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S Temperley T, Temperley HC, O'Sullivan NJ, Corr A, Brennan I, Kelly ME, Prior L. Tracheoesophageal fistula development following radiotherapy and tyrosine kinase inhibitors in a patient with advanced follicular thyroid carcinoma: a case-based review. Ir J Med Sci 2024; 193:1143-1147. [PMID: 37922099 DOI: 10.1007/s11845-023-03559-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/23/2023] [Indexed: 11/05/2023]
Abstract
INTRODUCTION Tracheoesophageal fistulas (TEF) are a rare complication that can occur in patients with radioactive iodine refractory metastatic follicular thyroid carcinoma (FTC) following treatment with radiotherapy (RT) and tyrosine kinase inhibitors (TKI). METHODS We describe the case of a TEF development in a 69-year-old male who underwent targeted therapy TKIs and adjuvant RT for radioactive iodine refractory FTC. RESULTS In the case, staging investigations revealed a metastatic, poorly differentiated FTC refractory to radioactive iodine. After 2 years of disease control on Lenvatinib, the patient's condition progressed, necessitating a switch to Cabozantinib. Soon after, they presented with haemoptysis secondary to invasion of the primary thyroid tumour into the trachea. Radical radiotherapy (45 Gy/30 fractions) was also administered to the thyroid gland, ultimately complicated by radiation necrosis. Four months post-completion of RT and recommencing TKI, the patient presented with haemoptysis and hoarseness secondary to recurrent laryngeal nerve compression and tracheal invasion, as well as dysphagia secondary to oesophageal compression. Following an acute presentation with intractable throat pain, investigations revealed a TEF. Surgical and endoscopic management was deemed inappropriate given the patient's rapid deterioration and anatomical position of the TEF, and therefore a palliative approach was taken. CONCLUSION This case report highlights a rare cause of TEF development in a patient having TKI therapy post-RT for advanced FTC. It highlights the importance of monitoring TEF development in this cohort of patients. It demonstrates the importance of patient counselling and education regarding treatment options and the rare side effects of treatments.
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Affiliation(s)
- Tatiana S Temperley
- School of Medicine, University of Limerick, Limerick, Ireland
- Department of Oncology, The Beacon Hospital, Dublin, Ireland
| | - Hugo C Temperley
- Department of Radiology, St. James's Hospital, Dublin, Ireland.
- Department of Surgery, St. James's Hospital, Dublin, Ireland.
| | | | - Alison Corr
- Department of Radiology, St. James's Hospital, Dublin, Ireland
| | - Ian Brennan
- Department of Radiology, St. James's Hospital, Dublin, Ireland
| | - Michael E Kelly
- Department of Surgery, St. James's Hospital, Dublin, Ireland
| | - Lisa Prior
- Department of Oncology, The Beacon Hospital, Dublin, Ireland
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Ye WD, Tan LC, Veryaskina YA, Han PZ, Yu PC, Shi X, Liu WL, Kai ZT, Lin RJ, Huang LS, Semenov A, Zhimulev IF, Ji QH, Qu N, Titov SE, Wang YL. Synchronous papillary and follicular thyroid carcinomas: the first retrospective cohort study and literature review. Transl Cancer Res 2024; 13:1924-1935. [PMID: 38737695 PMCID: PMC11082670 DOI: 10.21037/tcr-23-1526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/16/2024] [Indexed: 05/14/2024]
Abstract
Background Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) contribute to more than 95% of thyroid malignancies. However, synchronous PTC and FTC are less common; it is most commonly discovered incidentally as synchronous malignancies during operation, which adds difficulties to intraoperative decision-making and postoperative treatment. Therefore, we analyzed the clinicopathological characteristics and prognosis of patients with PTC and FTC in our center. Methods We conducted a search of single PTC, single FTC, and synchronous PTC/FTC patients who received initial surgery treatment at Fudan University Shanghai Cancer Center from 2006 to 2018 and collected paraffin-embedded samples of synchronous patients. Clinicopathological characteristics were collected from the electronic medical record system. Follow-up was performed through telephone contact or medical records. Exome sequencing was performed by ThyroLead panel. Results Total of 42 synchronous PTC/FTC patients, 244 single FTC patients, and 2,959 single PTC patients were included. It showed a similarity between the clinicopathological features of synchronous thyroid cancer patients and single PTC patients, with a greater proportion of females, higher probabilities of lymph node metastasis, and higher rate of concurrence of Hashimoto's disease. The disease-free survival (DFS) curve indicated a worse prognosis of the synchronous group and single PTC group compared to the single FTC group, who had a propensity for neck lymph node recurrence; however, logistic multivariate regression analysis did not find any factor related to recurrence in the synchronous group. After re-checking pathology, DNA extraction, and quality control, genetic alteration information of 62 samples including primary tumors and metastatic lymph nodes from 35 synchronous cancer patients was displayed. In total, 81 mutations and 1 fusion gene were identified, including mutations related to outcomes and targeted therapy. Besides, some rare mutations in thyroid cancer were found in these patients. Conclusions To conclude, synchronous PTC/FTC tend to be incidentally discovered during or after operation, behaving more like single PTC. The prognosis of synchronous patients is worse than that of single FTC patients and supplemental cervical lymph node dissection, total thyroidectomy, and postoperative radioiodine therapy should be taken into consideration after diagnosis. The next-generation sequencing (NGS) showed a unique molecular feature of synchronous patients with some rare mutations.
