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Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literature.
Adnan, Z, Sabo, E, Kassem, S
Frontiers in endocrinology. 2025;:1505800
Abstract
Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland, typically associated with an indolent course and favourable prognosis. However, although rare, PTC can demonstrate aggressive behaviour, including vascular invasion with extension into major vessels. Intraluminal tumor thrombus involving the great veins, such as the internal jugular vein (IJV), is an uncommon but significant complication. We present the case of a 56-year-old male who was referred to our clinic for evaluation of a right-sided anterior neck mass. Neck ultrasonography revealed a 5.5 x 6.5 cm heterogeneous mass within the right thyroid lobe and a suspected intraluminal thrombus in the right internal jugular vein. Fine-needle aspiration biopsy under ultrasound guidance confirmed the diagnosis of papillary thyroid carcinoma. Subsequent preoperative contrast-enhanced computed tomography (CT) of the neck confirmed the presence of an intraluminal tumours thrombus extending into the right IJV. The patient underwent total thyroidectomy, right modified radical neck dissection, and resection of the involved segment of the IJV. Postoperatively, the patient received radioactive iodine (I-131) ablation therapy. At the one-year follow-up, imaging studies indicated a recurrence of the disease. A review of the literature focusing on vascular involvement in PTC and diagnostic methods for tumours thrombus reveals that, while rare, intraluminal tumor thrombus should be considered in patients with PTC, especially when there is evidence of vascular invasion. Early and accurate preoperative diagnosis using Doppler ultrasonography and/or contrast-enhanced CT is critical for optimal surgical planning and improved prognosis. Given the potential for recurrence, vigilant long-term follow-up is recommended.
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Effects of vitamin D supplementation on TSH and thyroid hormones: A systematic review of randomized controlled trials.
Safari, S, Shojaei-Zarghani, S, Molani-Gol, R, Rafraf, M, Malekian, M
Endocrinologia, diabetes y nutricion. 2025;(1):37-46
Abstract
OBJECTIVE Approximately 200 million people have been diagnosed with thyroid disease worldwide. Associations between thyroid disorders and nutritional factors have been established in former studies. METHODS The Web of Science, PubMed, and Scopus databases and Google Scholar were searched without date restriction until June 2023 by using relevant keywords. All original articles written in English that studied the effects of vitamin D supplementation on TSH and thyroid hormones were eligible for the present review. RESULTS The present review included a total of 16 randomized controlled trials (RCTs) with 1127 participants (intervention group, 630; control group, 497). Based on the findings made, vitamin D supplementation had no significant effects on serum TSH levels in 9 cases (56.2%) reported in the trials. However, TSH levels were elevated in 4 studies (26.6%) and low in 3 (18.7%) cases after vitamin D administration. Four cases reported in 6 RCTs and 4 cases reported in 5 trials indicated no significant effects on thyroxine (T4) and triiodothyronine (T3) levels after vitamin D supplementation, respectively. Moreover, 8 cases of 11 included RCTs reported that vitamin D intake had no significant effects on fT4, and 5 cases of 7 RCTs demonstrated no significant effects on fT3 levels after vitamin D supplementation. CONCLUSION Most findings suggest that vitamin D supplementation had no significant effects on thyroid hormones and more than half indicated no significant effect on TSH levels. Nevertheless, high-quality research is further required to prove these achievements and evaluate vitamin D effects on other markers of thyroid function.
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Reproductive life and differentiated thyroid carcinoma in women: reciprocal influences on their respective outcome.
Costante, G, Kyrilli, A, Poppe, K
Current opinion in oncology. 2025;(1):7-11
Abstract
PURPOSE OF REVIEW To analyze the reciprocal influences between female reproductive life and DTC management. RECENT FINDINGS Data on pregnancy outcome in DTC patients indicate that after conceiving, these women may need an increased L-T4 dose to maintain suppressed serum TSH levels. Nevertheless, this does not determine major harm in terms of pregnancy outcome. Analogously, the most recent findings obtained with the propensity score matching approach have confirmed that pregnancy does not significantly affect DTC clinical course and eventually tumor prognosis. A recent metanalysis and a large case-control study excluded a significant effect of radioactive iodine treatment (RAIT) on several reproductive variables in DTC patients, providing reassuring evidence that the current recommendations on RAIT for women of childbearing age are sufficiently well tolerated and do not affect fertility nor pregnancy rate. Nonetheless, it seems reasonable to recommend special attention for older than 35 years women requiring higher RAIT activities. SUMMARY Overall, the most recent studies have provided sufficiently reassuring evidence that the occurrence of pregnancy and DTC management are of no reciprocal harm for adverse outcome in affected women of childbearing age. Thus, female DTC patients should be managed according to the individual response to treatment before pregnancy. When DTC diagnosis is made after conception, delaying surgery does not represent a harm in most patients.
