1
|
Wang B, Huang J, Chen L. Management of medullary thyroid cancer based on variation of carcinoembryonic antigen and calcitonin. Front Endocrinol (Lausanne) 2024; 15:1418657. [PMID: 39449744 PMCID: PMC11499115 DOI: 10.3389/fendo.2024.1418657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 09/25/2024] [Indexed: 10/26/2024] Open
Abstract
Carcinoembryonic antigen (CEA) and calcitonin (Ctn) are pivotal biomarkers in the diagnosis and management of medullary thyroid carcinoma (MTC). However, their diagnostic reliability in perioperative period remains a topic of ongoing debate. This review synthesizes researches on perioperative fluctuations in CEA and Ctn levels, and evaluates the impact of their different combinations on MTC diagnosis, treatment decisions, and prognosis. Our findings highlight it is crucial to understand and interpret the various combinations of CEA and Ctn fluctuations within a clinical context. Furthermore, to reduce diagnostic errors and improve patient outcomes, we recommend follow-up diagnostic and treatment protocols designed to address the potential pitfalls associated with the use of these biomarkers.
Collapse
Affiliation(s)
- Bo Wang
- Department of Paediatric Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Huang
- Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Chen
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilian University of Munich, Munich, Germany
| |
Collapse
|
2
|
Vázquez-Lorente H, Dunđerović DM, Tatić SB, Radojević-Škodrić S, Gomes CM, Paunović IR, Dragutinović V. Matrix Metalloproteinases 2 and 9 and Their Tissue Inhibitors in the Diagnostics of Medullary Thyroid Carcinoma. Appl Immunohistochem Mol Morphol 2023; 31:121-127. [PMID: 36512647 DOI: 10.1097/pai.0000000000001092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 11/02/2022] [Indexed: 12/15/2022]
Abstract
Medullary Thyroid Carcinoma (MTC) is a tumor of the neuroendocrine system. In recent years, the need to assess the MTC diagnostic-related parameters has emerged with the aim to elucidate the mechanisms involved in this pathology. The objective of this study was to evaluate the role of Matrix Metalloproteinases (MMPs) 2 and 9, their tissue inhibitors of matrix metalloproteinases (TIMPs), S100 protein, and amyloid in the diagnostic of MTC. Thirty-two samples with MTC (72% women) were included in this cross-sectional study and divided by groups: T category 1 (T1)≤20 mm and T category 2 (T2) 20 to 40 mm of tumor size. MMPs 2 and 9, TIMPs 2 and 1, S100 protein, and calcitonin in tissues were obtained by immunohistochemical techniques. The presence of amyloid in tissue sections was detected on Thioflavin T-stained slides under fluorescent microscope. Percentage of positive cells (P) observed for MMP-2 was higher in those samples presenting T2 MTC with respect to those with T1 MTC ( P <0.05). Moreover, P-MMP-2 showed a direct correlation with higher T category of MTC (Rho=0.439, P < 0.001), whereas P-MPP-9 was directly correlated with S100 protein and the intensity of calcitonin in tissues (Rho=0.419, P =0.017; Rho=0.422, P =0.016, respectively. Therefore, MMPs were directly correlated with some traditional biomarkers of MTC. In this regard, P-MMP-2 was more expressed in type 2 MTC. Combining the analysis of traditional and other useful biomarkers of MTC as MMPs 2 and 9 could be a useful strategy in the diagnostic of MTC.
Collapse
Affiliation(s)
- Héctor Vázquez-Lorente
- Department of Physiology, School of Pharmacy, Institute of Nutrition and Food Technology "José Mataix," University of Granada, Granada, Spain
| | | | | | | | - Cláudio M Gomes
- Institute of Biosystems & Integrative Sciences
- Department of Chemistry and Biochemistry, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - Ivan R Paunović
- Faculty of Medicine, University of Belgrade
- Center for Endocrine Surgery, Clinical Center of Serbia
| | - Vesna Dragutinović
- Institute of Chemistry in Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
3
|
Muacevic A, Adler JR, Siddiqi AI, Shafiq W, Irfan H. Case Report: A Challenging Clinical Problem of Calcitonin-Negative Medullary Thyroid Cancer Diagnosis and Surveillance. Cureus 2022; 14:e32088. [PMID: 36600874 PMCID: PMC9803929 DOI: 10.7759/cureus.32088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
Medullary carcinoma of the thyroid is a rare neuroendocrine carcinoma that originates from the malignant proliferation of parafollicular C cells. In almost 100% of the cases, medullary carcinoma of the thyroid is associated with high levels of calcitonin and carcinoembryonic acid (CEA). Both carcinoembryonic antigen and calcitonin are used for the diagnosis and surveillance of medullary carcinoma of the thyroid. Calcitonin-negative medullary carcinoma of the thyroid is an extremely rare entity that is characterized by classic medullary carcinoma of the thyroid morphology without raised serum calcitonin levels. We describe the case of a middle-aged lady who presented with a few-month history of neck swelling associated with compressive symptoms. CT of the neck showed a large right thyroid nodule with central necrosis and retrosternal extension to the superior mediastinum. There was also a 360-degree encasement of the right common carotid artery. She underwent fine needle aspiration (FNAC) of the right thyroid nodule, and histopathology showed typical features of medullary carcinoma of the thyroid. Immunohistochemical staining for calcitonin and carcinoembryonic antigen was negative but positive for other neuroendocrine markers, i.e., synaptophysin and chromogranin A. Serum calcitonin and carcinoembryonic antigen levels were also in the normal range. So, a rare diagnosis of calcitonin-negative medullary carcinoma of the thyroid was made. As the disease was inoperable because of vascular encasement, a plan for external beam radiation therapy (ERBT) to the neck was made. Medullary carcinoma of the thyroid with normal serum levels of calcitonin is a very rare entity, with only a few cases reported in the literature. In this case report, we have presented a rare case of medullary thyroid carcinoma (MTC) with normal-range serum calcitonin levels, how it was diagnosed, and how to follow up postoperatively.
