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386
M. Sakr
Melanoma: Melanoma has been associated
with thyroid metastases, and autopsy studies
report an incidence of up to 39% [377].
Shimaoka et al., analyzed 2050 consecutive
autopsy reports between 1955 and 1960.
Sixteen (39%) of 41 patients who died of malignant melanoma had metastatic deposits in the
thyroid gland [414]. It is possible that as therapy has improved for this disease, rates may
currently be lower.
Additional case reports: These include pancreatic malignancies, and sarcomas [379, 406,
412, 415, 416]. The majority of these patients
presented with multiple metastases against a
background of aggressive disease and as such
was considered inappropriate for thyroid
surgery.
The third factor that alters prognosis is the
“disease-free interval.” The best outcomes have
been reported in patients with indolent tumors
who present with long disease-free intervals
[417].
Additional factors affecting outcomes are “comorbidities” and “management” in terms of the
ability to perform a complete surgical resection
and the effectiveness of adjuvant therapy for the
tumor type.
13.11 Metastatic Lesions
fromtheThyroid
13.11.1 Overview
Sometimes, thyroid cancer is very large and
starts growing into structures in the neck, such
as the trachea, esophagus, blood vessels, muscles, or nerves. This is considered “locally
advanced” thyroid cancer. Thyroid cancer may
metastasize to LNs, lungs, bone, and occasionally brain. Fortunately, metastases will often
take up iodine at rst. Therefore, RAI may still
be a useful treatment for patients with metastases. It is particularly useful for small lung
metastases that may not be visible by CT scan
but are seen on a RAI scan. Metastatic thyroid
cancer, that is large enough and visible on US or
CT scan, should be surgically removed. This is a
common treatment for LN metastases in the
neck. However, for tumors that either lose the
ability to take up RAI or are not surgically
resectable, new clinical trials are currently
enrolling patients that have metastases (determined by high Tg levels).
13.11.2 Treatment Strategy
ofMetastatic Thyroid Cancer
Metastases may be discovered at the time of initial disease staging or during follow-up. If metastases are found following initial therapy, some
patients may subsequently experience a reduction in tumor burden with additional treatments
that may offer a survival or palliative benet
[418–422]. The preferred hierarchy of treatment
for metastatic disease is surgical excision of locoregional disease in potentially curable patients,
131
I therapy for RAI-responsive disease, EBRT, or
other directed treatment modalities such as thermal ablation, TSH-suppressive thyroid hormone
therapy for patients with stable or slowly progressive asymptomatic disease, and systemic
therapy with kinase inhibitors, especially for
patients with signicantly progressive macroscopic refractory disease.
Localized treatments with thermal (radiofrequency or cryo-) ablation [423], ethanol ablation
[424], or chemo-embolization [425] may be benecial in patients with a single or a few metastases and in those with metastases at high risk of
local complications; the treatments should be
performed in such patients before the initiation of
any systemic treatment. These modalities may
control treated metastases, avoid local complications, and delay initiation of systemic treatment.
Additionally, surgical therapy in selected incurable patients is important to prevent complications in targeted areas, such as the CNS and
central neck compartment. Conversely, conservative intervention with TSH-suppressive thyroid
hormone therapy may be appropriate for selected
patients with stable asymptomatic local metastatic disease and most patients with stable
asymptomatic non-CNS distant metastatic
disease.
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13 Malignant Thyroid Disease
387
13.11.3 Oncological Principles
ofTreatment ofDistant
Metastatic Disease
The overall approach to treatment of distant metastatic thyroid cancer is based upon the following
observations and oncological principles:
– Morbidity and mortality are increased in
patients with distant metastases, but individual
prognosis depends upon factors including histology of the primary tumor, distribution and
number of sites of metastasis (e.g., brain, bone,
lung), tumor burden, age at diagnosis of metastases, and 18 FDG and RAI avidity [426–431].
– Improved survival is associated with responsive-
ness to directed therapy (surgery, EBRT, thermal
ablation, etc) and/or RAI [420, 426–431].
– In the absence of demonstrated survival bene-
t, certain interventions can provide signicant palliation or reduce morbidity [423–434].
– Treatment of a specic metastatic area must
be considered in light of the patient’s performance status and other sites of disease; for
example, 5–20% of patients with distant
metastases die from progressive cervical disease [431, 435].
– Mutation proling of metastatic tumor (to
detect abnormalities in genes such as BRAF,
TERT, RAS, or PAX8/PPARγ) has not yet
denitively proven to be of value for estimating patient prognosis or for predicting
response to treatments. Thus, routine mutation
proling cannot be recommended at this time
outside of research settings.
– There is little if any benet derived from the
treatment of RAI-refractory DTC [436] or
those with RAS mutations [437] with RAI.
13.11.4 Treatment ofPulmonary
Metastases
stability (or lack thereof) of metastatic lesions.
Pulmonary pneumonitis and brosis are rare
complications of high-dose RAI treatment.
Dosimetric approaches to therapy with a limit of
“80 mCi whole-body retention at 48h and 200
cGy to the bone marrow” should be considered in
patients with diffuse
131
I pulmonary uptake [438].
13.11.4.2 Pulmonary Micro-Metastases
Patients with pulmonary micro-metastases
(<2 mm) that are RAI-avid have the highest rates
of complete remission after treatment with
RAI.These patients should be treated with RAI
repeatedly every 6–12months as long as disease
continues to concentrate RAI and respond clinically. In the presence of widespread metastases,
especially when in bone, additional RAI may
temporarily stabilize progression, but it is unlikely
to result in cure. The RAI activity can be given
empirically (100–200 mCi) or determined by
dosimetry The risks of bone marrow suppression
or pulmonary brosis should generate caution
when repeated doses of RAI are being considered.
Absolute neutrophil count and platelet counts are
the usual markers of bone marrow suppression,
and pulmonary function testing including diffusing capacity of the lungs for carbon monoxide can
be markers of pulmonary toxicity.
13.11.4.3 Macro-Nodular Pulmonary
Metastases
If demonstrated to be RAI-avid, macro-nodular
pulmonary metastases may also be treated with
RAI.Number of RAI doses must be individualized based on the disease response to treatment,
age of the patient, and the presence or absence of
other metastatic lesions [47, 426]. Patients with
“solitary” pulmonary WDTC metastasis may be
considered for surgical resection, although the
potential benet weighed against the risk of surgery is unclear.
