Independent Clonal Origins of Distinct Tumor Foci in Multifocal Papillary Thyroid Carcinoma

Shattuck, Trisha M.; Westra, William H.; Ladenson, Paul W.; Arnold, Andrew

doi:10.1056/nejmoa044190

Cited by 231 publications

(183 citation statements)

References 35 publications

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“…About 30% of patients with low-risk WDTC harbor contralateral cancers (12,13). While the clinical relevance of these cancers is still unclear, these tumors may represent multicentricity or intrathyroidal spread (14,15). Often these are microcarcinomas that are not detected on preoperative imaging.…”

Section: Figmentioning

confidence: 99%

Frequency of High-Risk Characteristics Requiring Total Thyroidectomy for 1–4 cm Well-Differentiated Thyroid Cancer

Kluijfhout

Pasternak

Lim

et al. 2016

Thyroid

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Section: Figmentioning

confidence: 99%

Frequency of High-Risk Characteristics Requiring Total Thyroidectomy for 1–4 cm Well-Differentiated Thyroid Cancer

Kluijfhout

Pasternak

Lim

et al. 2016

Thyroid

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“…avaliaram se focos não contíguos do tumor surgem como metástases de um tumor primário único ou se originam de novos clones com precursores independentes. Os autores concluem que em pacientes com carcinoma papilar multifocal os tumores focais surgem como tumores independentes (16).…”

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Carcinoma diferenciado de tireóide: avaliação inicial e acompanhamento

Golbert

Wajner

Rocha

et al. 2005

Arq Bras Endocrinol Metab

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RESUMOO câncer de tireóide é responsável por cerca de 1% dos novos casos de doença maligna diagnosticados. A maioria destes tumores são carcinomas papilares e foliculares, também denominados de carcinomas diferenciados de tireóide (CDT). Estes carcinomas têm uma taxa de cura de aproximadamente 80%, enquanto 20% apresentarão recorrência local e 5 a 10% desenvolverão metástases à distância. Porém, alguns pacientes apresentam uma doença mais agressiva. A identificação de tais pacientes tem grande impacto no manejo clínico do CDT. Várias classificações de estádio clínico e fatores prognósticos são apresentados, bem como os principais exames para seguimento dos pacientes com CDT. Thyroid carcinoma accounts for roughly 1% of all new malignant diseases. Of these, at least 94% are differentiated thyroid carcinoma (DTC), either papillary thyroid carcinoma or follicular thyroid carcinoma. Patients with DTC are usually considered as having a good prognosis, 80% of patients are cured, 20% will develop loco-regional recurrence and 5-10% distant metastasis. However, the disease may have an aggressive course in some patients. The identification of these patients has a major impact in the clinical management of DTC. Several prognostic factors and classification will be addressed, as well the most useful tests for patient's follow-up. CARCINOMAS DIFERENCIADOS DE TIREÓIDEO CÂNCER DE TIREÓIDE é a neoplasia maligna mais freqüente do sistema endocrinológico, apesar de ser uma patologia relativamente rara, sendo responsável por aproximadamente 1% dos novos casos de doença maligna (1). A cada ano, nos EUA, surgem 14.000 novos casos, e ocorrem 1.100 mortes decorrentes do carcinoma diferenciado da tireóide (2). No Brasil, estes números são proporcionais, ocorrendo 66 novos casos em cada 100.000 habitantes por ano (3).As neoplasias da tireóide são classificadas de acordo com o tipo histológico em adenoma folicular, carcinoma papilar, carcinoma folicular e carcinoma anaplásico ou indiferenciado. A maioria dos tumores tireoi-

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“…However, it is known that papillary thyroid carcinoma occurs frequently as multifocal disease and Shattuck et al showed that these multiple foci PTC's are of different clonal origin [5], similar to non-neoplastic thyroid hyperplasia [6]. This might indicate that the whole thyroid gland, as a field, might be influenced by factors promoting neoplastic transformation, which becomes enhanced when additional growth stimulating factors are present.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it is known that PTC often occurs as multifocal disease [2]. Shattuck et al showed that multifocal PTC is, in general, a polyclonal disease and discussed the potential influence of environmental factors on the genesis of PTC [5]. It has been suggested previously that structural aberrations might not be the initiating events in tumorigenesis but may well be subsequent phenomena in proliferating tissue [6].…”

Section: Introductionmentioning

confidence: 99%

Genetic Background May Confer Susceptibility to PTC in Benign Multinodular Thyroid Disease

Thavarajah¹,

Weber²

2012

JCT

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Purpose: The incidence of hyperplastic thyroid nodular disease has been consistently rising over the last decades. In addition, unsuspected papillary thyroid carcinoma (PTC) can be found in up to 34% of patients operated for benign thyroid lesions. PTC tends to occur multi-focally and is commonly of polyclonal origin. We set out to test the hypothesis that in benign thyroid disease, a unique genetic signature can already be identified in the benign pathology, which is associated with a susceptibility of the thyroid tissue to neoplastic transformation in the context of additional growth promoting stimuli. Patients and Methods: We obtained a set of 23 samples from patients with multinodular goiter (MNG), 12 of whom also harbored an unsuspected PTC. We used global gene expression analysis to evaluate for dissimilarities in the gene expression patterns between these two groups. We also compared these patterns to the profiles of 3 normal thyroid and 7 PTC samples. Results: We were able to accurately distinguish between hyperplastic nodules of patients with multinodular goiter and those that were associated with a PTC. One of the strongest differentially expressed genes, CDC42, has been implicated to respond to environmental factors such as UVB radiation and might point to novel factors contributing to PTC genesis in the setting of pre-existing benign proliferative disease. Conclusion: While the comparison between histologically identical samples cannot distinguish the two groups of goiters, unsupervised or supervised approaches allowed us to identify a molecular signature associated with PTC susceptibility in multinodular goiter.

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Independent Clonal Origins of Distinct Tumor Foci in Multifocal Papillary Thyroid Carcinoma

Abstract: Individual tumor foci in patients with multifocal papillary thyroid cancer often arise as independent tumors.

Cited by 231 publications

References 35 publications

Frequency of High-Risk Characteristics Requiring Total Thyroidectomy for 1–4 cm Well-Differentiated Thyroid Cancer

Frequency of High-Risk Characteristics Requiring Total Thyroidectomy for 1–4 cm Well-Differentiated Thyroid Cancer

Carcinoma diferenciado de tireóide: avaliação inicial e acompanhamento

Genetic Background May Confer Susceptibility to PTC in Benign Multinodular Thyroid Disease

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