid carcinoma with skull metastasis.A 48-year-old female patient presenting with painless,pulsatile,progressively increasing swelling in the occipitoparietal region of the scalp approached for an X-ray of the skull.Ultrasound of palpable swelling in the neck revealed a heteroechoic lesion with increased vascularity.Foci of calcification were seen involving both lobes of the thyroid.Ultrasound of scalp showed a destructive mass in the skull with increased vascularity.Biopsy of thyroid lesions revealed branching papillae having a dense fibrovascular core covered by cuboidal epithelial cells with nuclei having a clear ground glass appearance.This case illustrates how isolated extensive skull metastasis can be found in papillary carcinoma patients without causing significant morbidity.Therefore,in the clinical course of thyroid papillary carcinoma,skull metastasis should be considered,and the patients should be meticulously investigated and followed up.
文摘AA amyloidosis is often secondary to chronic inflammatory diseases but can rarely occur in patients with malignant neoplasms. A 33 years old woman with papillary carcinoma of thyroid was hospitalized in our department of Nephrology for nephrotic syndrome. Renal histology finds AA amyloidosis. To our knowledge, this is the first report of a patient with papillary carcinoma of thyroid and secondary (AA) amyloidosis with amyloid deposition in the kidneys causing nephrotic syndrome.
文摘The central nervous system plays an important role in regulating thyroid hormone homeostasis. 5-HT is one of the important neurotransmitters involved in energy balance regulation. 5-HT transporters affect 5-HT function by regulating SERT protein expression and transcriptional activity. Based on the biological correlation between thyroid hormone and thyroid tumors, 5-HTTLPR is associated with thyroid tumors under stress. Animal models of thyroid disease have shown that some of the transmitters in the brain’s monoaminergic nervous system have changed, and when the monoamine transporter gene expression is altered, it is found that this disorder is more pronounced. This article discusses whether thyroid papillary carcinoma patients are associated with 5-HTTLPR and whether the mechanism of thyroid papillary carcinoma “gene x environment” has an effect. Briefly describe the role of 5-HTTLPR in the development of patients with papillary thyroid carcinoma, and provide a basis for clinical diagnosis and treatment of papillary thyroid cancer.
文摘This review aimed to describe the inculpation of microRNAs(miRNAs)in thyroid cancer(TC)and its subtypes,mainly medullary thyroid carcinoma(MTC),and to outline web-based tools and databases for bioinformatics analysis of miRNAs in TC.Additionally,the capacity of miRNAs to serve as therapeutic targets and biomarkers in TC management will be discussed.This review is based on a literature search of relevant articles on the role of miRNAs in TC and its subtypes,mainly MTC.Additionally,web-based tools and databases for bioinformatics analysis of miRNAs in TC were identified and described.MiRNAs can perform as oncomiRs or antioncoges,relying on the target mRNAs they regulate.MiRNA replacement therapy using miRNA mimics or antimiRs that aim to suppress the function of certain miRNAs can be applied to correct miRNAs aberrantly expressed in diseases,particularly in cancer.MiRNAs are involved in the modulation of fundamental pathways related to cancer,resembling cell cycle checkpoints and DNA repair pathways.MiRNAs are also rather stable and can reliably be detected in different types of biological materials,rendering them favorable diagnosis and prognosis biomarkers as well.MiRNAs have emerged as promising tools for evaluating medical outcomes in TC and as possible therapeutic targets.The contribution of miRNAs in thyroid cancer,particularly MTC,is an active area of research,and the utility of web applications and databases for the biological data analysis of miRNAs in TC is becoming increasingly important.
基金supported by a grant from the Gansu Provincial Nature Foundation Project(no.23URRA2346).
文摘Background:To observe the changes in serum calcitonin levels after application of different surgical methods for primary medullary thyroid microcarcinoma(MTMC)and explore a more reasonable surgical method.Methods:A retrospective analysis of 36 patients with MTMC,16 in group A and 20 in group B,was performed.In group A,tumors were single and confined to the thyroid lobe,and thyroid lobectomy with isthmusectomy was performed.In group B,tumors were in the isthmus or invaded the thyroid gland,or there were multiple foci in bilateral lobes,and patients with primary foci underwent total thyroidectomy.The median follow-up time was 3.6 years.Clinical and pathological characteristics and changes in serum calcitonin(CTn)and carcinoembryonic antigen levels after the surgery were compared between the 2 groups.Results:The difference in the biochemical cure rate after surgery was statistically significant between patients with preoperative serum calcitonin levels<150 pg/mL and≥150 pg/mL(P<0.01).No significant differences in the biochemical cure rates and serum calcitonin levels were noted at different time points after surgery between group A and group B(P>0.05).One recurrence and metastasis were observed in each group after surgery.Conclusions:After performing different surgical methods for the primary foci of MTMC,the changes in serum calcitonin and carcinoembryonic antigen levels are similar.Especially for patients with single foci confined to the thyroid lobe without lateral cervical lymph node metastasis and with serum calcitonin levels<150 pg/mL,the unilateral thyroid lobectomy with isthmectomy can achieve the same therapeutic effect and biochemical cure rate as total thyroidectomy.
