633 results match your criteria: "Kuma Hospital[Affiliation]"

Managing thyroid nodules diagnosed cytologically as follicular neoplasms (FN) is challenging for patients and clinicians. Gene panel testing was recently introduced to determine the management strategy for FN; however, it is unavailable in Japan. In this study, we assessed FN management.

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We and other investigators reported that mild TSH suppression with levothyroxine (LT) was needed to achieve normal free triiodothyronine (FT) levels and metabolic euthyroid state in athyreotic patients. Consequently, management methods based on thyroid tissue volume have been implemented for patients receiving LT at the Kuma Hospital. This retrospective study examined the composition of the thyroid hormone measurement items (serum-free thyroxine [FT], FT, and FT + FT) in patients receiving LT monotherapy.

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Article Synopsis
  • KEAP1 is a protein that usually promotes the degradation of NRF2, a factor that helps cells respond to oxidative stress, but mutations in KEAP1 can lead to diseases like familial multinodular goiter.
  • This study analyzed 39 patients with this goiter, identifying five with specific KEAP1 mutations that did not correlate with any other mutations related to goiter.
  • Results showed that these mutations led to increased activity of NRF2, causing thyroid hyperplasia and a protective response against oxidative stress, indicated by the upregulation of antioxidant and detoxification genes.
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Familial nonautoimmune hyperthyroidism (NAH) is a rare type of autosomal dominant hyperthyroidism caused by constitutively active pathogenic variants of the thyrotropin receptor () gene. Although affected family members present with varied levels of hyperthyroid features, even when the same pathogenic variant is present, total thyroidectomy followed by radioiodine therapy is recommended for long-term management. Herein, we present the case of an 18-year-old proband and her family members with NAH (TSHR-I640V), who presented with diverse thyroid dysfunctions: fluctuations between euthyroid and subclinical hyperthyroidism, mild hyperthyroidism, and overt hyperthyroidism.

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  • The study investigates factors that can predict the recurrence of papillary thyroid carcinoma (PTC) after patients undergo airway resection, with a focus on a group of 149 patients monitored for an average of 93 months.
  • Out of these patients, 11 (6.7%) experienced tracheal excision site recurrence (ESR), with significant predictors identified as a Ki-67 labeling index of 5% or higher and a thyroglobulin doubling rate greater than 0.33/year.
  • The findings suggest that patients with high Ki-67 LI and high Tg-DR should receive careful monitoring post-surgery, and adjuvant treatments like external beam radiotherapy could be
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Prognostic factors of papillary and follicular carcinomas based on pre-, intra-, and post-operative findings.

Eur Thyroid J

October 2024

Department of Surgery, Kuma Hospital, Shimoyamate-dori, Chuo-ku, Kobe, Hyogo, Japan.

Article Synopsis
  • Papillary thyroid carcinoma (PTC) is primarily diagnosed through preoperative cytology, with factors like tumor size and metastasis significantly affecting its prognosis; certain aggressive variants also play a role in expected outcomes.
  • Follicular thyroid carcinoma (FTC) is typically assessed post-surgery, with various invasive classifications influencing prognosis—vascular invasion is a critical factor, affecting outcomes more than capsular invasion.
  • Monitoring dynamic markers post-surgery, such as thyroglobulin-doubling rate, is vital for evaluating treatment effectiveness and providing follow-up care for patients with thyroid carcinomas.
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Background: Patients with intermediate-risk papillary thyroid carcinoma (PTC) have a favorable prognosis with standard treatment of total thyroidectomy (TT) and adjuvant radioactive iodine therapy (RAIT). However, the benefits of TT or adjuvant RAIT remain undetermined, and they are often omitted in Japan. We investigated risk factors for life-threatening distant recurrence in patients with intermediate-risk PTC who are optimal candidates for adjuvant RAIT.

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  • Researchers developed a mouse model of thyroid storm (TS) using triiodothyronine and lipopolysaccharide to better understand the condition and test treatments like ghrelin.
  • The TS mouse model showed increased serum IL-6 levels, indicating hypercytokinemia, and had a survival rate of about 30% without treatment, but improved significantly to 66.7% with ghrelin administration.
  • This study provides insights into TS mechanisms and potential therapeutic strategies, marking progress towards effective treatments for this life-threatening condition.
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Background: Papillary thyroid carcinoma (PTC) often extends to adjacent organs. According to the 8th Tumor-Node-Metastasis Classification, extension to the strap muscles was graded as T3b. We investigated the prognostic impact of T3b and the appropriateness of T3b in patients aged ≥55 years who were classified as stage II.

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Anti-PD immunotherapy is currently under investigation in anaplastic thyroid carcinoma (ATC). Tumor cell surface PD-L1 expression is considered predictive of therapeutic response. Although papillary thyroid carcinoma has been widely studied for PD-L1 expression, there are limited data on ATC.

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Background: Fine-needle aspiration cytology serves as an important preoperative diagnostic tool for thyroid nodules. Despite its excellent diagnostic accuracy, diagnoses based solely on morphological observation can be challenging. Therefore, various ancillary diagnostic techniques have been applied, including immunocytochemistry (ICC).