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Affiliation(s)
- Wei-Dong Ye
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Li-Cheng Tan
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yulia Andreevna Veryaskina
- Laboratory of Gene Engineering, Institute of Cytology and Genetics, SB RAS, Novosibirsk, Russian Federation
- Department of the Structure and Function of Chromosomes, Laboratory of Molecular Genetics Institute of Molecular and Cellular Biology, SB RAS, Novosibirsk, Russian Federation
| | - Pei-Zhen Han
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Peng-Cheng Yu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao Shi
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wan-Lin Liu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhen-Tian Kai
- Department of Bioinformatics, Zhejiang Shaoxing Topgen Biomedical Technology Co., Ltd., Shanghai, China
| | - Rui-Jue Lin
- Department of Technology, Zhejiang Topgen Clinical Laboratory Co., Ltd., Huzhou, China
| | - Li-Sha Huang
- Department of Medicine, Zhejiang Shaoxing Topgen Biomedical Technology Co., Ltd., Shanghai, China
| | - Arseny Semenov
- Saint Petersburg State University Hospital, Saint Petersburg, Russian Federation
| | - Igor Fyodorovich Zhimulev
- Department of the Structure and Function of Chromosomes, Laboratory of Molecular Genetics Institute of Molecular and Cellular Biology, SB RAS, Novosibirsk, Russian Federation
| | - Qing-Hai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ning Qu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Sergei Evgenievich Titov
- Department of the Structure and Function of Chromosomes, Laboratory of Molecular Genetics Institute of Molecular and Cellular Biology, SB RAS, Novosibirsk, Russian Federation
- AO Vector-Best, Novosibirsk, Russian Federation
| | - Yu-Long Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Tabatabaizadeh M, Hasibi Taheri S, Eydi M, Shayestehpour M. The occurrence of Adrenocorticotropic hormone-independent Cushing's syndrome in a woman with the history of papillary thyroid carcinoma: a case report. J Med Case Rep 2021; 15:113. [PMID: 33691778 PMCID: PMC7948365 DOI: 10.1186/s13256-021-02684-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/18/2021] [Indexed: 11/26/2022] Open
Abstract
Background Thyroid papillary carcinoma is one of the most common endocrine tumors, and it accounts for 85% of thyroid tumors. Adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome is a rare disease. In this case report, we discuss a very rare case of coexistence of papillary thyroid carcinoma and Cushing's syndrome with an adrenal origin. Case presentation The patient was a 33-year-old Iranian/Persian woman with a history of papillary thyroid carcinoma treated with iodine 131 three years ago. She presented with weight gain, amenorrhea, and mood disorders in the last six months. She was diagnosed with an ACTH-independent Cushing's syndrome due to benign adrenal adenoma and underwent laparoscopic adrenalectomy surgery. The symptoms of the syndrome were disappeared after the surgery. Conclusions ACTH-independent Cushing's syndrome due to adrenal tumor and papillary thyroid cancer occurs sporadically. The co-occurrence of two endocrine tumors with different origins is rare. It is recommended that the occurrence of other endocrine neoplasms be considered when an endocrine tumor is diagnosed.
