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We hypothesize that the prevalence of FTC during the last decade in our center in Greece was very low due to correction of iodine deficiency and a relative increase in the prevalence of microPTC. More than 50% of PTC diagnosed during the last decade were microPTCs that were detected incidentally in older persons with preexisting MNG or a prominent hot nodule. This is one of the highest, if not the highest percentage of microPTCs that were incidentally detected. Despite many of these having features of invasiveness, most appear to remain clinically silent. Research is needed to identify factors predisposing microPTCs to evolve from a subclinical to a clinically apparent form.

Objective: Recently, small medullary thyroid carcinomas (smallMTCs; %1.5 cm) are frequently diagnosed, occasionally as incidental findings in surgical specimens. Their clinical course varies. We examined tumour size as a predictor of clinical behaviour. Design: A retrospective study. Methods: A total of 128 smallMTC patients (35.2% males and 45% familial) were followed up for 0.9-30.9 years. According to tumour size (cm), patients were classified into four groups: group 1, 0.1-0.5 (nZ33); group 2, 0.6-0.8 (nZ33); group 3, 0.8-1.0 (nZ29) and group 4, 1.1-1.5 (nZ33). Results: Pre-and post-operative calcitonin levels were positively associated with the tumour size (P!0.001). Capsular and lymph node invasion were more frequent in groups 3 and 4 (P!0.03); the stage was more advanced and the outcome was less favourable with an increasing tumour size (P!0.001). Groups 1 and 2 patients were more frequently cured (group 1, 87.8%; group 2, 72.7%; group 3, 68.9%; and group 4, 48.5%; PZ0.002). The 10-year probability of lack of disease progression according to the tumour size differed between patients with tumour sizes of 0.1-1.0 and 1.1-1.5 cm (96.6%, 81.3%, x 2 Z4.03, PZ0.045 for log-rank test). Post-operative calcitonin was the only predictor significantly associated with the 10-year progression of disease. Post-operative calcitonin levels R4.65 pg/ml predicted disease persistence (sensitivity 93.8% and specificity 90%) and R14.5 pg/ml predicted disease progression (sensitivity 100%, specificity 82%, receiver operating characteristic curve analysis). Conclusions: Tumour size may be of clinical importance only in patients with MTCs O1 cm in size. Post-operative calcitonin is a more important predictor than size for disease progression.

Objective: Medullary thyroid carcinoma (MTC) has varying clinical course. We assessed trends in MTC presentation during the last 34 years. Design: Retrospective study. Methods: One hundred and fifty one patients (44.4% males) were followed for 0.9-34 years.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with a high incidence of arterial and venous thrombotic complications. However, thromboembolic events in unusual sites such as limb and visceral arterial ischemia are reported rarely in the literature. Herein, we describe a rare case of a patient with severe coronavirus disease 2019 (COVID-19) infection who experienced severe abdominal pain during the hospitalization and presented simultaneously renal artery, splenic artery and vein as well as aortic thrombi despite prophylactic antithrombotic treatment. Information about his follow-up post discharge is also provided. This case report raises significant clinical implications regarding the correct dose of antithrombotic treatment during the acute phase of the severe COVID-19 infection and highlights the need for incessant vigilance in order to detect thrombosis at unusual sites as a possible diagnosis when severe abdominal pain is present in severe COVID-19 patients.

Objective. Thyroid-stimulating-hormone (TSH) receptors are expressed in endothelial cells. We investigated whether elevated TSH levels after acute recombinant TSH (rhTSH) administration may result in alterations in blood pressure (BP) in premenopausal women with well-differentiated thyroid carcinoma (DTC). Designs. Thirty euthyroid DTC female patients were evaluated by rhTSH stimulation test (mean age 40.4 ± 8.6 years). A 24 h ambulatory systolic and diastolic blood pressure (SBP, DBP) monitoring (24 hr ABPM) was performed on days 2-3(D2-3). TSH was measured on day 1(D1), day 3(D3), and day 5(D5). Central blood pressure was evaluated on D3. Twenty-three patients were studied 1–4 weeks earlier (basal measurements). Results. TSH levels were D1: median 0.2 mU/L, D3: median 115.0 mU/L, and D5: median 14.6 mU/L. There were no significant associations between TSH on D1 and D3 and any BP measurements. Median D5 office-SBP and 24 h SBP, DBP, and central SBP were correlated with D5-TSH (P < 0.04). In those where a basal 24 h ABPM had been performed median pulse pressure was higher after rhTSH-test (P = 0.02). Conclusions. TSH, when acutely elevated, may slightly increase SBP, DBP, and central SBP. This agrees with previous reports showing positive associations of BP with TSH.

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