Monday, February 26, 2024

Tall Cell Variant Thyroid Cancer

Thyroid Cancer Causes And Risk Factors

Thyroid Cancer Surgery, Especially for Papillary and Follicular Thyroid Cancer

Its not clear exactly what causes thyroid cancer to develop. However, there are a number of known potential risk factors, some of which can be modified and others that cant. According to the National Cancer Institute, risk factors for developing thyroid cancer include:

Other research led by Dr. Harari is looking at whether certain environmental exposures, including to pesticides and flame retardants, have a link to thyroid cancer.

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How Is Papillary Thyroid Cancer Diagnosed

Papillary thyroid cancer usually presents as a lump or nodule on your thyroid gland. You may notice it, or your healthcare provider may discover it during a routine neck examination. Sometimes, the nodule is discovered incidentally by imaging tests you get for other medical reasons.

Your healthcare provider will likely order the following tests to help diagnose PTC:

  • Imaging tests: Your provider may order imaging tests to identify the nodule on your thyroid. These tests might include thyroid ultrasound, CT scan and/or magnetic resonance imaging .
  • Fine needle aspiration : Your provider will likely want to take a small tissue sample, called a biopsy, from the nodule on your thyroid using a very thin needle. A pathologist will look at the tissue under a microscope to see if there are cancer cells and, if so, what type of thyroid cancer it is.

Your healthcare provider may also recommend genetic counseling to see if you have a genetic condition that may have caused PTC and may cause other types of tumors.

How Is Papillary Thyroid Cancer Staged

Papillary thyroid cancer staging is based on the results of the physical examination, biopsy, imaging tests and the pathologic findings of surgery itself .

Papillary thyroid cancer has a staging system that is not like other cancers. This staging system for papillary thyroid cancer takes into account the age of the patient. The break point of age in the American Joint Committee on Cancer staging system for papillary thyroid cancer is 55 years of age. Therefore, if you are less than 55 years of age, the most advanced papillary thyroid cancer is stage II disease.

In papillary thyroid cancer staging, and for that matter all cancer staging, the earlier the stage of disease is the more favorable and curable the cancer. Therefore, the lower/smaller the number, the better the chance for cure and long term survival. :1167-214.)

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Tips For Talking To Your Doctor

  • make a list of what you are feeling and how often it happens, including as much detail as possible
  • think about your family/whnau history of cancer and tell your doctor
  • go back to your doctor if you dont feel better, even if tests show you dont have a problem you can ask for a second opinion if you want one
  • take a family/whnau member or friend with you to the appointment for support

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Prognostic Outcomes Of Tall Cell Variant Papillary Thyroid Cancer: A Meta

thyroid

Scharukh Jalisi

Abstract

Objective. To evaluate the prognosis of tall cell variant compared to usual variant papillary thyroid cancer by comparing disease-related mortality and recurrence data from published studies. Methods. Ovid MEDLINE keyword search using tall cell variant papillary thyroid cancer was used to identify studies published in English that calculated disease-related mortality and recurrence rates for both TCV and UV. Results. A total of 131 cases of tall cell variant papillary thyroid cancer were reviewed. The combined odds ratio of recurrence for TCV compared to UV is 4.50 with a 95% confidence interval from 2.90 to 6.99. For disease-related mortality, the combined odds ratio for TCV was compared to UV of 14.28 with a 95% confidence interval from 8.01 to 25.46. . Currently published data suggests that TCV is a negative prognostic indicator in papillary thyroid cancer and requires aggressive therapy. This meta-analysis provides the largest prognostic data series on TCV in the literature and clearly identifies the need for accurate pathological identification of TCV and its further study as an independent prognostic factor.

1. Introduction

5. Conclusions

References

  • W. A. Hawk and J. B. Hazard, The many appearances of papillary carcinoma of the thyroid, Cleveland Clinic Quarterly, vol. 43, no. 4, pp. 207216, 1976.

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    What Is Radioactive Iodine Therapy

    Radioactive iodine can be used for the treatment of overactive thyroid and certain types of thyroid cancer. The term radioactive may sound frightening, but it is a safe, generally well-tolerated, and reliable treatment that targets thyroid cells so there is little exposure to the rest of your bodys cells.