13.11.4.1 Therapeutic Decision
Key criteria for therapeutic decisions include (1)
size of metastatic lesions (macro-nodular
detected by chest radiography, micro-nodular
detected by CT scan), (2) avidity for RAI and, if
applicable, response to prior RAI therapy, and (3)
t.me/Dr_Mouayyad_AlbtousH
13.11.5 Treatment ofBone
Metastases
Treatment of patients with bone metastases using
RAI is rarely curative, but some patients with
RAI-avid bone metastases may benet from this
388
M. Sakr
therapy [47, 420]. Other focal treatment modalities may include surgery and EBRT. These
patients should also be considered for systemic
therapy with bone-directed agents. The RAI
activity can be given empirically (100–200mCi)
or determined by dosimetry.
13.11.6 Treatment ofBrain
Metastases
Brain metastases typically occur in older patients
with more advanced disease and are associated with
a poor prognosis [439]. Surgical resection and stereotactic EBRT are the mainstays of therapy [439,
440]. There are few data showing efcacy of RAI.
Stereotactic radiation therapy is preferred to
whole-brain radiation because (1) it may prolong
life expectancy, (2) it induces less short- and
long-term toxicities compared with whole-brain
radiation (fatigue, headache, cognitive decline,
and behavioral changes), and (3) it may be effective even in patients with multiple brain lesions.
13.11.7 Prognosis
About 30% of patients with thyroid cancer will
have metastatic cancer, with most having spread
of the cancer to cervical LNs and only 1–4% having spread outside of the neck to other organs
such as the lungs and bone. Most patients with
thyroid cancer have an excellent prognosis, even
if there is spread outside of the neck at the time of
diagnosis. However, death, while rare, occurs
mainly in patients that have spread of the cancer
outside of the neck to other organs.
The lung is the most common site of distant
metastasis (84%). The 5-year survival is about 75%
in patients with single-organ metastasis and 15% in
patients with multi-organ metastases. The average
interval between the rst and second metastases is
15months. Progression from single- to multi-organ
metastases occurs in about 75% of patients at
5years. Multi-organ distant metastases are predictive of poor overall survival as these patients had a
three-fold higher risk of death than patients with
single-organ metastases. An age>45years and an
unstimulated Tg level of >30ng/ml when distant
metastasis was discovered are predictive of the
development of multi- organ metastases.
13.12 Molecular Basis forThyroid
Carcinogenesis
13.12.1 Introduction
Both differentiated and anaplastic thyroid carcinoma arise from the “follicular” cells, while
medullary thyroid carcinoma (MTC) arises from
“para-follicular” C-cells. Differentiated thyroid
carcinoma (DTC) is further classied into PTC
and FTC, while MTC is further classied into
familial (30%) (multi-focal) and sporadic patterns (70%) (uni-focal). Familial MTCs (FMTCs)
usually present as a part of MEN-2A (together
with phaeochromocytoma and parathyroid
hyperplasia) or MEN-2B syndromes (together
with pheochromocytoma and mucosal neuromas
and/or GIT ganglio-neuromas) but can still present as pure FMTC [441, 442].
Thus, familial thyroid carcinomas can be either,
FMTC for which the underlying genetic pattern is
well-established or familial non- medullary thyroid
carcinoma (FNMTC), for which the genetic background is currently emerging. Although considered as rare forms, familial papillary and follicular
carcinomas can be broadly classied into two
groups; a group with extra-thyroid familial pathologies with higher incidence of FNMTC as in case
of familial adenomatous polyposis (FAP), PTENhamartoma tumor syndrome, Carney’s complex
type 1, and Werner’s syndrome. The other group is
characterized by the predominance of the thyroid
malignancy as in pure familial PTC (FPTC), FPTC
with multinodular goiter, FPTC associated with
renal cell carcinoma [441].
13.12.2 Genetic Background
forFMTC
A germ-line point mutation in the RET gene on
chromosome 10q11.2 is responsible for the
hereditary MTC. The RET proto-oncogene has
t.me/Dr_Mouayyad_AlbtousH
13 Malignant Thyroid Disease
389
21 exons distributed over 60kb. Analysis of the
nucleotide sequence revealed that it encodes a
receptor tyrosinekinase with four cadherinrelated repeats and a cysteine-rich region in the
extra-cellular domain. About 85% of all mutations responsible for FMTC are well known. In
the majority of MEN-IIA and FMTC patients,
mutations are clustered in six cysteine residues
(codons 609, 611, 618, and 620in exon 10, and
codons 630 and 634 in exon 11) in the RET
cysteine- rich extracellular domain. These mutations have been detected in about 95% of MENIIA syndrome and 85% of FMTC families.
Somatic RET point mutations have been identied in about 50% of patients with sporadic MTC
[441, 443].
13.12.3 Genetic Background
forFNMTC
A recent review [444] on the genetics of FNMTC
conrmed six potential regions for harboring an
FNMTC gene: MNG1 (14q32), TCO (19p13.2),
FPTC/PRN (1q21), NMTC1 (2q21), FTEN
(8p23.1–p22), and the telomere–telomerase complex. Important genes reported to have been
excluded are RET, TRK, MET, APC, PTEN, and
TSHR.The familial cancer syndromes associated
with NMTC are summarized in Table13.20 and
those with predominance of NMTC are shown in
Table13.21.
13.12.4 Evolving Molecular
Understanding ofSporadic
Cases ofThyroid Carcinoma
Thyroid follicular cell growth requires the effect
of TSH through cAMP pathway and growth factors (e.g., IGF-1) through MAP kinase (MAPK)
and Phosphatidyl-Inositol-3 kinase (PI3K) pathways [446]. In radiation-induced PTC, expression of RET/PTC was reported to be the main
mutation. RET/PTC is a chimeric gene formed
by chromosomal recombination, and the product
retains the tyrosine kinase domain of
RET. Normally, RET is not expressed or
expressed in low quantities in follicular cells.
Recombination occurs with heterologous gene,
either in the form of RET/PTC-1 or RET/PTC-2.
These mutations are present in 66–87% of the
radiation-induced PTC.However, it is not exclusive to this type as it is found in around 40% of
sporadic pediatric PTC and 15–20% of sporadic
adult PTC [288, 289].
Other effectors of the MAPK pathway are also
implicated in the thyroid carcinogenesis including BRAF, the predominant isoform of the serinethreonine kinase (RAF) in thyroid cells [289].
Recent studies reported mutations of BRAF as
the most common mutation in PTC (36–69%).
