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)

Thyroid papillary carcinoma, exceptionally, can appear with cervico-lateral metastases in absence of thyroid evident disease. In that case we can have an infected branchial cyst, therefore is very important a correct preoperative diagnosis with FNAB. In literature were described 30 cases of cervico-lateral cystic masses that the histology revealed as occult papillary carcinoma metastases. Our experience is about 80 cases of papillary carcinoma, in only 2 cases the cancer was evident as a tight-elastic tumour in cervico-lateral region, hypoechogenic to the US scan with irregular and thick wall: one of the patient had multinodular goiter; the other one didn't have clinical of US scan character of thyroid disease. FNAB on lymph nodes shows doubtful cells evidence. Both patient had a total thyroidectomy with functional cervico-lateral and MAS lymphadenectomy. In one patient histology showed a papillary carcinoma of 4 mm in the right lobe, in the other patient the cancer was unknown. FNAB, in all doubtful cases, is the most important diagnosis test.
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PMID:[Isolated cystic cervical lymphatic metastasis from occult papillary carcinoma of the thyroid: unusual and rather difficult diagnosis]. 1100 6

Familial medullary thyroid carcinoma only is related to germline mutations in the protooncogene RET, mainly in exons 10, whereas noncysteine mutations (exons 13-15) are considered infrequent. We analyzed 148 patients from 47 familial medullary thyroid carcinoma only families, and we found noncysteine RET mutations in 59.5% of these families. Of the index cases with noncysteine mutations, 43.4% presented with a multinodular goiter and high basal calcitonin; they were older at diagnosis than those with mutation in exon 10 and had more multifocal medullary thyroid carcinoma, but no difference in size, bilaterality, presence of C cell hyperplasia, or nodal metastases was found. Gene carriers with noncysteine RET mutations had a lower incidence of medullary thyroid carcinoma (78.2% vs. 94.1%) than those with mutation in exon 10; 20.2% had C cell hyperplasia only, although thyroidectomized at an older age. In conclusion, familial medullary thyroid carcinoma with noncysteine RET mutations are not infrequent and are overrepresented in presumed sporadic medullary thyroid carcinoma, suggesting that RET analysis should routinely be extended to exons 13, 14, and 15. The phenotype is characterized by a late onset of the disease, suggesting a delayed appearance of C cell disease rather than a less aggressive form. In familial medullary thyroid carcinoma gene carriers, the optimal timing for thyroidectomy remains controversial. Based on these data, we propose that surgery should be performed before elevation of the basal calcitonin level, potentially as soon as the pentagastrin test becomes abnormal.
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PMID:Familial medullary thyroid carcinoma with noncysteine ret mutations: phenotype-genotype relationship in a large series of patients. 1150 6

Kidney metastases from thyroid cancer are rare. We report two such patients and demonstrate that the in vivo 131I uptake by the kidney metastasis is associated with high levels of sodium iodide (Na+/I-) symporter (NIS) expression in the first case. Case 1: A 61-year-old woman with papillary thyroid carcinoma-follicular variant (PTC-FV) presented with scapular metastasis. After thyroidectomy and scapulectomy, a 131I posttherapy scan showed left upper quadrant uptake. A 3.0-cm metastatic PTC-FV deposit was removed by partial nephrectomy. Case 2: A 53-year-old woman presented with back pain. A computed tomography (CT) scan showed a 3.5-cm renal mass, a multinodular goiter, and lung metastases thought secondary to a renal cell carcinoma. A unilateral nephrectomy revealed metastatic PTC-FV. After thyroidectomy, a 131I posttherapy scan showed lung and skeletal metastases. NIS immunoreactivity in tumoral tissue was strongly positive in the primary tumor, shoulder, and kidney metastasis in case 1, as well as in the primary tumor in case 2. Spotty, low-level NIS expression was observed in the kidney metastasis in case 2. In conclusion, kidney metastases of PTC-FV may occasionally retain adequate levels of NIS expression, enabling their detection during life. Thus, intense uptake in the abdomen during 131I imaging should not be assumed to be physiological gastrointestinal tract residual radionuclide activity.
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PMID:Renal metastases from thyroid papillary carcinoma: study of sodium iodide symporter expression. 1152 75