Collapse
|
4
|
Moretti G, Troiani E, Sarlo F, Baroni S, Urbani A. Analytical Performance Evaluation of a New Calcitonin Assay. J Appl Lab Med 2022; 7:568-574. [PMID: 34993539 DOI: 10.1093/jalm/jfab162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/13/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The use of efficient laboratory calcitonin (CT) testing is required for optimal management of medullary thyroid carcinoma. Several pitfalls are related to the calcitonin laboratory assays and a careful evaluation is needed. We report the analytical performances of the new Siemens ADVIA-Centaur-CALCT (CT-XPT) assay and its comparison with our standard method DiaSorin-Calcitonin-II-Gen (CT-LIA) assay. METHODS Analytical performance of the CT-XPT-assay, limit of blank (LOB), limit of detection (LOD), and limit of quantification (LOQ), were determined. We also evaluated the in vitro stability of the sample, together with the linearity and percentage recovery. RESULTS The CT-XPT-assay showed a better detection limit than the CT-LIA assay, with lower values of LOB (0.86 pg/mL vs 1.00 pg/mL) and LOQ (1.65 pg/mL vs 3.00 pg/mL). Both values were in agreement with those reported by the manufacturer. Within- and between-run precision demonstrated a good concordance of results. Regarding the in vitro stability of CT, the low CT concentration sera showed a much greater decrease in CT levels compared to the high concentration sera. Correlation studies showed a good correlation between the two methods (Kappa Cohen coefficent, KC: 0.68, agreement % for male: 89.58%; KC: 0.63; agreement % for female: 88.33%). CONCLUSIONS Our findings showed a good correlation between the CT-LIA and CT-XPT methods. Moreover, we demonstrated that the analytical performance of the CT-XPT assay, together with its technical specifications, could represent major features of the CT-XPT method. Collectively, the technical evaluation and the analytical results described in the presented paper highlight that the novel CT-XPT is a valid method for CT testing in a clinical diagnostic setting.
Collapse
Affiliation(s)
- Giacomo Moretti
- Dipartimento di Chimica Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., Rome, Italy
| | - Eliana Troiani
- Dipartimento di Chimica Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., Rome, Italy
| | - Francesca Sarlo
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Baroni
- Dipartimento di Chimica Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., Rome, Italy.,Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Urbani
- Dipartimento di Chimica Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., Rome, Italy.,Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
5
|
Yue W, Zhang Y. Oncologic outcomes of calcitonin-negative medullary thyroid carcinoma. Front Endocrinol (Lausanne) 2022; 13:1025629. [PMID: 36506082 PMCID: PMC9727137 DOI: 10.3389/fendo.2022.1025629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/07/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Calcitonin (Ct)-negative medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor. This study aimed to clarify its incidence, clinicopathologic characteristics, management, and treatment outcome. METHODS We retrospectively analyzed data of patients with primary MTC. Patients were divided into two groups according to the preoperative serum Ct level (Ct-negative and Ct-positive). The demographic, pathologic, and molecular characteristics, and treatment outcomes were compared between the two groups. In the Ct-negative group, we analyzed the association between the operation type and treatment outcome. RESULTS Of the total 312 patients, 24 were diagnosed with Ct-negative MTC. The rate of lymph node metastasis was significantly higher in the Ct-positive than in the Ct-negative group (47.9% vs. 0%, p<0.001). The proportion of patients with Ki-67 ≤10% was significantly higher in the Ct-negative than in the Ct-positive group (87.5% vs. 38.2%, p<0.001). Excellent response was achieved by 91.7% and 34.7% of patients in the Ct-negative and Ct-positive groups, respectively (p<0.001). In the Ct-negative group, excellent response was achieved by all female patients, but only 50% of male patients. CONCLUSIONS Ct-negative MTC is rare and unlikely to develop lymph node metastasis. Unilateral lobectomy tends to provide a satisfactory chance of excellent response; however, this requires further validation.
