Displaying publications 1 - 20 of 21 in total

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  1. Sathasivam H, Loh YM, Saw CL, Khalid N
    Gerodontology, 2017 Jun;34(2):276-279.
    PMID: 27384017 DOI: 10.1111/ger.12240
    OBJECTIVE: A case of oral metastatic follicular thyroid carcinoma is presented.

    BACKGROUND: Metastatic tumours are more frequent in older individuals and can be the only sign/symptom of an undiagnosed primary malignancy.

    CASE REPORT: A 69-year-old lady presented with an enlarging mandibular swelling. Incisional biopsy and imaging studies were suggestive of metastatic follicular thyroid carcinoma.

    CONCLUSION: Metastatic tumours should be considered in the differential diagnosis of mandibular swellings especially in older individuals.

    Matched MeSH terms: Adenocarcinoma, Follicular
  2. Wong TH, Tan TH, Chin SC, Lee BN
    Med J Malaysia, 2018 06;73(3):181-182.
    PMID: 29962506
    Recently, encapsulated follicular variant of papillary thyroid carcinoma has been reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) to emphasize the benign nature of this entity. In our institution, we have assessed 455 patients treated with radioiodine ablation for differentiated thyroid carcinoma and 20 of them were retrospectively found to fulfill the new NIFTP criteria. There was no evidence of metastasis on post radioiodine whole body scans for NIFTP cases and these patients were in remission subsequently. The benign features of these patients' whole body scans and good clinical outcome following treatment further support NIFTP as a low risk thyroid neoplasm.
    Matched MeSH terms: Adenocarcinoma, Follicular/pathology
  3. Mohd Rohani MF, Amir Hassan SZ
    Clin Nucl Med, 2022 Jan 01;47(1):e20-e22.
    PMID: 34028418 DOI: 10.1097/RLU.0000000000003698
    A 57-year-old woman was referred for radioactive iodine therapy 12 weeks after completion thyroidectomy and left modified radical neck dissection for pT2N1Mx follicular variant papillary thyroid carcinoma. After 4 weeks of l-thyroxine withdrawal, stimulated serum thyroglobulin level was less than 0.1 ng/mL with positive thyroglobulin antibody. Posttherapy 131I scintigraphy with SPECT/CT of the head and abdominopelvic region showed thyroid residual in the neck, occipital bone metastasis, and heterogenous tracer uptake in a large peritoneal mass, likely arising from the left ovary. Left salpingo-oophorectomy was performed, and histopathologic examination revealed endometrioid carcinoma of left ovary.
    Matched MeSH terms: Adenocarcinoma, Follicular*
  4. Deka L, Gupta S, Gupta R, Gupta K, Kaur CJ, Singh S S
    Malays J Pathol, 2017 Apr;39(1):33-37.
    PMID: 28413203
    BACKGROUND: Fine needle aspiration cytology (FNAC) is a reliable and reproducible diagnostic technique for thyroid lesions with certain limitations. Computed morphometric methods have been introduced with a view to improve the diagnostic yield of thyroid aspirates. However, a review of the existing literature revealed conflicting reports regarding morphometric parameters in thyroid neoplasms.

    MATERIALS AND METHODS: This study included 50 cases of thyroid lesions (20 cases of colloid goitre, 15 of follicular adenoma, 5 of follicular carcinoma and 10 papillary carcinomas). Digital images of cytologic smears of these cases were captured using a dedicated photomicrography system and nuclear profiles traced manually. With self-designed image analysis software, nuclear morphometric measurements, including texture analysis, were performed. Discriminant analysis was performed including the morphometric parameters and percentage of correctly classified nuclei noted.

    RESULTS: Nuclear morphometry parameters showed that papillary thyroid carcinoma had the highest perimeter, area, radius and elongation factor compared to other thyroid lesions. Discriminant analysis revealed that altogether 77.9% of cells could be correctly classified to their lesion category based on the nuclear morphometric and textural parameters. Of the neoplastic cases, 84.5% of cells of follicular neoplasms and 72.5% of papillary carcinoma were classified to the respective category.

    CONCLUSION: Nuclear morphometry, including texture analysis, can assist in the cytologic diagnosis of thyroid lesions, considering the high degree of accuracy of classification. Further studies and methodological refinements can achieve higher accuracy.