Mucoepidermoid carcinoma (MEC) of the thyroid gland is a rare neoplasm with 40 cases reported in the world literature to date. Controversy surrounds the treatment of this rare neoplasm. It has been described as a low-grade indolent tumor that rarely metastasizes and only recurs locally without morbidity. Suggested treatment has consisted of a lobectomy or subtotal thyroidectomy. We report a case of a 63-year-old woman with a 15-year history of a multinodular goiter with a dominant left lobe nodule. Fine-needle aspiration was inconclusive. The patient opted for a total thyroidectomy. Final pathology yielded a diagnosis of mucoepidermoid carcinoma. We propose that despite its low-grade appearance the morbidity and mortality associated with its ability to locally recur and metastasize justify the need for more aggressive surgical therapy.
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PMID:Mucoepidermoid carcinoma of the thyroid gland: a case report and suggested surgical approach. 1160 57

We report herein the case of a 43 year-old man who was operated 1998 of left colectomy and hepatic resection for colic adenocarcinoma metastasized in the liver. He suffers of multinodular goiter from some years; was admitted to our hospital with a 2-month history of enlargement of goiter and appearance of a new nodule. Physical and imaging examinations disclosed a new nodules in the thyroid. Was operated of total thyroidectomia and lymphoadenectomia cervical in the December 2002. Hystologic examinations revealed adenocarcinoma which was consistent with a diagnosis of metastases from the primary colon adenocarcinoma to the thyroid. The rarity, diagnosis, and prognosis of thyroid metastasis from colon carcinoma are discussed.
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PMID:[Metastatic thyroid tumors from adenocarcinoma of the colon: clinical and anatomo-pathological contribution]. 1290 99

A forty-five-year-old female patient presented with thyroid nodules eight years after radical nephrectomy for renal cell carcinoma (T2N0M0, grade 2, clear cell subtype) in the right kidney. Ultrasonography of the neck showed multiple hypoechoic macronodules. There was no lymphadenomegaly. During total thyroidectomy following an initial diagnosis of multinodular goiter, frozen section analysis was made, which showed metastasis from renal cell carcinoma. Immunohistochemical studies demonstrated that the tumor cells were negative for thyroglobulin staining. No recurrences or other metastatic disease were seen during a follow-up period of 12 months. Although clinically the thyroid gland is a rare site for tumor metastasis, this possibility should be kept in mind in patients with a previous history of renal cell carcinoma.
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PMID:Thyroid metastasis from renal cell carcinoma eight years after radical nephrectomy: a case report. 1554 44

Radioiodine ((131)I) treatment for multinodular toxic and non-toxic goiter is therapeutic procedure especially used in patients with contraindication for surgery. (131)I treatment diminishes the size of the goiter and treats hyperthyroidism. Sometimes, due to low radio-iodine uptake (RAIU), this procedure should not be used. In patients with goiter, the elimination of medication or substances rich in iodine is the first step to increase RAIU. Recombinant TSH (rhTSH) enhances RAIU in metastases distant from thyroid cancer. Studies were performed in recent years using rhTSH to increase the radio-iodine uptake in multinodular toxic and non-toxic goiter. These methods led to enhanced radio-iodine uptake, decreased the level of activity of the (131)I administered, changed the distribution of (131)I in the thyroid, lowered the absorption dose, and increased the number of patients with hypothyroidism. The uses of rhTSH can lead to exacerbation of the signs and symptoms of hyperthyroidism, so patients should be hospitalized. Until now there has been no evidence that the adverse effects outweigh the positive results of using rhTSH. The use of rhTSH in benign goiter disease is not yet approved, but its positive activity in multinodular goiter is very interesting and promising.
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PMID:[The use for recombinant human TSH in patients with toxic and non-toxic nodular goiter]. 1592 2

Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid cancer measuring less than 10mm in its greatest diameter. It is the most common form of thyroid cancer, detected in up to 36% in autopsy studies. The wide availability and use of neck ultrasonography in the evaluation of carotid arteries and of the thyroid resulted in an increased detection of PTMC. PTMC is often multifocal. The diagnosis is usually based on a combination of clinical examination, laboratory investigations, and specialized radiological techniques (mainly neck ultrasonography combined with fine-needle aspiration cytology). A common scenario is the diagnosis of PTMC as an incidental finding following thyroidectomy for a presumably benign thyroid disease. Despite some controversy, most authors agree that PTMC should be treated by total or near-total thyroidectomy, provided it can be performed safely. Because of its many and major advantages, in our clinical practice, total or near-total thyroidectomy is the procedure of choice for the management of PTMC. Given the high incidence of PTMC as an incidental finding and the frequent multi-focality, we also favor total or near-total thyroidectomy for the surgical management of nodular thyroid disease (multinodular goiter or dominant presumably benign thyroid nodule/s). Despite some controversy, we perform central neck lymph node dissection electively, in the presence of cervical lymphadenopathy. Radioiodine ablation therapy may be used as an adjuvant therapy. Prognostic factors (such as tumor multicentricity, positive lymph nodes, capsular or vascular invasion) or scoring systems (such as the AMES) can be used to select patients for radioiodine adjuvant therapy. Suppression therapy is needed after surgical management. Despite the potential for neck lymph node and even distant metastases, the biological behavior of PTMC is in general benign and the prognosis is very good.
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PMID:Papillary thyroid microcarcinoma: a surgical perspective. 1600 55

Hemangioendotheliomas of the thyroid are neoplasms that are rarely encountered in the Alpine region in Europe. The endemic goiter in this iodine-deficient region can be considered as a predisposing factor. We report the second case of an epithelioid hemangioendothelioma (EHE) of the thyroid gland and the first clinical case with malignant behavior. A 73-year-old woman with a long history of multinodular goiter presented with a rapidly growing thyroid mass, free of distant metastases. A total thyroidectomy was performed. Histologically the lesion had characteristic epithelioid and spindle cell proliferation in a background of chondromyxoid stroma. Cytoplasmic vacuolization in the epithelioid and spindle cells were present. Tumor cells were positive for factor VIII-related antigen, MNF116, PAN-ceratin, CD 34, and CD 31 and negative for cytokeratin allowing the diagnosis of EHE. Nine months after the primary resection the tumor locally recurred. A palliative resection was performed in a second operation followed by interferon-alpha therapy. The patient rapidly developed a second local relapse and died 13 months after the diagnosis of an EHE had been made. An improvement of the very poor prognosis of this rare tumor may depend on early tumor diagnosis and surgery combined with a multimodal treatment.
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PMID:An authentic malignant epithelioid hemangioendothelioma of the thyroid: a case report and review of the literature. 1640 12

Thyroid carcinoma is an uncommon malignancy in the first two decades of life. It presents as a solitary thyroid nodule, multinodular goiter or as a long standing painless neck mass or both. Pediatric patients with thyroid carcinoma tend to present with more advanced disease than adults and have higher recurrence rates. The majority of all thyroid carcinomas in children and adolescents are of the papillary type. Surgery is the initial treatment, but the optimal surgical management is controversial. Ablation therapy with radioactive iodine, in order to destroy any thyroid remnant, and thyroxin therapy follow surgery. The prognosis even in cases with distant metastases is relatively good. Follow up should be performed at regular intervals and includes clinical examination, measurement of serum thyroglobulin levels, whole body scintigraphy and neck ultrasonography. As follow up is life long the care of these patients should be passed on to an adult endocrinologist. The consequences in adult patients with a history of childhood thyroid carcinoma should be evaluated.
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PMID:Differentiated thyroid carcinoma in children and adolescents: clinical course and therapeutic approach. 1644 84


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