Clinical characteristics and molecular pathology of skull ectopic thyroid cancer

Diagnosis and treatment of ectopic thyroid carcinoma: A case report and literature review

Introduction

Ectopic thyroid cancer (ETC) is primary thyroid cancer occurring in ectopic thyroid tissue, and its incidence rate is approximately 0.3%-0.5% of thyroid cancer. Only approximately 132 cases of ETC have been diagnosed and treated worldwide in the past 110 years, with most of them being adults. Of note, patients with ETC are prone to misdiagnosis and mistreatment.

Case report

This was a 13-year-old adolescent female who reported having a sensation of swallowing obstruction when eating blocky foods. Color Doppler Ultrasound (CDU) found a 2.3 cm ×1.7 cm × 2.1 cm hypoechoic nodule slightly to the right of the deep surface of the tongue base, with a honeycomb shape. Meanwhile, a mixed echogenic nodule of approximately 2.0 cm × 1.9 cm × 2.3 cm was seen deep in the mouth floor, and a very low echogenic region of 1.4 cm × 1.1 cm × 1.8 cm was observed in the nodule. We then performed a fine needle aspiration biopsy (FNAB) of the thyroid nodules guided by CDU, and the results showed papillary thyroid carcinoma (PTC). Then, a local extended resection of the thyroid carcinoma was performed. Bilateral cervical IA and adjacent subhyoid lymph node dissection was performed through a small anterior cervical incision. The patient recovered well, and was discharged on the fifth day after surgery. The patient only took levothyroxine tablets for replacement therapy after surgery. The patient was followed up for 36 months, and the thyroid function remained in the normal range. Reexamination by CDU showed no tumor recurrence, lymph node enlargement, or obvious change in the tongue base ectopic thyroid.

Conclusions

ETC is an extremely rare type of thyroid cancer, which is easy to be misdiagnosed. Preoperative use of CDU, nuclide scanning, computed tomography (CT)/Magnetic resonance imaging (MRI), and FNAB can significantly reduce the misdiagnosis rate of this disease. Surgery is currently the main treatment for ETC. Complete resection still has a high cure rate. For patients with advanced ETC who cannot be completely resected, external radiotherapy and targeted therapy can be tried, but the prognosis needs to be verified with more cases in the future.

NCOA3 is a critical oncogene in thyroid cancer via the modulation of major signaling pathways

PURPOSE

The Nuclear Receptor Coactivator (NCOA3, also known as SRC-3, AIB1, p/CIP, RAC3, ACTR, and TRAM1), acts as an oncogene in multiple tumors, but its biological function in thyroid cancer remains unclear. This study was designed to explore the role of NCOA3 in thyroid cancer.

METHODS

The study assessed NCOA3 expression in thyroid cancer and their matched non-cancerous thyroid tissues at mRNA and protein levels. Then we evaluated the effect of NCOA3 on malignant activities of thyroid cancer cells. To better understand the oncogenic role of NCOA3 in thyroid tumorigenesis, we tested the effect of NCOA3 on major proteins related to thyroid cancer.

RESULTS

Our data demonstrated that protein expression of NCOA3 was significantly upregulated in thyroid cancer tissues. NCOA3 knockdown inhibited cell proliferation and invasion, and induced cell cycle arrest and apoptosis in thyroid cancer. Conversely, ectopic expression of NCOA3 promoted cell proliferation and invasiveness in thyroid cancer. Mechanistically, NCOA3 could improve the survival and invasiveness of thyroid cancer cells through the modulation of the ErbB, AKT, ERK, and β-catenin pathways.

CONCLUSION

Collectively, these findings suggest that NCOA3 is critical in the initiation and development of thyroid cancer, and might be a possible marker for prognosis and therapy.

Ectopic Mediastinal and Lumbar Thyroid Tissue

The thyroid gland is found in the neck and corresponds to the 2-4 tracheal cartilages. It is rarely found in other sites and is termed ectopic thyroid tissue (ETT) once found. In this report, we present a case of a 19-year-old female who was diagnosed with ETT in the lumbar region and posterior mediastinal region after total thyroidectomy for a large dominant thyroid nodule. ETT has a unique presentation and physicians should be vigilant to diagnose it correctly and promptly to decrease morbidity associated with the disease.

gga-miR-146c Activates TLR6/MyD88/NF-κB Pathway through Targeting MMP16 to Prevent Mycoplasma Gallisepticum (HS Strain) Infection in Chickens

