carcinoma medular de tiroides
TRANSCRIPT
CARCINOMA MEDULAR DE
TIROIDES
FUCS
bull MIGUEL AacuteNGEL LOZANO ARIAS
bull INFORMATICA NIVEL MEDIO
bull BOGOTA DC
bull 2011
LA GLANDULA TIROIDES
bull ldquothe thyroid is one of the largest of the endocrine organs weighing approximately 15 to 20 g The normal thyroid is made up of two lobes joined by a thin band of tissue the isthmus which is approximately 05 cm thick 2 cm wide and 1 to 2 cm high The individual lobes normally have a pointed superior pole and a poorly defined blunt inferior pole that merges medially with the isthmus Each lobe is approximately 20 to 25 cm in thickness and width at its largest diameter and it is approximately 40 cm in lengthrdquo 1
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize8966jpg
CANCER MEDULAR DE TIROIDES
bull ldquoEs un caacutencer de la glaacutendula tiroides que comienza en un tipo de ceacutelulas denominadas ceacutelulas C que liberan una hormona llamada calcitoninardquo278
httpescuelamedpucclpaginascursosterceroanatomiapatologicaimagenes_apfotos937-941941jpg
VISTA MICROSCOPICA DE NEOPLASIA EN LA GLANDULA TIROIDES
VISTA MACROSCOPICA DE NEOPLASIA EN GLANDULA TIROIDES
bull httpescuelamedpucclpublpatgeneralFotosBig133jpg
CAUSAS
bull ldquoLa causa del carcinoma medular tiroideo (CMT) se desconoce
bull A diferencia de otros tipos de caacutencer de la tiroides es menos probable que este tipo de carcinoma sea causado por radioterapia al cuello aplicada para tratar otros caacutenceres durante la infanciardquo6
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
FUCS
bull MIGUEL AacuteNGEL LOZANO ARIAS
bull INFORMATICA NIVEL MEDIO
bull BOGOTA DC
bull 2011
LA GLANDULA TIROIDES
bull ldquothe thyroid is one of the largest of the endocrine organs weighing approximately 15 to 20 g The normal thyroid is made up of two lobes joined by a thin band of tissue the isthmus which is approximately 05 cm thick 2 cm wide and 1 to 2 cm high The individual lobes normally have a pointed superior pole and a poorly defined blunt inferior pole that merges medially with the isthmus Each lobe is approximately 20 to 25 cm in thickness and width at its largest diameter and it is approximately 40 cm in lengthrdquo 1
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize8966jpg
CANCER MEDULAR DE TIROIDES
bull ldquoEs un caacutencer de la glaacutendula tiroides que comienza en un tipo de ceacutelulas denominadas ceacutelulas C que liberan una hormona llamada calcitoninardquo278
httpescuelamedpucclpaginascursosterceroanatomiapatologicaimagenes_apfotos937-941941jpg
VISTA MICROSCOPICA DE NEOPLASIA EN LA GLANDULA TIROIDES
VISTA MACROSCOPICA DE NEOPLASIA EN GLANDULA TIROIDES
bull httpescuelamedpucclpublpatgeneralFotosBig133jpg
CAUSAS
bull ldquoLa causa del carcinoma medular tiroideo (CMT) se desconoce
bull A diferencia de otros tipos de caacutencer de la tiroides es menos probable que este tipo de carcinoma sea causado por radioterapia al cuello aplicada para tratar otros caacutenceres durante la infanciardquo6
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
LA GLANDULA TIROIDES
bull ldquothe thyroid is one of the largest of the endocrine organs weighing approximately 15 to 20 g The normal thyroid is made up of two lobes joined by a thin band of tissue the isthmus which is approximately 05 cm thick 2 cm wide and 1 to 2 cm high The individual lobes normally have a pointed superior pole and a poorly defined blunt inferior pole that merges medially with the isthmus Each lobe is approximately 20 to 25 cm in thickness and width at its largest diameter and it is approximately 40 cm in lengthrdquo 1
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize8966jpg
CANCER MEDULAR DE TIROIDES
bull ldquoEs un caacutencer de la glaacutendula tiroides que comienza en un tipo de ceacutelulas denominadas ceacutelulas C que liberan una hormona llamada calcitoninardquo278
httpescuelamedpucclpaginascursosterceroanatomiapatologicaimagenes_apfotos937-941941jpg
VISTA MICROSCOPICA DE NEOPLASIA EN LA GLANDULA TIROIDES
VISTA MACROSCOPICA DE NEOPLASIA EN GLANDULA TIROIDES
bull httpescuelamedpucclpublpatgeneralFotosBig133jpg
CAUSAS