文摘Thyroid cancer is the most common endocrine malignancy.While there has been no appreciable increase in the observed mortality of well-differentiated thyroid cancer,there has been an overall rise in its incidence worldwide over the last few decades.Patients with papillary thyroid carcinoma(PTC)and clinical evidence of central(cN1)and/or lateral lymph node metastases require total thyroidectomy plus central and/or lateral neck dissection as the initial surgical treatment.Nodal status in PTC patients plays a crucial role in the prognostic evaluation of the recurrence risk.The 2015 guidelines of the American Thyroid Association(ATA)have more accurately determined the indications for therapeutic central and lateral lymph node dissection.However,prophylactic central neck lymph node dissection(pCND)in negative lymph node(cN0)PTC patients is controversial,as the 2009 ATA guidelines recommended that CND“should be considered”routinely in patients who underwent total thyroidectomy for PTC.Although the current guidelines show clear indications for therapeutic CND,the role of pCND in cN0 patients with PTC is still debated.In small solitary papillary carcinoma(T1,T2),pCND is not recommended unless there are high-risk prediction factors for recurrence and diffuse nodal spread(extrathyroid extension,mutation in the BRAF gene).pCND can be considered in cN0 disease with advanced primary tumors(T3 or T4)or clinical lateral neck disease(cN1b)or for staging and treatment planning purposes.The role of the preoperative evaluation is fundamental to minimizing the possible detrimental effect of overtreatment of the types of patients who are associated with low disease-related morbidity and mortality.On the other hand,it determines the choice of appropriate treatment and determines if close monitoring of patients at a higher risk is needed.Thus,pCND is currently recommended for T3 and T4 tumors but not for T1 and T2 tumors without high-risk prediction factors of recurrence.
文摘A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She underwent a right salpingo-oophorectomy in May 2022. The anatomical pathology result is in favor of a papillary carcinoma developed on stroma ovarii. No adjuvant treatment was necessary since the tumor was well limited, without capsular rupture, stage IA. The thyroid test was normal. The patient is currently being monitored. There is no sign of recurrence 20 months after surgery.
文摘Objective:To study the correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion.Methods:A total of 128 patients with thyroid papillary carcinoma who received surgical treatment in the hospital between May 2013 and May 2016 were collected, CEUS was used to make clear the peak intensity (PI) and area under the curve (AUC) of tumor tissue and surrounding normal tissue, and the median of PI and AUC was referred to further divide the patients into high PI group and low PI group as well as high AUC group and low AUC group, 64 cases in each group. Fluorescent quantitative PCR was used to determine proliferation and invasion gene mRNA expression in tumor tissues.Results: PI and AUC levels in tumor tissue were lower than those in surrounding normal tissue;proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low PI group were higher than those of high PI group, and invasion gene Ki-67 mRNA expression was higher than that of high PI group while P53 and MRP-1 mRNA expression were lower than those of high PI group;proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low AUC group were higher than those of high AUC group, and invasion gene Ki-67 mRNA expression was higher than that of high AUC group while P53 and MRP-1 mRNA expression were lower than those of high AUC group.Conclusion: Thyroid papillary carcinoma CEUS parameters PI and AUC levels can quantifiably reflect the cancer cell proliferation and invasion activity.