Collapse
|
6
|
Utilizing the circulating tumor markers in diagnosis and management of medullary thyroid cancer. Pathol Res Pract 2022; 229:153694. [DOI: 10.1016/j.prp.2021.153694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 11/20/2022]
|
7
|
Salh AM, Ahmed SF, Omar SS, Hassan SH, Mohammed SH, Kakamad FH. Medullary thyroid carcinoma with normal serum calcitonin and carcinoembryonic levels; a case with review of literature. INTERNATIONAL JOURNAL OF SURGERY OPEN 2022. [DOI: 10.1016/j.ijso.2022.100443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
8
|
Kim MJ, Back K, Choe JH, Kim JH, Kim JS. Feasibility of lateral sentinel lymph node biopsy in medullary thyroid cancer: A surrogate tool for determining prophylactic lateral neck dissection-A pilot study. Head Neck 2021; 43:3276-3286. [PMID: 34288208 DOI: 10.1002/hed.26808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/28/2021] [Accepted: 07/08/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUNDS This study aimed to evaluate usefulness of lateral sentinel lymph node biopsy (SLNB) in determining lateral neck dissection (LND) of patients with medullary thyroid cancer (MTC). METHODS Sixteen patients with MTC were enrolled in the study from January 2013 to June 2019. Intratumoral injection of technetium (Tc)-99m phytate followed by lymphoscintigraphy was performed preoperatively. Lateral sentinel lymph nodes were detected by a collimated gamma probe and underwent frozen analysis. Ipsilateral LND was performed in all patients to assess lateral LN status. RESULTS The identification rate of sentinel lymph nodes (SLNs) detected by radioisotope was 87.5% (14 of 16 patients). The sensitivity, specificity, positive predictive value, and negative predictive value of frozen analyses were 66.7%, 100%, 100%, and 91.6%, respectively. Based on final histopathology, however, the diagnostic values of lateral SLNB were all 100%. CONCLUSIONS This study showed that lateral SLNB can be a promising surgical tool for decisions on LND in patients with MTC.
Collapse
Affiliation(s)
- Min Jhi Kim
- Department of Surgery, CHA Ilsan Medical Center, Cha University School of Medicine, Goyang-si, South Korea
| | - Kyorim Back
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jun-Ho Choe
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung-Han Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jee Soo Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| |
Collapse
|
9
|
Fernández-Ferreira R, De la Peña-López IR, Zamudio-Coronado KW, Delgado-Soler LA, Torres-Pérez ME, Bourlón-de Los Ríos C, Cortés-González R. Calcitonin-Negative Neuroendocrine Carcinoma of the Thyroid Gland: Case Report and Literature Review. Case Rep Oncol 2021; 14:112-122. [PMID: 33776692 PMCID: PMC7983544 DOI: 10.1159/000510807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 11/24/2022] Open
Abstract
Calcitonin-negative neuroendocrine tumor (CNNET) of the thyroid is an extremely rare entity. In some of the previously reported cases within the literature, the terms “atypical medullary thyroid carcinoma,” “calcitonin-free oat cell carcinoma,” and “a distinct clinical entity” were applied to NETs without definitive evidence of calcitonin production. In the English-language literature, not only are there only few reported cases of CNNET, but the criteria for diagnosis in these cases are also controversial. Most of the current published cases were also treated surgically for local disease. We describe a case of NET of the thyroid with calcitonin, chromogranin A and thyroglobulin negativity, synaptophysin and TTF-1 positivity, and a high Ki-67 proliferation index with metastases in the cervical region as well as mediastinal adenopathies. This case was considered an unresectable thyroid carcinoma, and chemotherapy including cisplatin and etoposide was started as neoadjuvant treatment at the department of medical oncology. Total thyroidectomy plus bilateral and central cervical dissection was performed, and the patient underwent 2 cycles of adjuvant radiotherapy. Currently, the patient's <sup>18</sup>F-FDG-PET/CT findings show a complete response 17 months after diagnosis. In conclusion, CNNET of the thyroid is very rare and there is limited evidence regarding treatment in patients with metastases. Chemotherapy including cisplatin and etoposide as well as early aggressive surgical resection appears to positively impact patients' survival.
Collapse
Affiliation(s)
- Ricardo Fernández-Ferreira
- Department of Oncology Medicine, Comprehensive Oncology Center "Diana Laura Riojas de Colosio," Medica Sur Clinic & Foundation, Mexico, Mexico
| | - Ildefonso Roberto De la Peña-López
- Department of Oncology Medicine, Comprehensive Oncology Center "Diana Laura Riojas de Colosio," Medica Sur Clinic & Foundation, Mexico, Mexico
| | - Karla Walkiria Zamudio-Coronado
- Department of Endocrinology, Diabetology and Thyroid, National Institute of Medical Sciences and Nutrition "Salvador Zubiran", Mexico, Mexico
| | | | | | - Christianne Bourlón-de Los Ríos
- Department of Oncology Medicine, Comprehensive Oncology Center "Diana Laura Riojas de Colosio," Medica Sur Clinic & Foundation, Mexico, Mexico
| | | |
Collapse
|
10
|
Chen L, Zhao K, Li F, He X. Medullary Thyroid Carcinoma With Elevated Serum CEA and Normal Serum Calcitonin After Surgery: A Case Report and Literature Review. Front Oncol 2020; 10:526716. [PMID: 33194586 PMCID: PMC7653021 DOI: 10.3389/fonc.2020.526716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/06/2020] [Indexed: 12/26/2022] Open
Abstract
Background Medullary thyroid carcinoma (MTC) is a relatively rare malignant tumor subtype originated the parafollicular C cells of the thyroid gland, producing tumor markers including calcitonin (Ctn), carcinoembryonic antigen (CEA), and chromogranin A. Preoperative serum Ctn and CEA value is important for assessing disease burden, postoperative serum Ctn and CEA can help to determine whether there are recurrence and distant metastasis. Case Presentation We report a rare case in which the CEA level continued to increase and the Ctn value was normal after total thyroidectomy and central lymph node dissection in a MTC patient. The patient was asymptomatic during one and half year follow-up until lateral lymph node metastasis was revealed. However, the CEA level raised again after lateral neck lymph node dissection and bone metastases were found by 18F-FDG PET-CT. Conclusion This case reminded us the recurrence of MTC should be suspected for patients with simply elevated CEA after surgery for MTC. Differential diagnosis of other malignant tumors and timely lymph node biopsy is of great significance for management.