bull ldquoLa causa del carcinoma medular tiroideo (CMT) se desconoce
bull A diferencia de otros tipos de caacutencer de la tiroides es menos probable que este tipo de carcinoma sea causado por radioterapia al cuello aplicada para tratar otros caacutenceres durante la infanciardquo6
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize8966jpg
CANCER MEDULAR DE TIROIDES
bull ldquoEs un caacutencer de la glaacutendula tiroides que comienza en un tipo de ceacutelulas denominadas ceacutelulas C que liberan una hormona llamada calcitoninardquo278
httpescuelamedpucclpaginascursosterceroanatomiapatologicaimagenes_apfotos937-941941jpg
VISTA MICROSCOPICA DE NEOPLASIA EN LA GLANDULA TIROIDES
VISTA MACROSCOPICA DE NEOPLASIA EN GLANDULA TIROIDES
bull httpescuelamedpucclpublpatgeneralFotosBig133jpg
CAUSAS
bull ldquoLa causa del carcinoma medular tiroideo (CMT) se desconoce
bull A diferencia de otros tipos de caacutencer de la tiroides es menos probable que este tipo de carcinoma sea causado por radioterapia al cuello aplicada para tratar otros caacutenceres durante la infanciardquo6
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
CANCER MEDULAR DE TIROIDES
bull ldquoEs un caacutencer de la glaacutendula tiroides que comienza en un tipo de ceacutelulas denominadas ceacutelulas C que liberan una hormona llamada calcitoninardquo278
httpescuelamedpucclpaginascursosterceroanatomiapatologicaimagenes_apfotos937-941941jpg
VISTA MICROSCOPICA DE NEOPLASIA EN LA GLANDULA TIROIDES
VISTA MACROSCOPICA DE NEOPLASIA EN GLANDULA TIROIDES
bull httpescuelamedpucclpublpatgeneralFotosBig133jpg
CAUSAS
bull ldquoLa causa del carcinoma medular tiroideo (CMT) se desconoce
bull A diferencia de otros tipos de caacutencer de la tiroides es menos probable que este tipo de carcinoma sea causado por radioterapia al cuello aplicada para tratar otros caacutenceres durante la infanciardquo6
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
httpescuelamedpucclpaginascursosterceroanatomiapatologicaimagenes_apfotos937-941941jpg
VISTA MICROSCOPICA DE NEOPLASIA EN LA GLANDULA TIROIDES
VISTA MACROSCOPICA DE NEOPLASIA EN GLANDULA TIROIDES
bull httpescuelamedpucclpublpatgeneralFotosBig133jpg
CAUSAS
bull ldquoLa causa del carcinoma medular tiroideo (CMT) se desconoce
bull A diferencia de otros tipos de caacutencer de la tiroides es menos probable que este tipo de carcinoma sea causado por radioterapia al cuello aplicada para tratar otros caacutenceres durante la infanciardquo6
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
VISTA MACROSCOPICA DE NEOPLASIA EN GLANDULA TIROIDES
bull httpescuelamedpucclpublpatgeneralFotosBig133jpg
CAUSAS
bull ldquoLa causa del carcinoma medular tiroideo (CMT) se desconoce
bull A diferencia de otros tipos de caacutencer de la tiroides es menos probable que este tipo de carcinoma sea causado por radioterapia al cuello aplicada para tratar otros caacutenceres durante la infanciardquo6
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
CAUSAS
bull ldquoLa causa del carcinoma medular tiroideo (CMT) se desconoce
bull A diferencia de otros tipos de caacutencer de la tiroides es menos probable que este tipo de carcinoma sea causado por radioterapia al cuello aplicada para tratar otros caacutenceres durante la infanciardquo6
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
CLASES DE CMT
bull ldquoHay dos formas de carcinoma medular tiroideo
bull Carcinoma medular tiroideo esporaacutedico el cual no se transmite de padres a hijos La mayoriacutea de estos carcinomas son esporaacutedicos Esta forma afecta principalmente a los adultos mayores
bull Carcinoma medular tiroideo hereditario el cual se transmite de padres a hijosrdquo2
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull httpwwwaddisonesimagbociojpg
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
FACTORES DE RIESGO
bull ldquoUn antecedente familiar de este tipo de carcinoma
bull Antecedentes familiares de neoplasia endocrina muacuteltiple (NEM)
bull Historia previa de feocromocitoma neuromas de la mucosa o hiperparatiroidismordquo4
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
httpwwwconganatorgseapdatosregionalesvcamino1jpg
