Złośliwy nerwiak osłonkowy szyi imitujący guz tarczycy — opis przypadku i przegląd piśmiennictwa. Praca z ośrodka referencyjnego w chirurgii endokrynologicznej

Malignant peripheral sheath tumors (MPNST) are rare soft tissue sarcomas originating from peripheral sheath cells. The main risk factor is neurofibromatosis type 1 (NF-1). The localization in the head and neck region is uncommon (up to 15% of all cases of MPNST) making the diagnosis difficult due to anatomical and clinical reasons. We present a case of 45-years-old female with the NF-1- linked MPNST localized in the thyroid region with clinical manifestation as a left thyroid tumour. The patient underwent surgery and adjuvant radiation therapy, remaining disease-free for 14 months after the treatment.Złośliwe nerwiaki osłonkowe (MPNST) należą do rzadko spotykanych mięsaków tkanek miękkich, wywodzących się z komórek osłonek nerwów obwodowych. Najważniejszym czynnikiem ryzyka ich rozwoju jest nerwiakowłókniakowatość typu 1 — choroba Recklinghausena. Umiejscowienie tych nowotworów w regionie głowy i szyi zdarza się rzadko, a postawienie prawidłowego rozpoznania jest trudne z przyczyn anatomicznych i skrytego przebiegu klinicznego omawianych guzów. W pracy prezentujemy przypadek 45-letniej kobiety z nerwiakowłókniakowatością typu 1 i złośliwym nerwiakiem osłonkowym umiejscowionym w rzucie lewego płata tarczycy. Chora przebyła zabieg wycięcia guza z następczą radioterapią. W trakcie 14-miesięcznej obserwacji po leczeniu nie stwierdzono nawrotu choroby

Expression of FAS/APO 1/CD 95 in thyroid tumors.

Using immunohistochemistry, Fas/Apo-1 protein expression was investigated in thyroid cancers of 67 patients. Thyroid biopsies from twenty eight patients with benign thyroid diseases were also examined. The patients with thyroid cancer manifested a variable histology of the cancer, including 14 patients with follicular carcinoma, 48 with papillary carcinoma, 5 patients with medullary carcinoma. The benign thyroid disease involved nodular goitre in 11 patients and follicular adenoma in other 17 patients. The study aimed at examining immunohistochemical expression of Fas protein in order to determine whether the level of its expression correlated with histological diagnosis. In individual patients Fas expression was more prevalent in thyroid carcinomas as compared to benign tumors (p=0.001). A marked increase in Fas expression was found in papillary carcinoma, as compared to follicular and medullary carcinomas (p=0.02). In conclusion, Fas was significantly more frequently overexpressed in thyroid cancer, indicating its role in thyroid tumorigenesis

Wstępne próby konstrukcji bibliotek peptydowych jako narzędzia w diagnostyce nowotworów złośliwych tarczycy

Introduction: Cancer of thyroid gland is the most common malignancy of the endocrine system. The treatment improvement could be achieved by early diagnosis. The aim of the study was to identify cancer specific antigenes with use of peptide libraries. Material and methods: The material from 6 patients with thyroid cancer (4 with papillary cancer, 1 with follicular cancer and 1 with oxyphilic tumor) were analyzed. It was performed with use of lipophylic peptide libraries by direct comparison of staining of specimens prepared from normal and malignant tissue. Results: Preliminary results confirm practical value of peptide libraries in early diagnostics of thyroid cancer. Conclusions: It is important to optimize construction of peptide libraries by using different staining agents hydrolyzed by proteases.Wstęp: Nowotwory złośliwe tarczycy należą do najczęstszych nowotworów złośliwych układu endokrynnego. Poprawa wyników leczenia wiąże się z postępem wczesnej diagnostyki raka. Celem niniejszych badań jest poszukiwanie wskaźników nowotworowych za pomocą bibliotek peptydowych umieszczonych na podłożu z bibuły. Materiał i metody: Analizie poddano tkanki pobrane od 6 pacjentów: 4 z rakiem brodawkowatym tarczycy, 1 z nowotworem pęcherzykowym oraz 1 pacjenta z rakiem oksyfilnym. Badania wykonywano z wykorzystaniem bibliotek peptydowych lipofilowych, porównując tkankę zdrową i chorą oraz oceniając zmianę zabarwienia w poszczególnych bibliotekach. Wyniki: Wstępne wyniki wskazują, że biblioteki peptydowe można zastosować w diagnostyce nowotworów tarczycy. Wnioski: Niezbędna jest optymalizacja budowy bibliotek peptydowych, gdzie konieczne jest zastosowanie innego barwnika hydrolizowanego przez proteazy

Expression of FAS/APO 1/CD 95 in thyroid tumors.

