BACKGROUND Multiple primary malignant neoplasms(MPMNs)are rare,while synchronous MPMNs(SMPMNs)are even less common.Owing to the progression of medical technology and the extension of life expectancy,its incidence is g...BACKGROUND Multiple primary malignant neoplasms(MPMNs)are rare,while synchronous MPMNs(SMPMNs)are even less common.Owing to the progression of medical technology and the extension of life expectancy,its incidence is gradually increasing.CASE SUMMARY Although reports of breast and thyroid dual cancers are common,cases of an additional diagnosis of kidney primary cancer within the same individual are rare.CONCLUSION We present a case of simultaneous MPMN of three endocrine organs,reviewing the relevant literature to enhance our understanding of SMPMNs while emphasizing the increasingly important need for accurate diagnosis and multidisciplinary management whenever this challenging situation arises.展开更多
BACKGROUND Differentiated thyroid cancer(DTC)often seriously impacts patients’lives.Radionuclide Iodine-131(131I)is widely used in treating patients with DTC.However,most patients know little about radionuclide thera...BACKGROUND Differentiated thyroid cancer(DTC)often seriously impacts patients’lives.Radionuclide Iodine-131(131I)is widely used in treating patients with DTC.However,most patients know little about radionuclide therapy,and the treatment needs to be performed in a special isolation ward,which can cause anxiety and depression.AIM To explore anxiety and depression status and their influencing factors after 131I treatment in patients with DTC.METHODS A questionnaire survey was conducted among postoperative patients with DTC who received 131I treatment at our hospital from June 2020 to December 2022.General patient data were collected using a self-administered demographic characteristics questionnaire.The self-rating depression scale and self-rating anxiety scale were used to determine whether patients were worried about their symptoms and the degree of anxiety and depression.The patients were categorized into anxiety,non-anxiety,depression,and non-depression groups.Singlevariable and multiple-variable analyses were used to determine the risk factors for anxiety and depression in patients with thyroid cancer after surgery.RESULTS A total of 144 patients were included in this study.The baseline mean score of self-rating anxiety and depression scales were 50.06±16.10 and 50.96±16.55,respectively.Notably,48.62%(70/144)had anxiety and 47.22%(68/144)of the patients had depression.Sex,age,education level,marital status,household income,underlying diseases,and medication compliance significantly differed among groups(P<0.05).Furthermore,multivariate logistic regression analysis showed that education level,per capita monthly household income,and medication compliance level affected anxiety(P=0.015,0.001,and 0.001 respectively).Patient’s sex,marital status,and underlying diseases affected depression(P=0.007,0.001,and 0.009,respectively).CONCLUSION Nursing interventions aiming at reducing the risk of anxiety and depression should target unmarried female patients with low education level,low family income,underlying diseases,and poor adherence to medications.展开更多
BACKGROUND Parathyroid adenoma(PTA)is known as an adenomatous hyperparathyroidism syndrome.At earlier times,the major symptoms of this disease included high blood calcium and low phosphorus.PTA is a benign neuroendocr...BACKGROUND Parathyroid adenoma(PTA)is known as an adenomatous hyperparathyroidism syndrome.At earlier times,the major symptoms of this disease included high blood calcium and low phosphorus.PTA is a benign neuroendocrine neoplasm.We have reviewed the literature and found that it is rare for patients with hyperparathyroidism to have benign tumors with multiple organs at the same time.This report describes a patient with a PTA and four nonfunctional adenomas.CASE SUMMARY We report a case of primary hyperparathyroidism in a 39-year-old woman with multiple organ tumors.The patient was admitted to hospital because of hypercalcemia.Laboratory,imaging,and histological examinations confirmed a left parathyroid neoplasm.Right thyroid adenoma was discovered during hospitalization.She had a medical history of uterine fibroids,right benign mammary gland tumor,and meningioma.The patient recovered after surgical and conservative treatments.CONCLUSION Primary hyperparathyroidism with multiple organ tumors is uncommon,and further studies should be conducted to determine if there is genetic heterogeneity.展开更多
