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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We analyzed the regional lymph node metastases of 98 patients with thyroid cancer who underwent bilateral modified neck dissection. Bilateral jugular lymph node metastases were frequent in patients with papillary carcinoma of the thyroid, especially in those patients with obvious carcinoma in both lobes of the gland, cancer arising in the isthmus, clinically detectable bilateral lymphadenopathy, and recurrent thyroid cancer. In patients whose cancer was clinically confined to one lobe, and where there were no obviously enlarged contralateral lymph nodes, the occurrence of contralateral jugular lymph node metastasis was significantly correlated with the contralateral paratracheal lymph node metastasis. The bilateral lymphadenectomy appears to be appropriate in these instances.
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PMID:Bilateral cervical lymph node metastases in well-differentiated thyroid cancer. 234 81

A 52 year-old woman with recurrent thyroid cancer showed an accumulation of Tl-201 chloride in the left side of the neck. This proved to be reflux and retention of Tl-201 chloride in the left internal jugular vein and was verified with a Tc-99m HSA flow study. This phenomenon could be mistaken for metastases of thyroid cancer.
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PMID:Visualization of jugular vein on a thallium-201 scan for thyroid cancer. 274 96

This paper analyses the results of sixty-eight patients with thyroid carcinoma in whom bilateral modified radical neck dissection was performed, and discusses the indications for bilateral modified radical neck dissection. High frequencies of bilateral jugular lymph node metastases were found in eleven patients with obviously widespread involvement of both thyroid lobes, 13 with cancer mainly located in the isthmus, 2 with clinically detectable bilateral or contralateral jugular chain lymph node metastases, and 10 with recurrent thyroid cancer. Bilateral modified radical neck dissection, therefore appears to be indicated for those conditions. On the other hand, lymph node metastases in the contralateral neck were histologically confirmed in 6 out of 27 patients (22 per cent), in whom papillary carcinoma was clinically confined to one lobe, and where there were no obviously enlarged lymph nodes in the contralateral neck. In those patients, the histological confirmation of the contralateral thyroid lobe involvements, and of the contralateral paratracheal lymph node metastasis, appears to be a valid indication for elective contralateral modified radical neck dissection.
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PMID:Indications for bilateral neck dissection in well-differentiated carcinoma of the thyroid. 343 19

Nuclear medicine, ultrasound, CT, and MRI are imaging methods that can be used to evaluate the thyroid gland. All these techniques give structural information about the thyroid gland and show the location and size of thyroid nodules. Nuclear medicine scanning also adds functional information about nodules. In many practices, however, FNA has supplanted imaging methods as the primary method of thyroid nodule evaluation because it is safe, inexpensive, and results in a better selection of patients for operation. Imaging studies are very useful in the setting of recurrent thyroid cancer. Ultrasound is extremely sensitive in the detection of recurrent malignancy in regional cervical lymph nodes and as a guide in performing a biopsy of these nodes. CT is very useful in identifying distant metastases in the chest and abdomen. Nuclear medicine scanning can detect functioning distant metastases when the metastases are from differentiated thyroid cancers. MRI can be used to evaluate the possibility of recurrent thyroid cancer; however, because of its relatively high cost, it is used less frequently than other imaging methods.
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PMID:Thyroid imaging techniques. 822 84

We evaluated the risk of bilateral or contralateral cervical lymph node metastases in 135 patients with papillary thyroid cancer who underwent bilateral neck dissection. We confirmed that bilateral jugular lymph node metastases were frequent in patients with obvious carcinoma in both lobes of the gland, in those with cancers arising in the isthmus, in those with clinically detectable bilateral lymphadenopathy, and in those with recurrent thyroid cancer. However, only 24% of the patients who had cancer clinically confined to one lobe with no bilateral or contralateral lymphadenopathy had histologically detected bilateral or contralateral jugular lymph node metastases. But the occurrence of contralateral jugular lymph node metastases was significantly correlated with both clinical lymphadenopathy in the ipsilateral neck and contralateral paratracheal lymph node metastases. Bilateral lymph dissection might be beneficial for these patients.
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PMID:Risk of bilateral cervical lymph node metastases in papillary thyroid cancer. 844 Dec 71

