Insular variant of poorly differentiated thyroid carcinoma
| Autor: | Constantine Theoharis, Mark Kulaga, Nancy J. Rennert, Regina Dodis, Ioana Fat, Tobias Carling |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism medicine.medical_treatment Thyroid carcinoma Iodine Radioisotopes Endocrinology Poorly Differentiated Thyroid Carcinoma Fluorodeoxyglucose F18 Medicine Humans Thyroid Neoplasms chemistry.isotope Thyroid cancer medicine.diagnostic_test business.industry Thyroidectomy Cancer Neck dissection General Medicine medicine.disease Iodine i 131 chemistry Positron emission tomography Positron-Emission Tomography Radiology business |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 17(1) |
| ISSN: | 1934-2403 |
| Popis: | Objective To present a case of an insular variant of poorly differentiated thyroid carcinoma (PDTC) and to review the literature related to diagnosis, natural history, and treatment of this unusual form of thyroid cancer. Methods We present the clinical, laboratory, and pathologic findings of the study patient and review Englishlanguage literature related to PDTC published between 1970 and the present. Results PDTC is a controversial and rare epithelial thyroid cancer, intermediate between differentiated thyroid carcinoma and anaplastic thyroid carcinoma that exhibits increased aggressiveness, propensity to local recurrence, distant metastases, and increased mortality. PDTC warrants aggressive management with total thyroidectomy followed by radioactive iodine ablation and potentially additional therapy for residual or recurrent disease. Some carcinomas do not take up radioactive iodine, and dedifferentiated clones of distant metastases may evolve. It is unclear whether chemotherapy is beneficial. Use of additional imaging modalities, including positron emission tomography, 18-fludeoxyglucose positron emission tomography/computed tomography, 18-fludeoxyglucose positron emission tomography/computed tomography/magnetic resonance imaging, 124I positron emission tomography/computed tomography, positron emission tomography/magnetic resonance imaging fusion studies, and recombinant human thyrotropin-stimulated radioactive iodine uptake for cancer surveillance are discussed. Conclusions PDTC is an unusual and aggressive form of thyroid cancer. Fine-needle aspiration cytology may not yield sufficient information to specifically diagnose PDTC. Aggressive management with total thyroidectomy and neck dissection followed by high-dose radioactive iodine remnant ablation is standard. Iodine I 131 whole body scanning is often the initial test for tumor surveillance, with other imaging modalities applied as needed. (Endocr Pract. 2011;17:115-121) |
| Databáze: | OpenAIRE |
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