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Objective: The simplest way to determine the adequacy of aspirated materials is the on-site gross visual assessment of aspirated materials. However, few studies have examined the gross findings of thyroid aspirates. This study aimed to clarify the diagnostic significance of clay-like material aspirated from thyroid nodules.

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Methotrexate (MTX) is a well-known agent that can potentially cause lymphoproliferative disorder (LPD), known as MTX-related LPD (MTX-LPD). Only two cases of thyroid MTX-LPD have been reported to date. This study aimed to report 11 cases of MTX-LPDs arising in the thyroid gland and discuss their clinicopathological characteristics.

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Backgruound: Hashimoto thyroiditis (HT) is suspected to correlate with papillary thyroid carcinoma (PTC) development. While some HT cases exhibit histologic features of immunoglobulin G4 (IgG4)-related disease, the relationship of HT with PTC progression remains unestablished.

Methods: This cross-sectional study included 426 adult patients with PTC (≥1 cm) undergoing thyroidectomy at an academic thyroid center.

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Introduction: Thyroglobulin (Tg) is a very sensitive and specific marker in patients who have undergone total thyroidectomy for papillary thyroid carcinoma (PTC). However, the presence of a Tg antibody (TgAb) interferes with Tg immunometric assays, making Tg levels unreliable indicators. There are currently no other tumor markers to monitor in patients with PTC whose serum is TgAb-positive.

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Insufficient thyroid hormone production in newborns is referred to as congenital hypothyroidism. Multinodular goiter (MNG), characterized by an enlarged thyroid gland with multiple nodules, is usually seen in adults and is recognized as a separate disorder from congenital hypothyroidism. Here we performed a linkage analysis of a family with both nongoitrous congenital hypothyroidism and MNG and identified a signal at 15q26.

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Calcium oxalate crystals as a cause of multiple punctate echogenic foci in benign thyroid lesions.

J Med Ultrason (2001)

July 2024

Department of Internal Medicine, Kuma Hospital, 8-2-35 Shimoyamate-Dori, Chuo-Ku, Kobe, Hyogo, 650-0011, Japan.

Purpose: Multiple punctate echogenic foci (MPEF) on thyroid ultrasonography reflects psammoma bodies in papillary thyroid carcinomas. However, MPEF is also observed in benign thyroid lesions. The aim of this study was to determine the origin of MPEF in patients with benign thyroid lesions.

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Article Synopsis
  • Lenvatinib is the main treatment for advanced thyroid cancer that's resistant to radioactive iodine, but it can cause serious side effects that often lead to dose changes or interruptions.
  • Recent studies suggest that taking breaks ("planned drug holidays") from the medication could help manage these side effects while maintaining treatment effectiveness.
  • In a study involving 262 patients, those who took planned drug holidays showed significantly better clinical outcomes, including longer overall survival and progression-free survival rates compared to those who continued without breaks.
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Papillary thyroid carcinoma (PTC) with marked cystic formation (CPTC) is not a subtype of PTC, and its clinical characteristics have not been fully investigated. This study aimed to clarify the clinical and pathological characteristics of CPTC and propose important indicators for its clinical management. Thirty-three CPTC nodules with cystic areas occupying >50% of their volume were examined.

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Context: Telomerase reverse transcriptase promoter (TERT-p) mutations, which upregulate TERT expression, are strongly associated with tumor aggressiveness and worse prognosis in papillary thyroid carcinomas (PTCs). TERT expression is also observed in a proportion of PTCs without TERT-p mutations, but such tumors show less aggressiveness and better prognosis than TERT-p mutation-positive tumors.

Objective: TERT has multiple splicing variants whose relationships with the TERT-p status and clinicopathological characteristics remain poorly understood.

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Context: The mortality rate in thyroid storm (TS) has been reported to be higher than 10%.

Objective: We aimed to evaluate the effectiveness of the 2016 guidelines for the management of TS proposed by the Japan Thyroid Association and Japan Endocrine Society.

Methods: In this prospective multicenter registry-based study, patients with new-onset TS were registered in the Research Electronic Data Capture (REDCap), a secure web platform.

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Objectives: Injury to the external branch of the superior laryngeal nerve (EBSLN) causes low-pitch voice and voice fatigue, particularly in female subjects, and available treatments are limited. Here, we assess a novel surgical procedure to restore a high-tone voice: ansa cervicalis to EBSLN anastomosis (A-E anastomosis).

Methods: Between November 2012 and April 2022, 13 patients (12 female) underwent unilateral EBSLN resection and A-E anastomosis, while 20 (16 female) underwent EBSLN resection during thyroid surgery.

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Differentiating BRAF V600E- and RAS-altered encapsulated follicular-patterned thyroid tumors based on morphology remains challenging. This study aimed to validate an 8-score scale nuclear scoring system and investigate the importance of nuclear pseudoinclusions (NPIs) in aiding this differentiation. A cohort of 44 encapsulated follicular-patterned tumors with varying degrees of nuclear atypia and confirmed BRAF V600E or RAS alterations was studied.

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