11/185. Follicular thyroid carcinoma with rhabdoid phenotype.The aim of this paper is to highlight the occurrence of an unusual histological variant of follicular carcinoma of the thyroid. Three cases are presented: each of the tumours contained a significant population of rhabdoid cells (accounting for 30-40% of the total tumour content). They were all found in female patients aged 65, 43 and 56 years, who presented with enlarged thyroid glands and were subjected to lobectomies. The tumours contained foci of well-differentiated follicular carcinoma, with areas of capsular and vascular invasion, and an accompanying rhabdoid cell component that merged with the neoplastic follicles. Immunohistochemically, the follicular component was positive with thyroglobulin, but the rhabdoid cells were negative in all three cases. The cytoplasmic aggregates in the rhabdoid cells were strongly positive for epithelial markers and vimentin. Two tumours pursued an aggressive biological course similar to other composite extrarenal rhabdoid tumours. A rhabdoid component accompanying thyroid follicular carcinomas is an adverse prognostic factor.- - - - - - - - - - ranking = 1keywords = thyroid (Clic here for more details about this article) |
12/185. Thyroid carcinoma with isolated spinal metastasis: case history and review of the literature.An unusual case of metastatic follicular thyroid cancer presenting with symptoms of a radiculopathy at C6 is presented. The patient underwent a laminectomy and removal of tumor with resolution of his symptoms. He was found to have a well differentiated follicular thyroid carcinoma and subsequently had total thyroidectomy and 131I treatment. This patient's presentation raised questions about appropriate preoperative evaluation in this clinical scenario. This case highlights the importance of a thorough pre-operative work up for metastatic spine tumors. This should include evaluation of the thyroid consisting of thorough clinical history with particular attention to prior radiation exposure. palpation of the thyroid also should be included as part of a routine pre-operative physical in cases of metastatic lesions of unknown origin. Thyroid function studies should not be utilized unless a clinical suspicion for thyroid cancer is raised during the examination.- - - - - - - - - - ranking = 0.85714285714286keywords = thyroid (Clic here for more details about this article) |
13/185. Recombinant human thyroid-stimulating hormone (rhTSH) in the radioablation of well-differentiated thyroid cancer: preliminary therapeutic experience.iodine-131 (I-131) ablation of thyroid remnant and/or persistent, recurrent or metastatic tumour is part of the initial and subsequent management of well-differentiated thyroid carcinoma. Key to optimizing the safety and efficacy of radioablation is maximizing the selective uptake of radioiodine by normal or neoplastic thyroid tissue. This is achieved by ensuring adequate serum concentrations of thyroid-stimulating hormone (TSH). Exogenous TSH administration obviates the thyroid hormone suppression therapy withdrawal that is necessary for endogenous TSH elevation. It also avoids the marked morbidity, discomfort, and impairment in professional and educational pursuits and quality of life that often result from such withdrawal. Multicentre clinical studies have documented the safety and efficacy of recombinant human TSH (rhTSH) in promoting radioiodine uptake in the diagnostic scanning of well-differentiated thyroid cancer. Study of the use of rhTSH to facilitate radioablation of remnant and malignant thyroid tissue is at an earlier stage, with formal clinical investigation underway. Since April 1995, however, rhTSH has been employed as a radioablative adjunct in over 100 patients in the manufacturer's Compassionate Use Program. Twelve of these cases, reported or reviewed in the present paper, provide preliminary evidence that rhTSH is safe and effective in the radioablation setting. More data are needed to confirm these observations and to provide guidelines for optimal radioiodine dosing, and should be furnished by ongoing clinical investigation. rhTSH is the only acceptable treatment option in a subgroup of patients with well-differentiated thyroid cancer, including those with hypopituitarism, ischaemic heart disease, a history of "myxoedema madness," debilitation due to very advanced disease or inability to produce TSH due to continued production of thyroxine by thyroid remnant or metastatic tumour. Therapeutic use of rhTSH may be considered in an increasing number of other cases.- - - - - - - - - - ranking = 2.4285714285714keywords = thyroid (Clic here for more details about this article) |
14/185. Mixed follicular and parafollicular thyroid carcinoma.A rare case of mixed follicular-parafollicular thyroid carcinoma which occurred in a 50-year-old man, is reported. The ultrastructural aspects of the tumor showed: a biphasic growth pattern with microfolliculi and solid areas; the coexpression of thyroglobulin and calcitonin antigens in the same follicle-like structures; the presence of neuroendocrine granules, microvilli and intracytoplasmic canaliculi bordered by microvilli. These characteristics lead us to a diagnosis of mixed follicular-parafollicular thyroid carcinoma.- - - - - - - - - - ranking = 0.85714285714286keywords = thyroid (Clic here for more details about this article) |