Full thickness burns of 30% TBSA by napalm was inflicted to rats and the pathologi-cal changes of the thyroid were observed with optical and electron microscopy and with peroxi-dase histoehemistry for 15 days postburn...Full thickness burns of 30% TBSA by napalm was inflicted to rats and the pathologi-cal changes of the thyroid were observed with optical and electron microscopy and with peroxi-dase histoehemistry for 15 days postburn.Dynamic changes of the serum level of T<sub>3</sub> and T<sub>4</sub> wereobserved concomitantly.It was found that the postburn pathological changes of the thyroid couldbe distinguished into 3 phases as follows:The phase of injury inhibition.This lasted from the 2nd to the 24th hour postburn and wascharacterized by marked damage of the follicular epithelium.The phase of structural and functional recovery.This lasted from the 3rd to 6th day post-burn and was characterized by abated damage of the thyroid and a tendency to recover.The phase of active function.This lasted from the 10th to the 15th day postburn.The syn-thesizing and releasing organellae of the thyroid were well-restored.The changes of T<sub>4</sub> were parallel to the pathological changes of the thyroid in all the stages,while T<sub>3</sub> level was continously inhibited because of the low serum level of T<sub>4</sub>,the metabolic dis-turbance of T<sub>4</sub> deiodination,and the inhibition of thyroid secretion in the early postburn stage andthe metabolic disturbance of T<sub>4</sub> deiodination in the middle and late postburn stages.In the earlypostburn stage,the inhibition on thyroid peroxidase was an important factor to inhibit the func-tion of the thyroid.展开更多
BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,H...BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,Hürthle cell carcinoma,poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma have been reported in the literature,but there have been no reports about PTMC.CASE SUMMARY A 45-year-old woman presented with a thyroid mass and thrombosis in a middle thyroid vein during a physical examination.She had no symptoms,and the physical examination showed no positive signs.Subsequent ultrasonographyguided fine-needle aspiration biopsy results indicated an atypical lesion of ambiguous significance,with some actively growing cells(TBSRTCⅢ)and the BRAFV600E mutation not present.This patient underwent left thyroidectomy,isthmus lobectomy,prophylactic central lymph node dissection and thromboembolectomy.Postoperative pathology showed papillary microcarcinoma of the left thyroid,and the thrombus in the middle thyroid vein was a tumor thrombus.CONCLUSION Middle thyroid vein tumor thrombus is an extremely rare condition in PTMC,but it does exist.Lobectomy and thromboembolectomy may be an option for patients with thrombi in the middle vein of the thyroid,and we strongly suggest close follow-up of these patients.展开更多
BACKGROUND Papillary thyroid cancer(PTC)has good prognosis so that the local recurrence or distant metastasis can occur later on the lifetime follow up.In this study,we report recurrence of PTC in subcutaneous area co...BACKGROUND Papillary thyroid cancer(PTC)has good prognosis so that the local recurrence or distant metastasis can occur later on the lifetime follow up.In this study,we report recurrence of PTC in subcutaneous area combined with lymph node metastasis.A suspicion of needle tract implantation after core needle biopsy was found.CASE SUMMARY A 66-year-old female patients who underwent right thyroid lobectomy for PTC complained of palpable nodule on anterior neck area.The location of the palpable nodule was not associated with her postoperative scar.After excision of the skin tumor,it was diagnosed as recurrence of PTC.Furthermore,results of subsequent imaging showed lymph node metastasis on her right cervical area.According to the previous medical records,the patient received core needle biopsy through the neck of the patient midline and hematoma was noted after the procedure.The time interval from the first diagnosis to local recurrence or metastasis to the skin and lymph nodes was ten years.As treatment,the patient underwent lymph node dissection in the right and completion thyroidectomy for radioisotope treatment.CONCLUSION Needle tract implantation can occur after core needle biopsy.Further studies are needed to compare core-needle biopsy and fine-needle aspiration.展开更多
