The Difference in Clinical Behavior of Gene Fusions Involving Fusions and Fusions in Thyroid Nodules.

Background: Molecular testing has been used as an adjunct to morphological evaluation in the workup of thyroid nodules. This study investigated the impact of two gene fusions, and , that have been described as oncogenic events in thyroid neoplasms.

Methods: We performed a retrospective, single-centered study at a McGill University teaching hospital in Montreal, Canada, from January 2016 to August 2021.

Effect of Having Concurrent Mutations on the Degree of Aggressiveness in Patients with Thyroid Cancer Positive for Promoter Mutations.

This study aimed to examine whether concurrent mutations with a promoter mutation are associated with a greater likelihood of more aggressive disease than a promoter mutation alone. The medical records of 1477 patients who underwent thyroid surgery at two tertiary hospitals between 2017 and 2022 were reviewed. Twenty-four patients had promoter mutations based on molecular profile testing.

Coexisting Molecular Alterations Increase the Risk of Malignancy in Thyroid Nodules with Copy Number Alterations.

Molecular mutations and alterations play a role in thyroid tumorigenesis. Different alterations are associated with different clinical and pathological characteristics. Copy number alterations (CNAs) are known to be present in some thyroid tumors; however, their idiosyncratic clinicopathological implications are not yet well elucidated.

Graves' thyrotoxicosis soon after hemithyroidectomy for low-risk papillary thyroid carcinoma.

Hyperthyroidism is a medical problem that is commonly encountered by emergency physicians, internists and endocrinologists. The development of hyperthyroidism in the postoperative setting of hemithyroidectomy is quite rare. Reported causes include destructive thyroiditis and inappropriate thyroid hormone replacement.

Mutational status may supersede tumor size in predicting the presence of aggressive pathologic features in well differentiated thyroid cancer.

Background: In clinical practice, thyroid tumor size plays a critical role in the staging of thyroid malignancies and in the selection of nodules that should undergo ultrasound-guided fine-needle aspiration. Thyroid tumor size is influenced by the elapsed time since the beginning of oncogenesis and by the presence of somatic mutations driving growth, such as BRAF mutations, associated with aggressive phenotypes, and RAS-like mutations, associated with more indolent behavior. Although large nodules are often considered to be more alarming, the true impact of tumor size on prognosis remains controversial.

BRAF V600E mutation is associated with aggressive features in papillary thyroid carcinomas ≤ 1.5 cm.

Background: While some studies suggest that the BRAF V600E mutation correlates with a high-risk phenotype in papillary thyroid microcarcinoma (PTMC), more evidence is necessary before this mutation can be used to help guide decision making in the management of small thyroid nodules. This study investigated whether BRAF V600E mutation is associated with aggressive features in PTMC (≤ 1 cm) and small PTC (1-1.5 cm).

Association of Bethesda category and molecular mutation in patients undergoing thyroidectomy.

Objectives: The aim of this study was to ascertain the relationship between Bethesda category and molecular mutation of thyroid nodules in patients undergoing thyroidectomy.

Design: A retrospective cohort of patients who underwent thyroidectomy following needle biopsy and molecular profile testing was performed.

Setting: Two tertiary care academic hospitals.

Thyroidectomy for Graves' Disease Predicts Postoperative Neck Hematoma and Hypocalcemia: A North American cohort study.

Objective: Examine the association of Graves' disease with the development of postoperative neck hematoma.

Design: A cohort of patients participating in the Thyroid Procedure-Targeted Database of the National Surgical Quality Improvement Program from January 1, 2016 to December 31, 2018.

Setting: A North American surgical cohort study.

Molecular testing for cytologically suspicious and malignant (Bethesda V and VI) thyroid nodules to optimize the extent of surgical intervention: a retrospective chart review.

Background: Molecular testing has been used for cytologically indeterminate thyroid nodules (Bethesda III and IV), where the risk of malignancy is 10-40%. However, to date, the role of molecular testing in cytologically suspicious or positive for malignancy (Bethesda V and VI) thyroid nodules has been controversial. The aim of this study was to determine whether patients who had molecular testing in Bethesda V and VI thyroid nodules had the optimal extent of surgery performed more often than patients who did not have molecular testing performed.

Reversible, severe mitral regurgitation in thyrotoxic Graves' disease.

Mitral valve prolapse is a common finding in Graves' disease. However, severe mitral regurgitation (MR) is a relatively uncommon manifestation of Graves' disease. We report a case of a 32-year-old woman with toxic Graves' disease and MR.

Active surveillance for low-risk small papillary thyroid cancer in North American countries: past, present and future (bridging the gap between North American and Asian practices).

Papillary thyroid cancer (PTC) is increasingly being diagnosed worldwide; yet the mortality remains very low, suggesting widespread overdiagnosis. While traditional management of PTC includes thyroid surgery, sometimes followed by radioactive iodine treatment, there is a global trend towards more conservative approaches for patients who are considered as the lowest risk of recurrence or death from their disease. Active surveillance (AS), once called watchful waiting, involves close follow-up, with the intention to intervene if the cancer progresses, or on patient request.

