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O'Connell L, Prichard RS, O'Reilly E, Skehan S, Gibbons D, McDermott EW. Running in the family: A rare diagnosis of familial papillary thyroid cancer. Int J Surg Case Rep 2015; 16:64-6. [PMID: 26432498 PMCID: PMC4643435 DOI: 10.1016/j.ijscr.2015.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 09/10/2015] [Accepted: 09/15/2015] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Whilst inherited medullary thyroid cancer has been extensively reported, familial non-medullary thyroid cancer is a rare and less well described clinical entity. Familial forms of the disease demonstrate more aggressive features than sporadic non-medullary thyroid cancer. PRESENTATION OF CASE A 54 year old lady was referred with globus on a background of a longstanding goitre. Three first degree relatives had a history of non-medullary thyroid carcinoma. Investigations revealed a papillary thyroid carcinoma and the patient proceeded to total thyroidectomy and ipsilateral Level VI neck dissection, followed by adjuvant radioiodine ablation. DISCUSSION Familial papillary thyroid carcinoma syndrome is defined as three or more first degree relatives diagnosed with the disease in the absence of other known associated syndromes. It is often associated with the presence of benign thyroid disorders, and is characterised by the early onset of multi-focal bilateral locally advanced tumours. CONCLUSION Familial papillary thyroid cancer is a rare clinical entity but should be considered where ≥3 first degree relatives are diagnosed with non-medullary thyroid cancer. It is necessary to exclude other familial tumour syndromes to make the diagnosis. It demonstrates more aggressive features with higher rates of local recurrence than its sporadic counterpart, and therefore mandates more aggressive management than might otherwise be indicated. Screening of first degree relatives should be considered. SUMMARY The case of a 54 year old female diagnosed with familial non-medullary thyroid carcinoma is reported.
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Affiliation(s)
- L O'Connell
- Department of Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - R S Prichard
- Department of Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - E O'Reilly
- Department of Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - S Skehan
- Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - D Gibbons
- Department of Pathology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - E W McDermott
- Department of Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Neri E, Bali MA, Ba-Ssalamah A, Boraschi P, Brancatelli G, Alves FC, Grazioli L, Helmberger T, Lee JM, Manfredi R, Martì-Bonmatì L, Matos C, Merkle EM, Op De Beeck B, Schima W, Skehan S, Vilgrain V, Zech C, Bartolozzi C. ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents. Eur Radiol 2015; 26:921-31. [PMID: 26194455 PMCID: PMC4778143 DOI: 10.1007/s00330-015-3900-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 06/07/2015] [Accepted: 06/22/2015] [Indexed: 02/06/2023]
Abstract
Objectives To develop a consensus and provide updated recommendations on liver MR imaging and the clinical use of liver-specific contrast agents. Methods The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) formed a multinational European panel of experts, selected on the basis of a literature review and their leadership in the field of liver MR imaging. A modified Delphi process was adopted to draft a list of statements. Descriptive and Cronbach’s statistics were used to rate levels of agreement and internal reliability of the consensus. Results Three Delphi rounds were conducted and 76 statements composed on MR technique (n = 17), clinical application of liver-specific contrast agents in benign, focal liver lesions (n = 7), malignant liver lesions in non-cirrhotic (n = 9) and in cirrhotic patients (n = 18), diffuse and vascular liver diseases (n = 12), and bile ducts (n = 13). The overall mean score of agreement was 4.84 (SD ±0.17). Full consensus was reached in 22 % of all statements in all working groups, with no full consensus reached on diffuse and vascular diseases. Conclusions The consensus provided updated recommendations on the methodology, and clinical indications, of MRI with liver specific contrast agents in the study of liver diseases. Key points • Liver-specific contrast agents are recommended in MRI of the liver. • The hepatobiliary phase improves the detection and characterization of hepatocellular lesions. • Liver-specific contrast agents can improve the detection of HCC.