BACKGROUND The recognized pattern of cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma involves a stepwise route.Contralateral lymph node skip metastasis is very rare.In addition,the patient in our ca...BACKGROUND The recognized pattern of cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma involves a stepwise route.Contralateral lymph node skip metastasis is very rare.In addition,the patient in our case report also suffered from a breast carcinoma accompanied by left supraclavicular lymphadenopathy,which made it difficult to distinguish the origin of the CLNM.Based on this case,we recommended that more detailed physical and imaging examinations are needed for patients with uncommon cervical lymphatic metastasis of primary cancer.CASE SUMMARY A 53-year-old women was admitted to the hospital for a neck mass in the left cervical region that had existed for 2 mo.The neck mass was suspected to be an enlarged lateral LN originating from papillary thyroid microcarcinoma of the contralateral thyroid lobe,according to ultrasound and ultrasound-guided fine needle aspiration biopsy.The patient underwent total thyroidectomy and radical cervical LN dissection.Postoperative pathology confirmed the diagnosis of papillary thyroid microcarcinoma with contralateral lymphatic skip metastasis.Unfortunately,a breast cancer was discovered 4 mo later,which was accompanied by ipsilateral supraclavicular LN metastasis.She accepted neoadjuvant chemotherapy and subsequent left modified radical mastectomy for treatment.The patient is currently receiving postoperative radiotherapy,and no local recurrence was observed in the 6-mo follow-up after surgery.CONCLUSIONWe present a rare case of papillary thyroid microcarcinoma with contralateral lymphatic skipmetastasis and breast cancer with supraclavicular lymphatic metastasis.展开更多
Thyroid cancer is the most common endocrine system tumor.Ultrasound guided fine needle puncture(FNA)can identify benign and malignant thyroid nodules.However,due to the limitation of cytological detection,some thyroid...Thyroid cancer is the most common endocrine system tumor.Ultrasound guided fine needle puncture(FNA)can identify benign and malignant thyroid nodules.However,due to the limitation of cytological detection,some thyroid nodules are difficult to distinguish benign and malignant.BRAF gene mutation is a common human oncogenic mutation and the highest mutation frequency in papillary thyroid carcinoma.The combination of FNA and BRAF gene detection can significantly improve the diagnostic rate of benign and malignant thyroid nodules and make up for the deficiency of single diagnosis of cytology.Moreover,while the incidence of thyroid cancer is growing rapidly worldwide,its mortality remains stable.The problem of overdiagnosis and overtreatment of thyroid cancer is becoming more and more obvious.However,due to the limitations of current studies on BRAF genes,its prognostic value for papillary thyroid carcinoma remains controversial.Therefore,in order to reduce the adverse effects of overdiagnosis and treatment,the relationship between gene and tumor biological behavior needs further study in the future.展开更多
基金Shanxi Soft Science General Program,No.2018041032-2.
文摘BACKGROUND Multiple primary malignant neoplasms(MPMNs)are rare,while synchronous MPMNs(SMPMNs)are even less common.Owing to the progression of medical technology and the extension of life expectancy,its incidence is gradually increasing.CASE SUMMARY Although reports of breast and thyroid dual cancers are common,cases of an additional diagnosis of kidney primary cancer within the same individual are rare.CONCLUSION We present a case of simultaneous MPMN of three endocrine organs,reviewing the relevant literature to enhance our understanding of SMPMNs while emphasizing the increasingly important need for accurate diagnosis and multidisciplinary management whenever this challenging situation arises.
基金Supported by Fujian Science and Technology Plan Project,No.2022J01784.