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An exceptionally rare case of a giant parathyroid adenoma with carcinoma-like presentation.
Kazakou, P, Vrachnis, D, Paschou, SA, Nastos, K, Sarlani, H, Kantreva, K, Stefanaki, K, Psaltopoulou, T, Kyriakopoulos, G, Korkolopoulou, P, et al
Hormones (Athens, Greece). 2025
Abstract
Giant parathyroid adenoma (GPA) is an extremely rare cause of primary hyperparathyroidism (PHPT) and may sometimes mimic parathyroid carcinoma (PC). Parathyroid carcinoma is also a very rare entity. Both preoperative and postoperative diagnosis of the two conditions remains a challenge. The purpose of this article is to present the diagnostic and therapeutic approach used for a 76-year-old female patient with a GPA measuring 5.4 × 2.3 cm, mimicking PC. The patient was referred to our clinic for the management of severe hypercalcemia revealed during the neurological evaluation of psychiatric and cognitive symptoms, confusion, weakness, and bone pain. PHPT was confirmed based on the patient's biochemical profile, which showed extremely high levels of serum calcium and parathyroid hormone (PTH). Wholebody computed tomography revealed a large nodule below the inferior pole of the right lobe of the thyroid gland and no further pathology in other organs. En bloc resection of the tumor with removal of the ipsilateral hemithyroid and other involved tissues was performed. Histopathological evaluation was diagnostic for a GPA. Post-surgery hungry bone syndrome (HBS) developed and was treated. However, the patient succumbed 3 weeks later due to septic shock. GPA is an exceptionally rare endocrine tumor that should be suspected along with PC in patients with significantly elevated levels of PTH and calcium, and/or palpable neck mass. In our case, diagnosis was based principally on histopathological examination together with clinical presentation, biochemical profile, and imaging studies. Resection of the tumor remains the treatment of choice.
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Hypoparathyroidism: Similarities and differences between Western and Eastern countries.
Yang, YY, Deng, YH, Sun, LH, Rejnmark, L, Wang, L, Pietschmann, P, Glüer, CC, A Khan, A, Minisola, S, Liu, JM
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2025
Abstract
BACKGROUD Hypoparathyroidism (hypoPT) is characterized by acute and chronic complications due to insufficient parathyroid hormone (PTH) production or action. Several management guidelines have been developed, but mostly based on evidence from Western countries. Data from Eastern countries have not been systematically compared with those from Western countries. METHODS Literatures regarding to the epidemiology, genetics, risk factors, clinical manifestations and therapies for hypoPT in Easten and Western countries, including China, South Korea, Japan, India, and USA, Canada, Italy, and etc., were searched through PubMed and CNKI. This review was officially endorsed by European Calcified Tissue Society (ECTS) board. RESULTS Postoperative hypoPT is the major form of hypoPT in both Western and Eastern countries. The genetic profiles and clinical features of hypoPT are similar in Eastern and Western countries. The most commonly used medications in Eastern countries are calcium and native vitamin D or active vitamin D analogues, similar to their Western counterparts. While PTH replacement therapy is not available and approved to use in most Eastern countries. CONCLUSION Physicians and surgeons should follow the guidelines on the management of thyroid nodules, taking more care of protecting parathyroid glands during surgery. The cross-talk between East and West in the management of hypoPT should be continued. Direct comparisons of the management strategies in patients with hypoPT between Eastern and Wester countries regarding to the morbidity, mortality, quality of life, optimal dosage, efficacies and side-effects of conventional therapies or newer medications, as well as pharmacogenetics and pharmacoeconomics, would be valuable.
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Food contamination from packaging material with special focus on the Bisphenol-A.
