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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

All cases of thyroid cancer reported to the Finnish Cancer Registry in 1958-62 were re-examined histologically; 227 cases of thyroid carcinoma were found. The correlation between survival rates and different histologic and clinical features was studied. The survival rates for papillary carcinoma were significantly higher than those for follicular carcinoma, and the latter significantly higher than those for anaplastic carcinoma. The survival rates for medullary carcinoma were similar to those for papillary carcinoma, but there were only 10 medullary tumors. Within papillary carcinoma, vascular invasion correlated with low survival rates. In follicular carcinoma, the encapsulated type, and in anaplastic carcinoma the diffuse small cell type had higher survival rates than other tumors. The extent of the primary tumor and the presence of distant metastases correlated with survival, but the presence of regional metastases did not. The presence of severe compression symptoms correlated with low survival rates. Young patients and females had higher survival rates than old patients and males. In making a postoperative estimation of prognosis it is best to take the histologic type, the extent of the primary tumor, and the presence of distant metastases into consideration. A tentative preoperative prognosis can be bases on the age and sex of the patient and the presence of distant metastases and severe compression symptoms.
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PMID:Prognosis in thyroid carcinoma. 118 68

We analyzed the patients treated with radiotherapy in Gunma University Hospital in 1990, to determine the characteristics of the practice of radiotherapy. During this period, 540 patients with various diseases received radiation therapy. Five hundred thirty-one (98.3%) of them had malignant tumors, and the remaining nine had benign diseases. Of the patients with malignant tumors, primary tumor of the head and neck (21.7%), and lung and mediastinum (13.0%) were most common. Four of nine patients with benign diseases had pterygium. Three hundred thirty-two patients (63%) had previously untreated malignant tumors. Curative radiotherapy was performed in 296 patients (56%), and palliative radiotherapy in 235 (44%). Of CRG patients, 43% were treated with radiation alone and 40% with surgery followed by radiotherapy. The proportion who received curative radiotherapy was the highest in patients with cervical cancer (80%). Twenty-four of 34 patients treated with intracavitary irradiation had cervical cancer. Interstitial irradiation was performed in nine patients. Four patients with pterygium were treated postoperatively with surface irradiation using an Sr-90 contact device. Radioactive iodine was administered to ten patients: eight thyroid cancer patients and two hyperthyroid patients.
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PMID:Analysis of patients treated with radiotherapy in the year 1990. 137 24

Included among the controversies involving thyroid cancer are the risk factors and treatment decisions in patients with nodal metastases. We have reviewed selected clinical, pathologic, and therapeutic parameters in patients who present with cervical node metastases and related these parameters to disease outcome. There were 108 patients (68 women, 40 men), who had a mean age of 54 years. Univariate analysis showed a significantly increased risk of recurrence to be associated with the presence of primary tumor invasion (vascular, lymphatic, nerve, or muscle), the age and sex of the patient, the presence of mediastinal nodes, and adjuvant treatment with iodine 131. The presence of tumor invasion, the age and sex of the patient, and the presence of mediastinal nodes were significantly associated with higher rates of recurrence when tested by multivariate analysis. The 5- and 10-year disease-free survival rates were 76% and 72%, respectively, with a mean follow-up of 86 months. A comparison of recurrence and survival rates in thyroid cancer patients who were either node positive or node negative during the same 10-year period (152 patients) showed no statistically significant differences. However, node-positive patients with the risk factors of tumor invasion, age over 45 years, and positive mediastinal nodes had more aggressive disease. Although thyroid cancer patients with nodal metastases generally have a good prognosis, high-risk subgroups have been identified who may benefit from a more aggressive therapeutic and follow-up approach.
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PMID:Prognostic factors and management considerations in patients with cervical metastases of thyroid cancer. 146 22