文摘BACKGROUND The gold standard treatment for papillary thyroid carcinoma is total thyroidectomy and indications for microwave thermal ablation for primary thyroid cancers have not yet been clearly established However,some patients refuse surgery and others have no indication for it,for example patients under palliative care as in this case,or cannot undergo surgery,based on their comorbidities.These indications are described in the most recent Korean,North American and European guidelines.Laser ablation,radiofrequency ablation,and microwave ablation are similarly safe and effective,so the choice should be based on the specific competences and resources of the pertaining centers.These indications are Percutaneous minimally-invasive techniques;they can be useful to stop disease progression and as an alternative to surgery in patients with contraindication or who refuse surgery.We present a case of a thyroid papillary carcinoma with 17 mm effectively treated with microwave thermal ablation and without recurrence after one year of follow up.CASE SUMMARY The authors present a case of a 71-years-old patient with a left lobe papillary thyroid carcinoma with 13 mm×17 mm×13 mm,with no indication for thyroid surgery given the context of another cancer in palliative treatment.Microwave thermoablation was performed on December 2021.Four months later he repeated computed tomography(CT)scan,which showed that the tumor had disappeared.Six months after ablation he underwent a positron emission tomography/CT-fluorodeoxyglucose scan,which didn’t show any evidence of hypermetabolic tumor lesions.CONCLUSION This case shows microwave thermoablation can be a safe and effective alternative to surgery in patients with no conditions to undergo surgery or when they refuse it.By treating the tumor,with this minimally invasive technique,we are stopping its growth and avoiding disease progression.
文摘BACKGROUND Papillary thyroid carcinoma(PTC)is regarded as a fairly common endocrine malignancy,which can be divided into different multiple variants due to wide morphologic differences.The majority of PTC variants have been reported,but PTC with nodular fasciitis-like stroma(NFS)is a rare pathological variant and has been infrequently reported in the relevant literature.This condition involves abundant reactive stromal components rich in spindle cells,which may account for 60%-80%of the tumor along with a typical papillary carcinoma.CASE SUMMARY A 44-year-old man presented with a 4-mo history of a palpable mass over the anterior aspect of the left neck,the tumor demonstrated gradual enlargement but was painless during the 4 mo prior to discovery.Thyroid function test results were normal.Physical examination showed an enormous and firm nodular mass in the left lobe of the thyroid gland extending to the level of the hyoid bone.Ultrasonography of the neck revealed a well-defined heterogeneous lesion measuring around 5.0 cm×4.0 cm with a hypoechoic complex nodule,decreased vascularity and speckles of microcalcification.The patient underwent left thyroidectomy with central compartment lymph node dissection.Final histopathological examination confirmed the diagnosis of PTC with extensive fibromatosis-like stroma combined with typical PTC.The patient was asymptomatic at the 3-mo follow-up.CONCLUSION PTC-NFS is a rare pathological variant and its diagnosis and prognosis may be similar to typical papillary carcinoma.
文摘Ovarian goiter is a form of single tissue teratoma of the ovary, accounting for 2% - 3% of mature ovarian teratomas. Malignant transformation may occur in rare cases. Papillary thyroid-type carcinoma represents the most common type of malignant struma ovarii, followed by follicular carcinoma. Malignant struma ovarii is commonly seen in women in the fifth decade. The diagnosis is often made post-operatively after histological examination. Histology also helps assess tumor aggressiveness (mitoses, necrosis, poorly differentiated subtype, etc.). Given the rarity of these lesions, no therapeutic consensus or prognostic value had yet been formally established. We report herein, the case of a 76-year-old woman with a cystic tumor of the right ovary and a nodular lesion of the bladder. The clinical symptomatology is nonspecific, associating abdomino-pelvic pain and a right latero-uterine mass on abdominal palpation. After total hysterectomy with bilateral adnexectomy, the diagnosis of papillary carcinoma arising from struma ovarii and extending into the bladder was made. Through this observation, we suggest to discuss the anatomoclinical particularities of this rare pathological entity.
文摘Introduction: The impact of pregnancy on the prognosis of papillary thyroid carcinoma (PTC) has been debated for several decades;however, no definitive conclusions have been reached. The main objective of this study is to demonstrate the short-term influence of pregnancy on the evolution and prognosis of PTC. Materials and Methods: A prospective descriptive and analytical study was conducted in the Endocrinology and Diabetology Department at the Hassan II University Hospital in Fez, including patients followed for papillary thyroid carcinoma presenting with a pregnancy during the year 2019 and 2020. The follow-up of these patients was continued until 1 year postpartum. We studied the clinical, paraclinical and therapeutic factors that could influence the prognosis of the disease. Results: We included 26 patients. Our study showed a significant correlation between recurrence and the presence of unfavorable histological signs (p = 0.02) as well as the initial Tg level (0.01). However, pregnancy was not an influencing factor (p = 0.41). Conclusion: Pregnancy does not seem to be a factor aggravating the prognosis of differentiated thyroid cancers.
基金supported by the National Natural Science Foundation of China(81772850 and 82273300)。
文摘Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.