JournalTOCs

Journal of Thyroid Research
Journal Prestige (SJR): 0.573

Citation Impact (citeScore): 2
Number of Followers: 1

This is an Open Access Journal

Open Access journal
ISSN (Online) 2042-0072
Published by Hindawi

[343 journals]

Spontaneous Slowing and Regressing of Tumor Growth in Childhood/Adolescent
Papillary Thyroid Carcinomas Suggested by the Postoperative
Thyroglobulin-Doubling Time
- Abstract: Background. Children and adolescents with papillary thyroid carcinomas (PTCs) have generally excellent prognoses despite their frequent extended disease. The tumor growth of young patients’ PTCs might show spontaneous slowing postoperatively. We compared young PTC patients’ postoperative thyroglobulin-doubling time (Tg-DT) with their preoperative hypothetical tumor volume-doubling time (hTV-DT). Methods. Fourteen PTC patients aged ≤18 years who underwent total thyroidectomy at Kuma Hospital in 1998–2016 had biochemically persistent disease postoperatively. We calculated their Tg-DTs and estimated their preoperative TV-DTs with the tumor size and the patient’s age at surgery, presuming that a single cancer cell was present at the patient’s birth. Results. Twelve patients had positive Tg-DTs ranging from 2.0 to 147 years, and the remaining two had negative Tg-DTs, indicating slow growth or even regression. The hTV-DTs were 0.3–0.6 years (median 0.5 years), which were significantly shorter than the Tg-DTs (), indicating much faster growth preoperatively. The analyses of the nine patients without radioactive iodine administration (RAI) gave similar results (). Conclusions. Irrespective of RAI, the patients’ postoperative Tg-DTs were significantly longer than their preoperative hTV-DTs and were negative values in two patients, indicating that the growth of these young patients’ PTCs had spontaneously slowed or even regressed postoperatively.
  PubDate: Wed, 16 May 2018 00:00:00 +000
The Outcome of Papillary Thyroid Cancer Associated with Graves’
Disease: A Case Control Study
- Abstract: Introduction. Thyroidectomy is now a less popular therapeutic option for Graves’ disease. The frequency of thyroid nodule and the cancer risk of these nodules accompanying Graves’ disease are controversial. The outcome of thyroid cancers coexisting with Graves’ disease is debated. Study Design. Designed as retrospective case control study of papillary thyroid cancers associated with Graves’ disease and those with euthyroid background. Pathological characteristics and outcome of papillary thyroid cancers in the two groups were compared. Results. The tumour characteristics did not differ significantly in the groups. The patients were followed for a mean period of 77.32 months and found significant incidences of disease progression in patients with papillary thyroid cancer associated with Graves’ disease (; OR 2.747, CI 1.078–7.004). Disease progression as new distant metastases mostly in skeletal locations was high in this group compared to euthyroid group (; OR 4.121, CI 1.008–15.600). There was higher incidence of cumulative metastatic diseases in papillary thyroid cancer associated with Graves’ disease. Conclusion. Papillary thyroid cancers associated with Graves’ disease show aggressive biological behaviour and favoured site of distant metastases was osseous locations. Early diagnosis by routine screening of Graves’ disease patients with ultrasound imaging and aspiration studies is recommended.
  PubDate: Tue, 08 May 2018 08:12:28 +000
Diagnostic Accuracy of Preoperative Neutrophil-to-Lymphocyte and
Platelet-to-Lymphocyte Ratios in Detecting Occult Papillary Thyroid
Microcarcinomas in Benign Multinodular Goitres
- Abstract: Objective. To investigate the diagnostic accuracy of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios in detecting occult papillary thyroid microcarcinomas in benign, multinodular goitres. Methods. 397 total thyroidectomy patients were identified from the institutional thyroid surgery database between 2007 and 2016 (94 males, 303 females, mean age 53 ± 14.5 years). NLR and PLR were calculated as the absolute neutrophil and absolute platelet counts divided by the absolute lymphocyte count, respectively, based on the preoperative complete blood cell count. Results. NLR was significantly higher in carcinomas and microcarcinomas compared to benign pathology (), whereas a direct association could not be established for PLR. Both NLR and PLR scored low in all parameters of diagnostic accuracy, with overall accuracy ranging between 45 and 50%. Conclusions. As surrogate indices of the systemic inflammatory response, NLR and PLR are inexpensive and universally available from routine blood tests. Although we found higher NLR values in cases of malignancy, NLR and PLR cannot effectively predict the presence of occult papillary microcarcinomas in otherwise benign, multinodular goitres.
  PubDate: Mon, 23 Apr 2018 00:00:00 +000
Significance of Testing Anti-Thyroid Autoantibodies in Patients with
Deranged Thyroid Profile
- Abstract: Background. We hypothesized that anti-thyroid antibodies are more often positive in individuals with deranged thyroid profile. Methods. This prospective cohort was done in Immunology Department, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from Jan 2017 to Oct 2017. All the samples that were referred to us for testing anti-thyroid antibodies (anti-TPO or anti-TG antibodies) and thyroid profile were included in the study. There were no exclusion criteria. Tests for anti-thyroid antibodies were performed by ELISA and thyroid profile by chemiluminescence. SPSS 23.0 was used for statistical analysis. Results. Over a course of a ten-month study period, we received a total of 316 serum samples for anti-TPO/TG antibodies along with thyroid profile testing (TSH). These included 115 males (36.4%) and 201 females (63.6%). Their age ranged from 3 to 89 years (mean ± SD, 42.22 ± 18.09). Anti-TPO antibodies were more often positive when TSH was deranged ( value 0.001). Anti-TPO antibodies are more often raised in females, in terms of both prevalence ( 0.001) and mean rank ( 0.002). Conclusion. As anti-thyroid antibodies are more often present when TSH is deranged, such individuals should be screened for anti-thyroid antibodies. This importance of screening is compounded by the fact that anti-thyroid antibodies may be positive in a significant percentage of elderly people.