Agarwal, A, Gandhi, S, Tripathi, AD, Gupta, A, Iammarino, M, Sidhu, JK
Critical reviews in biotechnology. 2025;(1):69-79
Abstract
Additives, such as bisphenol A (BPA) that are added to packaging material to enhance functionality may migrate into food products creating a concern for food safety. BPA has been linked to various chronic diseases, such as: diabetes, obesity, prostate cancer, impaired thyroid function, and several other metabolic disorders. To safeguard consumers, BPA migration limits have been defined by regulatory bodies. However, it is important to address the underlying factors and mechanisms so that they can be optimized in order to minimize BPA migration. In this review, we determine the relative importance of the factors, i.e. temperature, contact time, pH, food composition, storage time and temperature, package type, cleaning, and aging, and packaging damage that promote BPA migration in foods. Packaging material seems to be the key source of BPA and the temperature (applied during food production, storage, can sterilization and cleaning processes) was the critical driver influencing BPA migration.
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RNA methylation homeostasis in ocular diseases: All eyes on Me.
Tang, J, Zhou, C, Ye, F, Zuo, S, Zhou, M, Lu, L, Chai, P, Fan, X
Progress in retinal and eye research. 2025;:101335
Abstract
RNA methylation is a pivotal epigenetic modification that adjusts various aspects of RNA biology, including nuclear transport, stability, and the efficiency of translation for specific RNA candidates. The methylation of RNA involves the addition of methyl groups to specific bases and can occur at different sites, resulting in distinct forms, such as N6-methyladenosine (m6A), N1-methyladenosine (m1A), 5-methylcytosine (m5C), and 7-methylguanosine (m7G). Maintaining an optimal equilibrium of RNA methylation is crucial for fundamental cellular activities such as cell survival, proliferation, and migration. The balance of RNA methylation is linked to various pathophysiological conditions, including senescence, cancer development, stress responses, and blood vessel formation, all of which are pivotal for comprehending a spectrum of eye diseases. Recent findings have highlighted the significant role of diverse RNA methylation patterns in ophthalmological conditions such as age-related macular degeneration, diabetic retinopathy, cataracts, glaucoma, uveitis, retinoblastoma, uveal melanoma, thyroid eye disease, and myopia, which are critical for vision health. This thorough review endeavors to dissect the influence of RNA methylation on common and vision-impairing ocular disorders. It explores the nuanced roles that RNA methylation plays in key pathophysiological mechanisms, such as oxidative stress and angiogenesis, which are integral to the onset and progression of these diseases. By synthesizing the latest research, this review offers valuable insights into how RNA methylation could be harnessed for therapeutic interventions in the field of ophthalmology.
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Diagnostic performance of dual-energy computed tomography (DECT) quantitative parameters for detecting metastatic cervical lymph nodes in patients with papillary thyroid cancer: A systematic review and meta-analysis.
Zhang, L, Li, Y, Chen, Z, Dai, X, Gao, H, Chen, Y
European journal of radiology. 2025;:111917
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Abstract
PURPOSE This study systematically evaluated the diagnostic performance of dual-energy computed tomography (DECT) quantitative parameters in detecting cervical lymph node metastasis in patients with papillary thyroid cancer (PTC). METHOD We searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data databases for relevant original studies from database inception to March 2024. The quality of the included studies was evaluated using the QUADAS-2 tool. A bivariate random-effects model was used to calculate the pooled sensitivity and specificity of DECT. The threshold effect was determined by calculating Spearman correlation coefficients, meta-regression and subgroup analysis were performed to evaluate the sources of variability. Publication bias was assessed using the asymmetry of Deek's funnel plot. RESULTS Thirteen studies involving 951 patients (2,782 lymph nodes) were included in this meta-analysis. We analyzed four quantitative parameters of DECT, among which the normalized iodine concentration (NIC) in the arterial phase had the highest area under the receiver operating characteristic curve (AUC). The combined sensitivity, specificity, and AUC were 83 % (95 % confidence interval [CI]: 76 % - 89 %), 90 % (95 % CI: 82 % - 95 %), and 0.92 (95 % CI: 0.90 - 0.94), respectively. The Spearman correlation coefficient was - 0.244 (p = 0.4). Meta-regression and subgroup analysis revealed that use of blinding, mean patients' age, female proportion, presence of Hashimoto's thyroiditis, number of lymph nodes included in the study, and slice thickness were sources of heterogeneity for the NIC in the arterial phase. No significant publication bias was observed among the studies. CONCLUSIONS DECT, a noninvasive technique, can be used to distinguish metastatic from nonmetastatic cervical lymph nodes in patients with PTC by measuring quantitative lymph node parameters.
