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Halenka M, Munteanu H, Obereigneru R, Dohnal R, Karasek D, Schovanek J. Ethanol ablation of thyroid cysts in the young with a focus on efficacy and quality of life. Eur Thyroid J 2023; 12:e230085. [PMID: 37432713 PMCID: PMC10448585 DOI: 10.1530/etj-23-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/10/2023] [Indexed: 07/12/2023] Open
Abstract
Objective Ultrasound-guided percutaneous ethanol injection therapy (US-PEIT) is used in patients with recurrent symptomatic thyroid cysts as a credible alternative to surgery. Young patients commonly do not wish to undergo surgery and prefer ethanol ablation, if available. The effect of this approach on quality of life is an essential factor in deciding on the treatment options, especially in the young with a long life expectancy and no comorbidity. Methods We performed US-PEIT in a cohort of young patients, 15-30 years, from 2015 to 2020. The patients' general quality of life (QoL), self-reported compression symptoms and neck appearance were evaluated. Results The cohort comprised 59 patients with 63 cysts, more women than men, with a mean age of 23.8 years. About 1.5 mL of injected alcohol were needed to reach a 90.7% mean cyst volume reduction ratio in 12 months. The method did not fail in any of the patients; a single US-PEIT session was undertaken in 46% of them. The procedure significantly improved each of the patients' symptoms with a significant total score difference (P < 0.001). The total symptom score correlated with the initial cyst volume (P = 0.002; r = 0.395). The mean QoL score by SF-36 6 months after the last US-PEIT was significantly different for physical component summary 56.5 (P < 0.001) but not different for mental component summary 47.7 (P = 0.125), compared to age-corresponding norms. Conclusions US-PEIT is a safe and effective method for the young, leading to improvements in cosmetic and subjective complaints, and should also be considered as first-line treatment in the young.
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Affiliation(s)
- Milan Halenka
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Hana Munteanu
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Radko Obereigneru
- Faculty of Arts, Palacky University Olomouc, Olomouc, Czech Republic
| | - Roman Dohnal
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - David Karasek
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Jan Schovanek
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
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Maniam P, Hey SY, Summers D, Reid H, Nixon I. Ethanol ablation for recurrent symptomatic thyroid cysts: 5-year UK-based experience. Clin Otolaryngol 2023; 48:250-253. [PMID: 36507723 DOI: 10.1111/coa.14016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/02/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Pavithran Maniam
- Department of Otolaryngology & Head and Neck Surgery, NHS Lothian, Edinburgh, UK
| | - Shi Ying Hey
- Department of Otolaryngology & Head and Neck Surgery, NHS Lothian, Edinburgh, UK
| | | | - Helen Reid
- Department of Radiology, NHS Lothian, Edinburgh, UK
| | - Ian Nixon
- Department of Otolaryngology & Head and Neck Surgery, NHS Lothian, Edinburgh, UK
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Shimizu Y, Kawashiri SY, Noguchi Y, Nakamichi S, Nagata Y, Maeda T, Hayashida N. Height and Active Arterial Wall Thickening in Relation to Thyroid Cysts Status among Elderly Japanese: A Prospective Study. Biology (Basel) 2022; 11:biology11121756. [PMID: 36552266 PMCID: PMC9775353 DOI: 10.3390/biology11121756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
Height is inversely associated with inflammation that stimulates endothelial repair. In our previous study involving elderly men aged 60-69 years, we found that active arterial wall thickening, which is known as the process of endothelial repair, requires CD34-positive cells. As thyroid hormone regulates CD34-positive cell production and as the absence of thyroid cysts might indicate latent damage in the thyroid, the status of thyroid cysts possibly influences the association between height and active arterial wall thickening. We conducted a 2-year follow-up study of Japanese aged 60-69 years. For participants with thyroid cysts, height was significantly inversely associated with active arterial wall thickening (thyroid function and baseline CIMT adjusted odds ratio of active arterial wall thickening for one increment of standard deviation of height (5.7 cm for men and 4.8 cm for women), 0.66 [0.49, 0.89]), while for those without thyroid cysts, a positive tendency between the two parameters was observed (1.19 [0.96, 1.50]). An inverse association between height and active arterial wall thickening was observed only for elderly participants with thyroid cysts possibly because of a supportive role of thyroid hormone, as the absence of thyroid cysts might indicate latent damage in the thyroid.