Collapse
Affiliation(s)
- Li Chen
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Ke Zhao
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Fuxin Li
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Xianghui He
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| |
Collapse
|
11
|
Chowsilpa S, Jones R, Hang JF, Ali SZ. Characterization of "suspicious for malignancy" for non-papillary carcinoma diagnoses on thyroid fine-needle aspiration. J Am Soc Cytopathol 2020; 10:148-154. [PMID: 32773337 DOI: 10.1016/j.jasc.2020.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To evaluate the incidence, risk of malignancy, and management of "suspicious for malignancy" (SFM) for non-papillary carcinoma diagnoses according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). MATERIALS AND METHODS A retrospective search was performed for all thyroid fine-needle aspirations (FNAs) with an SFM diagnosis in the electronic Pathology database at The Johns Hopkins Hospital from 2000 to 2019. During this period, a total of 644 cases were diagnosed as SFM. Of these, 55 cases of "suspicious for non-papillary thyroid carcinoma" (SNPTC) were identified. These 55 cases were then compared with 65 random cases of "suspicious for papillary thyroid carcinomas" (SPTC) diagnoses as a control group. RESULTS The SNPTC subgroup consisted of 28 cases of "suspicious for medullary thyroid carcinoma" (SMTC) (50.91%), 4 cases of "suspicious for metastasis" (SMET) (7.27%), 3 cases of "suspicious for malignant lymphoma" (SML) (5.45%), 2 cases of "suspicious for poorly-differentiated thyroid carcinoma" (SPDC) (3.64%), and 18 cases of "suspicious for malignancy, not otherwise specified" (SNOS) (32.73%). When compared to SPTC, SNPTC patients' average age was older (P = 0.004). Ancillary studies assisted in diagnosing SNPTC more so than SPTC (P < 0.001). Immunohistochemical studies were performed for 11 cases, molecular studies for 6 cases, and needle rinse calcitonin level for 1 case. When correlated with surgical follow-ups, the risk of malignancy (ROM) was 91.18% for SNPTC compared to 93.75 for SPTC%. CONCLUSIONS SNPTC was rarely diagnosed when compared with SPTC. SMTC was the most commonly diagnosed SNPTC subgroup, followed by SNOS. The ROM of SNPTC was slightly lower than that of SPTC. Ancillary studies and previous clinical history, in addition to cytomorphology, was helpful when rendering the diagnosis of SNPTC.
Collapse
Affiliation(s)
- Sayanan Chowsilpa
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland; Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Robert Jones
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Jen-Fan Hang
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland; Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taiwan
| | - Syed Z Ali
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland; Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland.
| |
Collapse
|
12
|
Hou Y, He X, Chute DJ. Paraganglioma-like medullary thyroid carcinoma: A case report and literature review. Diagn Cytopathol 2020; 48:559-563. [PMID: 32125784 DOI: 10.1002/dc.24403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/11/2020] [Accepted: 02/20/2020] [Indexed: 12/26/2022]
Abstract
Medullary thyroid carcinoma (MTC) accounts for 3%-5% of all thyroid malignancies. Most MTC can be diagnosed by their typical cytologic and histologic morphology and immunohistochemical features. However, some rare variants of MTC may pose diagnostic difficulties on both cytology and histology. Paraganglioma-like MTC (PLMTC) is a rare, but widely recognized variant of MTC. PLMTC is known to share morphological and architectural similarities with paraganglioma, hyalinizing trabecular tumor, and carcinomas of thyroid follicular cell origin, such as follicular carcinoma and follicular variant of papillary thyroid carcinoma. The combination of clinicopathologic features and a battery of immunohistochemical markers is essential for making a correct diagnosis. Herein, we report one case of PLMTC with both cytologic and histologic features and review the clinicopathologic features of previously reported cases.
Collapse
Affiliation(s)
- Yanjun Hou
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Xin He
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Deborah J Chute
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| |
Collapse
|
13
|
Cai HJ, Wang H, Cao N, Huang B, Kong FL, Lu LR, Huang YY, Wang W. Calcitonin-negative neuroendocrine tumor of the thyroid with metastasis to liver-rare presentation of an unusual tumor: A case report and review of literature. World J Clin Cases 2020; 8:179-187. [PMID: 31970185 PMCID: PMC6962086 DOI: 10.12998/wjcc.v8.i1.179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/22/2019] [Accepted: 11/30/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neuroendocrine tumors mainly occur in the stomach, intestine, pancreas, and lung and are rarely detected in the thyroid. Thyroid neuroendocrine tumors, designated medullary thyroid carcinoma, generally present with elevated calcitonin. Calcitonin-negative neuroendocrine tumors of the thyroid are extremely rare.
