Histological findings of thyroid cancer after lenvatinib therapy

Okubo, Yoichiro; Toda, Soji; Sato, Shinya; Yoshioka, Emi; Ono, Kyoko; Hasegawa, Chie; Washimi, Kota; Yokose, Tomoyuki; Miyagi, Yohei; Iwasaki, Hiroyuki; Hayashi, Hiroyuki

doi:10.1111/his.15013

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…4 ). The Ki-67 labeling index was 1.76% (261/14806) using the average method, while it was 3.51% (43/1226) using the hotspot method [ 8 , 9 ]. We counted the Ki-67 labeling index using the “Patholoscope” analysis software (MITANI Corporation, Japan, URL: http://www.mitani-visual.jp/en/products/bio_imaging_analysis/patholoscope/ ), as previously described [ 10 , 11 ].…”

Section: Case Presentationmentioning

confidence: 99%

Primary omental smooth muscle tumor in an adult male: a diagnostic dilemma for leiomyoma: a case report

Ono,

Okubo,

Washimi

et al. 2024

J Med Case Reports

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Background The greater omentum comprises peritoneal, adipose, vascular, and lymphoid tissues. Most omental malignancies are metastatic tumors, and the incidence of primary tumors is rare. We report on a prior omental smooth muscle tumor case in an adult male patient. Case presentation A 54-year-old Japanese male patient with no relevant medical history was diagnosed with an abdominal mass during a routine medical checkup. Subsequent contrast-enhanced computed tomography revealed a mass of approximately 3 cm in size in the greater omentum, and a laparotomy was performed. A 27 × 25 × 20 mm raised lesion was found in the omentum. Microscopically, spindle cells were observed and arranged in whorls and fascicles. Individual tumor cells had short spindle-shaped nuclei with slightly increased chromatin and were characterized by a slightly eosinophilic, spindle-shaped cytoplasm. The mitotic count was less than 1 per 50 high-power fields. The tumor cells showed positive immunoreactivity for α smooth muscle actin, HHF35, and desmin on immunohistochemical examination. The Ki-67 labeling index using the average method was 1.76% (261/14806). No immunoreactivity was observed for any of the other tested markers. We considered leiomyoma owing to a lack of malignant findings. However, primary omental leiomyoma has rarely been reported, and it can be difficult to completely rule out the malignant potential of smooth muscle tumors in soft tissues. Our patient was decisively diagnosed with a primary omental smooth muscle tumor considering leiomyoma. Consequently, the patient did not undergo additional adjuvant therapy and was followed up. The patient was satisfied with treatment and showed neither recurrence nor metastasis at the 13-month postoperative follow-up. Discussion and conclusion We encountered a primary smooth muscle tumor of the greater omentum with no histological findings suggestive of malignancy in an adult male patient. However, omental smooth muscle tumors are extremely difficult to define as benign, requiring careful diagnosis. Further case reports with long-term follow-up and case series are required to determine whether a true omental benign smooth muscle tumor (leiomyoma) exists. In addition, proper interpretation of the Ki-67 labeling index should be established. This case study is a foundation for future research.

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Section: Case Presentationmentioning

confidence: 99%

Primary omental smooth muscle tumor in an adult male: a diagnostic dilemma for leiomyoma: a case report

Ono,

Okubo,

Washimi

et al. 2024

J Med Case Reports

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Clinicopathological analysis of thyroid carcinomas with the RET and NTRK fusion genes: characterization for genetic analysis

Okubo,

Toda,

Kadoya

et al. 2024

Virchows Arch

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Thyroid carcinomas exhibit various genetic alterations, including the RET and NTRK fusion genes that are targets for molecular therapies. Thus, detecting fusion genes is crucial for devising effective treatment plans. This study characterized the pathological findings associated with these genes to identify the specimens suitable for genetic analysis. Thyroid carcinoma cases positive for the fusion genes were analyzed using the Oncomine Dx Target Test. Clinicopathological data were collected and assessed. Among the 74 patients tested, 8 had RET and 1 had NTRK3 fusion gene. Specifically, of the RET fusion gene cases, 6 exhibited “BRAF-like” atypia and 2 showed “RAS-like” atypia, while the single case with an NTRK3 fusion gene presented “RAS-like” atypia. Apart from one poorly differentiated thyroid carcinoma, most cases involved papillary thyroid carcinomas (PTCs). Primary tumors showed varied structural patterns and exhibited a high proportion of non-papillary structures. Dysmorphic clear cells were frequently observed. BRAF V600E immunoreactivity was negative in all cases. Interestingly, some cases exhibited similarities to diffuse sclerosing variant of PTC characteristics. While calcification in lymph node metastases was mild, primary tumors typically required hydrochloric acid-based decalcification for tissue preparation. This study highlights the benefits of combining morphological and immunohistochemical analyses for gene detection and posits that lymph node metastases are more suitable for genetic analysis owing to their mild calcification. Our results emphasize the importance of accurate sample processing in diagnosing and treating thyroid carcinomas.

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Efficacy and Safety of Multikinase Inhibitors for Patients With Refractory Thyroid Cancer: Systematic Review and Network Meta-Analysis

Jing,

Wu,

et al. 2024

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Multikinase inhibitors (MKIs) improve the treatment of refractory thyroid cancer, included radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) and advanced medullary thyroid carcinoma (aMTC). Objective This study aims to compare the efficacy of MKIs in improving survival outcomes and safety. Data Sources Comprehensive database searches of MEDLINE via PubMed, EMBASE and Cochrane performed from inception to December 2023. Study Selection Three independent authors selected these studies. Randomised-controlled trials that compared the use of a MKI to other MKIs or placebo were included. Data Extraction and Synthesis This review followed PRISMA guidelines. Risk of bias was analyzed using the Cochrane RoB 2 tool. Bayesian network meta-analysis was performed. Treatments were grouped into common nodes based on the type of MKI. Main Outcomes and Measures Primary outcomes were progression-free survival (PFS) and overall survival (OS). Secondary outcomes included objective response rate, disease control rate, clinical benefit rate, and adverse events. Results Cabozantinib 60 mg/d (CAB60) was associated with the highest prolonged PFS in RAIR-DTC patients, followed by lentivatinib 18 or 24 mg/d (LEN18 or LEN24), and apatinib. PFS was also improved in in aMTC patients received CAB 140 mg/d (CAB140), CAB60, or anlotinib. A significantly greater improvement on the performance of OS was seen in CAB60, LEN24, anlotinib, and sorafenib in RAIR-DTC patients, but which in aMTC patients were lack of statistical differences. Compared with the low-dose of MKIs, high-dose of MKIs such as CAB, LEN, and vandetanib increased the incidence of adverse events. Conclusion CAB60, LEN, and apatinib are promising topical MKIs with statistically significant primary outcomes in RAIR-DTC patients, while CAB and anlotinib are effective in prolonging PFS in aMTC patients.

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Histological findings of thyroid cancer after lenvatinib therapy

Cited by 3 publications

References 30 publications

Primary omental smooth muscle tumor in an adult male: a diagnostic dilemma for leiomyoma: a case report

Primary omental smooth muscle tumor in an adult male: a diagnostic dilemma for leiomyoma: a case report

Clinicopathological analysis of thyroid carcinomas with the RET and NTRK fusion genes: characterization for genetic analysis

Efficacy and Safety of Multikinase Inhibitors for Patients With Refractory Thyroid Cancer: Systematic Review and Network Meta-Analysis

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