Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pathogenesis of thyroid carcinoma in Graves' goiter is still obscure and the methods for preoperative diagnosis of such carcinomas is not well established. We studied the incidence, clinical features, and pathological findings of thyroid carcinoma in Graves' goiter. From October, 1983 to September, 1985, a total of 739 patients with Graves' disease underwent subtotal thyroidectomy at Ito Hospital, Tokyo. All of these patients underwent roentgenography of the neck before surgery. Thyroid carcinoma was revealed in the resected specimen in 15 (2.0%) of 739 patients. During the same period, another 4 patients underwent surgery for thyroid carcinoma who had had Graves' disease previously and these 4 cases were included in the present study. The incidence of thyroid carcinoma associated with Graves' disease was 2.6% (19 of 743 cases). Histological examination revealed 15 papillary and 4 follicular carcinomas. The size of the carcinoma foci was 13.8 +/- 15.6 mm in diameter (range: 1-60 mm), 10 (52.6%) foci being 10 mm or greater. Invasive growth into the surrounding thyroid tissue was predominant and regional lymph node metastasis was noted in all 6 patients who underwent cervical dissection. Preoperative roentgenography revealed calcification in 5 (26.3%) of 19 cases. Our present study indicates that thyroid carcinoma in Graves' goiter may show markedly invasive growth with lymph node metastasis even though the primary tumor is small in size, and it is suggested that the detection of calcification may serve as a part of the diagnostic measures when the carcinoma focus is difficult to palpate in the diffusely-enlarged Graves' goiter.
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PMID:Thyroid carcinoma in Graves' disease. 236 49

The classification proposed by Woolner et al. (1961, 1971) has been applied to 139 cases of primary malignant tumors of the thyroid gland diagnosed in one of the largest hospitals of Rome, Italy, over a period of 5 years, from 1977 to 1981. These cases come from 1418 patients with enlargement of the thyroid surgically treated at the 5th Surgical Clinic of the University of Rome. All the histologic slides were re-examined, and the pathology records were reevaluated. Of these tumors, 56.8% were papillary, 30.9% follicular, 9.3% anaplastic or undifferentiated, and 2.1% medullary. There was a female predominance in all age groups and for all types of tumors, reflecting a total female to male ratio of 1.9:1. Papillary carcinoma occurred most commonly in young and young-adult patients, follicular in the middle-age group, and anaplastic in the elderly. The extent of the primary tumor, the presence of regional metastases, and the association with other thyroid nonneoplastic diseases such as lymphocytic and Hashimoto's thyroiditis, and nontoxic and toxic goiter were also recorded. Multicentric tumors were found in 38.9% of cases principally represented by papillary carcinomas. Regional lymph node metastases were observed mainly in young patients, and no correlation was found between thyroid cancer incidence and other nonneoplastic thyroid diseases.
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PMID:Primary malignant tumors of the thyroid gland. Histology, age and sex distribution and pathologic correlations in 139 cases. 686 38

Five ovarian tumors were associated with florid mesothelial hyperplasia that in four cases created initial problems in histologic classification and staging of the tumors. In two cases, small nests, cords, and gland-like arrangements of atypical mesothelial cells within the cyst wall of a serous or mullerian mucinous tumor of borderline malignancy were initially considered to possibly represent, or were misdiagnosed as, foci of stromal invasion, lymphatic invasion, or both. In the three other cases--an endometrioid adenocarcinoma, a struma ovarii, and a yolk sac tumor--papillary and sheet-like proliferations of mesothelial cells involved the extraovarian pelvic peritoneum; in one of the cases, necrosis of the mesothelial cells was prominent. These foci of extra-ovarian mesothelial hyperplasia were interpreted as metastatic tumor intraoperatively (three cases) and on initial microscopic examination (two cases). Factors that may have predisposed to the mesothelial hyperplasia included large size of the primary tumor (two cases), the presence of metastatic tumor elsewhere in the pelvis (three cases), ascites (two cases), and coexistent endometriosis (two cases). Distinction of mesothelial proliferation from invasive or metastatic ovarian tumor is obviously important in correct classification, staging, and management of the tumor. Awareness of the occasional occurrence of florid mesothelial hyperplasia in patients with ovarian neoplasms and attention to the histologic, histochemical, and immunohistochemical features of the mesothelial proliferation should facilitate the correct diagnosis.
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PMID:Florid mesothelial hyperplasia associated with ovarian tumors: a potential source of error in tumor diagnosis and staging. 841 78