    What Is A 5

    A relative survival rate compares people with the same type and stage of thyroid cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of thyroid cancer is 90%, it means that people who have that cancer are, on average, about 90% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.

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    Postoperative Management And Follow

    Postoperative care and follow-up was conducted according to the ATA management guidelines . Patients were administered suppressive doses of levothyroxine for suppression of thyroid stimulating hormone immediately after operation and were regularly followed-up. All patients underwent physical examination, thyroid function tests, serum Tg concentration, anti-Tg antibody, and neck US every 36 months for the first year, and annually thereafter. Postoperative radioactive iodine ablation was performed at 68 weeks after surgery, and whole-body scans were performed at 57 days after RAI ablation in patients who underwent total thyroidectomy . Patients who showed signs of recurrence on routine follow-up evaluation were assessed via additional diagnostic imaging, including CT scan, positron emission tomography/CT scan, and/or radioactive iodine whole-body scan, to determine the location and extent of suspected recurrence. In cases of suspected recurrence, diagnosis was confirmed via histologic examination using FNA or a surgical biopsy specimen.

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    Variants Of Papillary Thyroid Carcinoma

    Papillary Thyroid Cancer

    Return to: Papillary Thyroid Carcinoma

    Overview

    Papillary thyroid carcinoma is the most common malignancy of the thyroid, contributing to over 70% of thyroid cancers.1 These tumors are diagnosed using characteristic nuclear morphology however, within the classification of papillary thyroid carcinoma, there exist several distinct architectural and cytologic subtypes. About 50% of PTC are of the classical subtype, while the other 50% are made up of less common histologic variants.10 Conventional, or classical, papillary thyroid carcinoma , seen below, is characterized by papillary architecture with fibrovascular cores and psammoma bodies and tumor cells containing enlarged, overlapping nuclei with nuclear clearing and nuclear grooves and nuclear membrane irregularities . While papillary thyroid carcinoma tends to have an excellent prognosis, certain histologic variants have been shown to have more aggressive clinical courses. As such, determining the microscopic subtype of a papillary thyroid cancer is an important step in determining prognosis. Described below are the presentation, pathologic features, and prognostic indications of several of the more common variants of papillary thyroid carcinoma1-4.

    Papillary thyroid microcarcinoma

  • Immunohistochemistry & molecular markers: Both RET rearrangements and BRAF mutations are common findings, with BRAF mutations confering a worse prognosis.
  • Tall Cell Variant

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    What Is The Prognosis Of Papillary Thyroid Cancer

    Overall, the prognosis of papillary thyroid cancer is excellent, especially if youre younger than 40 at diagnosis and have a small tumor. PTC can often be treated successfully and is rarely fatal, even if it has spread to lymph nodes in your neck.

    Factors that may lead to a worse prognosis include:

    • Being older than 55 years at diagnosis.
    • Having a large tumor.
    • If the cancer has spread to distant parts of your body.
    • If you have a rare subtype of PTC, which are typically more aggressive, including the tall cell variant, diffuse sclerosis variant or solid variant.

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    When To Get Medical Advice

    See a GP if you have symptoms of thyroid cancer. The symptoms may be caused by less serious conditions, such as an enlarged thyroid , so its important to get them checked.

    A GP will examine your neck and can organise a blood test to check how well your thyroid is working.

    If they think you could have cancer or theyre not sure whats causing your symptoms, youll be referred to a hospital specialist for more tests.

    Find out more about how thyroid cancer is diagnosed.

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    Sporadic Medullary Thyroid Cancer

    Breast tumour resembling tall cell variant of papillary thyroid ...

    Sporadic medullary thyroid cancer comes from the C cells of your thyroid gland. These cells make a hormone that controls the amount of calcium in your blood.

    Between of medullary thyroid cancers are sporadic, meaning they arent hereditary. Sporadic medullary thyroid cancer occurs mainly in older adults.

    If diagnosed in stages I through III, MTC can have a good outlook.