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Predictive value of thyroglobulin after radioiodine therapy for excellent response to treatment in postoperative thyroid cancer.
Zhu, Y, Yang, X, Liu, Z, Zhang, Q, Li, Z, Hou, X, Zhu, H
Nuclear medicine communications. 2025;(2):146-151
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Abstract
OBJECTIVE This study aimed to assess the usefulness of thyroglobulin (Tg) after radioiodine (RAI) therapy in predicting excellent response (ER) to therapy in postoperative differentiated thyroid cancer (DTC). METHODS A retrospective observational study was conducted on postoperative DTC patients who underwent RAI from August 2018 to December 2022. Various factors were analyzed to predict ER to treatment. This involved Tg under stimulation (sTg) before RAI, Tg immediately (imTg) 112 h post-RAI and imTg/sTg(rTg). Based on the efficacy of RAI, patients were categorized into two groups: ER and non-ER (NER). Univariate logistic analysis was utilized to compare parameters between the two groups, followed by binary logistic regression analysis on factors associated with ER. Receiver operating characteristic (ROC) curves were employed to evaluate the sensitivity, specificity, and optimal diagnostic cutoff points for parameters affecting ER. RESULTS The analysis included 45 ER patients and 56 NER patients. Statistical significance was found in the binary logistic regression analysis for the number of lymph nodes in the lateral cervical region ( P = 0.016), sTg ( P = 0.021), and rTg ( P ≤ 0.001) concerning ER. ROC curve analysis revealed that the rTg area under the curve was 0.845, with an optimal cutoff value of 11.78, sensitivity of 82.6%, and specificity of 74.5%. CONCLUSION Post-RAI therapy, significant value is demonstrated by rTg with high sensitivity and specificity. This provides a foundation for the evaluation and decisions about DTC treatment in advance.
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Resmetirom: The First Food and Drug Administration-Approved Medication for Nonalcoholic Steatohepatitis (NASH).
Guirguis, E, Dougherty, J, Thornby, K, Grace, Y, Mack, K
The Annals of pharmacotherapy. 2025;(2):162-173
Abstract
OBJECTIVE To review the literature leading to the Food and Drug Administration (FDA) approval of the first medication, resmetirom, for the treatment of nonalcoholic steatohepatitis (NASH), including the pharmacology, pharmacokinetics, clinical studies, dosing, and adverse effects. Relevant data will be used to discuss how resmetirom impacts clinical practice. DATA SOURCES A literature search was conducted using MEDLINE from database inception to May 12, 2024. Keywords included non-alcoholic steatohepatitis, nonalcoholic fatty liver disease, and resmetirom. Study selection, data extraction and all English-language studies involving the use of resmetirom for nonalcoholic fatty liver disease (NAFLD)/NASH were included. DATA SYNTHESIS Resmetirom, a thyroid hormone receptor agonist, is administered at daily doses of either 80 mg or 100 mg. The drug was shown to provide NASH resolution as assessed by the NAFLD activity score, 80 mg-24.2%, 100 mg-25.9% compared to 14.2% with the placebo group (P < 0.001). Resmetirom, improved liver fibrosis, 80 mg-25.9%, 100 mg-29.9% compared to 9.7% with the placebo group (P < 0.001). Resmetirom's ability to improve fibrosis in patients with F2-F3 fibrosis offers valuable benefit for patients at risk of progressing to cirrhosis. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE Resmetirom expands the medication options available to treat patients with NASH which can be given alongside other medications to optimize metabolic factors such as glucagon-like peptide-1 and hydroxymethylglutaryl-coenzyme A reductase inhibitors. Resmetirom was well tolerated in studies. CONCLUSION Resmetirom serves as an attractive option in patients diagnosed with NASH with evidence of advanced fibrosis (F2-F3) in combination with exercise, diet, and other multimodal therapies targeting metabolic risk factors.
keywords:"Thyroid Gland" OR (Thyroid AND Gland) OR "Thyroid Gland" OR thyroid