Clinical findings of thyroid cancer in 288 Japanese Early soft tissue and bone metastases with raised serum thyroglobulin (Tg) in follicular and undifferentiated types
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2013, Vol 30, Issue 3
Abstract
OBJECTIVE Investigation of the clinical findings in 661 Japanese patients with thyroid nodules, of which 288 (44%) were malignant. METHOD AND RESULTS Of the 288 malignant thyroid nodules, histological examination showed papillary carcinoma (Ca) in 249 (86.5%), follicular Ca in 28 (9.7%), undifferentiated Ca in 4 (1.4%), and medullary Ca in 7 (2.4%). Even among the 104 cases of papillary Ca with normal serum levels of thyroglobulin (Tg) (4−78 ng/mL), microscopic cervical lymph node (CLN) metastases were identified in 84% at thyroidectomy. All 28 cases of papillary Ca with Tg >500 ng/mL showed extra-thyroid metastases, and an anti-Tg antibody level of >=100 U/ mL was detected in 10. High Tg secretion (>10,000 ng/mL) from soft tissue, bone or lung metastases was detected in 9 (32%) cases of follicular Ca and in 2 (50%) of undifferentiated Ca, in which metastatic curettage improved the clinical findings. Tg levels of 4,000−10,000 ng/mL were observed in 7 (25%) cases of follicular Ca and 1 (25%) of undifferentiated Ca. One elderly female with follicular Ca and Tg >10,000 ng/mL developed bone marrow dysplasia with proliferation of p53- and CD163-positive macrophages and peripheral pancytopenia 28.5 years after the diagnosis of thyroid Ca. Patients with follicular Ca with relatively low Tg of <2,000 ng/mL more commonly exhibited early lung metastases. The thyroid Ca, in 12 (4.8%) patients with papillary Ca and 1 (3.6%) with follicular Ca suspected of Cowden syndrome (CS), was associated with bilateral breast Ca, with a good prognosis, apart from 2 cases with high Tg levels (673 and 704 ng/mL). CONCLUSIONS Thyroid Ca had very early extra-thyroid metastases but a long survival rate.
Authors and Affiliations
T. NAKATSUJI
Keywords
Related Articles
- EP ID EP146404
- DOI -
- Views 47
- Downloads 0
Επιδημιολογική διερεύνηση της αιτιολογίας χρονίων νοσημάτων
Η αιτιολογική σχέση στην επιδημιολογία, την προληπτική Iατρική και γενικότερα την Ιατρική, έχει στοχαστικό (πιθανολογικό) και όχι αυστηρά προσδιοριστικό χαρακτήρα. Στην ανασκόπηση αυτή γίνεται αναφορά στις έννοιες της αι...
H πιθανότητα του θεραπευτικού ουδού μετά την κλινική εξέταση<br /> στη θεωρία λήψης των κλινικών αποφάσεων
Η πιθανότητα του θεραπευτικού ουδού μετά την κλινική εξέταση είναι εξ ορισμού η πιθανότητα του νοσήματος κατά την οποία η προσδοκώμενη αξία της θεραπείας είναι ίση με την προσδοκώμενη αξία της μη θεραπείας-«προσεκτικής α...
Διαβητική νεφροπάθεια 2002. Ποια είναι η καταλληλότερη αντιυπερτασική αγωγή;<br />
Patient satisfaction in Cyprus with ambulatory blood pressure monitoring in comparison with blood pressure measurement in the doctor's office and at home
OBJECTIVE To estimate patient satisfaction with ambulatory blood pressure monitoring in comparison with blood pressure measurement at home or in the doctor's office. METHOD A cross-sectional study was conducted at the...
The pleiotropic effects of aspirin
Aspirin reduces the possibility of serious atherothrombotic vascular events and death in a broad category of high risk patients by about one quarter. Aspirin has remained an enigmatic drug; not only does it present with...