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)

Synchronous occurrence of medullary and papillary carcinoma of the thyroid gland is very rare. We describe two cases of synchronous medullary and papillary carcinoma of the thyroid. In both cases, medullary carcinoma and papillary carcinoma were separate in the thyroid but mixed in some of the lymph node metastases. A review of the literature and our own cases revealed that composite medullary and papillary carcinoma metastases in the lymph nodes is a common feature of patients with synchronous medullary and papillary carcinoma of the thyroid gland.
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PMID:Composite metastatic carcinoma in lymph nodes of patients with concurrent medullary and papillary thyroid carcinoma: a report of two cases. 1506 80

We describe a rare case of solitary metastasis of follicular carcinoma of the thyroid gland into the petroclival region in a 58-year-old woman. The metastasis was the first and only manifestation of the disease. The histology of the tumor, differential diagnosis and clinical course are discussed. In a few similar cases described so far the tumor was always a well or moderately differentiated follicular carcinoma located in the petroclival region. As in this presentation, these cases also clinically mimic a meningioma. The differential diagnosis includes adenoma of the thyroid gland and thyroid gland dystopia. We demonstrated the primary focus of carcinoma within the thyroid after its detailed examination initiated by our finding. The clinical outcome of such rare cases is usually excellent, much better than in metastases of papillary carcinoma into the brain.
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PMID:Solitary intracranial metastasis of follicular carcinoma of the thyroid gland clinically mimicking a meningioma. 1523 20

Thyroid carcinoma is a rare disease in children, and is mostly of the papillary histological type. It is often extended at presentation with frequent lymph node metastases. Treatment includes surgery (total thyroidectomy and lymph node dissection) and radioiodine therapy in case of extensive disease. Life long thyroxine treatment is given to all patients and when carefully controlled is devoided of adverse effects. Long term prognosis is favorable, but a few deaths have been reported some decades after initial treatment. Adverse prognostic indicators are younger age at discovery and presence of distant metastases.
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PMID:Follicular-cell derived thyroid cancer in children. 1525 Nov 53

Adhesion of tumor cells to the extracellular matrix (ECM) is a crucial step for the development of metastatic disease and is mediated by specific integrin receptor molecules (IRM). The pattern of metastatic spread differs substantially among the various histotypes of thyroid cancer (TC). However, IRM have only occasionally been characterized in TC until now. IRM expression was investigated in 10 differentiated (FTC133, 236, 238, HTC, HTC TSHr, XTC, PTC4.0/4.2, TPC1, Kat5) and two anaplastic TC cell lines (ATC, C643, Hth74), primary cultures of normal thyroid tissue (Thy1,3), and thyroid cancer specimens (TCS). Expression of 16 IRM (beta1-4, beta7, alpha1-6, alphaV, alphaIIb, alphaL, alphaM, alphaX) and of four IRM heterodimers (alpha2beta1, alpha5beta1, alphaVbeta3, alphaVbeta5), was analyzed by fluorescent-activated cell sorter (FACS) and immunohistochemical staining. Thyroid tumor cell adhesion to ECM proteins and their IRM expression in response to thyrotropin (TSH) was assessed. Follicular TC cell lines presented high levels of integrins alpha2, alpha3, alpha5, beta1, beta3 and low levels of alpha1, whereas papillary lines expressed a heterogenous pattern of IRM, dominated by alpha5 and beta1. ATC mainly displayed integrins alpha2, alpha3, alpha5, alpha6, beta1 and low levels of alpha1, alpha4 and alphaV. Integrin heterodimers correlated with monomer expression. Evaluation of TCS largely confirmed these results with few exceptions, namely alpha4, alpha6, and beta3. The ability of TC cell lines to adhere to purified ECM proteins correlated with IRM expression. TSH induced TC cell adhesion in a dose-dependent fashion, despite an unchanged array of IRM expression or level of a particular IRM. Thyroid carcinoma cell lines of different histogenetic background display profoundly different patterns of IRM expression that appear to correlate with tumor aggressiveness. In vitro adhesion to ECM proteins and IRM expression concur. Finally, TSH-stimulated adhesion of thyroid tumor cell lines to ECM may not be associated with altered IRM expression.
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PMID:Differential pattern of integrin receptor expression in differentiated and anaplastic thyroid cancer cell lines. 1618 9

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

The author analyses a group of 2917 patients with papillary carcinoma of the thyroid gland, on 2210 of them (75.5%) a modified neck dissection was performed, 268 (9.2%) underwent central lymphodissection, in 449 (15.3%) the lymph nodes were not ablated. The signs correlating with the presence of regional metastases are discussed. The influence of the tumor size, invasion of the surrounding tissues and the presence of regional metastases on the prognosis for life and recovery is considered. Advantages of the modified cervical dissection which is thought to be the best method for treatment of a local recurrence of papillary carcinoma, safe and followed by a minimal number of complications when fulfilled by an experienced surgeon are discussed.
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PMID:[The influence of regional metastases on prognosis in papillary cancer of the thyroid gland]. 1679 15

