BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,H...BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,Hürthle cell carcinoma,poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma have been reported in the literature,but there have been no reports about PTMC.CASE SUMMARY A 45-year-old woman presented with a thyroid mass and thrombosis in a middle thyroid vein during a physical examination.She had no symptoms,and the physical examination showed no positive signs.Subsequent ultrasonographyguided fine-needle aspiration biopsy results indicated an atypical lesion of ambiguous significance,with some actively growing cells(TBSRTCⅢ)and the BRAFV600E mutation not present.This patient underwent left thyroidectomy,isthmus lobectomy,prophylactic central lymph node dissection and thromboembolectomy.Postoperative pathology showed papillary microcarcinoma of the left thyroid,and the thrombus in the middle thyroid vein was a tumor thrombus.CONCLUSION Middle thyroid vein tumor thrombus is an extremely rare condition in PTMC,but it does exist.Lobectomy and thromboembolectomy may be an option for patients with thrombi in the middle vein of the thyroid,and we strongly suggest close follow-up of these patients.展开更多
Objective: Preablative stimulated thyroglobulin(ps-Tg) has the potential to be used in identifying distant metastatic differentiated thyroid carcinoma(DM-DTC), but its single level can be affected by remnant thyroid t...Objective: Preablative stimulated thyroglobulin(ps-Tg) has the potential to be used in identifying distant metastatic differentiated thyroid carcinoma(DM-DTC), but its single level can be affected by remnant thyroid tissue and thyrotropin(TSH). The objective of this retrospective study was to evaluate the value of serial ps-Tg measurements in identifying DM-DTC specifically.Methods: A total of 317 DTC patients with serial measurements of ps-Tg, TSH and anti-Tg antibody were divided into M1(n=72) and M0(n=245) according to the presence of distant metastasis(DM) or not. The initial psTg measurement, with a corresponding TSH exceeding 30 μIU/m L, was marked as Tg1, and ps-Tg measured right before radioactive iodine(RAI) therapy was defined as Tg2, with a median interval of 8 days. ΔTg denotes Tg2–Tg1, and ΔTSH denotes TSH2–TSH1. Tg1, Tg2, ΔTg, and ΔTg/ΔTSH were tested for efficacy in identifying DM-DTC using receiver operating characteristic(ROC) curve analysis, and further compared with chest computed tomography(CT) and posttreatment whole-body RAI scan(Rx WBS).Results: Compared with single ps-Tg measurement(Tg1 or Tg2), both ΔTg and ΔTg/ΔTSH were more narrowly distributed around zero in the M0 group, which made their distribution in the M1 group more distinguished in a relatively dispersed way. ΔTg/ΔTSH manifested a higher accuracy(88.64%) and specificity(90.20%) in identifying DM-DTC than Tg1 or Tg2 measurements, with a much higher specificity than chest CT(90.20% vs. 66.00%) and a much higher sensitivity than Rx WBS(83.33% vs. 61.11%).Conclusions: Serial ps-Tg measurements even over as short an interval as 8 days hold incremental value in identifying DM-DTC. ΔTg/ΔTSH is a specific early biochemical marker for DM-DTC.展开更多
文摘BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,Hürthle cell carcinoma,poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma have been reported in the literature,but there have been no reports about PTMC.CASE SUMMARY A 45-year-old woman presented with a thyroid mass and thrombosis in a middle thyroid vein during a physical examination.She had no symptoms,and the physical examination showed no positive signs.Subsequent ultrasonographyguided fine-needle aspiration biopsy results indicated an atypical lesion of ambiguous significance,with some actively growing cells(TBSRTCⅢ)and the BRAFV600E mutation not present.This patient underwent left thyroidectomy,isthmus lobectomy,prophylactic central lymph node dissection and thromboembolectomy.Postoperative pathology showed papillary microcarcinoma of the left thyroid,and the thrombus in the middle thyroid vein was a tumor thrombus.CONCLUSION Middle thyroid vein tumor thrombus is an extremely rare condition in PTMC,but it does exist.Lobectomy and thromboembolectomy may be an option for patients with thrombi in the middle vein of the thyroid,and we strongly suggest close follow-up of these patients.
基金supported by the Ministry of Health Industry Special Scientific Research Projects of China (No. 201202012)the National Natural Science Foundation of China (No. 81571714)
文摘Objective: Preablative stimulated thyroglobulin(ps-Tg) has the potential to be used in identifying distant metastatic differentiated thyroid carcinoma(DM-DTC), but its single level can be affected by remnant thyroid tissue and thyrotropin(TSH). The objective of this retrospective study was to evaluate the value of serial ps-Tg measurements in identifying DM-DTC specifically.Methods: A total of 317 DTC patients with serial measurements of ps-Tg, TSH and anti-Tg antibody were divided into M1(n=72) and M0(n=245) according to the presence of distant metastasis(DM) or not. The initial psTg measurement, with a corresponding TSH exceeding 30 μIU/m L, was marked as Tg1, and ps-Tg measured right before radioactive iodine(RAI) therapy was defined as Tg2, with a median interval of 8 days. ΔTg denotes Tg2–Tg1, and ΔTSH denotes TSH2–TSH1. Tg1, Tg2, ΔTg, and ΔTg/ΔTSH were tested for efficacy in identifying DM-DTC using receiver operating characteristic(ROC) curve analysis, and further compared with chest computed tomography(CT) and posttreatment whole-body RAI scan(Rx WBS).Results: Compared with single ps-Tg measurement(Tg1 or Tg2), both ΔTg and ΔTg/ΔTSH were more narrowly distributed around zero in the M0 group, which made their distribution in the M1 group more distinguished in a relatively dispersed way. ΔTg/ΔTSH manifested a higher accuracy(88.64%) and specificity(90.20%) in identifying DM-DTC than Tg1 or Tg2 measurements, with a much higher specificity than chest CT(90.20% vs. 66.00%) and a much higher sensitivity than Rx WBS(83.33% vs. 61.11%).Conclusions: Serial ps-Tg measurements even over as short an interval as 8 days hold incremental value in identifying DM-DTC. ΔTg/ΔTSH is a specific early biochemical marker for DM-DTC.