The relationship between thyroid dysfunction and breast cancer (BC) is debated. To clarify this controversial issue, a prospective study on thyroid function in BC was performed. The prevalence of thyroid disease was examined in 102 consecutive BC patients with ductal infiltrating carcinoma after surgery and before starting any chemohormonal or x-ray therapy and in 100 age-matched control healthy women living in the same borderline iodine-sufficient geographic area. All subjects were submitted to clinical ultrasound thyroid evaluation and serum free T4, free T3, TSH, thyroperoxidase antibody, and thyroglobulin antibody determination. Fine needle aspiration was performed in all thyroid nodules. Estrogen and progesterone receptors (ER and PR, respectively) were assayed in 92 and 55 BC specimens, respectively. The overall prevalence of thyroid disease was 47 in 102 (46%) in BC patients and 14 in 100 (14%) in controls (P < 0.0001). The prevalence of nontoxic goiter was 27.4% in BC patients and 11% in controls (P = 0.003). Hashimoto's thyroiditis was found in 13.7% of BC patients and in only 2% of the controls (P < 0.005). Other thyroid disorders found in the BC group included 2 cases of Graves' disease, 2 of thyroid carcinoma, and 1 of subacute thyroiditis, whereas in the control group only 1 case of Graves' disease and none of the other disorders were found. Mean free T3, free T4, and TSH concentrations showed no difference between BC patients and controls. The prevalence of thyroperoxidase antibody was higher in BC patients than in controls (23.5% vs. 8%; P < 0.005), whereas the prevalence of thyroglobulin antibody was not different. In BC patients the presence of thyroid antibodies was more frequently associated with clinically detectable autoimmune thyroiditis (14 of 26, 51.8%; P = 0.03) and was more common in the younger group. The positivity of ER was found in 51 of 92 (55.43%) and that of PR was found in 26 of 55 (47.27%) BC specimens. No relationship was found among ER, PR status, and the presence of serum thyroid antibodies. In conclusion, 1) the present study provides evidence that the overall prevalence of thyroid disorders is increased in patients with breast cancer, and 2) thyroid autoimmune disorders, especially Hashimoto's thyroiditis, account to a large extent for the increased prevalence of thyroid disease in patients with breast cancer. This feature is independent from the ER and PR status of the primary tumor. The present findings call attention to the usefulness of screening for thyroid disease in any patient with breast cancer.
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PMID:Relationship between breast cancer and thyroid disease: relevance of autoimmune thyroid disorders in breast malignancy. 877 62

Malignant struma ovarii with metastasis in an extremely rare form of ovarian carcinoma. We describe two cases of malignant struma ovarii that demonstrated widespread peritoneal metastases. In the second case described here, furthermore, the tumor recurred II years later in the contralateral ovary and omentum, while the primary tumor previously was pure struma ovarii with no evidence of metastasis. Although thyroid tumors themselves are characterized by a long latent interval, patients with benign thyroid tissue arising in nonthyroidal organs with or even without dissemination should be managed with caution and need appropriate long-term follow-up after the initial surgery.
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PMID:"Malignant struma ovarii" with peritoneal metastasis: report of two cases. 1094 89

The aim of this study was to investigate the role of multimodality treatment in patients with anaplastic thyroid carcinoma. From 1992 to 1999, 39 consecutive patients with a histologically or cytologically proven anaplastic thyroid carcinoma were referred to the Thyroid Center of Padua General Hospital. There were 28 females and 11 males with a median age of 69 years (range 39-88 years). About one-third of patients had a history of preceeding nodular goiter. Two patients had areas of differentiated thyroid carcinoma at histological examination. Local disease was present in 26 patients while distant metastases, mainly to the lung, were present in 22 at diagnosis or quickly developed during the observation period in all the others except one. Thirty-two patients were previously untreated: 9 of them were in good general condition, 1 had limited lung metastases, and the tumor mass was considered resectable by the surgeon. These 9 patients were treated with cisplatin once a week and radiotherapy (RT) 36Gy in 18 fractions over three weeks, followed by total thyroidectomy (TT) and by further chemotherapy (CHT) with adriamycin and bleomycin in 4 patients. Seven patients, 3 with lung metastases at diagnosis, had undergone TT, followed by RT in 5, in another hospital and were subsequently referred to our center due to the presence of distant metastases. Therefore, a total of 16 patients (Group 1) was treated with TT, RT and CHT in various order. Nine patients with distant metastases at diagnosis (Group 2) received CHT; one of them had a disappearance of lung metastases and was then treated by TT and further CHT. Group 3 consisted of 14 elderly patients in poor general conditions; 4 of these received local RT, while the remaining did not receive any treatment. Four complete responses were seen in patients from Group 1, and 1 from Group 2. One patient without distant metastases at diagnosis is alive and free of disease 6 months after TT and adjuvant CHT, and 12 months after diagnosis. Three had long-term survival (14, 24, 27 months) with a disease-free interval of 6-8-10 months. The patient from Group 2 who was treated in a second time by TT is alive without disease after 60 months. Median survival rate was 11 months for Group 1, 5.7 months for Group 2 and 4 months for Group 3. In some patients multimodality treatment (TT, RT and CHT) is associated with increased survival. Nine out of 16 patients, who underwent surgery and complementary treatment, had no local progression. In all but one distant metastases developed, mainly in the lung, during or after post-surgical CHT. The best results were obtained in younger patients with less advanced disease. Early diagnosis is mandatory. Only a few patients responded to CHT, confirming that anaplastic thyroid carcinoma is often resistant to anticancer drugs. Our experience with combination modalities suggests that aggressive and appropriate combinations of RT, TT and CHT may provide some benefit in patients with anaplastic thyroid carcinoma. Preoperative CHT and RT may enhance surgical resectability of the primary tumor.
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PMID:A multimodality therapeutic approach in anaplastic thyroid carcinoma: study on 39 patients. 1119 10

