Testing for BRAF (V600E) Mutation in Thyroid Nodules with Fine-Needle Aspiration (FNA) Read as Suspicious for Malignancy (Bethesda V, Thy4, TIR4): a Systematic Review and Meta-analysis

AbstractIn patients with thyroid fine-needle aspiration (FNA) report of suspicious for malignancy (SFM), both lobectomy and thyroidectomy might be considered. BRAF mutation analysis could guide towards accurate surgical therapy. The primary outcome was the reliability of BRAF (V600E) in detecting malignancy in nodules with FNA reading of SFM. The secondary outcome was to analyze its positive predictive value (PPV) and negative predictive value (NPV) considering the surgical histology as gold standard. A literature search of online databases was performed in June 2019. BRAF prevalence among thyroid nodules with FNA read as SFM according to the most popular classification systems (i.e., Bethesda V, Thy4, TIR4 category) was searched. The random-effects model was used. Three hundred sixty original articles were identified and 34 were finally included in the study. There were 1428 thyroid nodules with FNA read as SFM and 1287 (90.1%) lesions underwent surgery with a cancer rate 89.6%. The pooled prevalence of BRAF (V600E) mutation among all nodules with SFM cytology was 47% (95% CI = 40 to 54, I2 = 85.5%). Pooled PPV and NPV of BRAF testing were 99% (95% CI, 97 –99) and 24% (95% CI, 16–32), respectively. BRAF (V600E) mutation was found in about one in two nodules with thyroid FNA read as SFM, its PPV to detect cancers was excellent, and its NPV was very poor. The routine BRAF testing in FNA read as SFM cannot be recommended. BRAF (V600E) test may be us eful to extend s...
Source: Endocrine Pathology - Category: Pathology Source Type: research

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In conclusion, the present case is an extremely rare occurrence of simultaneous multiple RDMs from PTC as the initial presentation.
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Conclusion: Patients with type 1 DM should be examined for thyroid diseases, and patients with suspected thyroid disease should be evaluated with a thyroid ultrasound. Type 1 DM and PTC coexistence albeit very rare; It should be known that type 1 diabetes can be seen together with thyroid cancer. PMID: 31686641 [PubMed - as supplied by publisher]
Source: Current Diabetes Reviews - Category: Endocrinology Authors: Tags: Curr Diabetes Rev Source Type: research
Conclusion: Our results suggest that high elasticity of a nodule on elastography is associated with a low risk of thyroid cancer. If further confirmed in other studies, elastography may prove useful as a complementary test for screening thyroid nodules in children.Resumo Objetivo: Avaliar a utilidade da elastografia (usando compress ão manual) como uma ferramenta adicional de diagnóstico em crianças e adolescentes com nódulos da tireoide. Materiais e Métodos: Este foi um estudo prospectivo realizado entre setembro de 2012 e agosto de 2013 em um hospital no Brasil. Realizamos elastografia,...
Source: Radiologia Brasileira - Category: Radiology Source Type: research
CONCLUSION: This case highlights the importance of defining the US characteristics of rare variants of thyroid neoplasms, since an early diagnosis is decisive in defining the patient's prognosis. PMID: 31140157 [PubMed - as supplied by publisher]
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
Conclusion: This case of thyroid bed PG supports the idea that PG reflects a cutaneous phenotype encompassed in the spectrum of systemic neutrophilic diseases. Endocrinologists should be aware that thyroid bed PG involvement is an albeit rare differential diagnosis to consider in patients who had undergone thyroid surgery, especially with a history of PG. Introduction Papillary thyroid carcinoma (PTC), the main variant of differentiated thyroid carcinoma (DTC), is the most common thyroid cancer, accounting for 70–80% of all thyroid carcinomas and occurring predominantly in women, generally with a good prognos...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
In conclusion, despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions and of the necessity of confirmation of their benign character. Elastography is a useful tool to initially differentiate PTC and IET. However, due to the high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and because of the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis and prevents, on one hand, unnecessary frequent diagnostic procedures and/or surgery and, on the other hand, missing ma...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Abstract A more conservative approach to the clinical management of thyroid nodules and differentiated thyroid cancer has recently been proposed by the 2015 ATA guidelines. In this context, fine-needle aspiration biopsy has been reserved for nodules with particular ultrasound features or dimensions that exclude low-risk thyroid lesions. Accordingly, a less aggressive surgical approach (i.e. lobectomy) has been recommended as the first-choice treatment in nodules with indeterminate cytology or in small cytologically confirmed malignant nodules. At the same time, radioactive remnant ablation has been considered only...
Source: ENDOCR REV - Category: Endocrinology Authors: Tags: Rev Endocr Metab Disord Source Type: research
AbstractA more conservative approach to the clinical management of thyroid nodules and differentiated thyroid cancer has recently been proposed by the 2015 ATA guidelines. In this context, fine-needle aspiration biopsy has been reserved for nodules with particular ultrasound features or dimensions that exclude low-risk thyroid lesions. Accordingly, a less aggressive surgical approach (i.e. lobectomy) has been recommended as the first-choice treatment in nodules with indeterminate cytology or in small cytologically confirmed malignant nodules. At the same time, radioactive remnant ablation has been considered only for DTC p...
Source: Reviews in Endocrine and Metabolic Disorders - Category: Endocrinology Source Type: research
Authors: Sitges-Serra A Abstract The prevalence of papillary thyroid cancer (PTC), particularly of low-risk PTC (MACIS
Source: Expert Review of Endocrinology and Metabolism - Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research
ConclusionOccult LNM in the contralateral lateral neck was found in 36.5% of patients. Five or more ipsilateral central LNM may aid in predicting contralateral lateral LNM, and high-risk patients may be more at risk. The clinical benefit of prophylactic contralateral lateral ND remains doubtful, however.
Source: World Journal of Surgery - Category: Surgery Source Type: research
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