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Affiliation(s)
- Yuji Shimizu
- Department of General Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka 537-8511, Japan
- Correspondence: ; Tel.: +81-95-819-7578
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
- Leading Medical Research Core Unit, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Yuko Noguchi
- Department of Community Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Seiko Nakamichi
- Department of General Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan
- Nagasaki University Health Center, Nagasaki 852-8521, Japan
| | - Yasuhiro Nagata
- Department of Community Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
- Leading Medical Research Core Unit, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Takahiro Maeda
- Department of General Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan
- Leading Medical Research Core Unit, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Naomi Hayashida
- Leading Medical Research Core Unit, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
- Division of Strategic Collaborative Research, Center for Promotion of Collaborative Research on Radiation and Environment Health Effect, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan
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Belle JM, Vasilottos N, Nebesio TD, James BC. Pediatric toxic polycystic thyroid. J Pediatr Endocrinol Metab 2017; 30:781-784. [PMID: 28672775 DOI: 10.1515/jpem-2016-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 04/18/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Polycystic thyroid disease (PCTD) is a rare condition and has been described in adults in the setting of subclinical and clinical hypothyroidism. We present the first known case of a pediatric patient with diffuse macrocystic degeneration of the thyroid. CLINICAL PRESENTATION A 6-year-old previously healthy patient was evaluated after presenting with a 16-month history of an enlarging polycystic thyroid and hyperthyroidism. Markers of autoimmune thyroid disease including thyroid stimulating immunoglobulin (TSI), thyroid stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody and thyroglobulin antibody were negative. No family history of benign or malignant thyroid or cystic disease was present. The patient underwent a total thyroidectomy without perioperative complication. She remains euthyroid with thyroid hormone replacement therapy. SUMMARY To our knowledge, this is the first report of PCTD in the pediatric population associated with hyperthyroidism without evidence of autoimmune disease. Somatic activating thyrotropin-receptor gene mutations are known to cause non-autoimmune hyperthyroidism in children, however it is unknown if similar mechanisms are responsible for pediatric PCTD. CONCLUSIONS Polycystic thyroid degeneration can occur in children and may result in a hyperthyroid state.
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Li P, Zheng W, Liu H, Zhang Z, Zhao L. Endobronchial ultrasound-guided transbronchial needle aspiration for thyroid cyst therapy: A case report. Exp Ther Med 2017; 13:1944-1947. [PMID: 28565791 DOI: 10.3892/etm.2017.4213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 12/23/2016] [Indexed: 12/29/2022] Open
Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is of limited usefulness for diagnosing thyroid disease, and few studies have reported its use in diagnosing and treating thyroid cysts. The present study investigated a unique case of diagnosis and treatment of a thyroid cyst by EBUS-TBNA. A 67-year-old male presented with back pain. Positron emission tomography/computed tomography scanning revealed low-density signals in the right lobe of the thyroid. Needle aspiration biopsies and drainage at this site was performed, and EBUS was used for guidance in diagnosing the thyroid cyst. A follow-up chest computed tomography scan indicated that the thyroid lesion had subsequently disappeared. The present study concludes that EBUS-TBNA provides an alternative approach for diagnosing and treating deep thyroid cysts located close to the airway. In all other cases, percutaneous needle aspiration or surgery should be the first choice.
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Affiliation(s)
- Peng Li
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Wei Zheng
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Hongbo Liu
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Zhenyong Zhang
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110022, P.R. China
| | - Li Zhao
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
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Suzuki S. Childhood and Adolescent Thyroid Cancer in Fukushima after the Fukushima Daiichi Nuclear Power Plant Accident: 5 Years On. Clin Oncol (R Coll Radiol) 2016; 28:263-271. [PMID: 26822892 DOI: 10.1016/j.clon.2015.12.027] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 12/29/2015] [Indexed: 02/02/2023]
Abstract
The accident at the Fukushima Daiichi Nuclear Power Plant occurred after the Great East Japan Earthquake on 11 March 2011, releasing a large amount of radioactive materials into the atmosphere. Questions were raised regarding the health effects of radiation exposure, which led to increased anxiety among the Fukushima residents about the possible development of thyroid cancer. Thus, thyroid ultrasound examinations began for those who were from the areas where the radiation doses were highest, and will continue for the long term. In total, 300 476 subjects aged 18 years or younger at the time of the disaster were screened from 9 October 2011 to 31 March 2014. The participation rate was 81.7% of the total population of this age and in the affected area. Among them, the proportions of those who fell into the categories A1 (no nodules or cysts present), A2 (nodule ≤ 5 mm or cyst ≤ 20 mm diameter), B (nodule > 5 mm or cyst > 20 mm diameter) and C (immediate need for further investigation) were 51.5, 47.8, 0.8 and 0%, respectively; 2294 subjects in categories B and C were recommended to undergo a confirmatory examination; 113 were subsequently diagnosed with malignancy or suspected malignancy by fine needle aspiration cytology. The full-scale survey (second round survey) began in April 2014, and was completed by 30 June 2015, and comprised 169 455 subjects (participation rate; 44.7%). The proportions of those who fell into the categories A1, A2, B and C were 41.6, 57.6, 0.8 and 0% (no case), respectively; 1223 subjects in category B were recommended to undergo a confirmatory examination, 25 of these were subsequently diagnosed with malignancy or suspected malignancy by fine needle aspiration cytology. The thyroid cancers identified in this survey so far are unlikely to be due to radiation exposure, and are more likely to be the result of screening using highly sophisticated ultrasound techniques. However, it would be advisable to continue long-term screening to determine whether the risk of childhood and adolescent thyroid cancer due to radiation exposure increases or not.