Follicular carcinoma of the thyroid rarely manifests itself as a distant metastatic lesion, and, when present, is usually found in flat bones. A soft tissue metastasis is extremely rare, and synchronous metastases to the bone and soft tissue is not reported in the literature so far. We report such a case of a 42-yr-old male, who presented with a goiter, scalp and forearm soft tissue swellings, and, fine needle aspiration cytology of all these swellings revealed a follicular neoplasm. A wide excision of the forearm swelling was carried out and the histopathology was consistent with features of metastatic follicular carcinoma of the thyroid. The main stay of treatment is surgical resection of the primary tumor. The various modalities of treatment of metastasis is discussed with a review of literature.
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PMID:Synchronous bony and soft tissue metastases from follicular carcinoma of the thyroid. 1467 56

We report a 47-year-old women who presented to her general practitioner and our hospital with weight loss of unknown etiology. Eight years previously she had undergone a hemithyroidectomy for nodular goiter with one cold nodule. Laboratory results revealed hypercalcemia, evidence of primary hyperparathyroidism and computer tomography of the thorax showed bilateral pulmonary metastasis. After undergoing CT-guided biopsy of a metastasis, histology revealed an endocrine primary tumor with low parathyroid hormone expression. In view of the history, clinical and biochemical findings we diagnosed a recently metastasized functioning parathyroid carcinoma, which eight years previously has been labeled as a benign atypical thyroid adenoma. The patient underwent surgical resection of all detected metastases. Afterwards the serum calcium and parathyroid hormone levels normalized. Parathyroid carcinoma is an uncommon tumor. In the absence of pathognomonic diagnostic criteria a definitive pathological diagnosis of parathyroid carcinoma often is not possible. The treatment of parathyroid carcinoma is essentially surgical. Patients with parathyroid carcinoma mostly die from uncontrollable hypercalcemia rather than from other tumor-related complications.
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PMID:[Rare cause of hypercalcemia]. 1921 66

Anaplastic thyroid carcinoma is a rare malignant neoplasia with high biological aggressiveness and rapid and lethal clinical course. In selected patients, an aggressive multimodal therapy could decrease illness progression both in the neck e in other sites. However, it is not clear if these combined treatments improve survival. In our institution, the Department of Nuclear Medicine has a 40-year experience in monitor and treatment of a group of 48 patient with ATC confirmation that clinical presentation could overlap pre-existent nodular goitre or rapid enlarging mass of recent onset. At onset, age do not change final poor prognosis and the survival seems most favorable in patients with a primary tumor size <6 cm. A better mean survival was noticed in those patients who respond to the multimodal therapy (8 months vs 4.6 months). Radioiodine (131 I) therapy is unnecessary due to the loss of NIS expression of the ATC cells. Therefore, after quick clinical and instrumental work up, our experience and the literature data suggest that the first line therapy is represented from external radiotherapy combined also with cisplatin or doxorubicin, followed by "curative" surgical procedure of the primary lesion in the neck and subsequent chemotherapy. For those patients who show distant metastasis at onset chemotherapy is the first line therapy followed by external radiotherapy and when possible subsequent surgical procedure.
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PMID:Anaplastic thyroid carcinoma. Practical aspects of multimodal therapy and data emerging from a 40-year experience at a single Italian institution. 2038 23

The finding of thyroid nodules is a very common occurrence in routine clinical practice. Approximately 5% to 7% of the entire population have thyroid nodules. Vascular lesions are one of the most controversial issues in thyroid pathology. These include benign lesions such as hemangiomas and, rarely, malignant tumors such as angiosarcomas or undifferentiated angiosarcomatoid carcinomas. In particular, angiosarcoma of the thyroid gland is a rare, highly aggressive malignant vascular tumor and in Italy the greatest geographical incidence of this lesion is witnessed near the Alps. Here, a case of thyroid angiosarcoma in a 71-year-old man with a history of goiter for about 20 years is described. The unusual localization of this lesion, the difficulties in reaching a definitive diagnosis for this particular histological type of primary tumor and a history of long-standing multinodular goiter in thyroid of an older man from outside the Alpine region prompted us to report this case of thyroid angiosarcoma mainly to discuss surgical, histopathological and immunohistochemical features.
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PMID:Primary thyroid angiosarcoma: an unusual localization. 2255 43


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