The receptor tyrosine kinase proto-RET is believed to contribute to thyroid oncogenesis by activation of its tyrosine kinase either by point mutation or rearrangement. The papillary thyroid cancer cell lines PTC-1113A, L, and R were established from a recurrent thyroid cancer and its metastases. The rearrangement of the proto-ret oncogene in the cell line PTC-1113A is demonstrated by Southern analysis utilizing the probe for rearranged ret that encodes the fusion protein H4/tyrosine kinase. In contrast, rearranged ret alleles were not found in the cell lines that developed from metastases, nor in DNA isolated from the recurrent tumor. The cell line PTC-1113A may represent a population of tumor cells that gained a growth advantage due to rearranged ret. This is the second human thyroid cancer cell line harboring rearranged ret, and may serve to study the function of ret activation in thyroid cancers.
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PMID:Proto-RET is rearranged in the new human papillary thyroid cancer cell line PTC-1113A. 868 3

The avidity of differentiated thyroid carcinoma for iodine is the basis for the use of radioiodine (131I) both for the detection and the treatment of recurrent thyroid cancer in patients following initial surgical treatment (thyroidectomy). Because recurrence of this type of cancer may be delayed for many years, long-term follow-up is needed. Nowadays such surveillance involves clinical assessment, monitoring of serum thyroglubulin, and, when indicated, whole-body imaging with 131I. Sensitivity of 131I imaging depends on proper preparation of the patient and careful attention to imaging technique. Interpretation of images requires knowledge of physiologic sites of radioiodine concentration and causes of artifacts. Because of the potential suppressive effect of the radiation from a diagnostic administration of 131I on the uptake of a subsequent therapeutic administration (so-called stunning of thyroid tissue) many centers limit the amount given for scanning to 2-3 mCi (74-111 MBq). Several tumor-seeking radioisotopic agents other than radioiodine have shown promise for improving the detection of metastases, and some of these agents offer a useful adjunct to 131I in the management of selected patients, particularly in those with suspected metastatic disease and negative 131I scans.
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PMID:Nuclear imaging in the management of thyroid carcinoma. 893 76

Serum thyroglobulin measurement by immunoassay is used to detect residual or recurrent thyroid cancer after thyroid ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal to attain optimal test sensitivity and interference by antithyroglobulin antibodies. To circumvent these problems, we amplified thyroglobulin messenger ribonucleic acid (mRNA) in peripheral blood using RT-PCR and compared the accuracy of this test to serum thyroglobulin immunoassay in patients with thyroid cancer. Thyroglobulin mRNA was amplified from peripheral blood of 77 patients who had undergone thyroidectomy for well differentiated thyroid cancer, 68 of whom while taking thyroid hormone for TSH suppression. Patient staging was based on the most recent radioiodine scan after thyroid hormone withdrawal. Ten normal control subjects were also studied. Among patients taking T4, thyroglobulin mRNA was detected in 26 of 33 patients with either thyroid bed or metastatic iodine-avid tissue on most recent withdrawal scan (79%), whereas serum thyroglobulin was detected in 12 of these 33 patients (36%; P < 0.001). Thyroglobulin mRNA was detected in 7 of 35 patients (20%) with negative radioiodine scans, 12 of 19 patients (63%) with radioiodine uptake in the thyroid bed, and all 14 patients with metastases, including 2 patients with antithyroglobulin antibodies. Thyroglobulin mRNA was detected in all 10 normal subjects. Epithelioid cells that stained strongly with antithyroglobulin antibodies were identified in blood. Detection of circulating thyroglobulin mRNA is a more sensitive marker of residual thyroid tissue or cancer than immunoassay for serum thyroglobulin, particularly in patients treated with thyroid hormone or who have circulating antithyroglobulin antibodies.
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PMID:Molecular diagnosis of residual and recurrent thyroid cancer by amplification of thyroglobulin messenger ribonucleic acid in peripheral blood. 985 49