15/185. Follicular thyroid cancer presenting initially with soft tissue metastasis.Follicular thyroid cancer rarely manifests itself as a distant metastatic lesion. We report a case of an otherwise asymptomatic 58-year-old woman with follicular thyroid cancer who initially presented with a soft tissue mass on the right scapular region. An incisional biopsy specimen of soft tissue metastasis showed thyroid follicular neoplasm. Upon this diagnosis, the thyroid gland was re-evaluated by ultrasound, which demonstrated a solitary, hypoechoic nodule in the right lobe. ultrasonography guided fine-needle aspiration biopsy of the thyroid nodule confirmed follicular neoplasm and the diagnosis of metastatic follicular thyroid cancer was established. The patient refused any type of treatment and left hospital against medical advice. 2.5 years later the patient was admitted to the hospital with giant, sarcoma-like multiple soft tissue masses. On this admission, the serum thyroglobulin level was extremely elevated (3500 ng/ml) and she only accepted to receive chemotherapy. epirubicin and cyclophosphamide were administered. She received three courses of chemotherapy and is alive with a stable disease after 3 months of follow-up. This case of follicular thyroid cancer is reported because of its uncommon initial presentation with soft tissue metastasis which spread to multiple areas as giant soft tissue masses during follow-up.- - - - - - - - - - ranking = 1.7210948085089keywords = thyroid nodule, thyroid, nodule (Clic here for more details about this article) |
16/185. A clear cell variant of follicular carcinoma presenting as an autonomously functioning thyroid nodule.We report a case of an autonomously functioning thyroid nodule (AFTN) that proved to be almost exclusively a clear cell variant of follicular carcinoma. AFTNs are generally felt to be benign lesions with exceptions forming the basis of case reports. Likewise, clear cell tumors of the thyroid are rare. To our knowledge, this combination of two unusual thyroid conditions has not been previously reported. The initial scans of this patient were so characteristic for a degenerating AFTN that attention was first directed toward a very large contralateral lobe. While it is debatable whether all AFTNs should be biopsied, on the basis of this and other cases, it is recommended that AFTNs that contain a central photopenic area on scan be biopsied to be sure that cystic degeneration, a commonly seen phenomenon in larger AFTNs, is indeed present rather than a malignancy.- - - - - - - - - - ranking = 1.7471025113436keywords = thyroid nodule, thyroid, nodule (Clic here for more details about this article) |
17/185. Establishment and characterization of the follicular thyroid carcinoma cell line ML-1.The present study focuses on the establishment and characterization of a new follicular thyroid carcinoma cell line. The human cell line ML-1 was derived from a dedifferentiated follicular thyroid carcinoma relapse, which progressed despite preceding surgery followed by two radioiodine therapies. More than 90% of the cells of this line express thyroglobulin, chondroitin sulfate, and vimentin antigens, but only about 70% show cytokeratin filaments and a negative surface charge density such as human erythrocytes. More importantly, cells of this line are able to take up iodine and/or glucose both in vitro and in vivo and to secrete thyroglobulin, chondroitin sulfate, and fibronectin into the interstitial space. In addition, triiodothyronine is released constitutively into culture supernatants. Moreover, it is also suitable for xenotransplantation studies because it is tumorigenic in NMRI nude mice in vivo. The cell line forms tumors with follicular structures when transplanted to nude mice. Due to these unique features the ML-1 cell line can be considered as a very suitable test model for pharmacological and cell biological studies. Since chemicals may interfere with the production of thyroid hormones, this cell line represents also a tool for toxicological investigations.- - - - - - - - - - ranking = 1keywords = thyroid (Clic here for more details about this article) |
18/185. Follicular carcinoma of the thyroid with extensive clear-cell differentiation: a potential diagnostic pitfall.Clear-cell features have been recognized in several different thyroid neoplasms. A case of thyroid follicular carcinoma with extensive clear- and Hurthle-cell features is described in a 37-yr-old white female, with cytochemical and immunohistochemical analysis. The tumor of the thyroid gland, with anterior neck soft-tissue extension, displayed clear cells on fine-needle aspiration, which were negative for thyroglobulin. The surgical specimen displayed predominately clear cells (80%), and only the nonclear-cell areas stained for thyroblobulin. Proper categorization of clear-cell lesions of the thyroid and soft tissues requires a multimodality approach, involving clinical/pathological correlation, morphological analysis, and ancillary tissue studies. Immunohistochemical stains for thyroglobulin are quite definitive in making the distinction between primary clear-cell thyroid tumors vs. metastatic clear-cell tumors. Cytologists should be aware, however, that the clear-cell areas of thyroid tumors might not stain for thyroglobulin.- - - - - - - - - - ranking = 1.4285714285714keywords = thyroid (Clic here for more details about this article) |
19/185. Discordant uptake of Tl-201 and Tc-99m MIBI in a patient with follicular adenoma.Two phase Tl-201 and Tc-99m MIBI thyroid scintigraphies were carried out in a 30-year-old woman who had a solitary cold thyroid nodule seen on a pertechnetate scan. Although an early Tl-201 thyroid image showed intense uptake in the nodule, Tc-99m MIBI demonstrated a hypoactive lesion on the early image. Delayed thyroid scans showed faster washout from the nodule compared to normal thyroid tissue for both Tl-201 and Tc-99m MIBI. Later on, the patient was operated on and the nodule was found to be a follicular adenoma by histopathological diagnosis.- - - - - - - - - - ranking = 0.86444342098909keywords = thyroid nodule, thyroid, nodule (Clic here for more details about this article) |
20/185. Thyroid follicular carcinoma: a case report.We present an 8-year-old boy with thyroid follicular carcinoma. Differentiated thyroid follicular carcinoma is very uncommon in childhood and is not usually suspected as the explanation of a thyroid nodule during infancy. The purpose of our paper is to demonstrate the imaging findings in a child and to emphasise the importance of including this tumour in the differential diagnosis of thyroid nodules in children.- - - - - - - - - - ranking = 0.87026957596603keywords = thyroid nodule, thyroid, nodule (Clic here for more details about this article) |
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