Occult thyroid cancer is an occasional incidental finding during surgery for other indications and is usually considered of minor clinical significance; however, the appropriate approach for incidentally found metastatic thyroid cancer is less clear especially when it occurs in the context of another malignancy that has more aggressive potential. Among 2,855 patients treated for squamous cancer of the tongue at The University of Texas M. D. Anderson Cancer Center, eight patients had coexisting differentiated thyroid cancer metastatic to cervical lymph nodes which was found incidentally during regional lymph node dissection. The eight patients included three women and five men with a median age of 47 years (range, 32-62 years); tumors were of the papillary variety in four patients and follicular in the other four. In one patient, no gross or microscopic primary tumor could be identified after thyroidectomy; in another patient, no gross tumor was evident, but whole organ section revealed an area of fibrosis consistent with a primary lesion. Two patients had primary lesions less than 1 cm in maximal diameter. In four patients who had no surgery, physical exam and radiologic evaluation failed to show any intrathyroidal lesions. Clinically relevant thyroid cancer did not develop in any of those patients during the duration of documented follow-up (1-15 years). Three patients died of progressive tongue cancer, one patient of unrelated pulmonary disease, and four patients remain alive without evidence of disease for 1 to 15 years of available follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Metastatic thyroid cancer as an incidental finding during neck dissection: significance and management. 836 60

Thyroid carcinoma may invade the mediastinum by direct extension of the primary tumor or metastases to the paratracheal or retroclavicular-parajugular lymph nodes. From 1975 to 1991 in 47 out of 622 thyroid cancer patients (7.6%) [14 papillary (PTC), 5 follicular (FTC), 16 medullary (MTC) and 12 undifferentiated carcinoma (UTC)] transsternal tumor resection has been performed. Four patients (UTC three, MTC one) deceased 7, 8, 35, and 41 days after resection of the primary tumor due to cardiac or tumor disease, and in one patient because of acute arteriotracheal haemorrhage after external irradiation; no patient deceased after transsternal resection as a result of cervicomediastinal lymphadenectomy. At the time of primary operation 80% of patients showed an advanced tumor stage (greater than pT3). In 34% of patients (PTC 64%, FTC 40%, MTC 13%, UTC 25%) no tumor recurrence was observed neither by imaging nor by biochemical methods. In 18 patients a transsternal microdissection of all four cervicomediastinal lymph node compartments has been performed. Histological analyses of excised and tumor involved lymph nodes revealed in 9 patients unilateral cervical and mediastinal and in 9 patients bilateral cervical and mediastinal lymph node metastases. In the case of unilateral cervicomediastinal lymph node metastases 2 out of 2 patients with papillary and 2 out of 6 patients with medullary thyroid carcinoma could be cured surgically. In the case of bilateral cervicomediastinal lymph node metastases 3 out of 4 patients with papillary thyroid carcinoma, but no other thyroid cancer patient were free of disease. In conclusion, main indications for transsternal cervicomediastinal resection in thyroid carcinoma are (1) primary tumors extending to the upper mediastinum, but without lymph node metastases, and (2) thyroid carcinomas with unilateral cervicomediastinal lymph node metastases. In the case of bilateral cervicomediastinal lymph node metastases probable only papillary thyroid carcinomas are supposed to be curable by transsternal multicompartmentectomy.
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PMID:[Trans-sternal cervico-mediastinal primary tumor resection and lymphadenectomy in thyroid gland cancer]. 156 3

A 63-year-old female, with a chief complaint of right chest pain was referred to our hospital because of an abnormal right chest wall shadow on chest X-ray. A rib tumor was suspected based on her chest CT scan. Percutaneous needle biopsy yielded a diagnosis of well-differentiated adenocarcinoma. As metastatic rib tumor was suspected, the primary tumor was sought for. A thyroid gland nodule was recognized by ultrasonography, and the cytological diagnosis was class V. Immunohistological demonstration of the thyroglobulin studies of the rib tumor tissue revealed papillary and trabecular patterns of cell arrangement and the presence of thyroglobulin existence. Definitive diagnosis of metastatic rib tumor from thyroid cancer was established. Immunohistological examination is useful to confirm the diagnosis of metastatic cancer of thyroid origin.
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PMID:[A case of metastatic rib tumor from thyroid cancer confirmed by the presence of thyroglobulin]. 175 51