This mutation was also reported to be associated
with more aggressive behaviors of PTC, as it is
detected in tall cell PTC and anaplastic carcinoma resulting from de-differentiation of PTC
Table 13.20 Familial cancer syndromes associated with NMTC [445]
Incidence of thyroid
Syndrome Inheritance Gene mutation Location
FAP AD APC tumor 5q21 2–12% PTC, cribriform or
Cowden’s
syndrome
Carney’s
complex
Werner’s
syndrome
FA P familial adenomatous polyposis, AD autosomal dominant, AR autosomal recessive, PTEN phophase and tensin,
PTC papillary thyroid cancer, FTC follicular thyroid cancer, ANT anaplastic thyroid carcinoma
AD PTEN-tumor
suppressor gene
AD PRKAR1-x 2p16
AR WRN gene 8p11–p12 10% FTC, PTC, ATC
t.me/Dr_Mouayyad_AlbtousH
10q23.2 >10% FTC, occasional PTC
17q22–24
cancer Type of thyroid cancer
classical variant
4% and 60% FTC and PTC
390
Table 13.21 Familial syndromes with predominance of NMTC [445]
Chromosomal
Tumor type Type of study Inheritance
PTC associated with PRN Kindreds with PTC and
PRN
Familial MNG with PTC Kindreds with PTC and
MNG
FPTC Kindreds with PTC Unknown 2q21 Unknown
Familial TCO without
oxyphilia
PRN familial renal cell neoplasia, MNG multinodular goiter, FPTC Familial papillary thyroid carcinoma, TCO Familial
carcinoma with oxyphilia
Kindreds with TCO AD 19p13.2 Unknown/TCO/
Unknown 1q21 Unknown
AD 14q Unknown
loci Candidates genes
TIMM44
M. Sakr
[289]. Interestingly, studies show no overlap
between the aforementioned mutations (RET/
PTC, BRAF or RAS mutations). Collectively,
these mutations are found in around 70% of PTC
cases [289, 447].
References
1. Cooper DS, Doherty GM, Haugen BR, Kloos RT,
Lee SL, Mandel SJ, etal. Revised American Thyroid
Association management guidelines for patients
with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.
2. Roher HD, Schulte KM.Operative therapie bei thyreoiditis. In: Rothmund M, Harder F, Siewert JR,
editors. Praxis der Viszeralchirurgie: Endokrine
Chirurgie. Berlin Heidelberg NewYork: Springer;
2000. p.199–202.
3. Curado MP, Edwards B, Shin HR, Storm H, Ferlay J,
Heanue M, etal. Cancer incidence in ve continents,
vol. 9. Lyon, France: IARC Scientic Publications,
No. 160, IARC; 2007.
4. Kilfoy BA, Zheng T, Holford T, Han X, Ward MH,
Sjodin A, et al. International patterns and trends
in thyroid cancer incidence, 1973–2002. Cancer
Causes Control. 2009;20(5):525–31.
5. Jemal A, Siegel R, Xu J, Ward E.Cancer statistics,
2010. Cancer J Clin. 2010;60(5):277–300.
6. dal Maso L, Lise M, Zambon P, Falcini F, Crocetti
E, Serraino D, etal. Incidence of thyroid cancer in
Italy, 1991–2005: time trends and age-period-cohort
effects. Ann Oncol. 2011;22(4):957–63.
7. Aschebrook-Kilfoy B, Kaplan EL, Chiu BC,
Angelos P, Grogan RH. The acceleration in papillary thyroid cancer incidence rates is similar among
racial and ethnic groups in the United States. Ann
Surg Oncol. 2013;20(8):2746–53.
8. Enewold L, Zhu K, Ron E, Marrogi AJ, Stojadinovic
A, Peoples GE, et al. Rising thyroid cancer incidence in the United States by demographic and
tumor characteristics, 1980–2005. Cancer Epidemiol
Biomarkers Prev. 2009;18(3):784–91.
9. Kent WDT, Hall SF, Isotalo PA, Houlden RL, George
RL, Groome PA. Increased incidence of differentiated thyroid carcinoma and detection of subclinical
disease. Canad Med Ass J. 2007;177(11):1357–61.
10. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA.
2006;295(18):2164–7.
11. Grodski S, Brown T, Sidhu S, Gill A, Robinson B,
Learoyd D, et al. Increasing incidence of thyroid
cancer is due to increased pathologic detection.
Surgery. 2008;144(6):1038–43.
12. Rego-Iraeta A, P’erez-M’endez LF, Mantinan B,
Garcia-Mayor RV. Time trends for thyroid cancer
in northwestern Spain: true rise in the incidence of
micro and larger forms of papillary thyroid carcinoma. Thyroid. 2009;19(4):333–40.
13. Simard EP, Ward EM, Siegel R, Jemal A. Cancers
with increasing incidence trends in the United
States: 1999 through 2008. Cancer J Clin.
2012;62(2):118–28.
14. Chen AY, Jemal A, Ward EM.Increasing incidence
of differentiated thyroid cancer in the United States,
1988-2005. Cancer. 2009;115(16):3801–7.
15. Aschebrook-Kilfoy A, Ward MH, Sabra MM,
Devesa SS. Thyroid cancer incidence patterns in
the United States by histologic type, 1992–2006.
Thyroid. 2011;21(2):125–34.
16. Smith-Bindman R, Lebda P, Feldstein VA, Sellami
D, Goldstein RB, Brasic N, et al. Risk of thyroid
cancer based on thyroid ultrasound imaging characteristics: results of a population-based study. JAMA
Intern Med. 2013;173(19):1788–96.
17. Cramer JD, Fu P, Harth KC, Margevicius S, Wilhelm
SM. Analysis of the rising incidence of thyroid
cancer using the surveillance, epidemiology and
end results national cancer data registry. Surgery.
2010;148(6):1147–52.
18. Hughes DT, Haymart MR, Miller BS, Gauger PG,
Doherty GM. The most commonly occurring papillary thyroid cancer in the United States is now a
microcarcinoma in a patient older than 45 years.
Thyroid. 2011;21(3):231–6.
t.me/Dr_Mouayyad_AlbtousH
13 Malignant Thyroid Disease
391
19. Udelsman R, Zhang Y.The epidemic of thyroid cancer in the United States: the role of endocrinologists
and ultrasounds. Thyroid. 2014;24(3):472–9.
20. Giordano TJ, Kuick R, Thomas DG, etal. Molecular
classication of papillary thyroid carcinoma: distinct
BRAF, RAS, and RET/PTC mutation-specic gene
expression proles discovered by DNA microarray
analysis. Oncogene. 2005;24:6646–56.