    Matched MeSH terms: Adenocarcinoma, Follicular/diagnosis*; Adenocarcinoma, Follicular/pathology
  5. Htwe TT, Karim N, Lam AK
    Singapore Med J, 2012 Mar;53(3):e49-51.
    PMID: 22434304
    This is a retrospective case study of a 61-year-old woman diagnosed with follicular thyroid carcinoma. The patient underwent thyroidectomy for the treatment of goitre after being admitted for shortness of breath. Microscopic and immunohistochemical studies were performed, which confirmed follicular carcinoma of the thyroid with an insular component. We also conducted a review of the literature on this uncommon entity.
    Matched MeSH terms: Adenocarcinoma, Follicular/pathology*; Adenocarcinoma, Follicular/surgery
  6. Than TH, Swethadri GK, Wong J, Ahmad T, Jamil D, Maganlal RK, et al.
    Singapore Med J, 2008 Apr;49(4):333-8.
    PMID: 18418527
    It has been suggested that Galectin-3 (Gal-3) and Galectin-7 (Gal-7) are potential tumour markers for differentiating thyroid carcinoma from its benign counter part. Galectins are beta-galactoside-binding proteins with Gal-3 being a redundant pre-mRNA splicing factor. They are supposed to be p53-related regulators in cell growth and apoptosis, being either anti-apoptotic or pro-apoptotic. Although the value of Gal-3 has been studied extensively, there is little knowledge regarding the expression of Gal-7 in thyroid malignancy.
    Matched MeSH terms: Adenocarcinoma, Follicular/diagnosis; Adenocarcinoma, Follicular/metabolism
  7. Zamora-Ros R, Cayssials V, Franceschi S, Kyrø C, Weiderpass E, Hennings J, et al.
    Int J Cancer, 2020 Apr 01;146(7):1841-1850.
    PMID: 31342519 DOI: 10.1002/ijc.32589
    Polyphenols are bioactive compounds with several anticarcinogenic activities; however, human data regarding associations with thyroid cancer (TC) is still negligible. Our aim was to evaluate the association between intakes of total, classes and subclasses of polyphenols and risk of differentiated TC and its main subtypes, papillary and follicular, in a European population. The European Prospective Investigation into Cancer and Nutrition cohort included 476,108 men and women from 10 European countries. During a mean follow-up of 14 years, there were 748 incident differentiated TC cases, including 601 papillary and 109 follicular tumors. Polyphenol intake was estimated at baseline using validated center/country-specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, no association between total polyphenol and the risks of overall differentiated TC (HRQ4 vs. Q1 = 0.99, 95% confidence interval [CI] 0.77-1.29), papillary (HRQ4 vs. Q1 = 1.06, 95% CI 0.80-1.41) or follicular TC (HRQ4 vs. Q1 = 1.10, 95% CI 0.55-2.22) were found. No associations were observed either for flavonoids, phenolic acids or the rest of classes and subclasses of polyphenols. After stratification by body mass index (BMI), an inverse association between the intake of polyphenols (p-trend = 0.019) and phenolic acids (p-trend = 0.007) and differentiated TC risk in subjects with BMI ≥ 25 was observed. In conclusion, our study showed no associations between dietary polyphenol intake and differentiated TC risk; although further studies are warranted to investigate the potential protective associations in overweight and obese individuals.
    Matched MeSH terms: Adenocarcinoma, Follicular/epidemiology*; Adenocarcinoma, Follicular/prevention & control
  8. Vijendren A, Ladha N, Hilger AW
    Med J Malaysia, 2014 Aug;69(4):187-8.
    PMID: 25500848
    Spontaneous thyroid haemorrhages are rare. There are reported cases occurring in thyroid nodules and cysts but none in thyroid malignancies. We describe a 48 year old who presented to the on-call ENT team with a rapidly progressing neck swelling that was interfering with his airway. After resuscitation, the patient underwent a right lobectomy to stop the bleeding. Histology showed a thyroid follicular carcinoma. As per the regional multidisciplinary team discussion, he underwent a completion thyroidectomy followed by radioactive iodine treatment. We conclude that spontaneous haemorrhages of the thyroid gland can occur in malignancies and stress the importance of early histological diagnosis.
    Matched MeSH terms: Adenocarcinoma, Follicular
  9. Syazni MA, Gendeh HS, Kosai NR, Ramzisham AR, Gendeh BS, Basiron NH, et al.
    Med J Malaysia, 2017 02;72(1):80-82.
    PMID: 28255152 MyJurnal
