These studies suggest that adiponectin may act as a biomarker of carcinogenesis and may constitute a molecular link between obesity and breast cancer.

No abstract

Papillary thyroid microcarcinomas (PTMs) are small tumors (< or =1 cm of diameter) that belong to the well-differentiated low-risk carcinomas of the thyroid, which are characterized by benign behavior, probably of little clinical significance, and do not affect patients' survival. They are found in otherwise normal thyroids or in multinodular goiters with a clinical frequency varying substantially according to different series. Sometimes, PTM may be associated with lymph node metastases at presentation and/or locoregional recurrences during follow-up. Distant metastases are extremely rare, but have been reported. Although deaths related to PTM are almost unknown, PTM raises therapeutic implications. This review addresses the issue of definition, treatment, and follow-up of PTM.

Non-medullary thyroid carcinoma (NMTC) is mostly sporadic, but familial clustering is described. We aimed to compare the features of patients with sporadic and familial NMTC (FNMTC) patients and to assess whether FNMTC patients with parent-child relationship exhibit the 'anticipation' phenomenon (earlier age at disease onset and increased severity in successive generations). Among 300 NMTCs followed in the Section of Endocrinology (University of Siena, Italy), 34 (11.3%) patients, all with the papillary histotype, (16 kindred), met the criteria of FNMTC. Twenty-seven of them (79.4%) exhibited a parent-child relationship and seven (20.6%) a sibling relationship. These patients were compared with 235 patients with sporadic papillary thyroid cancer (PTCs). To analyze the features of FNMTC of the first and second generations, we cumulated the series of Siena with 32 additional FNMTC patients (15 kindred) from the Department of Endocrinology-Endocrine Oncology, Thessaloniki, Greece. Significant difference between sporadic PTC and FNMTC patients included more frequent tumor multifocality (PZ0.001) and worse final outcome in FNMTC patients (PZ0.001). Among 47 FNMTC with parent-child relationship, we found an earlier age at disease presentation (P!0.0001), diagnosis (P!0.0001), and disease onset (PZ0.04) in the second generation when compared with the first generation. Patients in the second generation were more frequently males (PZ0.02); their tumors were more frequently multifocal (PZ0.003) and bilateral (PZ0.01), had higher rate of lymph node metastases at surgery (PZ0.02) and worse outcome (PZ0.04) when compared with the first generation. In conclusion, FNMTC displays the features of clinical 'anticipation' with the second generation acquiring the disease at an earlier age and having more advanced disease at presentation.

Adiponectin, an insulin-sensitising hormone produced by adipocytes, has direct antidiabetic, antiatherogenic, anti-inflammatory and antiangiogenic properties. Circulating adiponectin levels are lower in obesity, a disease state that is associated with certain malignancies. Recently, accumulating evidence suggests that adiponectin may have an important protective role in carcinogenesis. There is also evidence that at least some, if not most, cancer cell types express adiponectin receptors; thus adiponectin may act on tumour cells directly by binding and activating adiponectin receptors and downstream signalling pathways. Through its antiangiogenic properties, and also possibly through other mechanisms regulating cell proliferation discussed in this review, adiponectin may prove to be an effective novel anticancer agent. Large association and prospective studies to assess adiponectin levels in relation to risk from cancer, as well as mechanistic studies to prove adiponectin's role in the development of malignancies, and interventional trials to address potential roles of adiponectin in cancer pathogenesis and therapeutics are needed.

Circulating adiponectin is independently and inversely associated with the risk of thyroid cancer. Human thyroid carcinomas and cell lines express adiponectin receptors. However, in the absence of a major direct effect of adiponectin on thyroid cancer cell lines in vitro, the negative association observed herein may be attributed to the metabolic effects of adiponectin.

The incidence of thyroid cancer has been rising over the past few decades along with a parallel increase in obesity. Observational studies have provided evidence for a potential association between the two. By contrast, clinical data for a link between type 2 diabetes mellitus, a condition strongly associated with obesity, and thyroid cancer are limited and largely not supportive of such an association. Obesity leads to hypoadiponectinemia, a pro-inflammatory state, and insulin resistance, which, in turn, leads to high circulating insulin and insulin-like growth factor-1 levels, thereby possibly increasing the risk for thyroid cancer. Thus, insulin resistance possibly plays a pivotal role in underlying the observed association between obesity and thyroid cancer, potentially leading to the development and/or progression of thyroid cancer, through its interconnections with other factors including insulin-like growth factor-1, adipocytokines/cytokines and thyroid-stimulating hormone. In this review, epidemiological and clinical evidence and potential mechanisms underlying the proposed association between obesity and thyroid cancer risk are reviewed. If the association between obesity and thyroid cancer demonstrated in observational studies proves to be causal, targeting obesity (and/or downstream mediators of risk) could be of importance in the prevention and management of thyroid cancer.

ObJEctIVE: thyroglossal duct cyst (tGDc) carcinoma is a rare entity and its management is controversial. the aim of this retrospective study was to: (a) identify patients with tGDc carcinoma followed up in our clinic and (b) study specific characteristics of the disease and their association with thyroid carcinoma. DEsIGN: Medical files of patients with tGDc carcinoma were reviewed and tumour characteristics, lymph node metastases, treatment and follow-up were evaluated. rEsULts: A total of 6 patients, 4 females and 2 males, mean age 39.3 years (median 33.5), were treated for papillary thyroid carcinoma arising in a tGDc. carcinoma of the thyroid gland was found simultaneously in 4 of these patients, while in one patient thyroid carcinoma developed 10 years after the diagnosis of tGDc carcinoma. A variable clinical picture and presentation was recorded. the most aggressive manifestation of the disease in terms of local infiltration, local recurrence and lymph node metastases was observed in our youngest patients. cONcLUsIONs: Long-term follow-up is necessary for patients with thyroid carcinoma arising in a tGDc. In view of the frequent co-existence of thyroid cancer in these patients, we would recommend detailed thyroid evaluation and, eventually, total thyroidectomy at initial diagnosis of tGDc carcinoma.