Carcinoma, Medullary ; complications ; pathology ; Humans ; Male ; Middle Aged ; Thyroid Neoplasms ; complications ; pathology

Adult ; Carcinoma, Adenoid Cystic ; complications ; Female ; Humans ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; secondary ; Ultrasonography

We have reviewed 1066 thyroid lesions and compared the relative incidence of the so called 'palpation thyroiditis' between autoimmune thyroiditis and normal thyroid parenchyme surrounding the nodular thyroid lesion and also discussed the pathogenesis of palpation thyroiditis. The typical histopathologic features of 'palpation thyroiditis' were seen in 275 cases among 467 adenomatous goiters and in none of the autoimmune thyroiditis. We here in this paper suggest that the so called 'palpation thyroiditis' is not merely a secondary phenomenon to mechanical follicular damage by vigorous palpation, but this lesion more likely develops in conditions where certain types of physiologic alteration has occurred in follicular basement membrane, just like a pathogenesis of subacute granulomatous thyroiditis.
Adenocarcinoma/complications/pathology ; Adenoma/complications/pathology ; Carcinoma, Papillary/complications/pathology ; Diagnosis, Differential ; Goiter, Nodular/complications/pathology ; Humans ; *Iatrogenic Disease ; Palpation/*adverse effects ; Thyroid Gland/*injuries/pathology ; Thyroid Neoplasms/complications/*pathology ; Thyroiditis/diagnosis/etiology/*pathology ; Thyroiditis, Autoimmune/*pathology

Aged ; Bone and Bones ; pathology ; Carcinoma, Small Cell ; complications ; pathology ; Female ; Humans ; Hyoid Bone ; pathology ; Plasmacytoma ; complications ; Small Cell Lung Carcinoma ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; pathology

Adult ; Female ; Humans ; Motor Neuron Disease ; complications ; Neck ; pathology ; Thyroid Neoplasms ; complications

BACKGROUND: Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing, especially among thyroid cancer patients, and lung cancer is still the main cause of cancer death. Therefore, we aimed to investigate the risk of second primary lung cancer (SPLC) in patients with thyroid cancer. METHODS: We searched the PubMed, Web of Science, Embase, and Scopus databases up to November 24, 2021, for relevant research and merged the standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) to evaluate the risk of developing SPLC in patients with thyroid cancer. RESULTS: Fourteen studies involving 1,480,816 cases were included in our meta-analysis. The pooled result demonstrated that thyroid cancer patients may have a higher risk of SPLC than the general population (SIR = 1.21, 95% CI: 1.07-1.36, P  < 0.01, I2  = 81%, P  < 0.01). Subgroup analysis stratified by sex indicated that female patients may have a markedly higher risk of SPLC than male patients (SIR = 1.65, 95% CI: 1.40-1.94, P  < 0.01, I2  = 75%, P  < 0.01). CONCLUSIONS: Thyroid cancer patients are more likely to develop SPLC than the general population, especially women. However, other risk factors must be investigated, and more prospective studies are needed to confirm our results. REGISTRATION International Prospective Register of Systematic Reviews: No. CRD42021285399.
Humans ; Male ; Female ; Neoplasms, Second Primary/pathology* ; Systematic Reviews as Topic ; Lung Neoplasms/pathology* ; Risk Factors ; Thyroid Neoplasms/complications* ; Incidence

OBJECTIVE: To investigate the value of each single and combined applications of ultrasound thyroid imaging reporting and data system (TI-RADS), ultrasonic shear wave elastography in the diagnosis of thyroid microcarcinoma (TMC). METHOD: 323 patients with thyroid tiny nodules confirmed by surgery and pathology were analyzed prospectively. Then their TI-RADS and shear wave elastography features were summarized. SWE elasticity indices (mean, minimum and maximum value of interest) of nodules were measured. The surgical pathology results were regarded as the gold standard to calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS, shear wave elastography and their combination in the diagnosis of TMC. The receiver operating characteristic (ROC) curve of TI-RADS, shear wave elastography and combined application of both were drawn. The area under the ROC curve were calculated. Furthermore, the value of combined application of both examinations in the diagnosis of thyroid microcarcinoma (TMC) was investigated. RESULT: From 323 nodules,253 were thyroid carcinomas and 70 were benign. Areas under the ROC curves (AUC) of SWE parameters were 0. 648,0. 629 and 0. 605. For SWE, the optimal cut-off value according to ROC curve was SWE_max = 65.50 kPa and SWE_mean = 37.50 kPa. Generally, the sensitivity, specificity, accuracy, PPV and NPV were 88.14%, 82.86%, 87.00%, 94.89% and 65.91% for TI-RADS, and 49.01%, 74.29%, 54.49%, 87.32% and 28. 73% for SWE. There were statistically significant differences in the sensitivity, accuracy, PPV and no statistically significant differences in the specificity, and NPV. The sensitivity,specificity, accuracy, PPV and NPV were 95.26%, 67.14%, 89.16%, 91.29% and 79.66% for combined application of both. The area under the ROC curve of TI-RADS, shear wave elastography and their combination were 0.763, 0.616, 0.804. For nodules ≤ 5 mm, the sensitivity, specificity, accuracy, PPV and NPV were 91.67%, 66.67%, 87.07%, 92.44% and 64.29%. However, for nodules 5-10 mm,the sensitivity,specificity, accuracy, PPV and NPV were 98.50%, 67.44%, 90.91%, 90.34% and 93.55%. CONCLUSION The diagnose of TMC can be further improved by combined application of ultra-sonic TI-RADS and SWE.
Carcinoma ; complications ; Elasticity Imaging Techniques ; Humans ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; diagnosis

Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. About 14 cases of SMECE have been reported and this is the first reported case in Korea. A 57-year-old woman presented with right neck mass for 20 years. Total thyroidectomy was performed under the impression of thyroid carcinoma. The resected thyroid gland showed a poorly circumscribed hard mass. Histologically, the tumor consisted of solid nests of large atypical cells with dense fibrous stroma. The tumor cells showed squamoid appearance with abundant eosinophilic cytoplasm. There were also rare mucin-containing cells within the nests. Within the hyalinized stroma, numerous eosinophils were found. The surrounding thyroid parenchyma displayed Hashimoto's thyroiditis. There was metastasis in a regional lymph node. Two years after initial surgery, she underwent a modified radical neck dissection due to recurrent neck mass. After the radiation therapy for eight weeks, laryngectomy and esophagectomy were performed due to a recurrent carcinoma in the esophageal wall. We report an additional case of SMECE, with metastasis to regional lymph nodes and esophagus. The tumor appears to be more aggressive than previously reported and a correct diagnosis can be rendered by just examining the metastatic lesions.
Carcinoma, Mucoepidermoid/surgery ; Carcinoma, Mucoepidermoid/secondary* ; Carcinoma, Mucoepidermoid/pathology* ; Carcinoma, Mucoepidermoid/complications ; Case Report ; Eosinophilia/pathology ; Eosinophilia/complications* ; Esophageal Neoplasms/surgery ; Esophageal Neoplasms/secondary* ; Female ; Human ; Laryngectomy ; Lymph Nodes ; Middle Age ; Recurrence ; Sclerosis ; Thyroid Gland/pathology* ; Thyroid Neoplasms/surgery ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/complications ; Thyroiditis, Autoimmune/complications

OBJECTIVETo compare the total thyroidectomy or subtotal resection and gland lobe and isthmus lobectomy as initial treatment to TNM stage I and II differentiated thyroid cancer. The difference between recurrence rate and surgical complications were analysed.

METHODSThe literatures published between 1972-2012 were searched in Pubmed, Medline, Wanfang database, Chinese Biomedical Literature Database, Chinese scientific Journals database and China National Knowledge Infrastructure. According to the inclusion and deletion criteria, 17 articles were included to compare the postoperative recurrence and complications in randomized controlled or case-control studies, involving 13 articles in recurrence rate and 11 articles in complications.RevMan5.0 software package was used to perform meta-analysis.

RESULTSThirteen articles involved with the recurrence rate, the total case number was 3511. Among these cases, 414 recurred, overall recurrence rate was 11.59%, of which, 150 recurred cases in total or subtotal resection group (experimental group), the recurrence rate was 6.51%; 264 recurred cases in gland lobe lobectomy plus isthmus group (control group), the recurrence rate was 21.83%. Comparing the two groups, the odds ratio (OR) and their 95% confidence interval (95%CI) was 0.26 [0.21,0.33], Z value was 11.33, P < 0.01, which showed that the recurrence rate in experimental group was significantly lower than that in control group.Eleven articles involved with the complications, the total case number was 2388, 166 cases had postoperative complications. The complication rate was 6.95%, of which, 109 cases in experimental group, the complication rate was 8.52%; 57 cases in control group, the complication rate was 5.15%. Compared with the two groups, OR values and their 95%CI was 3.63 [2.47, 5.33], Z was 6.58, P < 0.01, the experimental group had significantly higher incidence of complications.

CONCLUSIONFor I and II differentiated thyroid cancer, total thyroidectomy or subtotal resection may reduce the chance of recurrence, but the postoperative complications is higher; while gland lobe and isthmus lobectomy has lower postoperative complications, but may increase the risk of relapse.

Humans ; Neoplasm Recurrence, Local ; epidemiology ; Postoperative Complications ; epidemiology ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; adverse effects ; methods

Adult ; Female ; Horner Syndrome ; etiology ; Humans ; Neck Dissection ; Postoperative Complications ; Thyroid Neoplasms ; pathology ; surgery