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)

A 59-year-old man with metastatic renal cell carcinoma developed symptomatic thyroid dysfunction following interleukin-2 (IL-2) and interferon-alpha (IFN-alpha) therapy. Thyroid evaluation prior to this therapy revealed evidence of subclinical Hashimoto's thyroiditis. Symptomatic thyrotoxicosis, including atrial fibrillation, developed after the initial two courses of intermittent intravenous bolus therapy with human recombinant IL-2 and IFN-alpha. At 4 weeks after initiation of immunotherapy, the thyroid antimicrosomal antibody (AMA) titer rose from 1:6,400 to 1:25,600; thyroid-stimulating immunoglobulin was negative. A technetium 99m-pertechnetate thyroid scan obtained while the patient was thyrotoxic showed diminished uptake in a symmetrically enlarged gland. The patient was temporarily treated with propranolol, digoxin, and quinidine. The atrial fibrillation quickly resolved, and thyrotoxicosis abated over the following 5 weeks, while the AMA titer rose further to 1:102,400. By 11 weeks after initiation of immunotherapy, hypothyroidism developed and persisted through two subsequent courses of cytokine therapy at Weeks 16 and 18. The tumor metastases partially responded to the immunotherapy. The patient has remained hypothyroid up to 27 weeks of follow-up. This case history suggests that IL-2 and IFN-alpha therapy may precipitate a fulminant autoimmune thyroiditis syndrome in a vulnerable patient with preexisting autoimmune thyroid disease.
 ...
PMID:Transient thyrotoxicosis and persistent hypothyroidism due to acute autoimmune thyroiditis after interleukin-2 and interferon-alpha therapy for metastatic carcinoma: a case report. 155 92

Thyroid and parathyroid disease after head and neck irradiation in infancy and childhood is well known. Patients irradiated for facial acne were older and received a comparatively lower dose of radiation. These mitigating factors suggest a decreased incidence of thyroid and parathyroid disease in these patients. Over the past 28 years (1961 through 1989), 347 consecutive patients were operated on for radiation-associated thyroid and/or parathyroid disease. One hundred and ten patients in this group were irradiated for treatment for adolescent facial acne vulgaris. The interval between radiation exposure and thyroidectomy ranged from 7 to 57 years (mean, 30 years). The overall incidence of thyroid carcinoma was 31% (34 of 110 patients). Regional metastases in 10 patients (29%) were treated with modified radical neck dissection. Hyperparathyroidism, detected in 31% (34 of 110 patients) of this population, was treated with sub-total parathyroidectomy in all cases. The association of thyroid carcinoma and hyperparathyroidism after adolescent radiation exposure for acne vulgaris appears to be more than coincidental. The incidence of thyroid and parathyroid disease may be independent of the timing and dosage of radiation treatment. These thyroid and parathyroid tumors may develop decades after the initial radiation exposure.
 ...
PMID:Thyroid carcinoma and hyperparathyroidism after radiation therapy for adolescent acne vulgaris. 183 47

Thyroid carcinomas are rare. Papillary carcinomas are the most frequent and preferentially spread via lymphatics. Cervical lymph node metastases are common and may be the presenting sign of the disease, when thyroid carcinoma is occult.
 ...
PMID:[Uncommon presentation of thyroid cancer]. 189 49

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

A total of 1050 patients with differentiated thyroid cancer (DTC) have been followed in the Thyroid Center of Padua by means of serum thyroglobulin (Tg) measured with IRMA method and anti-Tg antibodies (TgAb) assays. Circulating TgAbs were detected in 102 (9.7%) patients. In 32 of these 102, TgAbs were evaluated before and after total thyroidectomy and 131I ablation. In these patients no relationship was found between preoperative serum TgAb levels on the one hand and tumor stage at diagnosis or outcome of the disease on the other. During the follow-up, TgAb serum levels decreased or disappeared in 21 cases considered tumor-free, while they remained unchanged or even increased, in comparison with the preoperative ones, in 11 patients, 5 with proven metastases and 6 considered tumor-free. Evaluating the whole group of 102 TgAb-positive patients, we observed that TgAb serum levels, measured after thyroid ablation, were significantly higher in cases with metastases than in those considered tumor-free (653.0 +/- 196.9 vs 157.7 +/- 116.5 U/ml, m +/- SD, p less than 0.0001). In the group of patients with metastases and circulating TgAbs, Tg serum levels were elevated in 27% of cases on TSH-suppressive therapy and in 44% off therapy when nodal metastases were present, and in 67% of cases on TSH-suppressive therapy and in 83% off therapy when distant metastases were present.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Usefulness of the combined antithyroglobulin antibodies and thyroglobulin assay in the follow-up of patients with differentiated thyroid cancer. 229 57

It can be agreed that up to 90% of patients with well-differentiated thyroid carcinomas have occult cervical disease; however, the biologic and prognostic implications of that prevalence remain debatable. Thyroid suppression therapy is supported, but I131 treatment is recommended only for manifest distant metastases or extracapsular invasion by the primary tumor--not for occult cervical disease alone. A cervical central compartment block resection, consisting of an extended glandular-primary tumor excision that includes adjacent node-bearing soft tissue between the jugular veins, below the hyoid, and into the superior mediastinum, appears to be the best treatment for the primary tumor and occult regional metastases. This resection can be done through a single low, transverse incision, leaving the sternocleidomastoid muscle, the accessory nerve, and submandibular triangle intact, yet better clearing the primary source and the high-risk nodes in the parathyroid area. The rationale for this degree of resection is based on (1) the high risk of central neck recurrences and (2) the fact that the superior mediastinal nodal metastases may become extensive or inoperable before they are detectable and are the most likely nodes in which metastases may result in death. Delayed manifestations of other laterally placed occult cervical nodes can be treated by conservative neck dissection at the time of their appearance, without a worsening of the prognosis.
 ...
PMID:Management of occult metastatic cervical disease from well-differentiated thyroid carcinoma. 266 26

