Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma:a paradigm shift to reduce overtreatment of indolent tumors

Although growing evidence points to highly indolent behavior of encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC), most patients with EFVPTC are treated as having conventional thyroid cancer

Neonatal Hypothermia In Tehran, Iran: Incidence, Severity And Death Rate

Background:In 1958, Silverman demonstrated that maintenance ofbody temperature reduces mortality in low birth weight infants. From the early 1990s it was already recognized that adequate environmental warmth was essential in the case of newborns. However, neonatal hypothermia continues to be a significant issue in developing countries. Methods: In order to describe the incidence and severity of hypothermia after delivery and to determine the possibility ofrelatedmortalityrisk among neonates in a tettiary nursery, we measured the body temperature on admission of 898 consecutive inborn infants after birth by a low-reading thermometer. Body temperature less than 36.5°C was designated as 'hypothermia' . In such cases the infants were re-warmed according to WHO recommendations. Their body temperature was checked and recorded every hour and their final outcome was noted. Results: The overall incidence of hypothermia was 53.2%. 456 (i.e., 50.2% of) infants had mild hypothermia (35> T> 36.5) while 22 (2.5%) of them had moderate to severe hypothermia (T <35°C). The incidence and severity of hypothermia was found to be significantly associated with bitih weight (p= 0.000) and gestational age (p= 0.000). The duration of re-warming was also correlated with birth weight (p= 0.000). Logistic regression analysis showed that the mortality rate of hypothermic neonates is 3.64 times that of the normotherms. The risk of death was higher in the moderate to severe hypothermic groups than in the mild hypothermic infants. Conclusion: In our study, the incidence of hypothermia was found to be high with both the incidence and severity to be significantly associated with birth weight and gestational age. The risk of death was recognized to be higher in the hypothermic newborns than non-hypothermic ones

Squamous differentiation in papillary thyroid carcinoma: a rare feature of aggressive disease.

BACKGROUND:Papillary thyroid carcinoma with squamous differentiation (PTC-SD) is a poorly understood pathologic finding of unknown clinical significance. Selected case reports have suggested that PTC-SD is an aggressive tumor with a poor prognosis. Here we present the largest case series of PTC-SD reported in the United States. MATERIALS AND METHODS:The cancer registry at our tertiary care referral center was reviewed to identify all patients from 1995-2015 who had been diagnosed with PTC-SD on initial total thyroidectomy or lymph node dissection for recurrent disease. All cases were reviewed by an endocrine pathologist to confirm the diagnosis. Patient demographic, pathology, and outcomes data were collected and reviewed. RESULTS:During the study period, ten patients were diagnosed with PTC-SD, six in the primary tumor at the time of initial surgery, and four in lymph node metastases during surgery for recurrent disease. The median age at diagnosis was 56&nbsp;y and half of the patients were male. Aggressive features such as multifocality (67%), extrathyroidal extension (67%), positive margin (89%), lymph node metastases (80%), and extranodal extension (60%) were far more prominent than is typically seen in classic PTC. Long-term follow-up (median 56.5&nbsp;mo) demonstrated high rates of locoregional recurrence (60%), pulmonary metastases (30%), and mortality (10%). CONCLUSIONS:Squamous differentiation is a rare finding in PTC that is associated with aggressive pathologic features and poor long-term outcomes. This phenomenon may represent a step in progression toward dedifferentiation; thus, patients with PTC-SD should have close, life-long surveillance and should be treated according to evidence-based guidelines for high-risk thyroid cancers

A tumor-suppressing function in the epithelial adhesion protein Trask.

Trask/CDCP1 is a transmembrane glycoprotein widely expressed in epithelial tissues whose functions are just beginning to be understood, but include a role as an anti-adhesive effector of Src kinases. Early studies looking at RNA transcript levels seemed to suggest overexpression in some cancers, but immunostaining studies are now providing more accurate analyses of its expression. In an immuno-histochemical survey of human cancer specimens, we find that Trask expression is retained, reduced or sometimes lost in some tumors compared with their normal epithelial tissue counterparts. A survey of human cancer cell lines also show a similar wide variation in the expression of Trask, including some cell types with the loss of Trask expression, and additional cell types that have lost the physiological detachment-induced phosphorylation of Trask. Three experimental models were established to interrogate the role of Trask in tumor progression, including two gain-of-function models with tet-inducible expression of Trask in tumor cells lacking Trask expression, and one loss-of-function model to suppress Trask expression in tumor cells with abundant Trask expression. The induction of Trask expression and phosphorylation in MCF-7 cells and in 3T3v-src cells was associated with a reduction in tumor metastases while the shRNA-induced knockdown of Trask in L3.6pl cancer cells was associated with increased tumor metastases. The results from these three models are consistent with a tumor-suppressing role for Trask. These data identify Trask as one of several potential candidates for functionally relevant tumor suppressors on the 3p21.3 region of the genome frequently lost in human cancers