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Affiliation(s)
| | - Sara Hasibi Taheri
- Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, IR, Iran
| | - Mohammad Eydi
- Department of General Surgery, Kashan University of Medical Sciences, Kashan, IR, Iran
| | - Mohammad Shayestehpour
- Autoimmune Disease Research Center, Kashan University of Medical Sciences, Kashan, IR, Iran
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Abdelaal A, El Ansari W, Abusabeib A, Farghaly H, Tabeb AAM. Simultaneous occurrence of follicular and papillary thyroid carcinomas in same thyroid lobe: A case series of six patients from Qatar. Int J Surg Case Rep 2020; 73:65-70. [PMID: 32645594 PMCID: PMC7341056 DOI: 10.1016/j.ijscr.2020.06.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 12/02/2022] Open
Abstract
Simultaneous occurrence of papillary and follicular thyroid carcinomas in the same lobe are very rare. First case series of simultaneous occurrence of these two types of thyroid cancer in the Middle East and North Africa Region. Endocrinologists and pathologists should be aware of and vigilant to this variety. Occurrence of both types together shifts patients from low risk to intermediate or high risk which may reflect on management.
Background Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) are the first and second most common thyroid cancers comprising about 85% and 10% of all thyroid cancers. Simultaneous occurrence of medullary and papillary thyroid cancer has been reported with various presentations, but simultaneous occurrence of FTC in addition to PTC as differentiated cancers, is an unusual event that is rarely reported. Presentation of cases We report our experience of six rare cases of synchronous coexistence of FTC and PTC with unique features. Case 1 is 31 old Egyptian female. Case 2 is a 61 year old Sudanese male. Case 3 is a 59 year old Sudanese male. Case 4 is a 56 years old Indian female. Case 5 is a 35 years old Filipina female. Case 6 is a 52 years old Qatari female. The six cases are special in their co-occurrence of two thyroid carcinoma, consisting of histologic features of follicular thyroid carcinomas, and classical papillary thyroid carcinoma, possibly the first case series of simultaneous occurrence of these two types of thyroid cancer in the Middle East and North Africa Region. Conclusions We present rare cases of concurrent FTC and PTC. These six cases add more data highlighting the coincidental simultaneous coexistence of FTC and PTC. Endocrinologists and pathologists should be aware of and vigilant to this variety.
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Affiliation(s)
- Abdelrahman Abdelaal
- Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
| | - Walid El Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; College of Medicine, Qatar University, Doha, Qatar; School of Health and Education, University of Skövde, Skövde, Sweden.
| | - Abdelrahman Abusabeib
- Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
| | - Hanan Farghaly
- Department of Lab Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
| | - Abdelhakem A M Tabeb
- Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
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Samiee-Rad F, Farajee S, Torabi E. Concurrence of Papillary Thyroid Carcinoma and Hürthle Cell Carcinoma in an Iranian Woman with Hashimoto's Thyroiditis. IRANIAN JOURNAL OF PATHOLOGY 2019; 14:342-346. [PMID: 31754366 PMCID: PMC6824768 DOI: 10.30699/ijp.2019.99544.1986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/14/2019] [Indexed: 12/27/2022]
Abstract
The most usual form of the endocrine carcinoma is thyroid cancer (TC). In addition to papillary thyroid carcinoma (PTC), recent studies revealed incidence of RET/PTC rearrangement in other tumors, like Hürthle cell carcinoma (HCC) and even in non-carcinomatous disorders like Hashimoto's thyroiditis. Here, we present a case with concurrence of papillary thyroid carcinoma and Hürthle cell carcinoma. A 60-year-old woman referred to our hospital with a mass in her neck. Physical examinations revealed painful swelling in the thyroid. Ultrasonographic examination showed two hypoechoic nodules in the right lobe. Hürthle cell variant papillary carcinoma was suggested in the cytology report of the fine needle aspiration. Permanent histopathological diagnosis was co-existence of papillary thyroid carcinoma and Hürthle cell carcinoma. The patient was asymptomatic in 14 months follow up. Concurrence of papillary carcinoma and Hürthle cell carcinoma is a rare form of thyroid malignancies, with doubtful cytogenetic findings and biological behaviors. The results showed that it is necessary for the surgeons and pathologists to be aware of lesions for the optimal diagnostic and therapeutic interventions. Also, it is vital to follow up patients with the Hashimot’s thyroiditis who have multiple nodules to detect occult thyroid cancers and decide for better therapeutic programs.