    Sternal metastasis from differentiated thyroid carcinoma (DTC) is rare and presents a conundrum for surgeons. We present a lady diagnosed with follicular thyroid carcinoma and sternal metastasis who underwent thyroidectomy, sternectomy and sternoplasty with titanium mesh and acrylic plate. She developed a surgical site infection, of which multiple conservative approaches were attempted. She eventually required removal of the implant. Closure of sternal defect was completed with bilateral pectoralis major advancement flaps. This article highlights a series of complications faced during the course of treatment and how they were managed in a tertiary healthcare centre.
    Matched MeSH terms: Adenocarcinoma, Follicular
  10. Htwe TT, Hamdi MM, Swethadri GK, Wong JO, Soe MM, Abdullah MS
    Singapore Med J, 2009 Jul;50(7):724-8.
    PMID: 19644631
    Thyroid cancer is the most common among all endocrine malignancies. The worldwide prevalence of goitre in the general population is estimated at 4-7 percent and the incidence of malignancy in goitrous thyroid is about ten percent. It is postulated that goitrous thyroid is a precursor lesion to the development of malignant thyroid diseases. As Sarawak is a state well known for endemic goitre, this study focused on establishing the incidence of thyroid malignancy among goitrous thyroid swellings.
    Matched MeSH terms: Adenocarcinoma, Follicular/diagnosis; Adenocarcinoma, Follicular/ethnology; Adenocarcinoma, Follicular/epidemiology
  11. Loh LT, Lim V
    J ASEAN Fed Endocr Soc, 2017;32(1):57-59.
    PMID: 33442087 DOI: 10.15605/jafes.032.01.11
    Thyroid function is usually normal in differentiated thyroid carcinoma. We describe a case of a female patient who had metastatic follicular thyroid carcinoma (FTC) to the spine and lungs, who was clinically euthyroid but had very low free tetraiodothyronine (fT4) and normal thyroid stimulating hormone (TSH). Free triiodothyronine (fT3) and total T3 (TT3) were normal. Levothyroxine treatment increased fT4 marginally but caused a two- to three-fold rise in fT3 and TT3 along with suppressed TSH. This is likely due to hyperconversion of T4 to T3 from elevation in D2 deiodinase activity in the tumor. This phenomenon has been reported to occur in about 20% of metastatic FTC.
    Matched MeSH terms: Adenocarcinoma, Follicular
  12. Hamid HA, Gee KY, Muhammad R, Abd Rahman ZA, Das S
    Acta Medica (Hradec Kralove), 2009;52(1):19-22.
    PMID: 19754003
    Dural metastasis is a rare entity in clinical practice. We report a case of dural metastasis secondary to thyroid carcinoma, which on both preoperative CT and MRI and at surgery had the typical appearance of a meningioma. Histopathological findings confirmed metastatic follicular thyroid carcinoma as a primary site. Although rare, dural metastases can mimic a meningioma. Our experience in this case has led us to consider metastasis as a differential diagnosis even when a meningioma is suspected. We believe that reporting of the case of dural metastasis mimicking a meningioma may help clinicians in future.
    Matched MeSH terms: Adenocarcinoma, Follicular/secondary*
  13. Sharifah NA, Zakaria Z, Chia WK
    Methods Mol Biol, 2013;952:187-96.
    PMID: 23100233 DOI: 10.1007/978-1-62703-155-4_13
    Fluorescence in situ hybridization (FISH) is increasingly gaining importance in clinical diagnostics settings. Due to the ability of the technique to detect chromosomal abnormalities in samples with low cellularity or containing a mixed population of cells even at a single-cell level, it has become more popular in cancer research and diagnosis. Here, we describe the FISH technique for detection of PAX8-PPARγ translocation in follicular thyroid neoplasms, and the optimal protocol for the detection of this fusion gene using in archival formalin-fixed paraffin-embedded (FFPE) thyroid tissue sections.
    Matched MeSH terms: Adenocarcinoma, Follicular/metabolism*; Adenocarcinoma, Follicular/pathology
  14. Palo S, Biligi DS
    Malays J Pathol, 2017 Apr;39(1):55-67.
    PMID: 28413206
    OBJECTIVE: Due several overlapping histomorphological features and pitfalls in thyroid pathology, there is need to establish a panel of immunomarkers that would aid in proper diagnosis. This study was carried out to investigate the ability of HBME-1, CK19, and S100 in differentiating between hyperplastic, benign and malignant thyroid lesions.