21. Fowler CL, Pokorny WJ, Harberg FJ.Thyroid nodules in children: current prole of a changing disease. South Med J. 1989;82(12):1472–8.
22. Lansford CD, Teknos TN.Evaluation of the thyroid
nodule. Cancer Control. 2006;13(2):89–98.
23. Ross DS.Evaluation and nonsurgical management
of thyroid nodule. Randolph Surgery of the thyroid
and parathyroid glands. Saunders; 2003.
24. Watkinson JC, Gaze MN, Wilson JA. Tumours of
the thyroid and parathyroid gland. Stell and Maran’s
head and neck surgery. 4th ed. Oxford: ButterworthHeinemann; 2000.
25. Walsh RM, Watkinson JC, Franklyn J.The management of the solitary thyroid nodule: a review. Clin
Otolaryngol. 1999;24:388–97.
26. Mazzaferri EL. Current concepts: management of a solitary thyroid nodule. N Engl J Med.
1993;328(8):553–9.
27. Datta RV, Petrelli NJ, Ramzy J.Evaluation and management of incidentally discovered thyroid nodules.
Surg Oncol. 2006;15:33–42.
28. Shaha AR.Controversies in the management of thyroid nodule. Laryngoscope. 1999;110:183–93.
29. Hundahl SA, Fleming ID, Fremgen AM, Mench
HR.A National Cancer Data Base report on 53,856
cases of thyroid carcinoma treated in the US,
1985–1995. Cancer. 1998;83:2638–48.
30. Gilliland FD, Hunt WC, Morris DM, Key
CR. Prognostic factors for thyroid carcinoma: a
population-based study of 15,698 cases from the
surveillance, epidemiology and end results (SEER)
program, 1973–1991. Cancer. 1997;79:564–73.
31. Hughes CJ, Shaha AR, Shah JP, Loree TR.Impact of
lymph node metastasis in differentiated carcinoma
of the thyroid—a matched pair analysis. Head Neck.
1996;18:127–32.
32. Jemal A, Thomas T, Murray M. Cancer statistics.
CA Cancer J Clin. 2002;52(1):23–47.
33. Ashok S, Arthur ES. Surgery of differentiated
Thyroid cancer. In: Arthur ES, Demetrius P, Michel
G, editors. Endocrine surgery. 1st ed. NewYork, NY:
Marcel Dekker, Inc; 2004. p.59–75.
34. Pluijmen MJ, Eustatia-Rutten C, Goslings BM,
Stokkel MP, Arias AM, Diamant M, etal. Effects of
low-iodide diet on postsurgical radioiodide ablation
therapy in patients with differentiated thyroid carcinoma. Clin Endocrinol. 2003;58:428–35.
35. Park HM, Park YA, Jhow XH.Detection of thyroid
remnant/metastases with stunning—an ongoing
dilemma. Thyroid. 1997;7:277–80.
36. Vini L, Harmer C.Radioiodine treatment for differentiated thyroid cancer. J Clin Oncol. 2000;12:365–72.
37. Mazzaferri EL, Jhiang SM.Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994;97:418–28.
38. Sawka AM, Thephamongkhol K, Brouwers M, etal.
Clinical review 170: a systematic review and metaanalysis of the effectiveness of radioactive iodine
remnant ablation for well-differentiated thyroid cancer. J Clin Endocrinol Metab. 2004;89:3668–76.
39. Giuffrida D, Gharib H.Controversies in the management of cold, hot and occult thyroid nodules. Am J
Med. 1995;99:642–50.
40. Mazzaferri EL.An overview of the management of
papillary and follicular thyroid carcinoma. Thyroid.
1999;9:421–7.
41. Bal C, Padhy AK, Jana S, Pant GS, Basu
AK.Prospective randomized clinical trial to evaluate the optimal dose of 131I for remnant ablation
in patients with differentiated thyroid carcinoma.
Cancer. 1996;77:2574–80.
42. Haq MS, McCready RV, Harmer CL.Treatment of
advanced differentiated thyroid carcinoma with high
activity radioiodine therapy. Nucl Med Commun.
2004;25:799–805.
43. van Heerden JA, Hay ID, Goellner RJ, et al.
Follicular thyroid carcinoma with capsular invasion alone: a non threatening malignancy. Surgery.
1992;112:1130–6.
44. Reiners C, Farahati J.I
131
therapy of thyroid cancer
patients. Q J Nucl Med. 1999;43:324–35.
45. Roos DE, Smith JG.Randomized trials on radioactive iodine ablation of thyroid remnants for thyroid
carcinoma—a critique. Int J Radiat Oncol Biol Phys.
1999;44:493–5.
46. Cailleux AF, Baudin E, Travagli JP, Ricard M,
Schlumberger M. Is diagnostic iodine-131 scanning useful after total thyroid ablation for differentiated thyroid cancer? J Clin Endocrinol Metab.
2000;85:175–8.
47. Schlumberger M, De Vathaire F, Ceccarelli C,
Delisle MJ, Francese C, Couette JE, etal. Exposure
to radioactive iodine-131 for scintigraphy or therapy does not preclude pregnancy in thyroid cancer
patients. J Nucl Med. 1996;37:606–12.
48. Fatourechi V, Hay ID, Mullan BP, Wiseman GA,
Eghbali-Fatourechi GZ, Thorson LM, et al. Are
post therapy radioiodine scans informative and
do they inuence subsequent therapy of patients
with differentiated thyroid cancer? Thyroid.
2000;10:573–7.
49. Pacini F, Ladenson PW, Schlumberger M, Driedger
A, Luster M, Kloos RT, etal. Radioiodine ablation
of thyroid remnants after preparation with recombinant human thyrotropin in differentiated thyroid
carcinoma: results of an international, randomized, controlled study. J Clin Endocrinol Metab.
2006;91:926–32.
50. Maxon HR, Smith HS.Radioiodine-131in the diagnosis and treatment of metastatic well differentiated thyroid cancer. Endocrinol Metab Clin N Am.
1990;19:685–718.
t.me/Dr_Mouayyad_AlbtousH
392
M. Sakr
51. Brown AP, Greening WP, McCready VR, Shaw HJ,
Harmer CL. Radioiodine treatment of metastatic
thyroid carcinoma: the Royal Marsden Hospital
experience. Br J Radiol. 1984;57:323–7.