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Affiliation(s)
- Fatemeh Samiee-Rad
- Department of Pathology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sohayla Farajee
- Medical Student, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Erfan Torabi
- General Physician, 553 Army Hospital, Qazvin, Iran
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Appetecchia M, Lauretta R, Barnabei A, Pieruzzi L, Terrenato I, Cavedon E, Mian C, Castagna MG, Elisei R. Epidemiology of Simultaneous Medullary and Papillary Thyroid Carcinomas (MTC/PTC): An Italian Multicenter Study. Cancers (Basel) 2019; 11:cancers11101516. [PMID: 31600997 PMCID: PMC6826384 DOI: 10.3390/cancers11101516] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/25/2019] [Indexed: 11/16/2022] Open
Abstract
Background: The concomitant presence of papillary thyroid cancer (PTC) and medullary TC (MTC) is rare. In this multicentric study, we documented the epidemiological characteristics, disease conditions and clinical outcome of patients with simultaneous MTC/PTC. Methods: We collected data of patients with concomitant MTC/PTC at 14 Italian referral centers. Results: In total, 183 patients were enrolled. Diagnosis was mostly based on cytological examination (n = 58, 32%). At diagnosis, in the majority of cases, both PTC (n = 142, 78%) and MTC (n = 100, 54%) were at stage I. However, more cases of stage II–IV were reported with MTC (stage IV: n = 27, 15%) compared with PTC (n = 9, 5%). Information on survival was available for 165 patients: 109 patients (66%) were disease-free for both PTC and MTC at the last follow-up. Six patients died from MTC. Median time to progression was 123 months (95% confidence interval (CI): 89.3–156.7 months). Overall, 45% of patients were disease-free after >10 years from diagnosis (125 months); this figure was 72.5% for PTC and 51.1% for MTC. Conclusions: When MTC and PTC are concurrent, the priority should be given to the management of MTC since this entity appears associated with the most severe impact on prognosis.
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Affiliation(s)
- Marialuisa Appetecchia
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
| | - Rosa Lauretta
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
| | - Agnese Barnabei
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
| | - Letizia Pieruzzi
- Endocrinology Unit, University Hospital of Pisa, Pisa 56121, Italy.
| | - Irene Terrenato
- Biostatistics-Scientific Direction, IRCSS Regina Elena National Institute, Rome 00144, Italy.
| | | | - Caterina Mian
- Istituto Oncologico Veneto, University of Padua, Padua 35100, Italy.
| | | | - Rossella Elisei
- Endocrinology Unit, University Hospital of Pisa, Pisa 56121, Italy.
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Halicek M, Little JV, Wang X, Chen AY, Fei B. Optical biopsy of head and neck cancer using hyperspectral imaging and convolutional neural networks. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-9. [PMID: 30891966 PMCID: PMC6975184 DOI: 10.1117/1.jbo.24.3.036007] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 01/14/2019] [Indexed: 05/21/2023]
Abstract
For patients undergoing surgical cancer resection of squamous cell carcinoma (SCCa), cancer-free surgical margins are essential for good prognosis. We developed a method to use hyperspectral imaging (HSI), a noncontact optical imaging modality, and convolutional neural networks (CNNs) to perform an optical biopsy of ex-vivo, surgical gross-tissue specimens, collected from 21 patients undergoing surgical cancer resection. Using a cross-validation paradigm with data from different patients, the CNN can distinguish SCCa from normal aerodigestive tract tissues with an area under the receiver operator curve (AUC) of 0.82. Additionally, normal tissue from the upper aerodigestive tract can be subclassified into squamous epithelium, muscle, and gland with an average AUC of 0.94. After separately training on thyroid tissue, the CNN can differentiate between thyroid carcinoma and normal thyroid with an AUC of 0.95, 92% accuracy, 92% sensitivity, and 92% specificity. Moreover, the CNN can discriminate medullary thyroid carcinoma from benign multinodular goiter (MNG) with an AUC of 0.93. Classical-type papillary thyroid carcinoma is differentiated from MNG with an AUC of 0.91. Our preliminary results demonstrate that an HSI-based optical biopsy method using CNNs can provide multicategory diagnostic information for normal and cancerous head-and-neck tissue, and more patient data are needed to fully investigate the potential and reliability of the proposed technique.