    MATERIALS AND METHODS: Immunohistochemical analysis of 60 thyroidectomy specimens (10 hyperplastic nodules, 14 follicular adenomas and 36 malignant thyroid neoplasms) was carried out. The extent and intensity of HBME-1, CK19, and S100 immunoreactivity was assessed in each case.

    RESULTS: HBME-1 positivity was noted in 86.1% of malignant cases while the majority of the benign lesions were negative. Diffuse strong CK19 positivity was documented in 27/31 papillary carcinoma whereas all cases of follicular carcinoma and medullary carcinoma were negative. Most of the hyperplastic nodules and follicular adenomas were also CK19 negative, although focal weak staining was noted in a few cases. S100 was positive only in medullary carcinoma. HBME-1 was most sensitive (86.1%) and specific (87.5%) in distinguishing between benign and malignant thyroid lesions. The diagnostic accuracy was further increased when HBME-1 was used simultaneously with CK19/S100/CK19+S100. The sequential use of HBME-1 and CK19 also proved beneficial in discriminating between the various follicular-patterned thyroid lesions.

    CONCLUSION: HBME-1 immunolabeling suggests malignancy, whereas strong diffuse CK19 positivity substantiates papillary differentiation. The utilization of these markers (alone or in combination) along with histomorphological evaluation is helpful in the differential diagnosis. S100 has minimal utility in this regard.

    Matched MeSH terms: Adenocarcinoma, Follicular/diagnosis; Adenocarcinoma, Follicular/pathology
  15. Wong TH, Amir Hassan SZ
    Med J Malaysia, 2015 Dec;70(6):356-7.
    PMID: 26988209
    This is a case of follicular thyroid carcinoma with extensive lung, bone and brain metastases. Multi-modality treatments including total thyroidectomy, modified radical neck dissection, cranial radiotherapy and Iodine-131 (RAI) therapy were instituted. Post RAI therapy planar whole body scan showed RAI avid metastases in the skull, cervical spine, bilateral lungs and abdomen. With the use of SPECTCT imaging, rare adrenal metastasis and additional rib metastasis were identified. Besides, management strategy was altered due to detection of non-RAI avid brain and lung metastatic lesions.
    Matched MeSH terms: Adenocarcinoma, Follicular
  16. Adwin Z, Nur A, Suhaimi S, Rahman R
    Oman Med J, 2016 Jan;31(1):69-72.
    PMID: 26816570 DOI: 10.5001/omj.2016.13
    Follicular thyroid adenoma and carcinoma are very common. Benign and malignant lesions are usually indistinguishable from cytology alone and often require confirmatory resection. The spread of follicular carcinoma is usually hematogenous and is treated with surgery and adjuvant radioactive iodine. Very rarely, metastases occur in the mediastinum. Patients usually present with severe compressive symptoms. With proper treatment and follow-up, the prognosis for these type of thyroid malignancies is excellent. In the case presented here, our patient presented to the Universiti Kebangsaan Malaysia Medical Center with a progressively enlarging anterior neck swelling. The swelling had started 10 years before his presentation. We diagnosed him with an advanced thyroid malignancy with bulky mediastinal metastases. After extensive investigations and counseling, we chose to treat the patient with tumor excision and mediastinal metastases resection. Typically, mediastinal resection involves the removal of the sternum and use of an acrylic implant to recreate the sternum. In this case, the sternum and ribs were removed with subsequent myocutaneous flap coverage for the wound defect. Our experience represents an alternative treatment option in cases where implant use is unsuitable.
    Matched MeSH terms: Adenocarcinoma, Follicular
  17. Khoo ACH, Chen SL
    World J Nucl Med, 2019 9 14;18(3):301-303.
    PMID: 31516376 DOI: 10.4103/wjnm.WJNM_43_18
    Follicular thyroid cancers are known to spread hematogenously to the bones and lungs and rarely presenting with massive angioinvasion. We report a case of a middle-aged female who had undergone total thyroidectomy for minimally invasive follicular thyroid cancer with angioinvasion in 2014. She was noted to have a large tumor thrombus extending from the superior vena cava to the right atrium on whole body scan post-Iodine-131 (131I) remnant ablation therapy. We discuss the various imaging modalities, treatment options, and difficulties in managing such massive angioinvasion in patients with well-differentiated thyroid cancers.
    Matched MeSH terms: Adenocarcinoma, Follicular
  18. Chia, W.K., Zubaidah, Z., Reena Rahayu Md Zin, Rohaizak, M., Asmiati, A., Rafie, M.K., et al.
    Medicine & Health, 2012;7(1):47-56.
    MyJurnal
    Aneusomy is an early genetic event and a characteristic feature of many solid tumors. It is often associated with poor prognosis in cancer patients. The involvement of PAX8-PPARγ rearrangement in tumorigenesis of follicular thyroid lesions has been widely assessed. However, there were few reports on aneusomy of the PPARγ gene at the 3p25 locus in follicular thyroid lesions. It remains undetermined whether these abnormalities can be translated into improved diagnosis, classification, or outcome prediction. Herein, we report three cases of follicular thyroid neoplasms [two follicular thyroid carcinomas (FTCs) and one Hurthle cell adenoma (HCA)] with 3p25 aneusomy detected by fluorescence in situ hybridization (FISH). 3p25 trisomy was observed in one FTC and one HCA while 3p25 tetrasomy was observed in one FTC. Furthermore, all three lesions did not show overexpression of PPARγ protein. Hurthle cell neoplasms (HCN) are distinct clinically and histologically from other follicular thyroid neoplasms (FTN). However, the presence of the aneusomy in HCA and FTC indicates that there could be a biological continuum between the two and chromosomal gains might play an important role in the pathogenesis of these two types of neoplasms. Despite their differences, HCN and FTN may share the same early genetic event in tumour development.
    Matched MeSH terms: Adenocarcinoma, Follicular
  19. Ramli NSF, Mat Junit S, Leong NK, Razali N, Jayapalan JJ, Abdul Aziz A
    PeerJ, 2017;5:e3365.
    PMID: 28584708 DOI: 10.7717/peerj.3365
    BACKGROUND: Synthesis of thyroid hormones and regulation of their metabolism involve free radicals that may affect redox balance in the body. Thyroid disorders causing variations in the levels of thyroid hormones may alter cellular oxidative stress. The aim of this study was to measure the antioxidant activities and biomarkers of oxidative stress in serum and red blood cells (RBC) of patients with benign and malignant thyroid disorders and to investigate if changes in the antioxidant activities in these patients were linked to alterations in genes encoding the antioxidant enzymes.