52. Bal C, Kumar A, Tripathi M, Phom H, Murali NR,
Chandra P, et al. High-dose radioiodine treatment
for differentiated thyroid carcinoma is not associated with change in female fertility or any genetic
risk to the offspring. Int J Radiat Oncol Biol Phys.
2005;63:449–55.
53. Tubiana M, Haddad E, Schlumberger M, Hill
C, Rougier P, Sarrazin D. External radiotherapy in thyroid cancers. Cancer. 1985;55(Suppl.
9):2062–71.
54. Szubin L, Kacker A, Kakani R, Komisar A, Blaugrund
S.The management of post-thyroidectomy hypocalcemia. Ear Nose Throat J. 1996;75(612–4):616.
55. Chia SH, Weisman RA, Tieu D, Kelly C, Dillmann
WH, Orloff LA.Prospective study of perioperative
factors predicting hypocalcemia after thyroid and
parathyroid surgery. Arch Otolaryngol Head Neck
Surg. 2006;132:41–5.
56. Thakker RV. Hypocalcemia: pathogenesis, differential diagnosis and management. In: Favus MJ, editor.
Primer on the metabolic bone diseases and disorders
of mineral metabolism. 5th ed. Washington, DC:
American Society of Bone and Mineral Research;
2003. p.271–4.
57. Biondi B, Filetti S, Schlumberger M. Thyroidhormone therapy and thyroid cancer: a reassessment.
Nat Clin Pract Endocrinol Metab. 2005;1:32–40.
58. Demers LM, Spencer CA. Laboratory medicine
practice guidelines: laboratory support for the
diagnosis and monitoring of thyroid disease. Clin
Endocrinol. 2003;58(2):138–40.
59. Spencer CA, Bergoglio LM, Kazarosyan M, Fatemi
S, LoPresti JS. Clinical impact of thyroglobulin
(Tg) and Tg autoantibody method differences on
the management of patients with differentiated
thyroid carcinomas. J Clin Endocrinol Metab.
2005;90:5566–75.
60. Schlumberger MJ. Papillary and follicular thyroid
carcinoma. N Engl J Med. 1998;338:297–306.
61. Haq M, Harmer C. Non-surgical management
of thyroid cancer. In: Mazzaferri EL, Harmer C,
Mallick UK, Kendall-Taylor P, editors. Practical
management of thyroid cancer: a multidisciplinary
approach. London: Springer; 2006. p.171–91.
62. Harmer CL, McCready VR. Thyroid cancer:
differentiated carcinoma. Cancer Treat Rev.
1996;22:161–77.
63. Singh S, Singh A, Khanna AK. Thyroid
Incidentaloma. Indian J Surg Oncol.
2012;3(3):173–81.
64. Comisky M.Specialist palliative care for anaplastic thyroid carcinoma. In: Mazzaferri EL, Harmer
C, Mallick UK, Kendall-Taylor P, editors. Practical
management of thyroid cancer: a multidisciplinary
approach. London: Springer; 2006. p.411–9.
65. Schlumberger MJ. Papillary and follicular thyroid
carcinoma. N Engl J Med. 1998;338:296–7.
66. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray
T, etal. Cancer statistics, 2008. CA Cancer J Clin.
2008;58(2):71–96.
67. Goldgar DE, Easton DF, Cannon-Albright LA,
Skolnick MH.Systematic population-based assessment of cancer risk in rst-degree relatives of cancer
probands. J Natl Cancer Inst. 1994;86(21):1600–8.
68. Musholt TJ, Musholt PB, Petrich T, Oetting G,
Knapp WH, Klempnauer J.Familial papillary thyroid carcinoma: genetics, criteria for diagnosis, clinical features, and surgical treatment. World J Surg.
2000;24(11):1409–17.
69. Sherman SI, Angelos P, Ball DW, Beenken SW, Byrd
D, Clark OH, etal. Thyroid carcinoma: clinical practice guidelines. JNCCN. 2005;3(3):404–57.
70. Hemminki K, Eng C, Chen B.Familial risks for nonmedullary thyroid cancer. J Clin Endocrinol Metab.
2005;90(10):5747–53.
71. Ron E. Ionizing radiation and cancer risk:
evidence from epidemiology. Radiat Res.
1998;150(5):30–41.
72. Preston-Martin S, Franceschi S, Ron E, Negri
E. Thyroid cancer pooledanalysis from 14 casecontrol studies: what have we learned? Cancer
Cause Control. 2003;14(8):787–9.
73. Feldt-Rasmussen U. Iodine and cancer. Thyroid.
2001;11(5):483–6.
74. Ott RA, McCall AR, McHenry C, Jarosz H, Armin
A, Lawrence AM, etal. The incidence of thyroid
carcinoma in Hashimoto’s thyroiditis. Am Surg.
1987;53(8):442–5.
75. Singh B, Shaha AR, Trivedi H, Carew JF, Poluri
A, Shah JP. Coexistent Hashimoto’s thyroiditis
with papillary thyroid carcinoma: impact on presentation, management, and outcome. Surgery.
1999;126(6):1070–6.
76. Farbota LM, Calandra DB, Lawrence AM, Paloyan
E. Thyroid carcinoma in Graves’ disease. Surgery.
1985;98:1148–52.
77. Carcangiu ML, Zampi G, Pupi A, Castagnoli A, Rosai
J.Papillary carcinoma of the thyroid. A clinicopathologic study of 241 cases treated at the University of
Florence, Italy. Cancer. 1985;55:805–28.
78. Rosai J, Carcangiu ML, Delellis RA. Tumours of
the thyroid gland. In: Atlas of tumour pathology,
3rd series. Armed forces of Institute of Pathology.
Washington, DC: John Wiley & Sons, Ltd; 1992.
p.243.
79. Chan JK, Saw D. The grooved nucleus. A useful
diagnostic criterion of papillary carcinoma of the
thyroid. Am J Surg Pathol. 1986;10:672–9.
80. Deligeorgi-Politi H. Nuclear crease as a cytodiagnostic feature of papillary thyroid carcinoma in
ne-needle aspiration biopsies. Diagn Cytopathol.
1987;3:307–10.
81. Scopa CD, Melachrinou M, Saradopoulou C, Merino
MJ.The signicance of the grooved nucleus in thyroid lesions. Mod Pathol. 1993;6:691–4.
82. Gray A, Doniach I. Morphology of the nuclei of
papillary carcinoma of the thyroid. Br J Cancer.
