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

A direct radioimmunoassay for human serum thyroglobulin (TG) has been developed. The lower limit of detection of the assay was 7.5 ng/ml. The serum values in normal subjects were between 0 and 44 ng/ml (n = 34, 21 female subjects, 13 male subjects). In 22 of the 34 subjects, TG was not detectable. The mean value of TG in a group of 19 subjects with multinodular goiter was 115.8 +/- 62.7 ng/ml (mean +/- SD). A group of 16 thyrotoxic individuals also had an elevated TG concentration (107 +/- 71 ng/ml). The serum TG levels in 6 patients with differentiated thyroid carcinoma with metastases were much more elevated than in any other clinical situation (3430 +/- 1100 ng/ml). In patients with thyroid cancer in clinical remission (n = 9), the TG levels were normal. In 2 patients with non-differentiated thyroid tumors, TG was not detectable. The major methodological problem in TG determination is the presence of anti-TG autoantibodies which may interfere with the radioimmunoassay.
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PMID:[Clinical value of human thyroglobulin measurement]. 53 48

In a surgical series of 277 consecutive patients operated on the thyroid for benign diseases, a high prevalence rate (10.5%) of occult papillary carcinoma was found by means of an accurate histologic examination. Indications for surgery were euthyroid multinodular goiter in 25 patients, autonomously hyperfunctioning adenoma in 2 and Graves' disease in 2 patients. Neoplastic foci were unilaterally found in 25 cases but multifocally in 6 and bilaterally in 4 cases: the diameters ranged from 2-10 mm. After operation (14 subtotal and 15 total thyroidectomies), all patients received TSH-suppressive doses of T4. At a mean follow-up of 5.6 years, neither local recurrences nor lymph node or distant metastases had occurred; no patient died of the tumor. In keeping with other surgical and autopsy series, the prevalence of occult thyroid carcinoma in a normal population is calculated to be about 5-10%, whereas it is known that the prevalence of clinically evident thyroid cancer is only 0.05%. This means that only 1-2% of occult carcinomas may evolve in an overt tumor during life. In view of such an epidemiologic difference and the favorable course of our patients, although the mean follow-up is rather short, we suggest that lobectomy plus T4 treatment may be considered an adequate therapeutic approach in patients with occult papillary thyroid carcinoma.
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PMID:High prevalence of occult papillary thyroid carcinoma in a surgical series for benign thyroid disease. 236 70

The epidemiological data of thyroid carcinoma are difficult to evaluate. Several variables influence the biologic behaviour and the great number of occult papillary carcinomas obscure the picture. Among our 1116 patients we found as first symptoms solitary nodules in 41,4% being localized in differentiated carcinomas significantly more frequently in the right than is the left lobe. Multinodular goiter was seen in 24,2%, cervical lymph nodes in 10,9% and distant metastases in 3,2%. In medullary carcinoma cervical lymph nodes were seen in 27% and thus the second most frequent leading symptom. Together with sonography, thyroid scan and fine needle biopsy it is possible today to assure preoperatively at a high degree the diagnosis. A differentiated therapy is generally applied taking into account the particular prognosis of the patient, especially in papillary carcinoma. A more radical initial treatment is necessary in follicular carcinoma. In medullary carcinoma only the thyroidectomy without radiation has been proven as effective means.
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PMID:[Thyroid cancer: new knowledge and therapeutic strategy in an endemic area]. 329 28

Patients with multinodular goiter or related thyroid disorders rarely have acute airway distress due to tracheal deviation or compression. However, our institution cares for a large number of patients with untreated multinodular goiters, and in the progression of this disorder, tracheal deviation and airway problems are relatively common. During the past 4 years, we have cared for 24 patients who were admitted with acute, life-threatening airway distress that required emergency intervention. Nine patients had emergency intubation, the remaining 15 had stridor on admission and underwent emergency operations. The series consists of 19 females and five males whose ages ranged from 37 to 89 years. Only four patients had malignant thyroid lesions (two papillary-follicular, two anaplastic), and two of these had multiple pulmonary metastases. Fifteen of the patients with multinodular goiters had a mediastinal extension that led to marked tracheal deviation. Three patients had recurrent multinodular goiters decades after previous surgery. Twenty-one patients underwent surgery at our institution, and all did well. Only one patient required sternotomy for thyroidectomy. Two patients required tracheostomy procedures, one because of tracheomalacia and the other because of poor pulmonary reserve. Interestingly, two patients had acute symptoms when in their third trimester of pregnancy. We have routinely used the laryngoscope (fiberoptic rigid or flexible) for preoperative and postoperative evaluation of the vocal cords and for determination of the condition of the larynx. On the basis of our experience with acute airway distress, we strongly advocate elective surgery for patients with multinodular goiter at the first sign of tracheal compression, especially if they have mediastinal extension.
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PMID:Acute airway distress due to thyroid pathology. 368 46