Hiperparatiroidismo uno de los mas influyentes factores de riesgo
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
SIacuteNTOMAS
bull ldquoProblemas respiratorios debido al estrechamiento de las viacuteas respiratorias
bull Tos
bull Tos con sangre
bull Diarrea
bull Bocio (agrandamiento de la tiroides)
bull Tumor en la glaacutendula tiroidesrdquo2
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
BOCIO
httpgenesisuagmxsaludarticulosanterioresimagesbociojpg
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
SIGNOS Y EXAacuteMENES
bull ldquoEl meacutedico llevaraacute a cabo un examen fiacutesico Los ganglios linfaacuteticos en el cuello pueden presentar hinchazoacuten Las pruebas de la funcioacuten tiroidea generalmente son normales sin embargo un examen de la tiroides puede revelar noacutedulos (tumoraciones) solitarios o muacuteltiples
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull El examen fiacutesico medico es de suma importancia para detectar hiperplasias en estadios tempranos de carcinoma medular de tiroides
bull httpwwwlosmedicamentosnetconsejoswp-contentuploads201104bociojpg
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull Otros exaacutemenes que se pueden utilizar para diagnosticar el carcinoma medular tiroideo pueden ser
bull Examen de sangre para calcitonina
bull Examen de sangre para antiacutegeno carcinoembrionario (ACE)
bull Pruebas geneacuteticas
bull Biopsia de la tiroides
bull Gammagrafiacutea de la tiroides
bull Ecografiacutea de la tiroidesrdquo23httpwwwdoctorweborgstaticimagesbociojpg
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
OPCIONES DE TRATAMIENTO
bull ldquoCirugiacutea con frecuencia es necesario efectuar una traqueotomiacutea Si la enfermedad estaacute limitada a un aacuterea local lo cual es poco comuacuten se justifica la realizacioacuten de una tiroidectomiacutea total para reducir los siacutentomas que causa la masa tumoralrdquo39
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull httpwwwnlmnihgovmedlineplusspanishencyimagesencyfullsize14066jpg
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull Radioterapia Se puede usar la irradiacioacuten de haz externo en los pacientes que no son idoacuteneos para la cirugiacutea o cuyo tumor no puede extirparse quiruacutergicamente
bull Quimioterapia el caacutencer anaplaacutesico de la tiroides no responde al tratamiento con I131 se observa que el tratamiento con monofaacutermacosanticancerosos produce remisiones parciales en algunos pacientes Aproximadamente 30 de los pacientes logran una remisioacuten parcial con la doxorrubicina La combinacioacuten de doxorrubicina y cisplatino parece ser maacutes activa que la doxorrubicina sola y se ha observado que produce maacutes respuestas completas
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull ldquoTargeted systemic radiotherapy of pheochromocytoma and medullary thyroid cancerbull Divgi Cbull Sourcebull Columbia University New York NYbull Abstractbull Targeted systemic radiotherapy constitutes the systemic administration of a radioactive agent that
targets a molecule expressed preferentially on cancer cells The archetypal such therapy is 131-iodine ((131)I) therapy for differentiated thyroid cancers Radiotherapy typically delivers a calculated radiation-absorbed dose to tumor that takes into account (contiguous) normal tissue Systemic radiotherapy development currently uses schema more analogous to chemotherapy-a radioactivity estimate that does not cause any irreversible toxicity Historically arbitrary amounts of radioactivity shown to be effective on the basis of retrospective review were used for thyroidcancer therapy with (131)I as well as for neuroendocrine tumor therapy with (131)I-labeled meta-iodo-benzylguanidine (MIBG) Their established safety record has led to adaptations that include repeat therapies with nontoxic amounts of radioactivity There remains however a lack of clear understanding of the safety limits of systemic targeted radiotherapy This is probably most true in systemic therapy with MIBG in adult neuroendocrine tumors Bone marrow is the primary critical organ for most targeted systemic radiotherapy second