Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Evanston Hospital maintains an Irradiated Thyroid Evaluation Clinic that has evaluated 695 patients since 1975. One hundred fourteen patients were retrospectively analyzed, and an attempt was made to correlate the preoperative physical examination with the pathologic specimen after thyroidectomy. There was no statistically significant difference between the incidence of carcinoma in glands containing a single nodule (23 per cent) and in multinodular glands. Postirradiation thyroiditis complicated the physical description of glands preoperatively. The categorization of physical findings served only to identify persistent thyroid abnormalities, which must be explored surgically. The overall incidence of carcinoma in the 114 available cases was 34 per cent, with nodal metastases in 18 per cent of the patients with carcinoma.
 ...
PMID:Preoperative physical assessment of thyroid glands in previously irradiated patients. 49 52

Anaplastic, mostly spindle-cellular, carcinoma of the thyroid gland was diagnosed bioptically in a 65-year-old woman. Necroptically it was found that the carcinoma was associated with Hashimoto's lymphocytic thyroiditis. In the hitherto-differentiated carcinomatous parts the papillary component prevailed and the original lymphocytic stromal infiltration was in evidence here. In the anaplastic parts isolated macrocellular elements occurred and, in some places, also chondroid and osteoid structures, especially the structures of macrocellular bone tumor character. These structures were entirely missing in the distant metastases and were, therefore, evaluated as a stromal nontumorous metaplastic process.
 ...
PMID:[Anaplastic carcinoma of the thyroid gland with chondroid, osteoid, and marocellular metaplasia of the stroma, associated with Hashimoto's lymphocytic thyroiditis]. 58 23

A sensitive and specific double antibody radioimmunoassay for the measurement of serum thyroglobulin (Tg) has been developed. The minimum detectable concentration of Tg was 5.0 ng/ml. Coefficients of within and between assay variation were 2.4% and 12.0%, respectively. The mean recovery of Tg added to normal serum was 102.9%; and T4, T3, DIT and MIT did not crossreact in this assay system. Dilution curves of normal thyroid extract, tumor extract and patient's serum were shown to be parallel with the standard Tg preparation. The mean serum Tg level in normal males and females was 42.8 +- 5.3 ng/ml (mean +- SE) (N=29) and 117.1 +- 20.9 ng/ml (N=20), respectively. There was a significant difference between male and female groups (p less than 0.001). The mean serum Tg level was 365.0 +- 69 ng/ml in 19 hyperthyroid patients with Graves' disease and 248.1 +- 35.8 ng/ml in 21 patients who were in a euthyroid state from the treatment with antithyroid drugs, showing statistically no significant difference. However, 8 patients in permanent remission showed definitely low Tg values, 83.6 +- 16.2 ng/ml. The mean serum Tg level was 2101.1 +- 57.6 ng/ml in 6 patients with chronic thyroiditis without auto-anti Tg and 525.1 +- 207.5 ng/ml in 5 patients with thyroid adenoma. The effect of total thyroidectomy on the serum TSH and Tg was studied in a patient (M.T.) with pulmonary metastases from thyroid follicular adenocarcinoma. The serum TSH level rose progressively to hypothyroid levels during nine days after thyroidectomy; the value was 45.7 muU/ml on the 9th day after the thyroidectomy. The serum Tg level in this case was 4 925 ng/ml before surgery. After a transient fluctuation caused by the operation, the serum Tg level in the patient increased progressively during 39 days after surgery with a concomitant increase in serum TSH; the levels at the 3rd, 6th and 9th day after surgery were 5,825 ng/ml, 7,910 ng/ml and 11,190 ng/ml, respectively. The suppression of endogenous TSH secretion with treatment of T3 60 MICROGRAMS/DAY WAS FOLLOWED BY A GRADUAL FALL In serum Tg levels, decreasing to 630 ng/ml at the 114th day. Bovine TSH was administered to this patient at the 114th day, so as to study the effect of exogeneous TSH on serum Tg. Serum Tg reached a maximal peak at the 24 hr. after bovine TSH injection. The maximal increase of serum Tg above baseline was 221%. Despite complete removal of the thyroid gland, the increase in serum Tg after thyroidal stimulation with endogenous and exogenous TSH was observed in the patient. In addition, the increase in serum Tg after bovine TSH injection was also observed in two patients with differentiated thyroid carcinoma who underwent a total thyroidectomy and had only metastatic tissue. These results indicate that the elevated serum Tg was released from metastatic tissue by TSH. The present study demonstrates direct evidence that metastatic tissue from thyroid carcinoma is responsive to TSH...
 ...
PMID:[A radioimmunoassay for the measurement of thyroglobulin in human serum and its application to clinical study (author's transl)]. 63 80