Hyperthyroidism was diagnosed in 53 of 273 thyroid carcinoma patients at the time of their first examination (between 1971 and 1983). This corresponds to 19.5% of these mainly well-differentiated thyroid cancers. In 24 (45%) patients the hyperthyroidism and the thyroid carcinoma were two separate distinct illnesses: of 4 patients with Graves' disease (1.5% of 273), 2 had been operated because of an additional solitary cold nodule, and in the other 2 an occult carcinoma was found intraoperatively. Twenty patients of this group had Plummer's disease: there was a malignant cold nodule within a multinodular goiter with multifocal functional autonomy (MFA)(n = 14) or a carcinoma located near the solitary hot nodule of the toxic adenoma (TA)(n = 6). In these patients the distribution of the different histologies was about the same as in other thyroid cancer patients from this region. The remaining 29 patients (55%) had Plummer's disease, 28 with the classical finding of a solitary toxic adenoma, in which the hot nodule and the malignant tumor were identical. It was possible to confirm this identity histologically in 10 out of 24 cases, retrospectively. Eight of these patients had metastases with radioiodine uptake at the time of the first examination. Of the tumors in this group, 24 were follicular and 5 papillary carcinomas. As a rough estimate, one malignant, scintigraphically hot tumor is found for every 50 benign toxic adenomas. Criteria for the differentiation are: recent growth of the nodule, tumor size of greater than 5 cm diameter or greater than 35 g and an elevated T3-level of less than 0.06 nmol/l/g tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hyperthyroidism in thyroid cancer. Retrospective study of 53 cases]. 654 7

Metastatic cancer to the thyroid gland is uncommon. In this report we describe a patient with a malignant fibrous histiocytoma that metastasized to the thyroid, possibly to a preexisting thyroid nodule. A review of the literature reveals that breast and lung carcinoma are the most frequently identified sources of secondary thyroid carcinoma found at autopsy, while renal carcinoma comprises over 50% of secondary thyroid malignancies discovered clinically. A number of authors suggest that preexisting thyroid disease (i.e., multinodular goiter and thyroid nodules) may provide a nidus for metastases to the thyroid gland.
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PMID:Secondary malignancy of the thyroid gland: a case report and review of the literature. 783 66

Anaplastic carcinoma of the thyroid is a highly aggressive neoplasm with quickly total course. It is characterized by an average survival of 4-12 months. It infiltrates precociously into the windpipe, oesophagus, vessels of the neck and gives distant metastases in 10-48% of cases. In 30.8 to 80% of cases, this carcinoma originates in an old multinodular goiter. The hypothesis has been also advanced that this neoplasm could derive from a pre-existent well-differentiated carcinoma. The improvement in diagnostic techniques (especially immunohistochemistry) allows a more correct definition of this neoplasm, permitting a differential diagnosis with other tumours (lymphoma, medullary carcinoma, hemangioblastoma) with which in the past it has been erroneously identified. The results reported in the literature are controversial as regards long-term survival, but usually it is less than one year. Longer survival must lead to the suspicion of wrong diagnosis. A relatively better prognosis is observable in intraglandular forms, "minimi" neoplastic focus and young patients. The presence of regional metastatic lymph nodes doesn't seem to modify the prognosis. Instead, a factor which can condition the prognosis is the type of therapy. Now a days the most efficacious curative treatment is the multinodal one (surgery, radio- and chemotherapy). The best results about survival and quality of life have been obtained using chemo-radiotherapy before operation and chemotherapy after it.
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PMID:[Anaplastic carcinoma of the thyroid: long-term survival]. 815 60

