Povezanost diabetes mellitusa tip 2, hipotiroeoze i karcinoma štitnjače

This study aimed to investigate the association between type 2 diabetes mellitus (T2DM), antidiabetic therapy, hypothyroidism, and thyroid cancer. We analyzed data from 320 patients who underwent thyroid surgery for suspicion of cancer. The diagnosis of thyroid cancer was confirmed by histopathological analysis in 95 patients. No significant difference was found in the diagnosis of T2DM and hypothyroidism concerning the presence of thyroid cancer (p=0.13; p=0.85), nor in the gender of patients with T2DM and hypothyroidism with respect to the type of thyroid cancer (p=0.19; p=0.25). Patients with T2DM (Odds ratio [OR] 1.89; 95% CI, 0.856-4.163) and patients with hypothyroidism (OR, 1.05; 95% CI, 0.530-2.164) had higher prevalence of thyroid cancer, as did those who had both diagnoses combined (p=0.37; OR, 2.39; 95% CI, 0.333-17.278), compared with the patients who did not have those diagnoses. Men with T2DM (OR, 6.19; 95% CI, 1.180-32.513) had higher prevalence of thyroid cancer than women. Patients who were on oral antidiabetics (OR, 1.91; 95% CI, 0.804-4.512) had higher prevalence of thyroid cancer than those receiving insulin. According to the results of this study, we can conclude that there is an association between T2DM, hypothyroidism, oral antidiabetics, and thyroid cancer.Cilj ove studije je bio ispitati povezanost diabetes mellitusa tip 2 (T2DM), antidijabetičke terapije, hipotireoze i karcinoma štitnjače. Analizirani su podaci od 320 pacijenata koji su operirani zbog sumnje na karcinom štitnjače. Dijagnoza karcinoma štitnjače je potvrđena patohistološkom analizom kod 95 pacijenata. Nije nađena značajna razlika u prisutnosti dijagnoze T2DM i hipotireoze u odnosu na prisutnost karcinoma štitnjače (p=0.13; p=0.85), kao niti u spolu ispitanika s T2DM i hipotireozom s obzirom na tip karcinoma štitnjače (p=0.19; p=0.25). Pacijenti s T2DM (Odds ratio [OR] 1.89; 95% CI, 0.856–4.163) i pacijenti s hipotireozom (OR, 1.05; 95% CI, 0.530–2.164) su imali veću vjerojatnost od karcinoma štitnjače, kao i ispitanici koji su imali obje dijagnoze u kombinaciji (p=0.37; OR, 2.39; 95% CI, 0.333–17.278), u odnosu na pacijente koji nemaju te dijagnoze. Muškarci s T2DM (OR, 6.19; 95% CI, 1.180-32.513) su imali veću vjerojatnost od karcinoma štitnjače od žena. Veću vjerojatnost od karcinoma štitnjače imali su pacijenti koji uzimaju peroralne antidijabetike (OR, 1.91; 95% CI, 0.804–4.512) u odnosu na one koji uzimaju inzulin. Prema rezultatima ove studije možemo zaključiti da postoji povezanost T2DM, hipotireoze, peroralnih antidijabetika i karcinoma štitnjače

Epidemiology of simultaneous medullary and papillary thyroid carcinomas (MTC/PTC): An Italian multicenter study

Background: The concomitant presence of papillary thyroid cancer (PTC) and medullary TC (MTC) is rare. In this multicentric study, we documented the epidemiological characteristics, disease conditions and clinical outcome of patients with simultaneous MTC/PTC. Methods: We collected data of patients with concomitant MTC/PTC at 14 Italian referral centers. Results: In total, 183 patients were enrolled. Diagnosis was mostly based on cytological examination (n = 58, 32%). At diagnosis, in the majority of cases, both PTC (n = 142, 78%) and MTC (n = 100, 54%) were at stage I. However, more cases of stage II\u2013IV were reported with MTC (stage IV: n = 27, 15%) compared with PTC (n = 9, 5%). Information on survival was available for 165 patients: 109 patients (66%) were disease-free for both PTC and MTC at the last follow-up. Six patients died from MTC. Median time to progression was 123 months (95% confidence interval (CI): 89.3\u2013156.7 months). Overall, 45% of patients were disease-free after >10 years from diagnosis (125 months); this figure was 72.5% for PTC and 51.1% for MTC. Conclusions: When MTC and PTC are concurrent, the priority should be given to the management of MTC since this entity appears associated with the most severe impact on prognosis

A unique RET EXON 11 (G691S) polymorphism in an Indian patient with a collision tumor of the thyroid

BACKGROUND: Collision tumors of the thyroid are rare, with occasional reports dealing with their genetic analysis. CASE PRESENTATION: A 59 year old lady presented with a neck mass, associated with hoarseness of voice of 5 years duration. Radiological examination revealed nodular masses in the left lobe of her thyroid, along with one in the isthmus, extending into the right lobe and associated with enlarged neck nodes. FNAC from the left thyroid showed features of medullary carcinoma. On total thyroidectomy, 2 distinct tumor nodules were identified in the left lobe with another in the isthmus, showing features of medullary carcinoma (MTC), papillary carcinoma and follicular variant of papillary carcinoma, respectively, accompanied with nodal metastasis. Subsequently, she underwent radioablation. RET gene analysis of the patient, her 2 daughters and a grandson revealed a unique G691S polymorphism on Exon 11. CONCLUSION: This unique case of a collision tumor of thyroid, including component of an MTC deals with the value of RET gene analysis and therapeutic implications in the index case and in family members