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Affiliation(s)
- S Suzuki
- Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan.
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Mavrogenis G, Hassaini H, Sibille A, Feloni S, Deprez PH, Gillain C, Warzée P. Expanding the horizons of endoscopic ultrasound: diagnosis of non-digestive pathologies. Gastroenterol Rep (Oxf) 2014; 2:63-9. [PMID: 24760239 PMCID: PMC3920997 DOI: 10.1093/gastro/got033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Endoscopic ultrasound (EUS) is mainly used for the evaluation and sampling of mediastinal and abdominal lymph nodes, luminal and submucosal lesions of the upper and lower gastrointestinal tract, as well as in the diagnostic approach for pancreatic, biliary and liver disease. However, several non-digestive pathologies may be encountered as well, expanding the diagnostic potential of EUS. In this article, we present nine examples of extra-digestive abnormalities detected by means of EUS, including pathologies of the thyroid gland, mediastinal and abdominal vessels, lungs, kidney and the urinary bladder. The purpose of this article is to review the capabilities of EUS beyond routine evaluation of gastrointestinal organs.
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Affiliation(s)
- Georgios Mavrogenis
- Department of Gastroenterology, Grand Hôpital de Charleroi, Charleroi, Belgium and Department of Hepato-Gastroenterology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Grineva YN, Malakhova TV, Goryushkina YV. [The role of thin-needle aspiration biopsy in the diagnosis of thyroid nodules]. Probl Endokrinol (Mosk) 2005; 51:10-14. [PMID: 31627529 DOI: 10.14341/probl200551110-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Indexed: 06/10/2023]
Abstract
The paper analyzes the results of thin-needle aspiration biopsy (TNAB) performed in 1155 patients with thyroid nodules. The purpose of the paper was to evaluate the efficiency of TNAB in the differential diagnosis of thyroid nodules and in the detection of carcinoma among them. A prospective open uncontrolled study was conducted. According to the data of TNAB, benign, malignant, and suspected malignant masses were found in 808 (69.96%), 49 (4.2%), and 148 (12.8%) patients, respectively. The data of TNAB were compared with the histological findings in 333 patients undergoing surgery. The sensitivity, specificity, and other indices of the efficiency of TNAB were calculated by and without taking into account a group of suspected malignant changes. The sensitivity, specificity, and diagnostic accuracy were 93.9, 97.5, and 96.5%, respectively; the prognostic values as for the presence and absence of cancer were 93.8 and 97.5%, respectively, The presence of a group of suspected malignant changes substantially lowered the efficiency of TNAB. The specificity of TNAB in detecting thyroid cancer, assessed by taking into account this group was 52.5%; the prognostic value as to the presence of cancer was 39.8%. The diagnostic accuracy (63.2%), sensitivity (93.9%), and the prognostic value of TNAB in relation to the absence of cancer (97.5%) substantially unchanged. The presence of a rather large number of unrepresentative aspirates (13.0%), the bulk (74.7%) of which is presented by the contents of a cyst is another disadvantage of TNAB. A histological study revealed thyroid cancer in 6 out of these patients. The high (62%) incidence of cancer in the cystic nodes reasonably warrants the use of surgery in case of the repeated accumulation of the contents with a cystic node.
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Affiliation(s)
- Y N Grineva
- I.P. Pavlov First St. Petersburg State Medical University
| | - T V Malakhova
- I.P. Pavlov First St. Petersburg State Medical University
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