Mycoplasma gallisepticum (MG), a pathogen that infects chickens and some other birds, triggers chronic respiratory disease (CRD) in chickens, which is characterized by inflammation. The investigation of microbial pathogenesis would contribute to the deep understanding of infection control. Since microribonucleic acids (miRNAs) play a key role in this process, gga-mir-146c, an upregulated miRNA upon MG infection, was selected according to our previous RNA-sequencing data. In this paper, we predicted and validated that MMP16 is one of gga-miR-146c target genes. Results show that MMP16 is the target of gga-miR-146c and gga-miR-146c can downregulate MMP16 expression within limits. gga-miR-146c upregulation significantly increased the expression of TLR6, NF-κB p65, MyD88, and TNF-α, whereas the gga-miR-146c inhibitor led to an opposite result. gga-miR-146c upregulation effectively decreased apoptosis and stimulated DF-1 cells proliferation upon MG infection. On the contrary, gga-miR-146c inhibitor promoted apoptosis and repressed the proliferation. Collectively, our results suggest that gga-miR-146c upregulation upon MG infection represses MMP16 expression, activating TLR6/MyD88/NF-κB pathway, promoting cell proliferation by inhibiting cell apoptosis, and, finally, enhancing cell cycle progression to defend against host MG infection.

Diagnosis and management of a mediastinal ectopic thyroid laying on the right bronchus: case report and review of literature

Background

The mediastinal ectopic thyroid is very rare, accounting for less than 1% of all cases of ectopic thyroid tissue. The differential diagnoses with other diseases such as lymphomas, thymic tumors and dermoid cysts is mandatory, in fact each one, needs different management and treatment.

Case presentation

Here, we discuss a rare case of mediastinal ectopic thyroid presenting with a paratracheal mass laying on the right bronchus without symptoms. A 63-year-old male presented with an abnormal well-defined mass along the right paratracheal side, detected by chest x-ray. The CT scan confirmed the presence of a 6 × 8 cm heterogeneously enhanced mass, located behind the superior vena cava and left brachiocephalic artery, reaching azygos vein and right bronchus, without a mass effect. Taking into account the clinical importance of a mediastinal mass, we removed it surgically, through a double surgical approach consisting in a classical transverse cervicotomy for the left thyroid lobe, followed then by a longitudinal sternal splitting to remove the mediastinal mass and complete the thyroidectomy.

Conclusions

In case of mediastinal masses, the surgical excision is recommended, presenting the double advantage to clarify the diagnosis and to treat the pathology. As demonstrated in this case, a mediastinal ectopic thyroid should be taken into account in the differential diagnosis, considering its clinical importance.

The value of scintigraphy, computed tomography, magnetic resonance imaging, and single-photon emission computed tomography/computed tomography for the diagnosis of ectopic thyroid in the head and neck: A STROBE-compliant retrospective study

Because of its rarity, the exact imaging features of ectopic thyroid are poorly known.To analyze the value of scintigraphy, computed tomography (CT), magnetic resonance imaging (MRI), and single-photon emission computed tomography (SPECT)/CT in the diagnosis of ectopic thyroid in the head and neck.First, we retrospectively analyzed the scintigraphy, CT, MRI, and SPECT/CT images from 25 masses (22 patients) suspected of head and neck ectopic thyroid from 2006 to 2017 at the Shanghai Ninth People's Hospital. Each mass was imaged by nuclear imaging (scintigraphy with or without SPECT/CT) and radiological exam (CT and/or MRI). Pathological examination was considered as the gold standard. Secondly, thirteen malignant ectopic thyroids in the head and neck reported in the English literature from 2001 to 2017 were retrieved for comparison.The accuracy of scintigraphy was not significantly higher than that of CT (94.7%, vs 89.5%, P > .99) or MRI (92.3%, vs 84.6%, P > .99). Five masses which underwent scintigraphy with SPECT/CT were all true positive, while 1 was false negative on MRI, and 2 were false negative on CT. Compared to the benign ectopic thyroids in our study, the 13 malignant ectopic thyroids retrieved from the literature were grossly the same in shape, margins, and invasion on CT or MRI.The number of patients was limited, but scintigraphy combined with SPECT/CT could be a reliable method for the diagnosis of ectopic thyroid. Benign and malignant ectopic thyroids appear to be similar in shapes, margins, and invasion on CT or MRI.