1969;23(1):49–51.
t.me/Dr_Mouayyad_AlbtousH
13 Malignant Thyroid Disease
393
83. Johannessen JV, Gould VE, Jao W. The ne
structure of human thyroid cancer. Hum Pathol.
1978;9(4):385–400.
84. Lee TK, Myers RT, Marshall RB, Bond MG, Kardon
B. The signicance of mitotic rate: a retrospective study of 127 thyroid carcinomas. Hum Pathol.
1985;16(10):1042–6.
85. Patchefsky AS, Hoch WS. Psammoma bodies in diffuse toxic goiter. Am J Clin Pathol.
1972;57(5):551–6.
86. Chan JK, Tse CC.Mucin production in metastatic
papillary carcinoma of the thyroid. Hum Pathol.
1988;19(2):195–200.
87. Johannessen JV, Sobrinho-Simoes M. The origin
and signicance of thyroid psammoma bodies. Lab
Investig. 1980;43(3):287–96.
88. Selzer G, Kahn LB, Albertyn L. Primary malignant
tumors of the thyroid gland: a clinicopathologic
study of 254 cases. Cancer. 1977;40(4):1501–10.
89. Katoh R, Sasaki J, Kurihara H, Suzuki K, Iida Y,
Kawaoi A.Multiple thyroid involvement (intraglandular metastasis) in papillary thyroid carcinoma. A
clinicopathologic study of 105 consecutive patients.
Cancer. 1992;70(6):1585–90.
90. Russell WO, Ibanez ML, Clark RL, White
EC. Thyroid carcinoma. Classication,
Intraglandular dissemination, and
Clinicopathological study based upon whole organ
sections of 80 glands. Cancer. 1963;16:1425–60.
91. LiVolsi VA. Surgical pathology of the thyroid. In:
Bennington JL, editor. Major problems in pathology, vol. 22. Philadelphia: WB Saunders Co; 1990.
p.136–72.
92. Rosai J, LiVolsi VA, Sobrinho-Simões M, Williams
ED.Renaming papillary microcarcinoma of the thyroid gland: the Porto proposal. Intl J Surg Pathol.
2003;11:249–51.
93. Scopa CD, Petrohilos J, Spiliotis J, Melachrinou
M.Autopsy ndings in clinically normal thyroids. A
study in a southwestern Greek population. Int J Surg
Pathol. 1993;1:25–32.
94. Vickery AL, Carcangiu ML, Johannessen LV,
Sobrinho-Simões M. Papillary carcinoma. Sem
Diagn Pathol. 1985;2:90–100.
95. Harach HR, Franssila KO, Wasenius VW. Occult
papillary carcinoma of the thyroid: a “normal” nding in Finland. A systematic autopsy study. Cancer.
1985;56:531–8.
96. Chem KT, Rosai J.Follicular variant of thyroid papillary carcinoma: a clinicopathologic study of six
cases. Am J Surg Pathol. 1977;1(2):123–30.
97. LiVolsi VA. Papillary neoplasms of the thyroid.
Pathologic and prognostic features. Am J Clin
Pathol. 1992;97:426–34.
98. Sobrinho-Simões M, Soares J, Carneiro F, Limbert
E.Diffuse follicular variant of papillary carcinoma
of the thyroid: report of eight cases of a distinct
aggressive type of thyroid tumor. Surg Pathol.
1990;3:189–203.
99. Albores-Saavedra J, Gould E, Vardaman C, Vuitch
F. The macrofollicular variant of papillary thyroid carcinoma: a study of 17 cases. Hum Pathol.
1991;22:1195–205.
100. Johnson TL, Lloyd RV, Thompson NW, Beierwaltes
WH, Sisson JC.Prognostic implications of the tall
cell variant of papillary thyroid carcinoma. Am J
Surg Pathol. 1988;12:22–7.
101. Sobrinho-Simões M, Nesland JM, Johannessen
JV. Columnar-cell carcinoma. Another variant of
poorly differentiated carcinoma of the thyroid. Am
J Clin Pathol. 1988;89:264–7.
102. Wenig BM, Thompson LDR, Adair CF, Shmookler
B, Heffess CS. Thyroid papillary carcinoma of
columnar cell type. A clinicopathologic study of 16
cases. Cancer. 1998;82:740–53.
103. Sobrinho-Simoes M, Sambade C, Nesland JM,
Johannessen JV.Tall cell papillary carcinoma. Am J
Surg Pathol. 1989;13(1):79–80.
104. Chan JK, Tsui MS, Tse CH.Diffuse sclerosing variant of papillary carcinoma of the thyroid: a histological and immunohistochemical study of three cases.
Histopathology. 1987;11(2):191–201.
105. Santoro M, Thomas GA, Vecchio G, Williams GH,
Fusco A, Chiappetta G, etal. Gene rearrangement
and Chernobyl related thyroid cancers. Br J Cancer.
2000;82(2):315–22.
106. Nishiyama RH.Overview of surgical pathology of
the thyroid gland. World J Surg. 2000;24:898–906.
107. Baloch ZW, LiVolsi VA.Newly described tumors of
the thyroid. Curr Diagn Pathol. 2000;6:151–64.
108. Bi J, Lu B. Advances in the diagnosis and management of thyroid neoplasms. Curr Opin Oncol.
2000;12:54–9.
109. Dina ME, Cord S. Papillary Thyroid carcinoma.
In: Shane YM, Alan PBD, Martha AZ, editors.
Endocrine surgery. New York, Chicago, San
Francisco, Lisbon, London, Madrid: McGraw-Hill;
2010. p.47–64.
110. Shoup M, Stojadinovic A, Nissan A, Ghossein RA,
Freedman S, Brennan MF, etal. Prognostic indicators of outcomes in patients with distant metastases
from differentiated thyroid carcinoma. J Am Coll
Surg. 2003;197(2):191–7.
111. Passler C, Prager G, Scheuba C, Niederle BE,
Kaserer K, Zettinig G, et al. Follicular variant of
papillary thyroid carcinoma: a long-term follow-up.
Arch Surg. 2003;138(12):1362–6.
112. Shaha AR, Shah JP, Loree TR.Patterns of failure in
differentiated carcinoma of the thyroid based on risk
groups. Head Neck. 1998;20(1):26–30.
113. DeGroot LJ, Kaplan EL, McCormick M, Straus
FH. Natural history, treatment, and course of papillary thyroid carcinoma. J Clin Endocrinol Metab.
1990;71(2):414–24.