One hundred twenty-five patients with a history of prior irradiation to the head and neck region for benign disease underwent thyroidectomies between 1967 and 1976 at Evanston Hospital. One hundred twenty-four had a palpable abnormality. Forty-two had carcinoma, and nine of these had nodal metastases. Palpation was found to be more accurate than thyroid isotope scan in finding carcinoma within an abnormal gland. Some form of irradiation thyroiditis was found in one half of the resected specimens.
 ...
PMID:Thyroid disease following irradiation for benign conditions. 84 45

A study of the clinical, biochemical and histological findings of 57 patients with medullary thyroid carcinoma (MCT) in Norway, is presented. The diagnosis was established by light and electron microscopy and by measurements of immunoreactive calcitonin (iCT) in serum. The major factor influencing the prognosis was the extension of the disease at presentation. None of the 24 patients with tumour confined to the thyroid gland have died of the disease, and serum iCT was normal in 15 patients. Of 19 patients with regional lymph node metastes only 11 are alive 1 to 14 years after treatment, and of these 9 had increased serum iCt. 14 patients technically inoperable and/or with distant metastases, 12 have died of MCT, 1 are alive with elevated serum iCT. Of 14 patients with raised serum iCT, 8 have no clinical recurrence of the disease from 1 to 15 years after the operation. MCT-associated diseases were found in 8 patients, chronic thyroiditis in 10. Serum iCT was measured in 249 relatives of 42 patients, and abnormal elevations were found in 11 members of 6 families.
 ...
PMID:Medullary carcinoma of the thyroid in Norway. Clinical course and endocrinological aspects. 98 24

At the University of Chicago Hospitals, 40 per cent of patients with a history of irradiation to the neck and a palpable thyroid abnormality have been found recently to have carcinoma of the thyroid at operation. In a study of 100 unselected patients with a history of neck irradiation, 26 had palpatory abnormalities and seven of 15 who were operated upon had carcinoma of the thyroid. Five of these lesions demonstrated evidence of local invasion or lymph node metastases. This prevalence rate of carcinoma of at least 7 per cent in irradiated patients is the highest yet reported. These facts have led us to take a very aggressive position in the treatment of these patients. All patients must be examined carefully. When any palpatory abnormality is present which cannot be explained convincingly by thyroiditis, the patient should be operated upon. Total or near-total thyroidectomy should be performed in each patient by a qualified neck surgeon. In cases of proved carcinoma, a modified radical neck dissection should be added if cervical lymph nodes are clinically involved with tumor. Postoperative thyroid hormone suppression is mandatory and ablation of any residual iodine uptake in the neck or elsewhere by radioactive iodine is advocated. If treatment is aggressive, an excellent prognosis can be expected. However, deaths do occur from this disease. It is imperative that each of us be aware of this disease entity and that we treat these irradiated patients appropriately.
 ...
PMID:Recent developments in radiation-induced carcinoma of the thyroid. 125 1

Postmortem morphologic examination of the thyroid was performed in 122 residents of the Minsk Region, Byelorussian Republic. Various pathology underdiagnosed during life was found in 68%. Fourteen papillary carcinomas were detected in 11 (9.9%) of cases whereas 27 (22.1%) subjects revealed 46 follicular adenomas. Nodular goiter was established in 52.5%, thyroiditis--6.5% and cancer metastases--in 5.7% of cases. The male/female ratio for microcarcinoma was 8:3. All tumor-bearing subjects were over 41 years of age. Occurrence of the occult thyroid pathology in different regions of the country can be used to compare potential radiation and other hazards.
 ...
PMID:[Latent cancerous pathology of the thyroid]. 130 Jul 85