CASE SUMMARY Here, we present a case report of a 56-year-old female patient with a neck pain complaint. Total thyroidectomy was conducted after comprehensive evaluation, and diagnosis was confirmed as calcitonin-negative neuroendocrine tumor of the thyroid. Two months later, liver metastasis was detected, and transcatheter arterial chemoembolization was subsequently performed to control growth. However, the curative effect was unsatisfactory and multiple intrahepatic metastases occurred after 3 mo.
CONCLUSION Owing to the rarity of this disease, no clear guidelines are available for treatment. In addition to reporting this rare case, we have reviewed and summarized associated medical literature with an aim to provide a comprehensive reference platform for subsequent research.
Collapse
Affiliation(s)
- Huai-Jie Cai
- The Fourth Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Han Wang
- The Fourth Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Nan Cao
- The Fourth Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Bin Huang
- The Fourth Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Fan-Lei Kong
- Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Li-Ren Lu
- Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Ya-Yuan Huang
- Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Wei Wang
- Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| |
Collapse
|
14
|
Gambardella C, Offi C, Clarizia G, Romano RM, Cozzolino I, Montella M, Di Crescenzo RM, Mascolo M, Cangiano A, Di Martino S, Candela G, Docimo G. Medullary thyroid carcinoma with double negative calcitonin and CEA: a case report and update of literature review. BMC Endocr Disord 2019; 19:103. [PMID: 31619220 PMCID: PMC6794852 DOI: 10.1186/s12902-019-0435-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 09/24/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Medullary thyroid carcinoma is a malignant uncommon and aggressive tumour of the parafollicular C cells. In about 75% of cases it is sporadic while, in case of RET mutation, it is associated to multiple endocrine neoplasia type 2 (25% of cases). The biochemical features of medullary thyroid carcinoma include the production of calcitonin and carcinoembryogenic antigen. The above-mentioned features are useful in the diagnostic process as well as in the follow up and in the prognostication of the disease. Even if calcitonin elevation is strongly associated to MTC, it can also be found increased in many pathological different conditions as pregnancy, lactation, C-cells hyperplasia, autoimmune thyroiditis, end stage renal disease, lung and prostate cancer and several neuroendocrine tumours. Major medullary thyroid tumours are usually connected to high doses of circulating calcitonin, in fact non-secretory variants have hardly been described. CASE PRESENTATION We herein report the case of a 59 years old male, who had undergone total thyroidectomy for multinodular goiter with negative preoperative calcitonin, showing medullary thyroid carcinoma at definitive pathology. To the best of our knowledge, this is the first case documenting a non-secretory medullary thyroid carcinoma, with double negative markers at the time of diagnosis and at the relapse. CONCLUSION A Literature review underlining pathological hypothesis, differential diagnosis and alternative and innovative biomarkers to identify non-secretory medullary thyroid carcinoma was carried out.
Collapse
Affiliation(s)
- Claudio Gambardella
- Division of Thyroid Surgery - Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini, 5, 80131 Naples, Italy
- Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Chiara Offi
- Division of Thyroid Surgery - Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Guglielmo Clarizia
- Division of Thyroid Surgery - Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Roberto Maria Romano
- Division of Thyroid Surgery - Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive, Medicine University of Campania “Luigi Vanvitelli”, School of Medicine, Piazza Miraglia 2, 80138 Naples, Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive, Medicine University of Campania “Luigi Vanvitelli”, School of Medicine, Piazza Miraglia 2, 80138 Naples, Italy
| | - Rosa Maria Di Crescenzo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Angelo Cangiano
- Division of Thyroid Surgery - Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Sergio Di Martino
- Division of Thyroid Surgery - Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Giancarlo Candela
- Division of Thyroid Surgery - Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Giovanni Docimo
- Division of Thyroid Surgery - Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini, 5, 80131 Naples, Italy
| |
Collapse
|
15
|
Danila R, Livadariu R, Branisteanu D. CALCITONIN REVISITED IN 2020. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2019; 15:544-548. [PMID: 32377257 PMCID: PMC7200115 DOI: 10.4183/aeb.2019.544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Calcitonin (CT) is a polypeptidic hormone specifically secreted by the thyroid parafollicular cells (C cells) and tangentially involved in human phosphocalcic and bone metabolism. CT from other species (e.g. salmon) is more potent than human CT and has limited therapeutic applications. The neoplastic proliferation of C cells leads to medullary thyroid carcinoma (MTC) generally characterized by an increase of CT secretion. Serum CT is therefore the ideal marker for MTC and can confirm its presence at an early stage, as well as the follow up of its remission or progression/relapse/survival after surgery. There are, however, controversies such as the necessity of CT screening in patients with thyroid nodules, or particular situations causing false positive or false negative results. Our minireview also deals with an up-to-date of surgical procedures for MTC, as well as with non-surgical therapy.