An 11-yr-old female beaver (Castor canadensis) died after a 3 1/2 mo course of intermittent diarrhea, lethargy and anorexia. A postmortem examination revealed both a necrotizing ulcerative colitis and bilaterally enlarged thyroid glands. Histologically, the necrotizing colitis was similar to that caused by canine or feline parvovirus. Thyroid glands were multilobulated. Lobules were composed of irregularly arranged, variably sized follicles, some of which contained colloid. Follicles were lined by a pleomorphic population of tall cuboidal to columnar epithelial cells. Capsular invasion was present. Similar cells, forming follicles were present within the pulmonary parenchyma. This is the first documented case of a thyroid follicular carcinoma with pulmonary metastases in a beaver.
 ...
PMID:Thyroid follicular carcinoma with pulmonary metastases in a beaver (Castor canadensis). 281 May 61

Thyroid cancer is uncommon, with an incidence of 10,300 new patients each year and a mortality of 1,100 patients each year. Patient survival correlates with many factors, including tumor pathology, age, primary lesion size, distant metastases, extent of surgery, and radioiodine therapy. Deaths from thyroid cancer may occur many years after diagnosis, and such an indolent course has hampered the analysis of the multiple treatment programs advocated. Thyroid imaging continues to play an important role in the initial detection and follow-up management of thyroid cancer, but the search for a specific tracer for the primary lesion continues. The complementary role of serum thyroglobulin and radioiodine in the follow-up of the thyroidectomized patient is discussed. Radioiodine therapy has proven effectiveness in those patients with radioiodine-avid distant metastases and/or regional metastases. Whether radioiodine ablation of residual thyroid bed activity is beneficial remains controversial.
 ...
PMID:Radionuclide diagnosis and therapy of thyroid cancer: current status report. 298 29

Thyroid tumors were diagnosed in 26 dogs between 1977 and 1984. A total of 23 of the 26 tumors were carcinomas, and 3, detected as incidental findings at necropsy, were adenomas. The median patient age was 9.5 years. Dogs of the Beagle breed were affected most commonly (5 dogs). The most common physical abnormalities in carcinoma patients were cervical swelling, dyspnea, and coughing. A total of 25 of 26 dogs were clinically euthyroid. Aspiration cytology provided diagnostic information in 8 of 17 cases. In dogs with thyroid carcinoma, a cervical soft tissue lesion was identified consistently by use of radiography and scintigraphy with sodium pertechnetate. Pulmonary metastases were detected radiographically in 8 of 21 dogs with thyroid carcinoma. Thoracic nuclear imaging confirmed the radiographic findings in 11 of 14 dogs. Surgical excision of the thyroid mass was the primary treatment for 17 dogs with carcinoma. Eight dogs died within 2 years (median, 7 months) of surgery because of primary tumor regrowth or metastases. Four dogs were alive at a range of 3 to 48 months after surgery, and 4 dogs died from unrelated causes. Necropsy of 7 dogs with thyroid carcinoma revealed neoplastic infiltration of the cervical blood vessels and pulmonary metastases in each dog. The most common histologic patterns of thyroid carcinoma were solid or compact cellular (11 dogs) and mixed solid-follicular tumors (8 dogs). Dogs with a solid carcinoma had a median survival time of 10.5 months (6 dogs), and dogs with a mixed solid-follicular tumor had a median survival time of 8 months (3 dogs).
 ...
PMID:Clinical and pathologic features of thyroid tumors in 26 dogs. 301 18

Three hundred and eighteen grey scale histograms of thyroid glands in 121 patients have been analysed. The arithmetic average grey scale value (GWMi) and the most commonly appearing grey value (GWMa) were determined electronically. The normal range of GWMi was 24 +/- 4.6 (x +/- s) grey scale units (GWE), for GWMa it was 26 +/- 5.6 GWe (x +/- s). Macrofollicular thyroid adenomas (8 cases) and thyroids with diffuse autonomy (12 cases) differed with a GWMi of 21 +/- 3.8 and 23 +/- GEW (x +/- s) respectively and a GWMa of 23 +/- 3.9 and 25 +/- 4.8 GWE and were within the normal range (p greater than 0.05). Microfollicular thyroid adenomas (12 cases), immunological thyroid lesions (25 cases) and parathyroid adenomas (6 cases) had reduced GWMi (6 +/- 3.1 and 8 +/- 1.8 GWE respectively) and GWMa (5 +/- 3 and 7 +/- 2 GWE, p less than 0.005). Thyroid carcinomas (9 cases) and lymph node metastases (8 cases) were also significantly below normal, with a GWMi of 11 +/- 2.3 and 11 +/- 3.4 respectively (p less than 0.05). Analysis of grey scale histograms makes it possible to evaluate changes in the thyroid without reference to surrounding tissues.
 ...
PMID:[Gray-scale histogram analysis in thyroid sonography. Critique of visual evaluation of echogenicity]. 302 Jun 30


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>