    METHODS: Forty-one patients with thyroid disorders from University of Malaya Medical Centre were recruited. They were categorised into four groups: multinodular goitre (MNG) (n = 18), follicular thyroid adenoma (FTA) (n = 7), papillary thyroid cancer (PTC) (n = 10), and follicular thyroid cancer (FTC) (n = 6). Serum and RBC of patients were analysed for antioxidant activities, antioxidant enzymes, and biomarkers of oxidative stress. Alterations in genes encoding the antioxidant enzymes were analysed using whole exome sequencing and PCR-DNA sequencing.

    RESULTS: Patients with thyroid disorders had significantly higher serum superoxide dismutase (SOD) and catalase (CAT) activities compared to control, but had lower activities in RBC. There were no significant changes in serum glutathione peroxidase (GPx) activity. Meanwhile, GPx activity in RBC was reduced in PTC and FTC, compared to control and the respective benign groups. Antioxidant activities in serum were decreased in the thyroid disorder groups when compared to the control group. The levels of malondialdehyde (MDA) were elevated in the serum of FTA group when compared to controls, while in the RBC, only the MNG and PTC groups showed higher MDA equivalents than control. Serum reactive oxygen species (ROS) levels in PTC group of both serum and RBC were significantly higher than control group. Whole exome sequencing has resulted in identification of 49 single nucleotide polymorphisms (SNPs) in MNG and PTC patients and their genotypic and allelic frequencies were calculated. Analyses of the relationship between serum enzyme activities and the total SNPs identified in both groups revealed no correlation.

    DISCUSSION: Different forms of thyroid disorders influence the levels of antioxidant status in the serum and RBC of these patients, implying varying capability of preventing oxidative stress. A more comprehensive study with a larger target population should be done in order to further evaluate the relationships between antioxidant enzymes gene polymorphisms and thyroid disorders, as well as strengthening the minor evidences provided in literatures.

    Matched MeSH terms: Adenocarcinoma, Follicular
  20. Cheen Hoe AK, Hamzah F, Abdul Khader MA
    Malays J Med Sci, 2014 Sep-Oct;21(5):75-7.
    PMID: 25977638 MyJurnal
    The detection rate of thyroid incidentalomas is increasing; in fact, as many as 2.3% of patients undergoing FDG PET-CT for other indications have been found to have thyroid incidentalomas. The risk of malignancy in these thyroid incidentalomas can be as high as 47%. The increased uptake and the focal uptake pattern of F-18 fluorodeoxyglucose (FDG) in the thyroid during positron emission tomography (PET)-computed tomography (CT), and the calcification of the thyroid incidentaloma, are associated with even higher risk of malignancy. We report a case of a lady undergoing FDG PET-CT for breast cancer staging but noted to have a calcified thyroid incidentaloma, which was proven to be follicular thyroid carcinoma.
    Matched MeSH terms: Adenocarcinoma, Follicular
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