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    Common Symptoms Of Thyroid Cancer

    Although it remains unclear what causes thyroid cancer, the condition can result from mutations of cells within the thyroid gland. These genetic changes stimulate the rapid growth of cells, leading to the accumulation of abnormal cells that form a tumor. A person with a cancerous thyroid tumor can have multiple symptoms, including:

    • Difficulty swallowing
    • Changes of voice, including increasing hoarseness
    • A lump in the neck
    • Pain in the throat and neck
    • Swollen lymph node in your neck

    So, be sure to check what happens when cancer spreads to the lymph nodes and when other symptoms start to show. While anyone diagnosed with thyroid cancer can live a normal life, age can affect the survival rate. For example, a patient below 45 years has an excellent prognosis than an individual over 60. Therefore, age plays a critical role in determining the survival rate of patients with thyroid cancer, where the younger population has a higher survival rate than the elderly or people over 60 years.

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    How Does Radioactive Iodine Treat Thyroid Cancer

    The radioactive iodine enters the bloodstream after ingestion and is taken up by any thyroid-like cells. The radioactivity then destroys the cancer cells, and it gives off radiation that also destroys nearby cancer cells over time. The most common forms of thyroid cancer can generally be treated with massive doses of radioactive Iodine. A tracer dose of radioactive iodine can also be used to track cancer cells that may have spread to other parts of the body.

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    Tcv Versus Matched Ptc Cases

    The patient and tumor characteristics for TCV and matched PTC patients are summarized in Table 2. Comparing the TCV cohort with the matched PTC cohort, the 5 year disease-specific survival remained poorer . There was a higher proportion of disease-specific deaths in the TCV group, compared with the matched PTC group . Of the 19 patients in the TCV group who died of thyroid cancer, 15 had tumors with ETE and 4 had tumors without gross ETE. In comparison, all 10 patients in the matched PTC group who died had tumors with gross ETE.

    KaplanâMeier plot of DSS. Five-year DSS for TCV vs. matched PTC differs significantly on log-rank test .

    What Will Happen After Treatment

    Papillary Thyroid Carcinoma – Histopathology

    Most people do very well after treatment, but you may need follow-up care for the rest of your life. This is because most thyroid cancers grow slowly and can come back even 10 to 20 years after treatment. Your cancer care team will tell you what tests you need and how often they should be done.

    Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back. At first, your visits may be every 3 to 6 months. Then, the longer youre cancer-free, the less often the visits are needed.

    Sometimes treatments may not cure your cancer. You many need to keep getting treatment and care. From time to time tests will be done to see how your treatment is working.

    Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.

    You cant change the fact that you have cancer. What you can change is how you live the rest of your life.

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    Thyroid Hormone Replacement Therapy

    Thyroid hormone replacement therapy is often prescribed after thyroid surgery to replace the hormones that are no longer being produced by your thyroid tissue. Depending on how much of your thyroid was taken out, you may have to take the medication most commonly levothyroxine for the rest of your life.

    Thyroid hormone replacement can also help prevent the growth or recurrence of thyroid cancer. It does this by lowering your circulating level of the hormone TSH, which is secreted by your brains pituitary gland and tells your thyroid to make more thyroid hormone. High TSH levels can stimulate the growth of thyroid cancer cells. Higher doses of replacement thyroid hormone tell your body to make less TSH, slowing the growth of any thyroid cancer cells and lowering the odds of your cancer coming back.

    It can take a few adjustments to find the correct dosage of thyroid hormone replacement. During this time, you may need to see the doctor every 6 to 8 weeks for a blood draw to determine if your levels are optimal.

    Thyroid Nodules May Be Found During A Routine Medical Exam And Are Usually Not Cancer

    Your childs doctor may find a lump in the thyroid during a routine medical exam, or a nodule may be seen on an imaging test or during surgery for another condition. A thyroid nodule is an abnormal growth of thyroid cells in the thyroid. Nodules may be solid or fluid-filled.

    When a thyroid nodule is found, an ultrasound of the thyroid and lymph nodes in the neck is done. A fine-needle aspiration biopsy may be done to check for signs of cancer. Blood tests to check thyroid hormone levels and for anti-thyroid antibodies in the blood may also be done. This is to check for other types of thyroid disease.