Metastases from differentiated thyroid cancer are usually seen in the cervical or mediastinal lymph nodes, lung or bone. We report a case of papillary thyroid cancer metastasizing to lymph nodes in the porta hepatis. No other site of metastasis was apparent on neck or abdominal exploration or on iodine whole-body scans. The primary tumor was a multifocal papillary thyroid cancer arising on a background of multinodular goiter. The metastasis was observed on a diagnostic radioiodine scan after surgical resection of the primary tumor despite significant (11%) radioiodine uptake by residual thyroid tissue in the neck and was proven by histologic examination and thyroglobulin immunohistochemistry. Although rare, metastasis to porta hepatis lymph nodes should be considered in the differential diagnosis of abdominal radioiodine uptake in patients with differentiated thyroid cancer.
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PMID:Isolated porta hepatis metastasis of papillary thyroid cancer. 868 30

Thyroid hormone production by metastases of differentiated thyroid carcinoma is very rare and its pathogenesis is still unknown. The aim of this study was to present some clinical and demographic evidence that thyroid hormone-producing metastases of differentiated thyroid carcinoma are related to environmental factors, probably iodine deficiency. A cross-sectional study was performed on thirty-five patients with distant metastases, identified in a group of 125 patients with differentiated thyroid carcinoma previously submitted to total or near total thyroidectomy. In 6 patients (5 females, 1 male; age range, 50 to 64 yr) we had evidence that the metastases were actively producing thyroid hormones and in 29 patients (21 females, 8 males; age range 8 to 84 yr) the metastases were considered to be nonthyroid hormone-producing. Serum levels of T3, T4, and thyroglobulin were measured by RIA, TSH by IRMA, and 131I whole-body scintigraphy was performed 72 h after 187 Mbq of 131I. All patients with metastases producing thyroid hormones presented a pure follicular thyroid carcinoma. They also differed from patients with nonproducing metastases in the frequent presence of goiter of long duration as the first clinical manifestation of thyroid disease (p < 0.01), and a higher proportion of patients coming from an iodine deficient area (5/6 vs. 6/29, p < 0.05). In these patients the serum thyroglobulin levels tended to be higher (p = 0.069) as compared with the nonproducing metastases group. In conclusion, a late diagnosis of follicular carcinoma in patients with long-standing multinodular goiter allowed the development of well differentiated and bulky metastases retaining the ability to produce thyroid hormones.
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PMID:Thyroid hormone-producing metastases in differentiated thyroid cancer. 885 87

The aim of a cancer registry is to study the incidence of cancer in a well-determined population and to allow epidemiological research to the setting up of diagnosis and therapeutic strategies. The Belgian Thyroid Cancer Study Group (BTCSG) was founded in 1990. In the present study we report data collected from 1988 to 1995 in 397 patients with a differentiated (papillary and follicular) thyroid carcinoma living in the french-speaking area of Belgium. The sex ratio female/male is 3.5 and the median ages at the diagnosis, is similar (45 yrs, 12-82) in both sexes. Seven cases of thyroid cancer were registered in young patients less than 18 yrs old. Thyroid carcinoma were associated with multinodular goiter in more than 50% cases. Cancer was bilateral in 17%. Papillary histological type accounts for 84% in our series while its diagnosis was established in 45% at early clinical stages (TO-T1). These observations could probably be related with 1) broader indications and more aggressive options for the surgical removal of diffuse multinodular goiter, 2) more sophisticated pathologic examinations that might have led to the detection of a greater incidence of occult carcinomas, incidentally discovered. Lymph nodes metastases were present at the time of diagnosis in 20%, especially in young patients. The risk for local and/or lateral recurrence or distant metastases is significantly related to the size of the tumor, histologically verified lymph node metastases and the values of the EORTC prognostic index (> or = 50) that additionally takes into account the differentiation of the tumor. Considering our short median follow-up time of 25 months, it is currently too early to define if the controversial attitude about the extent of surgery (total thyroidectomy plus I131 or individualized surgery) can also negatively influence the risk for recurrence. In our series, eight patients died of thyroid cancer.
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PMID:[Belgian registry of thyroid cancer. Preliminary epidemiological characteristics revealed by a retrospective study (1988-1995). Belgian Thyroid Cancer Study Group]. 923 37


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