Serum thyroglobulin and imaging have been routinely used in the evaluation of thyroid cancer patients suspected of having metastatic or recurrent disease. A more sensitive technique capable of identifying the sites of disease not detected by current imaging methods might improve overall management. The objective in this study was to demonstrate the feasibility of using positron emission tomography (PET) for the detection of recurrent thyroid cancer. Thirty patients with a history of either papillary/follicular or medullary thyroid cancer suspected of having locally recurrent or metastatic cancer on the basis of elevated or rising blood markers were evaluated with PET. Imaging studies were performed with the radiotracer [F-18] fluorodeoxyglucose (FDG). A retrospective review of other imaging results was performed and compared to the PET results. PET was able to identify locally recurrent or metastatic papillary/follicular disease in all 24 patients studied with elevated or rising thyroglobulin. Similar results were obtained in 6 patients with medullary cancer recurrences in the presence of elevated calcitonin. In cases where follow-up data was obtainable (17/24 papillary/follicular cancers and 4/6 medullary cancers), disease was confirmed either directly by surgery and/or indirectly through changes or persistence of laboratory findings. The results support the hypothesis that in the presence of elevated blood markers indicative of recurrent thyroid cancer, PET may prove valuable as an adjunctive imaging test for identifying disease and influencing management in cases where conventional imaging fails to detect suspected disease.
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PMID:Imaging of locally recurrent and metastatic thyroid cancer with positron emission tomography. 1048 73

Solid tumor formation requires the development of a blood supply adequate to meet the metabolic demands of the enlarging tumor mass that cannot be sustained by simple diffusion. One principal stimulant to endothelial cell growth and migration, vascular endothelial growth factor (VEGF), is synthesized and secreted by thyroid cancer cells. Furthermore, VEGF overexpression is associated with an aggressive thyroid cancer phenotype in both animal models and clinical-pathological studies. In other malignancies, elevated serum levels of VEGF often correlate with stage of disease and other poor prognostic clinical features. Therefore, we hypothesized that serum VEGF levels would be significantly higher in patients with persistent or recurrent thyroid cancer than in those cured of the disease. Because TSH stimulates both normal and neoplastic thyroid cells, we also proposed that serum VEGF would be further increased by TSH stimulation. Sixty-nine patients with either papillary or follicular thyroid cancer, status post total thyroidectomy, and prior radioactive iodine ablation, who had undergone routine recombinant human TSH (rhTSH, Thyrogen, Genzyme Transgenics Corp., Cambridge, MA) assisted whole-body radioactive iodine scanning, were included in this study. This cohort (mean age 53 +/- 16 yr, 51% female) included 21 patients with no evidence of disease and 48 patients with local or distant metastases. Stored serum samples obtained for standard Tg determinations before and 72 h following standard rhTSH stimulation were identified and assayed for VEGF 165 (R \[amp ]\ D Systems, Minneapolis, MN). Baseline serum VEGF levels obtained at a time of TSH suppression were significantly higher in patients with known metastatic disease than in those with no evidence of disease (416 +/- 62 pg/ml vs. 185 +/- 25 pg/ml, P = 0.001). Patients with distant metastases had baseline serum VEGF levels that did not differ significantly from patients with only cervical recurrences (455 +/- 90 pg/ml in distant metastases vs. 330 +/- 44 pg/ml for local cervical recurrences). Short-term TSH stimulation, although causing a significant rise in serum Tg, resulted in no significant increase in serum VEGF measured 72 h after rhTSH injection in either the patients with known metastatic disease (416 +/- 62 pg/ml baseline vs. 419 +/- 71 pg/ml after TSH stimulation) or in cured patients (185 +/- 25 pg/ml baseline vs. 191 +/- 33 pg/ml after TSH stimulation). Subgroup analysis revealed that patients with metastatic disease arising from well differentiated primary thyroid cancers had significantly higher serum VEGF levels than patients with metastatic disease arising from poorly differentiated thyroid cancer primaries (485 +/- 74 pg/ml vs. 167 +/- 32 pg/ml, P = 0.003 by ANOVA). Poorly differentiated metastatic thyroid cancers had serum VEGF levels indistinguishable from patients cured of disease (167 +/- 32 pg/ml vs. 186 +/- 25 pg/ml). In summary, serum VEGF is significantly elevated in patients with metastatic differentiated thyroid cancer but not in those with poorly differentiated thyroid cancer metastases. No measurable increase in serum VEGF levels can be detected 72 h after short-term TSH stimulation with rhTSH. We conclude that serum VEGF may serve as a clinical useful marker of residual differentiated thyroid cancer.
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PMID:Serum vascular endothelial growth factor levels are elevated in metastatic differentiated thyroid cancer but not increased by short-term TSH stimulation. 1193 8


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