Preoperative prediction of non-invasive follicular thyroid neoplasm with papillary-like nuclear features: a Canadian single-Centre experience.

Background: An international group of experts recommended reclassifying non-invasive follicular variant of papillary thyroid cancers (FVPTC) as 'non-invasive follicular thyroid neoplasm with papillary-like nuclear features' (NIFTP) in April 2016. The purpose of this study was to establish preoperative clinical, laboratory, ultrasonographic, and cytological variables, which can differentiate NIFTP from FVPTC.

Methods: We conducted a retrospective chart review of consecutive patients from a single institution evaluated between January 2012 and December 2017.

Adrenocortical carcinoma: an ominous cause of hirsutism.

Hirsutism is a common medical presentation to family physicians, internists and endocrinologists. Although the cause is commonly benign, a more serious or life-threatening one should not be missed. Here we report a 58-year-old woman, assessed for hirsutism and 15-pound weight gain, with associated easy bruising and mood swings.

Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves' disease patients: a retrospective matched cohort study.

Background: Reported rates of thyroid cancer in Graves' disease (GD) vary widely. The aim of this study was to evaluate the prevalence of papillary thyroid carcinoma (PTC), including aggressive forms, in GD compared to matched controls undergoing thyroidectomy. Furthermore, it seeks to elucidate any patient- or tumour-associated factors predictive of malignancy or an aggressive course.

Carcinoembryonic antigen levels correlated with advanced disease in medullary thyroid cancer.

Background: Medullary thyroid cancer (MTC) cells are capable of secreting various tumor markers including calcitonin and carcinoembyronic antigen (CEA). The purpose of this study is to determine whether abnormal CEA levels may be used as a tumor marker to predict the severity of disease in MTC.

Methods: A retrospective analysis was completed for 33 patients with MTC who had preoperative serum CEA levels.

Feelings of Disenfranchisement and Support Needs Among Patients With Thyroid Cancer.

Purpose: To offer a better understanding of the experiences, preferences, and needs of patients with thyroid cancer.

Participants & Setting: 17 patients with thyroid cancer receiving treatment at a university-affiliated hospital in Montreal, Québec, Canada.

Methodologic Approach: Interviews were conducted with patients, and descriptive phenomenology was used to explore patients' lived experience.

I-131 Radiation-Induced Myelosuppression in Differentiated Thyroid Cancer Therapy.

Radioactive iodine (RAI) treatment of differentiated thyroid cancer has been used in clinical practice for almost 60 years and is generally accepted to be a safe and efficacious treatment. Severe toxicity in the form of radiation pneumonitis, sometimes progressing to fibrosis, and bone marrow suppression are reported but remain rare. We present a case of severe myelosuppression requiring hospitalization and transfusion support in an otherwise well, young female patient who had received 175 mCi I-131 for low-volume micronodular lung disease one month prior, with a cumulative lifetime administered activity of 575 mCi.

CALCITONIN SECRETORY INDEX AND UNSUSPECTED NODAL DISEASE IN MEDULLARY THYROID CARCINOMA.

Objective: Medullary thyroid carcinoma (MTC) is a rare thyroid malignancy originating from parafollicular C-cells with the potential for aggressive behavior. The extent of lymph node (LN) dissection at the time of surgery is controversial, with different schools of thought prevailing. Some systematically perform LN dissections, whereas others base their decision on radiologic evidence of disease and some with the assistance of pre-operative calcitonin (CT) levels.

Thyroid cancer patients receiving an interdisciplinary team-based care approach (ITCA-ThyCa) appear to display better outcomes: Program evaluation results indicating a need for further integrated care and support.

Background: Thyroid cancer (ThyCa) is generally associated with a favorable prognosis and excellent surgical outcomes. Consequently, its treatment is medically focused and current guidelines recommend interdisciplinary care including access to a nurse for complex cases alone. To date, no studies have evaluated the need for and impact of an Interdisciplinary Team-based Care Approach (ITCA-ThyCa) for general thyroid cancer patients, including a dedicated nurse as part of a larger interdisciplinary team, as well as patient-reported outcomes, as is recommended worldwide in cancer care.

The T4/T3 quotient as a risk factor for differentiated thyroid cancer: a case control study.

Background: The incidence of thyroid nodules is increasing among patients in North America. Few of these nodules harbour malignancy, thus further research is required to identify predictive markers of malignant thyroid disease. This study set out to understand the relationship between the levels of fT4 and fT3 and differentiated thyroid cancer.

Prostate-specific membrane antigen-directed nanoparticle targeting for extreme nearfield ablation of prostate cancer cells.

Almost all biological therapeutic interventions cannot overcome neoplastic heterogeneity. Physical ablation therapy is immune to tumor heterogeneity, but nearby tissue damage is the limiting factor in delivering lethal doses. Multi-walled carbon nanotubes offer a number of unique properties: chemical stability, photonic properties including efficient light absorption, thermal conductivity, and extensive surface area availability for covalent chemical ligation.