文摘BACKGROUND Differentiated thyroid cancer(DTC)often seriously impacts patients’lives.Radionuclide Iodine-131(131I)is widely used in treating patients with DTC.However,most patients know little about radionuclide therapy,and the treatment needs to be performed in a special isolation ward,which can cause anxiety and depression.AIM To explore anxiety and depression status and their influencing factors after 131I treatment in patients with DTC.METHODS A questionnaire survey was conducted among postoperative patients with DTC who received 131I treatment at our hospital from June 2020 to December 2022.General patient data were collected using a self-administered demographic characteristics questionnaire.The self-rating depression scale and self-rating anxiety scale were used to determine whether patients were worried about their symptoms and the degree of anxiety and depression.The patients were categorized into anxiety,non-anxiety,depression,and non-depression groups.Singlevariable and multiple-variable analyses were used to determine the risk factors for anxiety and depression in patients with thyroid cancer after surgery.RESULTS A total of 144 patients were included in this study.The baseline mean score of self-rating anxiety and depression scales were 50.06±16.10 and 50.96±16.55,respectively.Notably,48.62%(70/144)had anxiety and 47.22%(68/144)of the patients had depression.Sex,age,education level,marital status,household income,underlying diseases,and medication compliance significantly differed among groups(P<0.05).Furthermore,multivariate logistic regression analysis showed that education level,per capita monthly household income,and medication compliance level affected anxiety(P=0.015,0.001,and 0.001 respectively).Patient’s sex,marital status,and underlying diseases affected depression(P=0.007,0.001,and 0.009,respectively).CONCLUSION Nursing interventions aiming at reducing the risk of anxiety and depression should target unmarried female patients with low education level,low family income,underlying diseases,and poor adherence to medications.
文摘BACKGROUND Parathyroid adenoma(PTA)is known as an adenomatous hyperparathyroidism syndrome.At earlier times,the major symptoms of this disease included high blood calcium and low phosphorus.PTA is a benign neuroendocrine neoplasm.We have reviewed the literature and found that it is rare for patients with hyperparathyroidism to have benign tumors with multiple organs at the same time.This report describes a patient with a PTA and four nonfunctional adenomas.CASE SUMMARY We report a case of primary hyperparathyroidism in a 39-year-old woman with multiple organ tumors.The patient was admitted to hospital because of hypercalcemia.Laboratory,imaging,and histological examinations confirmed a left parathyroid neoplasm.Right thyroid adenoma was discovered during hospitalization.She had a medical history of uterine fibroids,right benign mammary gland tumor,and meningioma.The patient recovered after surgical and conservative treatments.CONCLUSION Primary hyperparathyroidism with multiple organ tumors is uncommon,and further studies should be conducted to determine if there is genetic heterogeneity.
文摘Full thickness burns of 30% TBSA by napalm was inflicted to rats and the pathologi-cal changes of the thyroid were observed with optical and electron microscopy and with peroxi-dase histoehemistry for 15 days postburn.Dynamic changes of the serum level of T<sub>3</sub> and T<sub>4</sub> wereobserved concomitantly.It was found that the postburn pathological changes of the thyroid couldbe distinguished into 3 phases as follows:The phase of injury inhibition.This lasted from the 2nd to the 24th hour postburn and wascharacterized by marked damage of the follicular epithelium.The phase of structural and functional recovery.This lasted from the 3rd to 6th day post-burn and was characterized by abated damage of the thyroid and a tendency to recover.The phase of active function.This lasted from the 10th to the 15th day postburn.The syn-thesizing and releasing organellae of the thyroid were well-restored.The changes of T<sub>4</sub> were parallel to the pathological changes of the thyroid in all the stages,while T<sub>3</sub> level was continously inhibited because of the low serum level of T<sub>4</sub>,the metabolic dis-turbance of T<sub>4</sub> deiodination,and the inhibition of thyroid secretion in the early postburn stage andthe metabolic disturbance of T<sub>4</sub> deiodination in the middle and late postburn stages.In the earlypostburn stage,the inhibition on thyroid peroxidase was an important factor to inhibit the func-tion of the thyroid.
文摘BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,Hürthle cell carcinoma,poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma have been reported in the literature,but there have been no reports about PTMC.CASE SUMMARY A 45-year-old woman presented with a thyroid mass and thrombosis in a middle thyroid vein during a physical examination.She had no symptoms,and the physical examination showed no positive signs.Subsequent ultrasonographyguided fine-needle aspiration biopsy results indicated an atypical lesion of ambiguous significance,with some actively growing cells(TBSRTCⅢ)and the BRAFV600E mutation not present.This patient underwent left thyroidectomy,isthmus lobectomy,prophylactic central lymph node dissection and thromboembolectomy.Postoperative pathology showed papillary microcarcinoma of the left thyroid,and the thrombus in the middle thyroid vein was a tumor thrombus.CONCLUSION Middle thyroid vein tumor thrombus is an extremely rare condition in PTMC,but it does exist.Lobectomy and thromboembolectomy may be an option for patients with thrombi in the middle vein of the thyroid,and we strongly suggest close follow-up of these patients.
