Identification of Cold Thyroid Lesions at Operation and Its Place in the Surgical Management of Carcinoma of the Thyroid

Dobyns, Brown M.; Bertozzi, Giancarlo

doi:10.1097/00000658-197010000-00015

Cited by 11 publications

(5 citation statements)

References 2 publications

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“…Metastatic carcinomas do not usually concentrate radioiodine in the presence of normal thyroid tissue (7,8), therefore, a total thyroidectomy with ablation of the residual thyroid tissue is necessary for 131 I treatment. In addition, primary thyroid carcinomas are observed to have cold regions in presurgical 123 I or 99m Tc scans (9,10). These lines of evidence suggest that thyroid carcinomas, especially papillary carcinomas, tend to concentrate iodide to a much lesser extent than normal thyroid tissues.…”

Section: Introductionmentioning

confidence: 99%

Increased expression of the sodium/iodide symporter in papillary thyroid carcinomas.

Saito¹,

Endo²,

Kawaguchi³

et al. 1998

J. Clin. Invest.

133

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Iodide is concentrated to a much lesser extent by papillary thyroid carcinoma as compared with the normal gland. The Na+/I- symporter (NIS) is primarily responsible for the uptake of iodide into thyroid cells. Our objective was to compare NIS mRNA and protein expression in papillary carcinomas with those in specimens with normal thyroid. Northern blot analysis revealed a 2.8-fold increase in the level of NIS mRNA in specimens with papillary carcinoma versus specimens with normal thyroid. Immunoblot analysis using anti-human NIS antibody that was produced with a glutathione S-transferase fusion protein containing NIS protein (amino acids 466-522) showed the NIS protein at 77 kD. The NIS protein level was elevated in 7 of 17 cases of papillary carcinoma but was not elevated in the normal thyroid. Immunohistochemical staining revealed abundant NIS in 8 of 12 carcinomas, whereas NIS protein was barely detected in specimens with normal thyroid. Although considerable patient-to-patient variation was observed, our results indicate that NIS mRNA is elevated, and its protein tends to be more abundant, in a subset of papillary thyroid carcinomas than in normal thyroid tissue.

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Section: Introductionmentioning

confidence: 99%

Increased expression of the sodium/iodide symporter in papillary thyroid carcinomas.

Saito¹,

Endo²,

Kawaguchi³

et al. 1998

J. Clin. Invest.

133

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“…These changes were found even though supplemental thyroxine had been given. Autoradiographs were done on all operative cases and showed that these lesions took up very little or no radioiodine, as occurs with most all carcinomas [12].…”

Section: Atypical Lesionsmentioning

confidence: 99%

“…However, some of these controls may have been living on neighboring atolls (south of Rongelap and Utirik) where slight amounts of fallout may have occurred [3]. By 1979 this group had reached 227 people, most of whom had been available for multiple examinations [9][10][11][12]. Another group of Rongelap controis were individuals born after the accident of exposed and unexposed Rongelap parents.…”

Section: The Need For Controlsmentioning

confidence: 99%

“…It is important to emphasize that, when a total thyroidectomy is indicated, that procedure should be done without mutilation or disfigurement or any risk to the recurrent laryngeal nerves, or the possibility of permanent parathyroid injury. It has been the author's policy that all patients with palpable nodules should be routinely given a small trace dose of radioiodine pre-operatively, as an adjunct to management during surgery [12]. This permits an assay of the function of the tumor at surgery.…”

Section: The Changing Trend In Surgical Managementmentioning

confidence: 99%

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The surgical management of benign and malignant thyroid neoplasms in marshall islanders exposed to hydrogen bomb fallout

Dobyns

Hyrmer

1992

World j. surg.

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On March 1, 1954, a serious fallout accident occurred during the United States atomic testing program at Bikini in the Trust Territory of the Pacific Islands. Following the detonation of a large thermonuclear device (known as Bravo) an unexpected shift in winds resulted in deposition of radioactive debris on several inhabited atolls in the Marshall Islands. During the early post-detonation period military, sea, and air surveys traced the hottest portion of the parabolic cloud as it drifted in an ever widening pattern of diminishing concentration eastward and southeast of Bikini. The center of the cloud passed North of the Rongelap Atoll, which was the nearest inhabited atoll. This report concerns the development of thyroid lesions, the special circumstances encountered during thyroid surgery, and the results of the surgical management of benign and malignant lesions that were subsequently encountered in this population.

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“…The serum hGH was 27.8 ng/ml. Serum cortisol was 12.5 pg/dl; prolactin (PRL), 6.1 ng/ml; luteinizing hormone (LH), 13.2 mIU/ml; and follicle stimulating hormone (FSH), 15.3 mIU/ ml. The output of 17 hydroxycorticoids (OHCS), and 17 ketosteroids (KS) in urine was 3.2 to 7.8 mg/day and 1.7 to 4.6 mg/day, respectively.…”

Section: Laboratory Findings At the Time Of Admissionmentioning

confidence: 99%

Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma

Yoshinari

Tokuyama

Okamura

et al. 1988

Cancer

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An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate 131I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of 131I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved.

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Identification of Cold Thyroid Lesions at Operation and Its Place in the Surgical Management of Carcinoma of the Thyroid

Cited by 11 publications

References 2 publications

Increased expression of the sodium/iodide symporter in papillary thyroid carcinomas.

Increased expression of the sodium/iodide symporter in papillary thyroid carcinomas.

The surgical management of benign and malignant thyroid neoplasms in marshall islanders exposed to hydrogen bomb fallout

Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma

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