We describe the case of a 37-year-old male patient suffering from papillary carcinoma of the thyroid gland with pulmonary metastases who after total thyroidectomy on 29/07/1998 was submitted to three treatments with high doses of (131)I and studied as to the whole body clearance of (131)I by measuring the dose rate of (131)I. The patient was referred to us for total ablation of post surgery remnant of thyroid tissue on 19/09/1998. Due to lymphadenic metastases and high Tg values: 450 ng/ml, he was purposely given therapeutically a high dose of 5146 MBq (131)I. On the whole body post-operative scintiscan that followed, a diffuse uptake of (131)I in the lungs and in the thyroid remnant was found. The patient was given 7307 MBq (131)I after 7 months and 5154 MBq of (131)I after another 10 months, because Tg was increased. Whole body scintiscan after the third treatment as mentioned above, showed poor uptake of (131)I in the thyroid gland area and in the lungs. No side effects were noticed, Tg fell to 4.5-7 ng/ml and the patient was in good condition with no abnormal findings on the X-rays or CT of the thorax. After iodine administration whole body measurements of the dose rate of the clearance of (131)I measured by an ionization chamber at a distance of 2 m from the thorax, were performed. For the first treatment effective half-lives of (131)I of the patient, as measured for the two components of the clearance curve, were 4.4 h and 16.8 h respectively. For the second and third treatment clearance curve had only one component and effective half-lives were 22.5 h and 11 h respectively. Remaining activity of (131)I at 48 h was for the first, second and third treatment: 13.3% (685 MBq), 22.8% (1670 MBq) and 4.2% (222 MBq) respectively. We do not know any similar case in the literature with whole body measurements of (131)I clearance in patients undergoing repeated (131)I treatment as above, especially with diffuse pulmonary uptake of (131)I indicating metastatic lesions after the first treatment of (131)I post total thyroidectomy. The interest of the above case also lies on the fact that there were three successive treatments with (131)I and three whole body (131)I measurements. Clearance rate indicated the need for additional treatment and the treatment followed was successful.
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PMID:Whole-body (131)I washout in a patient with metastatic well-differentiated papillary thyroid carcinoma treated with repeated (131)I administration. 1686 37

Thyroid cancer (TC) is the commonest endocrine malignancy. In the overwhelming majority of cases, thyroid carcinomas are well-differentiated malignancies that respond favorably to treatment; however, this outcome cannot be absolutely guaranteed. The absence of large prospective randomized clinical trials in TC-due to its low incidence and protracted clinical course in cases with persistent/recurrent metastatic disease-results in considerable debates regarding the optimal treatment and follow-up regimens in this malignancy. Some of these debates originated several decades ago, yet are still ongoing despite interim advancements in other domains of oncology. Here we discuss what we believe are the issues of major controversy in TC; these are mentioned in the following non-exhaustive list: (i) the optimal management of solitary and multiple thyroid nodules; (ii) the role of basal calcitonin measurements in the diagnostic investigation of nodular thyroid disease; (iii) the extent of the initial operation after establishment of the diagnosis of TC; (iv) the intensity and frequency of radioactive iodine (RAI; (131)I) therapies (especially in patients with persistent/recurrent metastatic disease); (v) the degree and duration of long-term thyroid hormone suppression therapy (THST) required for optimal outcomes in TC patients; (vi) the optimal management of patients with RAI-refractory disease or other "high-risk" clinicopathologic features; and, finally, (vii) the optimal algorithm for lifelong follow-up of TC patients after their initial treatment. We present elements of the above controversies as pertinent to the various types of TC. We have opted for breadth rather than depth of commentary, at the same time providing the reader with extended up-to-date bibliography.
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PMID:Unresolved issues, dilemmas and points of interest in thyroid cancer: a current perspective. 1698 89

Iatrogenic vascular traumas are increasing and their proportion exceeds 40% of all vascular injuries. We report on a rare case of iatrogenic injury of the brachiocephalic arterial trunk during surgical intervention due to postirradiation arteriopathy, which was successfully treated with a silver prosthesis graft. A 58-year-old male underwent surgery for metastases of papillary carcinoma of the thyroid gland, located in lymph nodes adjacent to the right common carotid artery and right subclavian artery. During the surgery, there was an intraoperative injury of the brachiocephalic arterial trunk that included spontaneous rupture and tear of the subclavian and common carotid artery, as the result of extreme fragility of the arterial wall, probably due to the previous irradiation therapy. Emergency sternotomy and clavicle resection were followed by blood flow reconstruction by use of an Y prosthesis that was applied for terminoterminal anastomosis between the brachiocephalic trunk to common carotid artery and subclavian artery. The authors concluded that irradiation therapy may lead to progressive arteriopathy in affected arteries.
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PMID:[Iatrogenic injury of the brachiocephalic arterial trunk and its branches--case report]. 1721 8

We report a case of follicular carcinoma of the thyroid gland with concurrent tuberculous lymphadenitises as neck lymph node metastases of thyroid carcinoma. A 71-year-old woman presented with multiple painless masses in the thyroid gland and painless lymphadenopathies in the right neck. She and her family had no previous history of tuberculosis. A diagnosis of thyroid cancer with lymph node metastases was made, and the patient underwent total thyroidectomy with neck dissection. Lymph nodes were hard and severely adhered to the internal jugular vein. The histopathological diagnosis was follicular carcinoma and multiple nodes of adenomatous goiter of the thyroid gland, and tuberculous lymphadenitises of lymph nodes in the right neck. There was no findings of coexisting pulmonary tuberculosis. The possibility of coexisting tuberculous lymphadenitis must thus be ruled out when we find painless lymph node swelling in aged patients with head and neck cancer including thyroid cancer.
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PMID:[A case of follicular carcinoma of thyroid gland with concurrent tuberculous lymphadenitises]. 1730 97


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