Testing for Afirma in Thyroid Nodules with High-Risk Indeterminate Cytology (TIR3B): First Italian Experience

We described the first Italian experience with Afirma tests in a single Italian institution and assessed the performance of the Afirma test in TIR3B. Moreover, this is a preliminary study to assess the patient response to the offer of Afirma testing. The Afirma test was proposed to 67 patients with thyroid nodules that had yielded TIR3B cytology. Fifty-one patients (76.1%) chose the Afirma test, 25/51 underwent the test but the remaining 26 did not because of cost. A total of 41/67 (61.2%) patients underwent surgery, and 22/41 (53.7%) nodules were carcinomas. Of the 25 tested by Afirma, 9 (36%) were classified as Afirma-suspicious (Afirma-S); seven of them underwent surgery, and in 6/7 (85.7%), a cancer was proven at histology. Afirma is the procedure that many Italian patients with TIR3B lesions would choose. However, its routine clinical application in Italy is currently limited by high costs for the patient. When Afirma is performed in this setting of patients, the cancer risk of suspicious result is higher than that expected in all the series of TIR3B. Therefore, testing for Afirma in these nodules may be useful for managing patients and tailoring their surgical approach.
Source: Endocrine Pathology - Category: Pathology Source Type: research

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ConclusionA large hypervascular mass presenting as a papillary thyroid carcinoma is difficult to discern but with combination of ultrasonography, soft tissue CT and angiography imaging, along with fine needle aspiration, and possible use of MRI would be successful in narrowing down the differential list to the final diagnosis of papillary thyroid carcinoma, supporting the need for punctual surgical intervention.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Authors: Chacón González M, Ibáñez Muñoz A, Rodríguez Vicente L, Ortega Renedo I, Rozanova Klecheva M, Yagüe Hernando A, Lizuaín Abadia ME, Jiménez Del Rio B Abstract The case is presented of 78 year-old who consulted due to decreased visual acuity in right eye for several months. Indirect ophthalmoscopy revealed an orange-yellow coloured choroidal mass at the posterior pole, without retinal detachment. Computed tomography showed a thyroid mass in the isthmus, as well as multiple pulmonary nodules and metastatic foci. The findings of transbronchial lung b...
Source: Archivos de la Sociedad Espanola de Oftalmologia - Category: Opthalmology Tags: Arch Soc Esp Oftalmol Source Type: research
CONCLUSION: TOETVA is an acceptable approach for thyroid carcinoma. Poorly differentiated cancer, as well as extrathyroidal extension, result in patients being unsuitable for TOETVA. It is imperative to identify the circumstances under which conversion to open thyroidectomy must take place. PMID: 31749078 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
ConclusionThis case draws attention to the unique clinical value of molecular testing in the diagnosis of MTC. The authors believe this case supports the consideration for molecular testing to prevent missed diagnoses in cases of rare benign-appearing disease.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
SUMMARY: The use of transoral sonography–guided fine-needle aspiration for intraoperative localization of retropharyngeal masses has been described by Fornage et al. The purpose of this study was to assess the accuracy of this technique. We reviewed the images and medical records of 26 patients with a retropharyngeal lesion suspicious for a metastatic lymph node of Rouviere identified on CT and/or PET/CT. There were 14 patients with a history of thyroid cancer, 7 with mucosal squamous cell carcinoma, 1 with renal cell carcinoma, 1 with parotid acinic cell cancer, 1 with metastatic colon adenocarcinoma, and 2 with no ...
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: HEAD & amp; NECK Source Type: research
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
In conclusion, quantification of cytological features could be used to develop a computer-aided tool for diagnosing PTC in thyroid nodules with indeterminate FNAC results.
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
Authors: Li H, Zhao J, Zhang J, Wang C, Li M, Wu S, Su Z, Pan Q Abstract A total of 15-30% of thyroid nodules that are evaluated by fine-needle aspiration are not clearly determined to be benign or malignant. Gene mutation analysis is recommended for the evaluation of thyroid nodules using clinical guidelines. The detection of circulating tumor DNA (ctDNA) has the potential to aid in the screening, diagnosis and prediction of thyroid cancer prognosis, and can be used when tissues are difficult to obtain. In the present study, whole-exome sequencing (WES) was performed on tumors and matched normal tissues from 10 pa...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
In this study, we summarize AUS/FLUS diagnosed cases from thyroid fine needle aspirations in our center from 2015 to 2017 to explore the impact of BRAF V600E detection on the cytopathological diagnosis of PTC. BRAF V600E detection could significantly reduce the AUS/FLUS diagnosis rates from 11.59 to 8.42% when all BRAF V600E-mutated AUS/FLUS cases were diagnosed as conforming to PTC (20.01 to 19.13% in 2016 and 10.92 to 7.93% in 2017, respectively). The AUS/M rates decreased from 0.67 to 0.64 in 2016 and from 0.33 to 0.23 in 2017. We further discuss a case with a single BRAF V600E cytological mutant lacking a postoperative...
Source: Endocrine Pathology - Category: Pathology Source Type: research
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