  PubDate: Wed, 11 Apr 2018 00:00:00 +000
Cytomorphological Spectrum of Thyroiditis: A Review of 110 Cases
- Abstract: Introduction. Different types of thyroiditis may share some parallel clinical and biochemical features. Timely intervention can significantly reduce morbidity and mortality. Aim. Aim of this study is to find the frequency of various thyroiditis, study the cytomorphological features and correlate with clinical findings including radiological findings, thyroid function test, and anti-thyroid peroxidase antibodies (Anti-TPO antibodies). Materials and Methods. The study included consecutive 110 cases of thyroiditis. Detailed cytomorphological features were studied and correlated with ultrasonography findings, thyroid function test, anti-thyroid peroxidase antibodies (anti-TPO) and histopathological features where thyroidectomy specimens were received for histopathological examination. Results. The majority were Hashimoto’s thyroiditis () and females (). Other forms of thyroiditis were Hashimoto’s thyroiditis with colloid goiter (), De Quervain’s thyroiditis (), and one case each of postpartum thyroiditis and Hashimoto’s thyroiditis with associated malignancy. The majority of patients were in the age group of 21–40 () and the majority () had diffuse enlargement of thyroid. The majority of patients were hypothyroid (). The serum anti-TPO antibodies were elevated in 47 patients out of 71 patients. In the 48 patients who underwent ultrasonography, 38 were diagnosed as having thyroiditis. The most consistent cytomorphological features seen in fine-needle aspiration smears of Hashimoto’s thyroiditis were increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. Conclusion. The diagnostic cytological features in Hashimoto’s thyroiditis are increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. FNAC remains the “Gold Standard” for diagnosing Hashimoto’s thyroiditis. Clinical history, thyroid function, and biochemical parameters are the key for diagnosis of other forms of thyroiditis.
  PubDate: Thu, 01 Mar 2018 00:00:00 +000
Displacement of the Recurrent Laryngeal Nerve in Patients with Recurrent
Goiter Undergoing Redo Thyroid Surgery
- Abstract: Thyroid reoperations are surgically challenging because of scarring and disturbances in the anatomy of the recurrent laryngeal nerve (RLN). This study was conducted on 49 patients who underwent redo surgery. 61 RLNs were identified and completely exposed. Their functional integrity was evaluated using intraoperative nerve monitoring (IONM). Indications for secondary surgery, anatomical changes secondary to recurrent goiter mass and prior surgery, and results of IONM were studied. Frequent indications for redo surgery were multinodular goiter (MNG) in 19 (38.8%) and results of cytology in 14 (28.5%) patients. The mean time interval between primary and redo thyroid surgery was 23.4 years. We laterally approached 41 (67.2%) thyroid lobes between the sternocleidomastoid and sternohyoid muscles. 16 (26.2%) RLNs were found to be adherent to the lateral surface of the corresponding thyroid lobe. The functional integrity of all RLNs was confirmed by IONM. The remnant thyroid tissue can then lead to goiter recurrence requiring secondary surgery after a long period of time. The indications for redo surgery were similar to primary cases. Lateral displacement of the RLN which is adherent to the lateral surface of recurrent goiter mass is common anatomic variation. Thyroid reoperations based on awareness of anatomical disturbances can be performed safely by an experienced surgeon with support of ancillary electrophysiological technology.
  PubDate: Wed, 28 Feb 2018 00:00:00 +000
Follicular Thyroid Carcinoma in a Country of Endemic Iodine Deficiency
(1994–2013)
- Abstract: Background. Follicular thyroid cancer (FTC) has historically been linked to iodine deficiency. Although Ghana is among the iodine deficient regions of the world, the proportions, trends, and the clinical features of FTCs have not been studied as a single disease entity. The aim of this study was to determine the relative frequencies, trends, and the clinicopathological characteristics of FTCs among all thyroid malignancies in our institution. Materials and Methods. This was a retrospective study from January 1994 to December 2013. Data were analysed using SPSS software version 23 (Chicago) and Graph pad prism version 5.00. Results. Follicular thyroid cancer was the second thyroid malignancy (35.0%) and showed a gradual rise in relative proportions over the period. The male-female ratio was 1 : 1.5. The mean ages were 46.9 (SD ±17.3) for males and 46.4 (SD ±13.3) years for females. Enlarged palpable anterior neck swelling was the commonest symptom in males (86.7%) and females (91.3%) (). Hurthle cell carcinoma was the commonest variant of FTC, with 26.7% males and 10.6% females (). Distant spread was found in 23.3% of males compared to 19.1% of females (). The common sites of distant spread were bones (57.2%) in males and cervical lymph nodes (44.4%) in females (). Conclusion. Follicular thyroid cancer was the second common thyroid malignancy (35.0%) with a gradual rise in trend over the study period and male-female ratio of 1.5 : 1. Large anterior neck swelling was the commonest clinical presentation of FTC.
  PubDate: Sun, 25 Feb 2018 00:00:00 +000