Using immunohistochemistry, Fas/Apo-1 protein expression was investigated in thyroid cancers of 67 patients. Thyroid biopsies from twenty eight patients with benign thyroid diseases were also examined. The patients with thyroid cancer manifested a variable histology of the cancer, including 14 patients with follicular carcinoma, 48 with papillary carcinoma, 5 patients with medullary carcinoma. The benign thyroid disease involved nodular goitre in 11 patients and follicular adenoma in other 17 patients. The study aimed at examining immunohistochemical expression of Fas protein in order to determine whether the level of its expression correlated with histological diagnosis. In individual patients Fas expression was more prevalent in thyroid carcinomas as compared to benign tumors (p=0.001). A marked increase in Fas expression was found in papillary carcinoma, as compared to follicular and medullary carcinomas (p=0.02). In conclusion, Fas was significantly more frequently overexpressed in thyroid cancer, indicating its role in thyroid tumorigenesis

Clinical and histopathological characteristics of patients with incidental and nonincidental thyroid cancer

Introduction: Thyroid nodules (TNs) are a common pathology. Their prevalence increases with age. Some of them are suspected of malignancy and qualified for surgery. Sometimes their malignant nature is detected incidentally after a surgical procedure. The aim of the study is to analyze clinical and histopathological characteristics of patients with incidental and nonincidental thyroid carcinoma (ITC vs. NITC). Material and methods: The case records of 3,241 patients with solitary and multiple TNs who were treated consecutively between 2008 and 2014 were analyzed retrospectively. After the final selection 235 (7.25%) patients were included in the study (202 females and 33 males, mean age: 52.9 +16.5 years). Seventy-five (31.91%) cases were incidentally diagnosed and 160 (68.09%) were diagnosed before surgery. Results : We did not observe any differences in age, gender or stage of disease at the time of diagnosis between the patients with ITC and NITC (p = 0.366, p = 0.850, p = 0.226 respectively). The occurrence of solitary nodules in patients with NITC was significantly higher compared to patients with ITC (p < 0.0001). There were no differences in histopathological types of thyroid cancer (TC). The logistic regression analysis showed that solitary TC was an independent predictor of NITC (p < 0.0001). Conclusions : There are no differences in gender, age or histopathological type of cancer in patients with ITC and NITC. Papillary TC is the predominant type in both groups. Incidence of TC in a solitary nodule is significantly higher in NITC than ITC. Solitary type of TC is an independent predictor of NITC. The prevalence of ITC is associated with multifocal type of TC

Follicular adenomas exhibit a unique metabolic profile. ¹H NMR studies of thyroid lesions.

Thyroid cancer is the most common endocrine malignancy. However, more than 90% of thyroid nodules are benign. It remains unclear whether thyroid carcinoma arises from preexisting benign nodules. Metabolomics can provide valuable and comprehensive information about low molecular weight compounds present in living systems and further our understanding of the biology regulating pathological processes. Herein, we applied ¹H NMR-based metabolic profiling to identify the metabolites present in aqueous tissue extracts of healthy thyroid tissue (H), non-neoplastic nodules (NN), follicular adenomas (FA) and malignant thyroid cancer (TC) as an alternative way of investigating cancer lesions. Multivariate statistical methods provided clear discrimination not only between healthy thyroid tissue and pathological thyroid tissue but also between different types of thyroid lesions. Potential biomarkers common to all thyroid lesions were identified, namely, alanine, methionine, acetone, glutamate, glycine, lactate, tyrosine, phenylalanine and hypoxanthine. Metabolic changes in thyroid cancer were mainly related to osmotic regulators (taurine and scyllo- and myo-inositol), citrate, and amino acids supplying the TCA cycle. Thyroid follicular adenomas were found to display metabolic features of benign non-neoplastic nodules and simultaneously displayed a partial metabolic profile associated with malignancy. This finding allows the discrimination of follicular adenomas from benign non-neoplastic nodules and thyroid cancer with similar accuracy. Moreover, the presented data indicate that follicular adenoma could be an individual stage of thyroid cancer development

Molecular Fingerprints of Thyroid Cancer Cells by Using Library of Molecular Receptors Formed by N-Lipidated Peptides Immobilized on Cellulose

A novel diagnostic method based on recognition of qualitative and quantitative composition of healthy and tumor tissue samples by library of molecular receptors was presented. Molecular receptors were formed by self-organization of N-lipidated peptides attached in the regular fashion via aminophenylamino-1,3,5-triazine linker to the surface of cellulose plate. For samples testing, the library was cloned into multiple, identical copies and for each experiment the new clone was used. The binding process was monitored by staining the discs with Brilliant Black and quantitative color measurement was performed in 256 grade gray scale. Substantial differences in the composition of healthy and tumor samples were observed in most cases. The highly individual chemical fingerprints were found to be reliant on the cancer type. For malignant papillary thyroid cancer statistical analysis identified two receptors most useful for diagnostic purposes

Diagnostics of Thyroid Malignancy and Indications for Surgery in the Elderly and Younger Counterparts: Comparison of 3,749 Patients

Background. It seems valuable for clinicians to know if diagnostics of thyroid malignancy (TM) and indications for surgery in the elderly patients differ from these in younger counterparts. Materials and Methods. Retrospective analysis of the medical records of 3,749 patients surgically treated for thyroid tumor. Data of patients with histopathology confirmed TM (n=309) were studied. Results. The rate of cytological prediction to malignancy was more than three times higher in elderly women. Compression was a main reason for surgery in the elderly (p<0.0001). The final diagnosis of malignancy was significantly higher in older women (p=0.002). Clinical suspicion of malignancy was positively correlated with histopathological diagnosis in total group of women (r=0.543, p<0.001) and total group of men (r=0.560, p<0.001). The subgroup of the eldest TM patients included a significantly higher number of subjects with advanced cancer and primary tumor progression (p<0.0001). Distant metastases were significantly more presented among the elderly patients (p=0.032). Conclusions. The rate of cytological prediction to malignancy in elderly women is high. Tracheal compression is a common surgical indication in the elderly patients. The final diagnoses of malignancy predominate in elderly women. The oldest TM patients present a higher number of advanced thyroid tumors and distant metastases