Collapse
Affiliation(s)
- R. Danila
- “Grigore T Popa” University of Medicine and Pharmacy, Faculty of Medicine - Surgery, Iasi, Romania
| | - R. Livadariu
- “Grigore T Popa” University of Medicine and Pharmacy, Faculty of Medicine - Surgery, Iasi, Romania
- *Correspondence to: Roxana Livadariu MD, “Grigore T Popa” University of Medicine and Pharmacy, Faculty of Medicine, Surgery, 16 Universitatii St., 700115 Iaşi, România, E-mail:
| | - D. Branisteanu
- “Grigore T Popa” University of Medicine and Pharmacy, Faculty of Medicine - Endocrinology, Iasi, Romania
| |
Collapse
|
16
|
Zhang G, Jiang Y, Zhang S, Zhao L, Fan J, Zhang Z, Ma J, Chen R, Xu Y. Genetic analysis of a hereditary medullary thyroid carcinoma case with normal preoperative serum calcitonin levels. Pathol Res Pract 2019; 215:152529. [PMID: 31409511 DOI: 10.1016/j.prp.2019.152529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/12/2019] [Accepted: 07/05/2019] [Indexed: 11/29/2022]
Abstract
CONTEXT Serum calcitonin is often elevated in medulla thyroid carcinoma (MTC) and thus serves as an indicator of primary and recurrent disease. However, there are MTC patients with normal Serum calcitonin and the underlying mechanisms are largely unknown. CASE DESCRIPTION A 48-year-old female patient presenting with a right anterior cervical mass was diagnosed with medullary carcinoma. She had elevated carcinoembryonic antigen (CEA) but normal Serum calcitonin levels. Next generation sequencing (NGS) of paired tumor and peripheral blood revealed a germline pathogenic RET mutation, indicating the hereditary nature of MTC in this patient. Two somatic loss-of-function mutations in DICER1 gene were also found, which we postulated to account for the normal calcitonin levels found in this patient. To our knowledge, this is the first report of a hereditary MTC case displaying a normal Serum calcitonin. CONCLUSIONS The case suggests NGS can be used in the diagnosis of hereditary MTC and exploring the reasons of normal Serum calcitonin in these patients.
Collapse
Affiliation(s)
- Gang Zhang
- Department of Breast and Thyroid Surgery, Daping Hospital, Army Military Medical University, Chongqing, 400042, China.
| | - Yan Jiang
- Department of Breast and Thyroid Surgery, Daping Hospital, Army Military Medical University, Chongqing, 400042, China.
| | - Shu Zhang
- Department of Breast and Thyroid Surgery, Daping Hospital, Army Military Medical University, Chongqing, 400042, China.
| | - Lianhua Zhao
- Department of Pathology, Daping Hospital, Army Military Medical University, Chongqing, 400042, China.
| | - Jun Fan
- Department of Breast and Thyroid Surgery, Daping Hospital, Army Military Medical University, Chongqing, 400042, China.
| | - Zhe Zhang
- Department of Breast and Thyroid Surgery, Daping Hospital, Army Military Medical University, Chongqing, 400042, China.
| | - Jianhui Ma
- Ludwig Institute for Cancer Research, La Jolla, CA, 92037, USA; Geneplus-Beijing Institute, Beijing, China.
| | | | - Yan Xu
- Department of Breast and Thyroid Surgery, Daping Hospital, Army Military Medical University, Chongqing, 400042, China.
| |
Collapse
|
17
|
Gambardella C, Offi C, Patrone R, Clarizia G, Mauriello C, Tartaglia E, Di Capua F, Di Martino S, Romano RM, Fiore L, Conzo A, Conzo G, Docimo G. Calcitonin negative Medullary Thyroid Carcinoma: a challenging diagnosis or a medical dilemma? BMC Endocr Disord 2019; 19:45. [PMID: 31142313 PMCID: PMC6541563 DOI: 10.1186/s12902-019-0367-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/08/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Medullary thyroid carcinoma is a neuroendocrine tumor belonging form a malignant growth of the thyroid parafollicular C-cells, representing from 1 to 10% of all thyroid cancer. The biochemical activity of medullary thyroid carcinoma includes the production of calcitonin and carcinoembryogenic antigen, which are sensitive tumor markers, facilitating the diagnosis, follow-up and prognostication. The diagnosis is reached through the identification of high basal calcitonin serum level or after pentagastrin stimulation test. Medullary thyroid carcinoma is able to produce other relevant biomarkers as procalcitonin, carcinoembryionic antigen and chromogranin A. In Literature are described few cases of medullary thyroid carcinoma without elevation of serum calcitonin, an extremely rare event. The aim of this study was to analyse the presentation, the main features and therapeutic management of medullary thyroid carcinoma associated with negative serum calcitonin levels. METHODS Using the PubMed database, a systematic review of the current Literature was carried out, up to February 2018. Finally, nineteen articles met our inclusion criteria and were selected according to the modified Newcastle-Ottawa scale. RESULTS Fourty-nine patients with definitive pathology confirming medullary thyroid carcinoma and with calcitonin serum level in the normal range were identified (24 female, 24 male and not reported gender in 1 case). Mean age was 51.7 years. Serum calcitonin levels were reported for 20 patients with a mean value of 8.66 pg/mL and a range of 0.8-38 pg/mL. Despite the low or undetectable calcitonin serum level, at immunochemistry in almost the half of the cases reported by the Authors, the tumors presented diffuse or focal positivity for calcitonin and carcinoembryionic antigen, while was reported a chromogranin A positivity in 41 of the 43 tested patients. CONCLUSIONS Calcitonin negative medullary thyroid carcinoma is an extremely rare pathology. The diagnosis and the surveillance is often challenging and delayed, due to the lack of elevation of serum markers as calcitonin and carcinoembryionic antigen. Further studies are needed, to better define options for management of non secretory medullary thyroid carcinoma and to identify new and reliable biomarkers associated to diagnosis and relapse of this medical dilemma.