We retrospectively analyzed the outcome of all patients who received their primary treatment for follicular thyroid cancer at the Mayo Clinic between 1946 and 1970. The diagnosis was confirmed by reexamination of preserved tissue specimens. The 57 female and 43 male patients (mean age, 53 years) underwent follow-up for a maximum of 32 years (mean, 17.4 years). All patients were treated surgically, and total removal of primary tumor was thought to have been accomplished in all but three. Only 2 of the 88 patients without distant metastatic lesions at the time of initial diagnosis underwent ablation of the thyroid remnant. At the conclusion of the study, 52 patients had died, thyroid cancer being the cause of death in 19. On the basis of univariate survival analysis, age more than 50 years, tumor size that exceeded 3.9 cm, higher tumor grade, presence of marked vascular invasion, adjacent tissue invasion, and distant metastatic involvement at the time of initial diagnosis were associated with increased cancer mortality. Multivariate analysis (by Cox proportional hazards model), however, identified only age greater than 50 years, marked vascular invasion, and metastatic disease at the time of diagnosis to be independent predictors of follicular thyroid cancer-related mortality. Patients with two or more of these predictors were classified as being high risk. These patients had 5- and 20-year survival rates of 47% and 8%, respectively; the corresponding survival data for the low-risk group were 99% at 5 years and 86% at 20 years. The identification of these risk groups may facilitate a more rational approach to treatment of follicular thyroid cancer.
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PMID:Follicular thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome. 198 50

A 37-year-old man with papillary carcinoma in an ectopic thyroid is presented. Excisional biopsy revealed the cervical mass to be a metastasis from thyroid cancer. X-ray, ultrasonography, and computed tomography, however, failed to identify the primary tumor in the thyroid. Incidental TI-201 uptake was noted in the midline of the anterior neck, and a palpable nodule was discovered in this area. Fine needle aspiration cytology demonstrated Class V papillary adenocarcinoma, and subsequent surgery confirmed a papillary carcinoma in the ectopic thyroid. This case suggests the usefulness of TI-201 scintigraphy for the detection of ectopic thyroid malignancy.
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PMID:Papillary carcinoma in ectopic thyroid detected by TJ-201 scintigraphy. 205 89

The incidence of second primary tumors was studied through record-linkage in 2,968 thyroid cancer patients reported to the Swedish Cancer Registry during the period 1958-1975. The cohort was matched with the Swedish Cancer Registry between 1959 and 1984. A total of 283 second primary tumors were reported more than one year after thyroid cancer diagnosis, and the standardized incidence ratio (SIR) was 1.18 (95% confidence interval = 1.03-1.31). A significant elevated risk of cancer of the kidney, endocrine glands, and nervous system was noted. Men had a higher risk (SIR = 1.37; 95% CI = 1.06-1.70) than women (SIR = 1.11; 95% CI = 0.96-1.28). Patients who were 36-45 years at the time of the thyroid cancer diagnosis were at highest risk of developing a second primary tumor (SIR = 1.35; 95% CI = 0.99-1.81). Significantly elevated risks were seen 5-9 years after the thyroid cancer diagnosis (SIR = 1.44; 95% CI = 1:14-1.69), and the SIR was close to unity after greater than or equal to 15 years of followup. Previously described elevated risks of subsequent leukemia and breast cancer were not confirmed in this study. Close medical surveillance, thyroid cancer treatment, hereditary factors, and a high frequency of autopsy could all contribute to the elevated risk of a second primary tumor in these patients.
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PMID:Second primary tumors following thyroid cancer. A Swedish record-linkage study. 226 Dec

Thirty (3.8%) of 780 patients with differentiated thyroid cancer seen between 1970 and 1987 had bone metastases. The primary tumor was follicular in 26 patients and papillary in four. Mean age at diagnosis was 61 years. The manifestation of bone metastases was the presenting symptom in 18 patients (60%). Treatment included total thyroidectomy, levothyroxine sodium therapy, and radioactive iodine treatments. Twenty-seven patients had bone metastases from the initial observation, with 44 sites involved. Of the sites, 27 (61%) were shown both on iodine 131 whole-body scan (WBS) and on x-ray film, 11 (25%) only on WBS, and six (14%) only on x-ray film. Multiple involvement was observed in 11 patients. The radiologic appearance was invariably osteolytic. Serum thyroglobulin was elevated in all patients. After radioactive iodine, no WBS+/X-ray+ metastases showed a complete response, although a sclerotic border was noted in several cases, whereas six WBS+/X-ray- lesions were no longer detectable by WBS. Treatment with radioactive iodine and bone surgery resulted in a complete cure in three patients and in a reduction of tumor mass in three. Twenty-one (70%) of the patients died of thyroid cancer after a mean survival of 86 months. Of the nine patients still alive, two are free of disease, three have a good quality of life, and four have severe disability.
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PMID:Clinical and biologic behavior of bone metastases from differentiated thyroid carcinoma. 258 23


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