The role of elective completion thyroidectomy after lobectomy for differentiated thyroid cancers remains controversial. The potential benefit of tumor removal by the second procedure is considered by some to be overbalanced by a prohibitive operative morbidity rate. During a 20-year period at the University of Chicago Medical Center, 26 patients underwent completion thyroidectomy within a 6-month period of the original thyroid operation. This group represents 8% of the 326 patients who underwent surgery during that time for differentiated thyroid cancer (269 papillary and 57 follicular). Of the 26 patients, 18 had papillary and eight had follicular cancers. The average size was 2.5 cm, with 24 of 26 being greater than 1 cm in diameter. At the first operation, 81% of tumors were intrathyroidal. Eight percent had lymph node metastases and 12% manifested local invasion. Tumor was found in eight (31%) of 26 of the reoperative specimens. The incidence of tumor did not vary by histologic type but did differ according to the extent of the original operation. Cancer was found in 50% (three of six) of those who had undergone previous partial lobectomy, in 33% (five of 15) of those after a total lobectomy, and in none of five who had undergone a prior bilateral (although incomplete) thyroid resection. One permanent recurrent nerve injury occurred at the first operation. No additional recurrent nerve injuries or hypoparathyroidism occurred as a result of the second operation. Finally, no disease characteristic of the initial tumor (e.g., size, clinical class, tumor capsular invasion, multifocality, thyroiditis, or extrathyroidal tumor invasiveness) predicted the presence or absence of tumor on the second side. We conclude that completion thyroidectomy is appropriate for patients with lesions 1 cm or greater who have undergone lobectomy or less at the original operation, because 40% of such patients would be expected to have residual cancer. With care, this operation can be performed with minimal morbidity.
 ...
PMID:Second operations for "completion" of thyroidectomy in treatment of differentiated thyroid cancer. 174 81

The clinical behavior and mortality rate of papillary carcinoma of the thyroid varies widely, and clinically insignificant microscopic foci of the disease are frequently found. Dietary iodine and radiation to the head and neck in childhood play a role in etiology. Needle aspiration cytology provides a highly accurate diagnosis. Ultrasound, radioactive iodine, and technetium scans are not specific and should only be used to complete diagnostic studies when aspiration cytology is negative for papillary carcinoma. The most important aspect of prognosis of an individual patient with papillary carcinoma of the thyroid is the age at which the disease is diagnosed, with an excellent prognosis, even in advanced primary disease or extensive lymph node involvement, in children and young adults. A multifactorial clinical risk group definition (AMES) is easy to use and reliably separates patients into low risk and high risk. Since 90% of patients with this disease rarely have metastases or late complications from the cancer, total or subtotal thyroidectomy is necessary in only 10% of cases for later use of postoperative radioactive iodine. More conservative surgical procedures are advised in low-risk patients. Papillary carcinoma incidentally found during operation for other conditions such as Graves disease or thyroiditis and reported first on the permanent pathology reports are always clinically insignificant and completely cured by removal; total thyroidectomy should be completely avoided. Postoperatively, thyroid hormone supplementation may be unnecessary after relatively conservative surgery in selected low-risk patients. Thyroid hormone must be maintained permanently after total or subtotal thyroidectomy.
 ...
PMID:Papillary carcinoma of the thyroid. 203 44

During a period of 20 years (1965-1985), 206 consecutive patients were operated on for radiation-associated nodular thyroids. The ages ranged between 8 and 76 years (mean 38.7). there were 136 women and 70 men. The average duration between radiation exposure and operation was 27 years. The operations performed were total thyroidectomy (192) or, in patients who had undergone a previous lobectomy in another institution, another lobectomy (14). In addition, 25 patients required a neck dissection for nodal metastases and 27 underwent simultaneous subtotal parathyroidectomy for coexistent hyperparathyroidism. The pathologic findings were: 87 (42.2%) carcinoma (73 papillary, 13 follicular, 1 undifferentiated); 92 (44.7%) follicular adenomas; and 27 (13.1%) thyroiditis. To date, with an average follow-up of 6 years (0.5-31 years), only two patients have expired from recurrent disease. A third died of unrelated cause. A comparison of the first 100 patients (12 years) with the last 106 patients (8 years) demonstrated that the incidence of carcinoma has dropped from 48 to 37%, the incidence of lymph node metastases has decreased from 35 to 26%, and the incidence of bilaterality has fallen from 75 to 54%. On the basis of this series, it was concluded that total thyroidectomy is still indicated for radiation-associated nodular thyroids. However, if the trend of decreasing incidence, bilaterality, and metastatic disease persists, this approach may have to be reevaluated in the near future.
 ...
PMID:Total thyroidectomy in irradiated patients. A twenty-year experience in 206 patients. 293 Oct 54


1 2 3 4 5 6 7 Next >>