Thyroid malignancy

Subtotal thyroidectomy is indicated in patients with very large goiters and thyroid malignancies and those who do not respond or cannot tolerate other therapies. Patients must be euthyroid prior to surgery, and patients often are administered iodide preoperatively to reduce gland vascularity. The overall surgical complication rate is 2.7%. Postoperative hypothyroidism occurs in 10% of patients who undergo subtotal thyroidectomy. 

Gy 5% increase in thyroid malignancies 20 years after exposure, with tumors appearing 4-5 years after exposure 16... 

More than 2,000 children who were irradiated for ringworm at New York University Medical Center over 20 years (age range 1-15 years) were compared to 1,380 control children. An additional 11,000 children (mean ages 7 to 8 years) irradiated for ringworm in Israel were also compared to control children. Significant increases in skin cancer, cancer of the scalp, and thyroid malignancies were noted. Risk of basal cell carcinoma of the skin was highest at 0.32 per Gy (100 rads). Total incidence was 0.01 per Gy for males and 0.04 per Gy for females. Total mortality from all sites was 10% of the incidence (0.001 for males 0.004 for females). 

MTC occurs as a sporadic disease and as part of the syndromes of MEN-2A, MEN-2B, and familial MTC (EMTC). "" MEN-2A and MEN-2B are autosomal dominant inherited multiglandular syndromes with age-related penetrance and variable expression. AH forms of MTC combined account for 5% to 10% of thyroid malignancies. Sporadic MTC is believed to comprise approximately 75% of all MTC. The routine measurement of serum calcitonin in nodular thyroid diseases assists in detecting unsuspected sporadic With the advent of... 

Numerous other proteins have been explored as potential markers for different types of thyroid malignancies (Table 10.3). Cbp/p300-interacting transactivator 1 (CITEDl) is a nuclear protein that is involved in the coregulation of transcription factors. This protein is present in a variety of different cell types and is overexpressed in papillary thyroid carcinomas (87% to 93%). However, CITEDl immunoreactivity is also expressed in up to 50% of follicular carcinomas, 16% of follicular adenomas, and 24% of nodular goiters. 

Cytokeratin (CK)19 is usually expressed in papillary carcinomas but may also be present in other thyroid malignancies and in some benign thyroid tumors. 

Statistically thyroid malignancy is a rare event, whereas benign thyroid nodules are abundant in iodine-deficient... 

The average annual numbers of therapeutic treatments with radiopharmaceuticals per 1,000 population for countries of health-care level 1 are 0.038 for thyroid malignancy (radionuclide 0.15 for hyperthyroidism (radionuclide 0.0046 for polycythemia... 

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