organ involvement may be renal as with MIBG and targeted radiopeptide therapy or pulmonary as with radioimmunotherapy Most therapies have tended toward multiple administrations of subtoxic amounts of radioactivity Therapy with MIBG in pheochromococytoma as well as targeted radiopeptide therapy in medullarythyroid cancer has followed this model Radioimmunotherapy appears very promising a definitive Phase 2 study needs completion All therapy has shown promise in extending disease survival (as compared with historical controls) with few major structural (or biochemical) responses This review will attempt to compliment the excellent existing literature by providing an overall systemic therapeutic approach to this promising endeavorrdquo11
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull Este articulo es realmente interesante ya que plantea una mejora en el tratamiento con radioterapia para pacientes con caacutencer medular de tiroides los estudios que aquiacute presentan demuestran que la mejora del tratamiento se ve reflejada en el aumento de la expectativa de vida de los pacientes tratados con el nuevo meacutetodo frente a los tratados con el meacutetodo tradicional
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull http1bpblogspotcom_nbADpD65WD4SmDX1fuRnVIAAAAAAAAGygbXhKLyxMhAEs320tiroidesjpg
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull ldquoCurrent role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer
bull Ilias I Divgi C Pacak Kbull Sourcebull Department of Endocrinology E Venizelou Hospital Athens
Greecebull Abstractbull Despite early reports of excellent diagnostic characteristics of
[(131)I][(123)I]-metaiodobenzylguanidine (MIBG) in the evaluation of pheochromocytomasparagangliomas (PHEOsPGLs) or medullary thyroid cancer as experience with it was accumulated the sensitivity dropped Nevertheless this modality is still useful in the diagnostic work-up of PHEOsPGLs because it is widely available and in case of positive scans it might indicate patients who are potential candidates for [(131)I]MIBG therapy
bull Published by Elsevier Incrdquo12
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull El medicamento que referencia el articulo medico se encuentra ampliamente difundido y es esta la principal ventaja del este faacutermaco Aun faltan bastantes estudios el articulo deja muchos interrogantes
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull ldquoAnn Acad Med Singapore 2011 Jun40(6)300-2
bull Melanocytic variant of medullary thyroidcarcinoma in a previously treated papillarycarcinoma patient
bull Mohamad I Zainuddin N Zawawi N Naik VR
bull Source
bull Department of Otorhinolaryngology - Head amp Neck Surgeryrdquo13
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull Este articulo propone que los melanocitos son una variante significativa de el carcinoma medular de tiroides despueacutes de que esta haya sido exitosamente tratada
bull http4bpblogspotcom_Fnq-_ypIXdgTO6t_bKf53IAAAAAAAAAEgQLDhcalP0hks1600melanocitosjpg
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull ldquoBreast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography
bull Nofech-Mozes S Mackenzie R Kahn HJ Ehrlich L Raphael SJbull Sourcebull Department of Anatomical Pathology Sunnybrook Health Sciences Center
Toronto ON Canada M4N 3M5bull Abstractbull Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer
comprising 5 to 8 of thyroid neoplasms In contrast to common thyroid tumors this tumor originates from the calcitonin-producing C cells Regional metastases to cervical lymph nodes occur early in the disease whereas distant metastasis occurs late Common metastatic sites include the liver bone brain and adrenal medulla We present a case of MTC metastatic to the breast We report on this case for the following reasons (1) metastasis to the breast is an extremely rare occurrence and could be easily confused clinically and pathologically with a primary breast neoplasm and (2) this is the first reported case of detection of breast metastasis by an MTC using FDG ((18)F-fluoro-2-deoxy-D-glucose) positron emission tomography with an accompanying histologic descriptionrdquo14
