Differentiated thyroid carcinoma

In 71 patients given 131I for differentiated thyroid carcinoma, salivary gland swelling with pain occurred in 50% (7) women had a significantly higher incidence than men. 

Kita T, Yokoyama K, Higuchi T, Kinuya S, Taki J, Nakajima K, Michigishi T, Tonami N. Multifactorial analysis on the short-term side effects occurring within 96 hours after radioiodine-131 therapy for differentiated thyroid carcinoma. Ann Nucl Med 2004 18(4) 345-9. 

When thyroid therapy is used not only to replace deficiency but also to prevent the growth of remnants of a differentiated thyroid carcinoma, a suppressive dosage is used, aiming at T4 concentrations in the high reference range and an undetectable TSH concentration or at least one that is below the lower end of the reference range, as measured by two-sided assays. Such therapy is warranted because of its long-term safety, efficacy, and tolerance, but some additional therapy for osteoporosis prevention should be considered. 

Heijckmann AC, Huijberts MS, Geusens P, de Vries J, Menheere PP, Wolffenbuttel BH. Hip bone mineral density, bone turnover and risk of fracture in patients on long-term suppressive L-thyroxine therapy for differentiated thyroid carcinoma. Eur J Endocrinol 2005 153(l) 23-9. 

Thyroid hormone-producing thyroid carcinoma is an uncommon cause of thyrotoxicosis. Precipitation of thyrotoxicosis by iodine-containing compounds in patients with thyroid carcinoma is rare, but has been attributed to amiodarone in a 77-year-old man with extensive hepatic metastases from a well-differentiated thyroid carcinoma (40). 

Koong SS, Reynolds JC, Movius EG, Keenan AM, Ain KB, Lakshmanan MC, Robbins J. Lithium as a potential adjuvant to 1311 therapy of metastatic, well differentiated thyroid carcinoma. J Clin Endocrinol Metab 1999 84(3) 912-6. 

Thyrotropin is an anterior pituitary hormone that stimulates the thyroid to produce and synthesize thyroxine (T4), triiodothyronine (T3), and thyroglobulin. Thyrotropin alpha is a commercially available analog of TSH that is used to help detection of metastatic differentiated thyroid carcinoma it is also known as recombinant human TSH (rhTSH). 

Spencer CA, LoPresti JS, Fatemi S, et al. Detection of residual and recurrent differentiated thyroid carcinoma by serum thyroglobulin measurement. Thyroid 1999 9 435-41. 

Spencer CA, Wang C, Fatemi S, et al. Serum thyroglobulin autoantibodies Prevalence, influence on serum thyroglobuUn measurement arid prognostic significance in patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 1998 83 ... 

Tg is primarily used as a tumor marker in patients carrying a diagnosis of differentiated thyroid carcinoma (DTC). Although serum Tg is elevated in patients with thyroid cancer, including thyroid follicular and papillary carcinoma, elevations are also are seen in nonneoplastic conditions such as thyroid adenoma, subacute thyroiditis, Hashimoto s thyroiditis, and Graves disease. Serum Tg concentrations are not increased in patients with medullary thyroid carcinoma. 

The frequency of TGB positivity in thyroid carcinomas is dependent on the degree of differentiation and the histologic subtype. Generally, poorly differentiated carcinomas contain less TGB than do better-differentiated tumors. The levels of TGB mRNA are also correspondingly lower in poorly differentiated than in well-differentiated thyroid carcinomas. TGB immunoreactivity is present in more than 95% of papillary carcinomas (Figs. 10.7 and 10.8) and follicular tumors. Because TGB is also expressed in metastatic lesions, stains for this marker are particularly valuable in... 

Poorly differentiated thyroid carcinomas of the insular type are usually TGB positive, although the extent of cellular staining is generally weak and focal.Undifferentiated (anaplastic) thyroid carcinomas are most commonly negative for TGB. In the series reported by... 

Ordonez and coworkers,5 of 32 (15.6%) cases of anaplastic carcinoma exhibited TGB immunoreactivity in a small number of cells using both monoclonal antibodies and polyclonal antisera. In this series, positivity was present in 3 of 8 giant cell, 1 of 4 spindle cell, and none of 6 squamoid or 13 mixed variants. Examination of serial sections in these cases failed to reveal evidence of entrapped normal follicular cells or foci of differentiated thyroid carcinoma. Other authors, however, have failed to demonstrate any TGB immunoreactivity in anaplastic carcinomas except in foci of residual differentiated tumor. 

Thyroid transcription factor-2 (TTF-2) and PAX-8, which are essential for thyroid organogenesis and differentiation, have also been studied in thyroid tumors. TTF-1, TTF-2, and PAX-8 were expressed in differentiated and poorly differentiated thyroid carcinomas, whereas TTF-1 and TTF-2 were expressed in 18% and 7% of anaplastic carcinomas, respectively. PAX-8, on the other hand, was present in 79% of anaplastic carcinomas. TTF-2 was negative in all other neoplastic and non-neoplastic tissues including those of pulmonary origin. Although PAX-8 was present in a variety... 

CA 15-3 and CA 19-9 are variably expressed in thyroid follicular tumors. Both follicular and papillary carcinomas reveal CA 15-3 positivity in 100% of cases, whereas CA 19-9 is present in 70% of papillary tumors but in no follicular carcinomas.CA 125 immunoreactivity has been reported in approximately 40% of papillary carcinomas.The distribution of mucin-related antigens (MUC) has also been analyzed in thyroid tumors.These studies have demonstrated that MUCl plays a key role in the glycosylation of well-differentiated thyroid carcinomas. However, there are no consistent differences between papillary and follicular carcinomas with respect to the expression of mucins. 

TGB, TTF-1, and TTF-2 are present in benign thyroid lesions and in more than 95% of differentiated thyroid carcinomas. 

Approximately 15% of poorly differentiated thyroid carcinomas and a significantly higher proportion of undifferentiated/anaplastic carcinomas are positive for BRAE mutations.Moreover, the mutations occur more commonly in those poorly differentiated and undifferentiated carcinomas with a papillary component. These findings suggest that the high-grade tumors progress from BRAF-positive papillary carcinomas. 

Ljungberg O, Bondeson L, Bondeson AG. Differentiated thyroid carcinoma, intermediate type A new tumor entity with features of follicular and parafollicular cell carcinomas. Hum Pathol. 1984 15 218-228. 

Pathological criteria for classifying thyroid cancer may show discrepancies in the differentiation between foUicu-lar adenoma and minimally invasive follicular carcinoma, and between follicular neoplasia and the folficular variant of papillary carcinoma (Lloyd et al., 2004 Saxen et ai, 1978). The inclusion of papillary microcarcinomas (1.0 cm or less in diameter), which are usually incidental findings or detected by the use of ultrasound-guided thyroid fine-needle aspiration cytology (Lin et al., 1997), the existence of radioactive fallout, which may lead to an increase of differentiated thyroid carcinoma and a rise in population age with time, should also be taken into account when analyzing the epidemiology of thyroid cancer. 

Thyroid cancer accounts for approximately 1% of all carcinomas. Well-differentiated thyroid carcinomas are the... 

Iodine in Thyroid Cancer Use of in the Diagnosis and Therapy of Differentiated Thyroid Carcinoma... 

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