Carcinoma, Papillary ; diagnosis ; pathology ; therapy ; Humans ; Practice Guidelines as Topic ; Thyroid Neoplasms ; diagnosis ; pathology ; therapy

Biopsy, Fine-Needle ; Carcinoma ; diagnosis ; pathology ; surgery ; Carcinoma, Medullary ; diagnosis ; pathology ; surgery ; Carcinoma, Papillary ; diagnosis ; pathology ; surgery ; Carcinoma, Papillary, Follicular ; diagnosis ; pathology ; surgery ; Diagnosis, Differential ; Goiter, Nodular ; diagnosis ; pathology ; therapy ; Hashimoto Disease ; diagnosis ; pathology ; therapy ; Humans ; Lymphoma ; diagnosis ; pathology ; surgery ; Thyroid Nodule ; pathology ; surgery ; Thyroidectomy

Intraductal papillary mucinous neoplasm (IPMN) is frequently found recently and is a precancerous lesion. Main duct-type should be resected since it can easily progress to invasive IPMN, whereas branch duct-type (BD) usually remains silent without malignant transformation. BD-IPMN should be resected if it has mural nodule, thick wall or septum, or solid component which are the obvious risk factors for malignancy. If the cyst size of BD-IPMN is more than 3 cm in diameter without obvious risk factors, it can be followed-up regularly or can be treated either with surgical resection or endoscopic ultrasonography (EUS)-guided ethanol lavage. Small BD-IPMN less than 3 cm in size without risk factors can be followed up with sonography, CT scan or EUS annually.
Adenocarcinoma, Mucinous/diagnosis/pathology/*therapy ; Carcinoma, Pancreatic Ductal/diagnosis/pathology/*therapy ; Carcinoma, Papillary/diagnosis/pathology/*therapy ; Diagnosis, Differential ; Ethanol/therapeutic use ; Humans ; Pancreatic Neoplasms/diagnosis/pathology/*therapy ; Risk Factors ; Tomography, X-Ray Computed

OBJECTIVETo explore the clinicopathologic characteristics, treatment and prognosis of differentiated thyroid carcinoma (DTC) in adolescents.

METHODSThe data of 46 patients with DTC under the age of 18 years were retrospectively reviewed.

RESULTSTwenty patients were misdiagnosed in this group (43.5%). All patients received operation, including 39 unilateral neck dissection and 6 bilateral neck dissection, followed by postoperative thyrotropin suppressive therapy. There were 42 cases of papillary carcinoma (91.3%) and 4 cases of follicular carcinoma (8.7%). Cervical lymph node metastasis was found in 39 cases (84.8%). In the follow-up period of 1 to 25 years (mean 10 years), no death of thyroid carcinoma occurred.

CONCLUSIONSThe most common DTC in adolescents is papillary carcinoma with better prognosis regardless of the higher incidence of cervical lymph node metastasis. The optimal extent of primary thyroidectomy and neck dissection followed by postoperative thyrotropin suppressive therapy in adolescents with DTC may improve the quality of life and decrease the incidence of complications.

Adenocarcinoma, Follicular ; diagnosis ; therapy ; Adolescent ; Carcinoma, Papillary ; diagnosis ; therapy ; Child ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Prognosis ; Retrospective Studies ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; diagnosis ; therapy

OBJECTIVETo explore the treatment and prognosis on patients with tracheal invasion by papillary thyroid carcinoma (PTC).

METHODSForty-five patients treated for PTC with tracheal invasion between 1980 and 1995 were retrospectively analyzed. The different kinds of surgical modalities were performed according to the extent and degree of tracheal invasion by PTC. Neck dissect was performed in 39 patients. External beam radiotherapy was used postoperatively in patients with gross residual tumor or microscopic residual tumor in pathologic margins after resection. Survival was evaluated using the Kaplan-Meier method.

RESULTS(1) Twenty-eight patients with limited tracheal invasion were treated with shave excision, the 5- and 10-year survival rates were 85.0% and 62.6%, respectively. After a shave excision, the differences of 5- and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05). (2) Ten patients were radical excision for intraluminal involvement extending through the tracheal cartilage, including circumferential sleeve resection (4 cases), tracheal window resection (5 cases) and total laryngectomy (1 case), the survival rate was 80.0% for five years and 58.3% for ten years. After a radical excision, the differences of 5- and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05). (3) For 7 patients performing the palliative operation, the 5-and 10-year survival rates were 42.9% and 28.6%, respectively. For 4 patients received postoperative radiotherapy, the 5-and 10-year survival rates were 50.0% and 50.0%, respectively. Three patients didn't received postoperative radiotherapy, the 5-year survival rate was 33.3%, no patient survived for ten years. In these patients of incomplete resection, the differences of 5-and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05).

CONCLUSIONSPTC with limited involvement of the trachea could be treated successfully by shaving tumor off the tracheal cartilage. Intraluminal involvement extending through the tracheal cartilage could be resected radically in patients with PTC. Postoperative radiotherapy could improve the survival of the patients with PTC with tracheal invasion who have been performed incomplete resection.

Adult ; Aged ; Carcinoma, Papillary ; diagnosis ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Prognosis ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; diagnosis ; pathology ; therapy ; Trachea ; pathology ; Tracheal Neoplasms ; diagnosis ; secondary ; therapy

OBJECTIVETo study the diagnostic criteria, clinicopathologic characteristics and prognosis of invasive micropapillary carcinoma (IMPC) of breast.

METHODSAll cases of breast carcinoma diagnosed during the period from 1989 to 2001 were retrospectively reviewed. One hundred examples with IMPC component, according to the 2003 World Health Organization classification of breast tumors, were identified. The clinicopathologic features and follow-up data of these cases were analyzed.

RESULTSAmongst the 100 cases of IMPC studied, 69% (69/100) had evidence of lymphovascular invasion. The incidence of regional lymph node metastasis was 84.8% (84/99). Follow-up information was available in 98 patients (mean of follow-up duration = 60.1 months). Eleven patients (11.2%) had local recurrence within a mean of 26.4 months after the operation, while 38 patients (38.8%) had distant metastases within a mean of 36.0 months. Thirty-six patients (36.7%) died of the disease. The overall 5-year survival rate was 59% and the 10-year survival rate was 48%. Univariate and multivariate analysis showed that the prognosis of patients was adversely affected by the presence of lymphovascular invasion and family history of breast cancer. On the other hand, tamoxifen therapy and adjuvant chemotherapy improved survival.

CONCLUSIONSBreast carcinoma with IMPC component is associated with poor prognosis, despites the relative proportion of this architectural pattern. The overall prognosis is related to the presence of lymphovascular invasion and family history of breast cancer. Hormonal therapy and individualized chemotherapy can improve the survival rate.

Adult ; Aged ; Antineoplastic Agents, Hormonal ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; Breast Neoplasms ; diagnosis ; genetics ; pathology ; therapy ; Carcinoma, Ductal, Breast ; diagnosis ; genetics ; pathology ; therapy ; Carcinoma, Papillary ; diagnosis ; genetics ; pathology ; therapy ; Chemotherapy, Adjuvant ; Cyclophosphamide ; therapeutic use ; Female ; Fluorouracil ; therapeutic use ; Follow-Up Studies ; Genetic Predisposition to Disease ; Humans ; Liver Neoplasms ; secondary ; Lymphatic Metastasis ; Mastectomy ; methods ; Methotrexate ; therapeutic use ; Middle Aged ; Neoplasm Recurrence, Local ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Rate ; Tamoxifen ; therapeutic use