文摘BACKGROUND Papillary thyroid cancer(PTC)has good prognosis so that the local recurrence or distant metastasis can occur later on the lifetime follow up.In this study,we report recurrence of PTC in subcutaneous area combined with lymph node metastasis.A suspicion of needle tract implantation after core needle biopsy was found.CASE SUMMARY A 66-year-old female patients who underwent right thyroid lobectomy for PTC complained of palpable nodule on anterior neck area.The location of the palpable nodule was not associated with her postoperative scar.After excision of the skin tumor,it was diagnosed as recurrence of PTC.Furthermore,results of subsequent imaging showed lymph node metastasis on her right cervical area.According to the previous medical records,the patient received core needle biopsy through the neck of the patient midline and hematoma was noted after the procedure.The time interval from the first diagnosis to local recurrence or metastasis to the skin and lymph nodes was ten years.As treatment,the patient underwent lymph node dissection in the right and completion thyroidectomy for radioisotope treatment.CONCLUSION Needle tract implantation can occur after core needle biopsy.Further studies are needed to compare core-needle biopsy and fine-needle aspiration.
基金Supported by The Project of Shanghai Municipal Health Commission,No. 20214Y0223
文摘BACKGROUND The recognized pattern of cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma involves a stepwise route.Contralateral lymph node skip metastasis is very rare.In addition,the patient in our case report also suffered from a breast carcinoma accompanied by left supraclavicular lymphadenopathy,which made it difficult to distinguish the origin of the CLNM.Based on this case,we recommended that more detailed physical and imaging examinations are needed for patients with uncommon cervical lymphatic metastasis of primary cancer.CASE SUMMARY A 53-year-old women was admitted to the hospital for a neck mass in the left cervical region that had existed for 2 mo.The neck mass was suspected to be an enlarged lateral LN originating from papillary thyroid microcarcinoma of the contralateral thyroid lobe,according to ultrasound and ultrasound-guided fine needle aspiration biopsy.The patient underwent total thyroidectomy and radical cervical LN dissection.Postoperative pathology confirmed the diagnosis of papillary thyroid microcarcinoma with contralateral lymphatic skip metastasis.Unfortunately,a breast cancer was discovered 4 mo later,which was accompanied by ipsilateral supraclavicular LN metastasis.She accepted neoadjuvant chemotherapy and subsequent left modified radical mastectomy for treatment.The patient is currently receiving postoperative radiotherapy,and no local recurrence was observed in the 6-mo follow-up after surgery.CONCLUSIONWe present a rare case of papillary thyroid microcarcinoma with contralateral lymphatic skipmetastasis and breast cancer with supraclavicular lymphatic metastasis.
基金It was supported by Lanzhou Science and Technology Plan Project(2018-3-58)。
文摘Thyroid cancer is the most common endocrine system tumor.Ultrasound guided fine needle puncture(FNA)can identify benign and malignant thyroid nodules.However,due to the limitation of cytological detection,some thyroid nodules are difficult to distinguish benign and malignant.BRAF gene mutation is a common human oncogenic mutation and the highest mutation frequency in papillary thyroid carcinoma.The combination of FNA and BRAF gene detection can significantly improve the diagnostic rate of benign and malignant thyroid nodules and make up for the deficiency of single diagnosis of cytology.Moreover,while the incidence of thyroid cancer is growing rapidly worldwide,its mortality remains stable.The problem of overdiagnosis and overtreatment of thyroid cancer is becoming more and more obvious.However,due to the limitations of current studies on BRAF genes,its prognostic value for papillary thyroid carcinoma remains controversial.Therefore,in order to reduce the adverse effects of overdiagnosis and treatment,the relationship between gene and tumor biological behavior needs further study in the future.