114. Hay ID, Grant CS, van Heerden JA, Goellner
JR, Ebersold JR, Bergstralh EJ. Papillary thyroid
microcarcinoma: a study of 535 cases observed in a
50-year period. Surgery. 1992;112(6):1139–46.
t.me/Dr_Mouayyad_AlbtousH
394
M. Sakr
115. Noguchi S, Yamashita H, Murakami N, Nakayama
I, Toda M, Kawamoto H. Small carcinomas of the
thyroid. A long-term follow-up of 867 patients. Arch
Surg. 1996;131(2):187–91.
116. Baudin E, Travagli JP, Ropers J, Mancusi F, BrunoBossio G, Caillou B, et al. Microcarcinoma of the
thyroid gland: the Gustave-Roussy institute experience. Cancer. 1998;83(3):553–9.
117. Wada N, Duh QY, Sugino K, Iwasaki H, Kameyama
K, Mimura T, et al. Lymph node metastasis from
259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and
optimal strategy for neck dissection. Ann Surg.
2003;237(3):399–407.
118. Shaha AR.Management of the neck in thyroid cancer. Otolaryngol Clin N Am. 1998;31(5):823–31.
119. Grebe SK, Hay ID.Thyroid cancer nodal metastases: biologic signicance and therapeutic considerations. Surg Oncol Clin N Am. 1996;5(1):43–63.
120. Rosenbaum MA, McHenry CR.Contemporary management of papillary carcinoma of the thyroid gland.
Expert Rev Anticancer Ther. 2009;9(3):317–29.
121. King AD, Ahuja AT, To EW, Metreweli C.Staging
papillary carcinoma of the thyroid: magnetic resonance imaging resonance imaging vs. ultrasound of
the neck. Clin Radiol. 2000;55(3):222–6.
122. Lang W, Borrusch H, Bauer L. Occult carcinomas
of the thyroid. Evaluation of 1,020 sequential autopsies. Am J Clin Pathol. 1988;90(1):72–6.
123. Som PM, Brandwein M, Lidov M, Lawson W, Biller
HF. The varied presentations of papillary thyroid
carcinoma cervical nodal disease: CT and MR ndings. AJNR Am J Neuroradiol. 1994;15(6):1123–8.
124. Beahrs O, Kiernan P, Hubert JJ. Cancer of theThyroid gland. In: Suen J, Myers E, editors. Cancer
of the head and neck. New York, NY: Churchill
Livingstone; 1981. p.599–632.
125. Ahuja A, Ng CF, King W, Metreweli C.Solitary cystic nodal metastasis from occult papillary carcinoma
of the thyroid mimicking a branchial cyst: a potential
pitfall. Clin Radiol. 1998;53(1):61–3.
126. Ahuja AT, Chow L, Chick W, King W, Metreweli
C.Metastatic cervical nodes in papillary carcinoma
of the thyroid: ultrasound and histological correlation. Clin Radiol. 1995;50(4):229–31.
127. Verge J, Guixa J, Alejo M, Basas C, Quer X, De
Castro J, et al. Cervical cystic lymph node metastasis as rst manifestation of occult papillary thyroid carcinoma: report of seven cases. Head Neck.
1999;21(4):370–4.
128. Fuchshuber P, Loree TR, DeLacure MD, Hicks
WL Jr. Differentiated thyroid carcinoma: risk
group assignment and management controversies.
Oncology. 1998;12(1):99–106.
129. Schlumberger M, De Vathaire F, Travagli JP, Vassal
G, Lemerle J, Parmentier C, et al. Differentiated
thyroid carcinoma in childhood: long term follow- up of 72 patients. J Clin Endocrinol Metab.
1987;65(6):1088–94.
130. Sivanandan R, Soo KC. Pattern of cervical lymph
node metastases from papillary carcinoma of the
thyroid. Br J Surg. 2001;88(9):1241–4.
131. Machens A, Hinze R, Thomusch O, Dralle H.Pattern
of nodal metastasis for primary and reoperative thyroid cancer. World J Surg. 2002;26(1):22–8.
132. Sellers M, Beenken S, Blankenship A, Soong
SJ, Turbat-Herrera E, Urist M, et al. Prognostic
signicance of cervical lymph node metastases in differentiated thyroid cancer. Am J Surg.
1992;164(6):578–81.
133. Shaha AR, Shah JP, Loree TR.Patterns of nodal and
distant metastasis based on histologic varieties in
differentiated carcinoma of the thyroid. Am J Surg.
1996;172(6):692–4.
134. Suen JY, Goepfert H. Standardization of neck
dissection nomenclature. Head Neck Surg.
1987;10(2):75–7.
135. Robbins KT, Shaha AR, Medina JE, Califano JA,
Wolf GT, Ferlito A, et al. Consensus statement on
the classication and terminology of neck dissection. Arch Otolaryngol. 2008;134(5):536–8.
136. Ducci M, Appetecchia M, Marzetti M.Neck dissection for surgical treatment of lymphnode metastasis
in papillary thyroid carcinoma. J Exp Clin Cancer
Res. 1997;16(3):333–5.
137. Coatesworth AP, MacLennan K.Cervical metastasis
in papillary carcinoma of the thyroid: a histopathological study. Int J Clin Pract. 2002;56(4):241–2.
138. Pingpank JF Jr, Sasson AR, Hanlon AL, Friedman
CD, Ridge JA. Tumor above the spinal accessory
nerve in papillary thyroid cancer that involves
lateral neck nodes: a common occurrence. Arch
Otolaryngol. 2002;128(11):1275–8.
139. Machens A, Holzhausen HJ, Dralle H.Skip metastases in thyroid cancer leaping the central lymph node
compartment. Arch Surg. 2004;139(1):43–5.
140. Zaydfudim V, Feurer ID, Grifn MR, Phay JE.The
impact of lymph node involvement on survival in
patients with papillary and follicular thyroid carcinoma. Surgery. 2008;144(6):1070–7.
141. McHenry CR, Rosen IB, Walsh PG. Prospective
management of nodal metastases in differentiated
thyroid cancer. Am J Surg. 1991;162(4):353–6.
142. Scheumann GF, Gimm O, Wegener G, Hundeshagen
H, Dralle H. Prognostic signicance and surgical
management of locoregional lymph node metastases in papillary thyroid cancer. World J Surg.
1994;18(4):559–67.
143. Noguchi S, Murakami N, Kawamoto H.Classication
of papillary cancer of the thyroid based on prognosis. World J Surg. 1994;18(4):552–7.