Collapse
Affiliation(s)
- Claudio Gambardella
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Chiara Offi
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Renato Patrone
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Guglielmo Clarizia
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Claudio Mauriello
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Ernesto Tartaglia
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Francesco Di Capua
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Sergio Di Martino
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Roberto Maria Romano
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Lorenzo Fiore
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Alessandra Conzo
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giovanni Conzo
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giovanni Docimo
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, School of Medicine, Via Sergio Pansini 5, 80131 Naples, Italy
| |
Collapse
|
18
|
Sukpanich R, Khanafshar E, Suh I, Gosnell J. Case report of a neuroendocrine tumor of the thyroid gland with limited calcitonin expression: a diagnostic challenge. AME Case Rep 2019; 3:12. [PMID: 31231713 DOI: 10.21037/acr.2019.05.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 04/12/2019] [Indexed: 12/19/2022]
Abstract
Medullary thyroid carcinoma (MTC) is a malignant tumor of the parafollicular cells, which produce calcitonin. As a result, calcitonin is an important tool for diagnosing MTC. When there is focal or no calcitonin staining, diagnosis of MTC can be challenging as this may suggest differences in cell origin and in prognosis and recurrence of the disease. The prognosis and guidelines for management and follow up for MTC remain inconclusive. Here, we present a case of primary neuroendocrine tumor of the thyroid gland with only focal calcitonin staining on immunohistochemistry and low serum calcitonin level despite a tumor size of almost 4 cm. The assumption of C-cell origin was made from positive staining for carcinoembryonic agent (CEA), thyroid transcription factor 1 (TTF-1) and paired box 8 (PAX8) without expression of thyroglobulin (Tg). The patient underwent thyroid lobectomy and follow-up monitoring with ultrasound and measurements of calcitonin and CEA levels, without any further surgical intervention. Few cases of neuroendocrine tumors with limited calcitonin expression have been published and the etiology and prognosis are still unknown. Our case suggests that limited calcitonin expression cannot completely exclude the diagnosis of MTC. This rare type of MTC should be differentiated from the typical presentation of MTC. Treatment and post-operative surveillance should be tailored based on the individual.
Collapse
Affiliation(s)
- Rupporn Sukpanich
- Endocrine Surgery Section, Department of Surgery, University of California, San Francisco, CA, USA.,Department of Surgery, Rajavithi Hospital, Rangsit University, Bangkok, Thailand
| | - Elham Khanafshar
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Insoo Suh
- Endocrine Surgery Section, Department of Surgery, University of California, San Francisco, CA, USA
| | - Jessica Gosnell
- Endocrine Surgery Section, Department of Surgery, University of California, San Francisco, CA, USA
| |
Collapse
|
19
|
Pastorello RG, Saieg MA. Metastases to the Thyroid: Potential Cytologic Mimics of Primary Thyroid Neoplasms. Arch Pathol Lab Med 2018; 143:394-399. [PMID: 30444438 DOI: 10.5858/arpa.2017-0570-rs] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Secondary tumors of the thyroid gland, although uncommon, can sometimes pose as diagnostic dilemmas on fine-needle aspiration cytology, frequently mimicking primary thyroid neoplasms. An accurate diagnosis of such lesions, however, is critical for patient management and prognosis. The present study reviews the cytologic aspects of secondary involvement of the thyroid, listing the most common primary malignancies that metastasize to this gland. Knowledge of such morphologic aspects, combined with prompt clinical correlation, is essential for the cytopathologist to achieve a proper, definite diagnosis.
Collapse
Affiliation(s)
- Ricardo Garcia Pastorello
- From the Department of Pathology, A.C. Camargo Cancer Center, Sao Paulo, Brazil (Drs Pastorello and Saieg); and the Department of Pathology, Santa Casa Medical School, Sao Paulo, Brazil (Dr Saieg)
| | - Mauro Ajaj Saieg
- From the Department of Pathology, A.C. Camargo Cancer Center, Sao Paulo, Brazil (Drs Pastorello and Saieg); and the Department of Pathology, Santa Casa Medical School, Sao Paulo, Brazil (Dr Saieg)
| |
Collapse
|
20
|
Yadav D, Agarwal S, Sharma A, Malik E, Kandasamy D, Thakar A, Yadav R, Barward A, Kini L. Synovial sarcoma masquerading as medullary thyroid carcinoma. Cytopathology 2018; 29:468-470. [PMID: 29873853 DOI: 10.1111/cyt.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2018] [Indexed: 11/29/2022]
Affiliation(s)
- D Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - S Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - A Sharma
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - E Malik
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - D Kandasamy
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - A Thakar
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India
| | - R Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - A Barward
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - L Kini
- Clinical Pathologist, CORE Diagnostics, New Delhi, India
| |
Collapse
|
21
|
Faugeras L, Pirson AS, Donckier J, Michel L, Lemaire J, Vandervorst S, D'Hondt L. Refractory thyroid carcinoma: which systemic treatment to use? Ther Adv Med Oncol 2018; 10:1758834017752853. [PMID: 29399055 PMCID: PMC5788129 DOI: 10.1177/1758834017752853] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/01/2017] [Indexed: 12/21/2022] Open
Abstract
The incidence of thyroid cancer has increased markedly in recent decades, but has been stable in terms of mortality rates. For the most part, these cancers are treated with surgery, which may or may not be followed by radioactive iodine depending on the tumor subtype. Still, many of these cancers will recur and may be treated with radioactive iodine or another surgery. It is unclear what treatment is best for cases of locally advanced or metastatic thyroid cancer that are refractory to radioactive iodine. Chemotherapy has a very low response rate. However, in the past few years, several systemic therapies, primarily targeted, have emerged to improve the overall survival of these patients. Alternative treatments are also of interest, namely peptide receptor radionuclide therapy or immunotherapy.