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull El articulo trata el tema de las metaacutestasis de el carcinoma medular de tiroides haciendo especial eacutenfasis en las metaacutestasis a distancias especialmente en mama
bull http4bpblogspotcom_YmCZlFt2utMTOv2n-jvZKIAAAAAAAAABIKqnwuja7pLQs1600CancerMetastasisjpg
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull ldquoCytology of hyalinising trabecular adenoma-like variant of medullarythyroid carcinoma
bull Santosh KV Raychaudhuri S Subramanya H Naveen Kumar BJbull Sourcebull Department of Pathology Vydehi Institute of Medical Sciences and
Research Center Bangalore Indiabull Abstractbull Medullary thyroid carcinoma is a rare thyroid neoplasm that can be
either sporadic or familial It occurs in adults presenting as a solitary cold nodule on thyroid scan Most are solid firm and non-encapsulated and occur in the mid portion or upper half of the thyroid gland corresponding to areas with greater numbers of C cells We present a case of a 36-year-old female with a swelling in the front of her neck for six years Fine needle aspiration done elsewhere revealed spindle cells suggestive of a spindle cell neoplasm The histopathology of the thyroidectomyspecimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma Subsequently we performed aspiration on the received specimen and studied the cytological findings The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrinechromatinrdquo15
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull Este trabajo investigativo plantea la posibilidad de una variante del carcinoma medular de tiroides en forma de un adenoma hialinizante trabecular Este estudio fue hecho en una mujer de 36 antildeos es necesario hacer estudios en otros pacientes para reafirmar la tesis del articulo
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
BIBLIOGRAFIacuteA
bull 1) httpbibliotecafucsaludeduco2052bookspagedoeid=4-u10-B978-1-4377-0324-500011-0--s0030ampisbn=978-1-4377-0324-5ampuniqId=270438322-24-u10-B978-1-4377-0324-500011-0--f0015
bull 2)
bull httpwwwnlmnihgovmedlineplusspanishencyarticle000374htm
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull 3)bull Goldman JM Goren EN Cohen MH et al Anaplastic thyroid
carcinoma long-term survival after radical surgery J Surg Oncol 14 (4) 389-94 1980 [PUBMED Abstract]
4)bull Aldinger KA Samaan NA Ibanez M et al Anaplastic carcinoma of
the thyroid a review of 84 cases of spindle and giant cell carcinoma of the thyroid Cancer 41 (6) 2267-75 1978 [PUBMED Abstract]
5)bull Carling T Udelsman R Thyroid tumors In DeVita VT Jr Hellman
S Rosenberg SA eds Cancer Principles and Practice of Oncology Vols 1 amp 2 8th ed Philadelphia Pa Lippincott Williams amp Wilkins 2008 pp 1663-82
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull 6)bull Shimaoka K Schoenfeld DA DeWys WD et al A randomized trial of
doxorubicin versus doxorubicin plus cisplatin in patients withadvanced thyroid carcinoma Cancer 56 (9) 2155-60 1985 [PUBMED Abstract]
7)bull Haigh PI Ituarte PH Wu HS et al Completely resected anaplastic
thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival Cancer 91 (12) 2335-42 2001 [PUBMED Abstract]
8)bull De Crevoisier R Baudin E Bachelot A et al Combined treatment of
anaplastic thyroid carcinoma with surgery chemotherapy and hyperfractionated accelerated external radiotherapy Int J RadiatOncol Biol Phys 60 (4) 1137-43 2004 [PUBMED Abstract]
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull 9) httpwwwcancergovespanolpdqtratamientotiroidesHealthProfessionalpage8
bull 10)
bull httpbibliotecafucsaludeduco2079dynameddetailvid=10amphid=110ampsid=4895cac3-c780-4f0c-9aeb-db9349e23b9340sessionmgr104ampbdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU3ddb=dmeampAN=113756ampanchor=Prevention-and-Screening
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull 11)
bull httpwwwncbinlmnihgovpubmed21803187
bull 12)
bull httpwwwncbinlmnihgovpubmed21803186
bull 13)
bull httpwwwncbinlmnihgovpubmed21779621
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710
bull 14)
bull httpwwwncbinlmnihgovpubmed18164420
bull 15)
bull httpwwwncbinlmnihgovpubmed21768710