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Brad GF, Jugănaru I, Nicoară DM, Scutca AC, Bugi MA, Asproniu R, Chelu AD, Basaca DG, Corneanu M, Mărginean O. Challenges in Diagnosing Adolescent Goiter: A Case Report with Brief Literature Insights in Juvenile Desmoid-Type Fibromatosis of the Thyroid Gland. J Clin Med 2025; 14:610. [PMID: 39860616 PMCID: PMC11766264 DOI: 10.3390/jcm14020610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 01/09/2025] [Accepted: 01/15/2025] [Indexed: 01/27/2025] Open
Abstract
The prevalence of goiter, thyroid nodules, and thyroid cancers in the pediatric population has increased. In some rare cases, local conditions such as juvenile desmoid-type fibromatosis (JDTF) can mimic specific thyroid pathology, complicating the diagnostic process. A 17-year-old obese adolescent girl was admitted to the Endocrinology Department with progressive swelling on the left side of the neck, persisting for approximately one year, recently accompanied by dysphonia and inspiratory dyspnea, and ultimately diagnosed as a unilateral nodular goiter associated with compressive phenomena. Despite her euthyroid status, the thyroid ultrasound identified a suspected, large, non-homogeneous, hypoechogenic nodule with calcifications in the left thyroid lobe (TI-RADS score of 4), confirmed by a cervical-region MRI. The biopsy specimens obtained through fine-needle aspiration were classified as Bethesda III ("atypia of undetermined significance" or "follicular lesion of undetermined significance"). Left thyroid lobe removal was performed by a specialized surgeon in thyroid pathology, with histopathological analysis revealing a diagnosis of JDTF in the thyroid gland. Post-surgery, the patient showed favorable progress without any relapse. Pediatric endocrinologists face challenges in diagnosing and managing thyroid nodules in children due to their higher malignancy potential. Familiarity with similar conditions, such as JDTF, is crucial in accurate diagnosis and appropriate pediatric management.
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Affiliation(s)
- Giorgiana-Flavia Brad
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (G.-F.B.); (D.-M.N.); (A.-C.S.); (R.A.); (D.-G.B.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Țurcanu”, 300011 Timișoara, Romania;
| | - Iulius Jugănaru
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (G.-F.B.); (D.-M.N.); (A.-C.S.); (R.A.); (D.-G.B.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Țurcanu”, 300011 Timișoara, Romania;
- Research Center for Disturbances of Growth and Development in Children BELIVE, ‘Victor Babeş’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania;
| | - Delia-Maria Nicoară
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (G.-F.B.); (D.-M.N.); (A.-C.S.); (R.A.); (D.-G.B.); (O.M.)
- Research Center for Disturbances of Growth and Development in Children BELIVE, ‘Victor Babeş’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania;
| | - Alexandra-Cristina Scutca
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (G.-F.B.); (D.-M.N.); (A.-C.S.); (R.A.); (D.-G.B.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Țurcanu”, 300011 Timișoara, Romania;
| | - Meda-Ada Bugi
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Țurcanu”, 300011 Timișoara, Romania;
| | - Raluca Asproniu
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (G.-F.B.); (D.-M.N.); (A.-C.S.); (R.A.); (D.-G.B.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Țurcanu”, 300011 Timișoara, Romania;
- Ph.D. School Department, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timișoara, Romania
| | - Alexandru-Daniel Chelu
- Research Center for Disturbances of Growth and Development in Children BELIVE, ‘Victor Babeş’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania;
- Department II of Microscopic Morphology, Pathological Discipline, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
- Research Center ANAPATMOL, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania
| | - Diana-Georgiana Basaca
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (G.-F.B.); (D.-M.N.); (A.-C.S.); (R.A.); (D.-G.B.); (O.M.)
- Ph.D. School Department, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timișoara, Romania
| | - Mărioara Corneanu
- Department II of Microscopic Morphology, Pathological Discipline, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
- Research Center ANAPATMOL, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania
- “Pius Brinzeu” County Emergency Clinical Hospital, 300723 Timișoara, Romania
| | - Otilia Mărginean
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeș’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (G.-F.B.); (D.-M.N.); (A.-C.S.); (R.A.); (D.-G.B.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Țurcanu”, 300011 Timișoara, Romania;
- Research Center for Disturbances of Growth and Development in Children BELIVE, ‘Victor Babeş’ University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania;
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Raad M, López WOC, Sharafshah A, Assefi M, Lewandrowski KU. Personalized Medicine in Cancer Pain Management. J Pers Med 2023; 13:1201. [PMID: 37623452 PMCID: PMC10455778 DOI: 10.3390/jpm13081201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Previous studies have documented pain as an important concern for quality of life (QoL) and one of the most challenging manifestations for cancer patients. Thus, cancer pain management (CPM) plays a key role in treating pain related to cancer. The aim of this systematic review was to investigate CPM, with an emphasis on personalized medicine, and introduce new pharmacogenomics-based procedures for detecting and treating cancer pain patients. METHODS This study systematically reviewed PubMed from 1990 to 2023 using keywords such as cancer, pain, and personalized medicine. A total of 597 publications were found, and after multiple filtering processes, 75 papers were included. In silico analyses were performed using the GeneCards, STRING-MODEL, miRTargetLink2, and PharmGKB databases. RESULTS The results reveal that recent reports have mainly focused on personalized medicine strategies for CPM, and pharmacogenomics-based data are rapidly being introduced. The literature review of the 75 highly relevant publications, combined with the bioinformatics results, identified a list of 57 evidence-based genes as the primary gene list for further personalized medicine approaches. The most frequently mentioned genes were CYP2D6, COMT, and OPRM1. Moreover, among the 127 variants identified through both the literature review and data mining in the PharmGKB database, 21 variants remain as potential candidates for whole-exome sequencing (WES) analysis. Interestingly, hsa-miR-34a-5p and hsa-miR-146a-5p were suggested as putative circulating biomarkers for cancer pain prognosis and diagnosis. CONCLUSIONS In conclusion, this study highlights personalized medicine as the most promising strategy in CPM, utilizing pharmacogenomics-based approaches to alleviate cancer pain.
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Affiliation(s)
- Mohammad Raad
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, NH 03824, USA
| | - William Omar Contreras López
- Neurosurgeon Clinica Foscal Internacional, Bucaramanga 680006, Colombia;
- Neurosurgeon Clinica Portoazul, Caribe, La Merced, Asunción, Centro, Barranquilla 680006, Colombia
| | - Alireza Sharafshah
- Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht 41937-1311, Iran;
| | - Marjan Assefi
- University of North Carolina, Greensboro, NC 27412, USA;
| | - Kai-Uwe Lewandrowski
- Center for Advanced Spine Care of Southern Arizona, Tucson, AZ 85712, USA;
- Department of Orthopaedics, Fundación Universitaria Sanitas, Bogotá 111321, Colombia
- Department of Orthopedics, Hospital Universitário Gaffre e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, Brazil
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