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Affiliation(s)
- E Neri
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy.
| | - M A Bali
- Department of Radiology, Hôpital Erasme, MRI Clinics, Bruxelles, Belgium
| | - A Ba-Ssalamah
- Department of Biomedical Imaging and Image-guided Therapy, The General Hospital of the Medical University of Vienna, Vienna, Austria
| | - P Boraschi
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
| | - G Brancatelli
- Department of Radiology, University of Palermo, Palermo, Italy
| | - F Caseiro Alves
- Medical Imaging Department and Faculty of Medicine, University Hospital of Coimbra, Coimbra, Portugal
| | - L Grazioli
- Department of Radiology, Spedali Civili di Brescia, Brescia, Italy
| | - T Helmberger
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University, Munich, Germany
| | - J M Lee
- Division of Abdominal Imaging, Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - R Manfredi
- Department of Radiology, University of Verona, Verona, Italy
| | - L Martì-Bonmatì
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - C Matos
- Department of Radiology, Hôpital Erasme, MRI Clinics, Bruxelles, Belgium
| | - E M Merkle
- Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Basel, Switzerland
| | - B Op De Beeck
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
| | - W Schima
- Department of Diagnostic and Interventional Radiology, KH Goettlicher Heiland, Krankenhaus der Barmherzigen Schwestern and Sankt Josef-Krankenhaus, Vienna, Austria
| | - S Skehan
- Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - V Vilgrain
- Radiology Department, Assistance Publique-Hôpitaux de Paris, APHP, Hôpital Beaujon, Clichy, Paris, France
| | - C Zech
- Abteilungsleiter Interventionelle Radiologie, Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Basel, Switzerland
| | - C Bartolozzi
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
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O'Reilly EA, Aucharaz N, Kelly G, Al Azawi D, Prichard RS, Evoy D, Rothwell J, Geraghty J, O'Doherty A, Skehan S, Quinn C, McDermott E. Abstract P1-01-01: The value of isosulphan blue dye in addition to isotope scanning in the identification of the sentinel lymph node in breast cancer patients with a positive lymphoscintigraphy: A randomised controlled trial (ISRCTN 98849733). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-01-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
The advent of multimodal and targeted breast cancer treatment has seen a radical shift from aggressive surgical intervention to a more minimalist approach, both within the breast and axilla. Primary among these changes is the utilisation of the sentinel lymph node biopsy (SLNB) to detect disease within the axilla and a move away from an obligatory axillary clearance when the sentinel node is positive. This depends on the accurate identification of the SLN and initial studies describe a higher identification rate and a lower false negative rate with a dual tracer identification technique. This encompasses a combination of a blue / green dye and radio-labelled isotope. The use of blue dye has been, of itself, associated with significant morbidity and therefore many clinicians may opt for single tracer identification.
Aims
The aim of the current study was to determine whether the addition of blue dye to radio-isotope increased the positive SLN detection rate, where the SLN was identified pre-operatively on a lymphoscintigram.
Methods
A prospective randomised controlled trial comparing the combined techniques of isosulphan blue dye and isotope scanning versus isotope scanning alone was performed at a single tertiary referral centre. Ethical approval was obtained prior to commencing the study from the hospital ethics committee. Enrolment commenced in March 2010 and ceased in September 2012. The study design was a randomised open label controlled parallel group trial. The primary outcome measure was the effect of the omission of the blue dye on the identification of SLN if the lymphoscintigram was positive (1 -3 nodes identified).
Results
A total of 673 patients were included in the final analysis with 344 patients receiving the combination (blue dye and radio-isotope) and 329 patients who received radio-isotope scanning alone. The groups were evenly matched both demographically and pathologically. The mean age was 48 years (48.3 versus 47.7 years; P = 0.47), the mean tumour size was 23.1mm (23.2mm versus 23.0mm; p = 0.89) and there was no statistically significant difference in the grade of the tumours between the two groups (p = 0.58). Overall, there was no difference in the number of nodes retrieved between the two groups (563 versus 523; p = 0.30). Similarly, there was no difference in the number of positive lymph nodes that were identified between the two groups (107 versus 98; 23.8% versus 22%; p = 0.65).
Conclusions
The addition of isosulphan blue dye does not aid in the identification of the SLN in patients who have a positive lymphoscintigram when radioisotope colloid is used.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-01-01.
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Affiliation(s)
- EA O'Reilly
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - N Aucharaz
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - G Kelly
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - D Al Azawi
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - RS Prichard
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - D Evoy
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - J Rothwell
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - J Geraghty
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - A O'Doherty
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - S Skehan
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - C Quinn
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
| | - E McDermott
- St Vincent's Healthcare Group, Elm Park, Dublin, Ireland; University College Dublin, Dublin, Ireland; St. Vincent's Healthcare Group, Elm Park, Dublin 4, Ireland; St Vincent's Healthcare Grouup, Elm Park, Dublin 4, Ireland
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