    Thyroid nodules usually donât cause symptoms or need treatment. Sometimes the thyroid nodules become large enough that it is hard to swallow or breathe and more tests and treatment are needed. Only one in five thyroid nodules become cancer.

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    Comparison Of Clinicopathological Characteristics Between Tcvptc And Classic Ptc With Tcf

    The baseline clinicopathological characteristics of TCVPTC and classic PTC with TCF are summarized in Table 2. The extent of surgery in the TCVPTC group was significantly more extensive than that in the classic PTC with TCF group . The mean tumor size was significantly larger in the TCVPTC group . ETE was significantly more frequent in the TCVPTC group compared with the classic PTC with TCF group . The proportion of harvested and positive LNs was higher in TCVPTCs . TCVPTCs had significantly more advanced T and N stage than classic PTCs with TCF . RAI ablation therapy was performed more frequently in the TCVPTC group . However, there was no significant between-group difference with respect to the recurrence rate . Moreover, mean age, sex distribution, multifocality, lymphatic invasion, vascular invasion, perineural invasion, BRAFV600E positivity, and TNM stage did not significantly differ between the two groups.

    Can You Treat Cancer And Live A Normal Life

    Pancreatic Metastasis of Tall Cell Variant of Papillary Thyroid ...

    Most thyroid cancers are treatable, especially when cancerous cells remain within the thyroid gland and has not metastasized to nearby lymph nodes or organs. Your doctor may suggest other therapy options if cancer has spread to other body parts. However, if your thyroid cancer cannot be cured, the treatment may involve removing or destroying cancerous cells and preventing them from growing, spreading, or returning.

    Sometimes, thyroid cancer treatment can be administered to relieve associated symptoms of the illness, such as pain and swallowing and breathing issues. Your doctor can diagnose your condition to determine if it is curable or recommend further examination to determine your prognosis or survival rate.

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    What Causes Thyroid Cancer

    In most cases, the cause of thyroid cancer is unknown. However, certain things can increase your chances of developing the condition.

    Risk factors for thyroid cancer include:

    • having a benign thyroid condition
    • having a family history of thyroid cancer
    • having a bowel condition known as familial adenomatous polyposis
    • acromegaly a rare condition where the body produces too much growth hormone
    • having a previous benign breast condition
    • weight and height

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    Comparison Of The Clinicopathological Features And Oncologic Outcomes Of The Classic Papillary Thyroid Carcinoma With Tall Cell Features And Tall Cell Variant

    Kwangsoon Kim1^, Chan Kwon Jung2^, Dong-Jun Lim3^, Ja Seong Bae1^, Jeong Soo Kim1^

    1 Department of Surgery, College of Medicine , The Catholic University of Korea , Department of Hospital Pathology, College of Medicine , The Catholic University of Korea , Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine , The Catholic University of Korea , , Korea

    Contributions: Conception and design: JS Bae Administrative support: CK Jung, DJ Lim, JS Kim Provision of study materials or patients: K Kim, JS Bae, JS Kim Collection and assembly of data: K Kim, CK Jung, JS Bae Data analysis and interpretation: K Kim, JS Bae Manuscript writing: All authors Final approval of manuscript: All authors.

    ^ORCID: Kwangsoon Kim, 0000-0001-6403-6035 Chan Kwon Jung, 0000-0001-6843-3708 Dong-Jun Lim, 0000-0003-0995-6482 Ja Seong Bae, 0000-0002-6271-2105 Jeong Soo Kim, 0000-0002-9982-7838.

    Correspondence to:

    Background: The tall cell variant of papillary thyroid carcinoma is the most common aggressive variant of PTC. Classic PTC with tall cell features is defined as PTC with noticeable tall cells but the percentage of these cells is lower than that required for the diagnosis of TCVPTC. We aimed to investigate the potential differences between TCVPTC and classic PTC with TCF with respect to clinicopathological characteristics and oncologic outcomes.

    Keywords: Tall cell features tall cell variant papillary thyroid carcinoma disease-free survival

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