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Affiliation(s)
- Martin Halicek
- University of Texas at Dallas, Department of Bioengineering, Richardson, Texas, United States
- Emory University and Georgia Institute of Technology, Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - James V. Little
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, Georgia, United States
| | - Xu Wang
- Emory University School of Medicine, Department of Hematology and Medical Oncology, Atlanta, Georgia, United States
| | - Amy Y. Chen
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, Georgia, United States
| | - Baowei Fei
- University of Texas at Dallas, Department of Bioengineering, Richardson, Texas, United States
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, Georgia, United States
- University of Texas Southwestern Medical Center, Advanced Imaging Research Center, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
- Address all correspondence to Baowei Fei, E-mail:
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Cracolici V, Mujacic I, Kadri S, Alikhan M, Niu N, Segal JP, Rosen LE, Sarne DH, Morgan A, Desouky S, Cipriani NA. Synchronous and Metastatic Papillary and Follicular Thyroid Carcinomas with Unique Molecular Signatures. Endocr Pathol 2018; 29:9-14. [PMID: 28710706 DOI: 10.1007/s12022-017-9491-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Despite the relatively high prevalence of thyroid cancer, the occurrence of multiple synchronous, distinct subtypes of primary thyroid carcinoma is uncommon. The incidental finding of papillary thyroid microcarcinoma in a gland with a biologically relevant follicular or medullary carcinoma is more frequent than the synchronous occurrence of multiple clinically significant carcinomas. We report a case of synchronous papillary and follicular thyroid carcinomas metastatic to lymph node and bone, respectively. Next generation sequencing showed BRAF V600E mutation in the primary papillary carcinoma and NRAS Q61R mutation in the primary follicular carcinoma and bony metastasis. To our knowledge, this is the first reported case of synchronous and metastatic primary papillary and follicular carcinomas, and the first report of synchronous BRAF V600E mutated papillary and NRAS mutated follicular carcinoma.
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Affiliation(s)
- Vincent Cracolici
- Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA.
| | - Ibro Mujacic
- Division of Molecular Pathology, Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA
| | - Sabah Kadri
- Division of Molecular Pathology, Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA
| | - Mir Alikhan
- Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA
| | - Nifang Niu
- Division of Molecular Pathology, Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA
| | - Jeremy P Segal
- Division of Molecular Pathology, Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA
| | - Lauren E Rosen
- Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA
| | - David H Sarne
- Section of Endocrinology, Department of Medicine, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA
| | - Adam Morgan
- Department of Pathology, St. Mary's Hospital, 700 South Park St, Madison, WI, 53715, USA
| | - Samy Desouky
- Department of Pathology, St. Mary's Hospital, 700 South Park St, Madison, WI, 53715, USA
| | - Nicole A Cipriani
- Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL, 60637, USA
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Zeng R, Shou T, Yang KX, Shen T, Zhang JP, Zuo RX, Zheng YQ, Yan XM. Papillary thyroid carcinoma risk factors in the Yunnan plateau of southwestern China. Ther Clin Risk Manag 2016; 12:1065-74. [PMID: 27418831 PMCID: PMC4935083 DOI: 10.2147/tcrm.s105023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective This study investigated clinical and pathological characteristics and risk factors in papillary thyroid carcinoma (PTC) patients’ native to Yunnan plateau in southwestern China. Methods Clinical data from 1,198 patients diagnosed with PTC (n=578) and control subjects (n=620) with benign thyroid disease (ie, thyroid nodule disease, benign thyroid diseases [BTD]) in Yunnan province were analyzed retrospectively. Results The mean patient age was lower for PTC than for BTD. Positive ratios of thyroid peroxidase antibody, thyroglobulin antibody (TGAb), and thyrotrophin receptor antibody (TRAb) were higher in PTC than in BTD patients. The ratio of PTC coexisting with Hashimoto’s thyroiditis (HT) or with lymphocytic thyroiditis was higher than that of BTD. The number of patients whose age at menarche was ≤13 years, who had given birth to less than or equal to two children, or who were in premenopause were higher in the PTC than in the BTD group. Multivariate conditional logistic regression analyses revealed that age >45 years, nodal size >1 cm, and elevated TG levels were protective factors against PTC. Abnormally elevated TGAb and TRAb levels were independent risk factors for PTC in females. Conclusion HT was not an independent risk factor for but was associated with PTC. TRAb is a risk factor for PTC in individuals living in the Yunnan plateau, but not for those in the plains region.
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Affiliation(s)
- Rong Zeng
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, People's Republic of China; Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, People's Republic of China; Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, People's Republic of China
| | - Tao Shou
- Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, People's Republic of China
| | - Kun-Xian Yang
- Surgical Oncology, The First People's Hospital of Yunnan Province Kunming, People's Republic of China
| | - Tao Shen
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Jin-Ping Zhang
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Rong-Xia Zuo
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Yong-Qing Zheng
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Xin-Ming Yan
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
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