Collapse
Affiliation(s)
- Laurence Faugeras
- Oncology Department, CHU UCL Namur, 1 rue Therasse, 5530 Yvoir, Belgium
| | | | | | - Luc Michel
- Department of General Surgery, CHU UCL Namur, Yvoir, Belgium
| | - Julien Lemaire
- Department of General Surgery, CHU UCL Namur, Yvoir, Belgium
| | | | | |
Collapse
|
22
|
Ehyaei S, Hedayati M, Zarif-Yeganeh M, Sheikholeslami S, Ahadi M, Amini SA. Plasma Calcitonin Levels and miRNA323 Expression in Medullary Thyroid Carcinoma Patients with or without RET Mutation. Asian Pac J Cancer Prev 2017; 18:2179-2184. [PMID: 28843253 PMCID: PMC5697478 DOI: 10.22034/apjcp.2017.18.8.2179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Medullary thyroid cancer (MTC) is an endocrine tumor featuring parafollicular or C-cell differentiation,
with calcitonin as a specific biomarker in MTC diagnosis. Germline mutations in the RET proto-oncogene are considered
responsible for its familial occurrence and somatic mutations can cause sporadic lesions. MicroRNAs can act as
oncogenes or tumor suppressors by inhibiting the expression of target genes.. The aim of this study was to investigate
relationships between plasma levels of calcitonin and miRNA323 expression in MTC patients with or without RET
mutation. Methods: In this cross-sectional study, MTC lesions (based on pathological confirmation) were investigated.
Genomic DNA was extracted and Exons 10 and 11 of RET were genotyped using PCR-sequencing. Division was into
two groups of 43 cases each with or without mutation. Plasma levels of calcitonin were determined in both. Results:
miRNA323 was measured using real-time-PCR. After performing normality tests, independent T-tests and Mann
Whitney tests were used for the statistical comparison of parametric and nonparametric data, respectively. Plasma
levels of calcitonin were significantly higher in MTC cases without a RET mutation compared to those with a mutation.
Conclusion: There was no significant difference between the two groups regarding the expression of miRNA323 so
that this parameter could not be used as a bio-index germ line mutations in MTCs. However, determination of calcitonin
levels in plasma might be helpful in this regard.
Collapse
Affiliation(s)
- Samira Ehyaei
- Department of clinical biochemistry, Faculty of Medical Sciences, Shahrekord University of Medical Science, Shahrekord, Iran.
| | | | | | | | | | | |
Collapse
|
23
|
Faour O, Gilloteaux J. Calcitonin: Survey of new anatomy data to pathology and therapeutic aspects. TRANSLATIONAL RESEARCH IN ANATOMY 2017. [DOI: 10.1016/j.tria.2017.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
24
|
Kamgar-Parsi K, Tolchard J, Habenstein B, Loquet A, Naito A, Ramamoorthy A. Structural Biology of Calcitonin: From Aqueous Therapeutic Properties to Amyloid Aggregation. Isr J Chem 2016. [DOI: 10.1002/ijch.201600096] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kian Kamgar-Parsi
- Applied Physics Program; University of Michigan; Ann Arbor MI 48109-1040 USA
| | - James Tolchard
- Institute of Chemistry and Biology of Membranes and Nanoobjects, CNRS, CBMN, UMR 5248; University of Bordeaux; 33600 Pessac France
| | - Birgit Habenstein
- Institute of Chemistry and Biology of Membranes and Nanoobjects, CNRS, CBMN, UMR 5248; University of Bordeaux; 33600 Pessac France
| | - Antoine Loquet
- Institute of Chemistry and Biology of Membranes and Nanoobjects, CNRS, CBMN, UMR 5248; University of Bordeaux; 33600 Pessac France
| | - Akira Naito
- Graduate School of Engineering; Yokohama National University; 79-5 Tokiwadai Hodogaya-ku Yokohama 240-8501 Japan
| | - Ayyalusamy Ramamoorthy
- Department of Chemistry and Biophysics Program; University of Michigan; 930 North University Avenue Ann Arbor MI 48109-1055 USA
| |
Collapse
|