144. Mazzaferi EL. Thyroid carcinoma: papillary and
follicular. In: Mazzaferi EL, Samaan N, editors.
Endocrine tumours. Cambridge, MA: Blackwell
Scientic; 1993. p.278–333.
145. Noguchi S, Murakami N, Yamashita H, Toda M,
Kawamoto H.Papillary thyroid carcinoma: modied
radical neck dissection improves prognosis. Arch
Surg. 1998;133(3):276–80.
t.me/Dr_Mouayyad_AlbtousH
13 Malignant Thyroid Disease
395
146. Noguchi S, Noguchi A, Murakami N. Papillary
carcinoma of the thyroid. II.Value of prophylactic
lymph node excision. Cancer. 1970;26(5):1061–4.
147. Noguchi S, Murakami N.The value of lymph-node
dissection in patients with differentiated thyroid cancer. Surg Clin N Am. 1987;67(2):251–61.
148. McConahey WM, Hay ID, Woolner LB, van Heerden
JA, Taylor WF.Papillary thyroid cancer treated at the
Mayo Clinic, 1946 through 1970: initial manifestations, pathologic ndings, therapy, and outcome.
Mayo Clin Proc. 1986;61(12):978–96.
149. Shah JP, Loree TR, Dharker D, Strong EW, Begg
C, Vlamis V. Prognostic factors in differentiated carcinoma of the thyroid gland. Am J Surg.
1992;164(6):658–61.
150. Cunningham MP, Duda RB, Recant W, Chmiel
JS, Sylvester JA, Fremgen A. Survival discriminants for differentiated thyroid cancer. Am J Surg.
1990;160:344–7.
151. Rossi RL, Cady B, Silverman ML, Wool MS,
Horner TA. Current results of conservative surgery
for differentiated thyroid carcinoma. World J Surg.
1986;10(4):612–22.
152. Yamashita H, Noguchi S, Murakami N, Kawamoto
H, Watanabe S. Extracapsular invasion of lymph
node metastasis is an indicator of distant metastasis
and poor prognosis in patients with thyroid papillary
carcinoma. Cancer. 1997;80(12):2268–72.
153. McWilliams RR, Giannini C, Hay ID, Atkinson
JL, Stafford SL, Buckner JC.Management of brain
metastases from thyroid carcinoma: a study of
16 pathologically conrmed cases over 25 years.
Cancer. 2003;98(2):356–62.
154. Hoie J, Stenwig AE, Kullmann G, Lindegaard
M.Distant metastases in papillary thyroid cancer. A
review of 91 patients. Cancer. 1988;61(1):1–6.
155. Lin JD, Chao TC, Chou SC, Hsueh C. Papillary
thyroid carcinomas with lung metastases. Thyroid.
2004;14(12):1091–6.
156. Schmitz-Winnenthal FH, Weckauf H, Hinz U,
Z’graggen K, Klar E, Buchler MW, et al. Detection
and prognostic relevance of cytokeratin 20in differentiated and anaplastic thyroid carcinoma by
RT-PCR.Surgery. 2003;134(6):964–72.
157. Watkinson JC, Gaze MN, Wilson JA. Metastatic
neck disease. In: Watkinson JC, Gaze MN, Wilson
JA, editors. Stell & Maran’s head and neck surgery.
4th ed. Oxford, Auckland, Boston, Johannesburg,
Melbourne, New Delhi: Butterworth Heinemann;
2000. p.201–32.
158. Sako K, Pradier RN, Marchetta FC, Pickren
JW. Fallibility of palpation in the diagnosis of
metastases to cervical nodes. Surg Gynecol Obstet.
1964;118:989–90.
159. Hao SP, Ng SH.Magnetic resonance imaging versus
clinical palpation in evaluating cervical metastasis
from head and neck cancer. Otolaryngol Head Neck.
2000;123(3):324–7.
160. Merritt RM, Williams MF, James TH, Porubsky
ES. Detection of cervical metastasis. A meta-
analysis comparing computed tomography
with physical examination. Arch Otolaryngol.
1997;123(2):149–52.
161. Hegedus L.Thyroid ultrasound. Endocrinol Metab
Clin N Am. 2004;30:339–60.
162. Papini E, Guglielmi R, Bianchini A, Crescenzi A,
Taccogna S, Nardi F, etal. Risk of malignancy in
non-palpable thyroid nodules: predictive value
of ultrasound and color-Doppler features. J Clin
Endocrinol Metab. 2002;87(5):1941–6.
163. Fish SA, Langer JE, Mandel SJ.Sonographic imaging of thyroid nodules and cervical lymph nodes.
Endocrinol Metab Clin N Am. 2008;37(2):401–17.
164. Cantisani V, Catania A, De Antoni E, Greco R,
Caruso R, Di Segni M, et al. Is pattern III as evidenced by US color-Doppler useful in predicting
thyroid nodule malignancy? Large-scale retrospective analysis. Clin Ter. 2010;161(2):e49–52.
165. Marchal G, Oyen R, Verschakelen J, Gelin J, Baert
AL, Stessens RC.Sonographic appearance of normal
lymph nodes. J Ultrasound Med. 1985;4(8):417–9.
166. Ying M, Ahuja A. Sonography of neck lymph
nodes. Part I: Normal lymph nodes. Clin Radiol.
2003;58(5):351–8.
167. Ahuja A, Ying M. Sonography of neck lymph
nodes. Part II: Abnormal lymph nodes. Clin Radiol.
2003;58(5):359–66.
168. Frates MC, Benson CB, Charboneau JW, et al.
Management of thyroid nodules detected at US:
Society of Radiologists in ultrasound consensus conference statement. Radiology. 2005;237(3):794–800.
169. Grifth JF, Chan AC, Ahuja AT, Leung SF, Chow LT,
Chung SC, etal. Neck ultrasound in staging squamous oesophageal carcinoma—a high yield technique. Clin Radiol. 2000;55(9):696–701.
170. Asteria C, Giovanardi A, Pizzocaro A, et al.
USelastography in the differential diagnosis of
benign and malignant thyroid nodules. Thyroid.
2008;18:523–31.
171. Tranquart F, Bleuzen A, Pierre-Renoult P, Chabrolle
C, Sam Giao M, Lecomte P. Elastosonography
of thyroid lesions (article in French). J Radiol.
2008;89:35–9.
172. Rago T, Santini F, Scutari M, Pinchera A, Vitti
P. Elastography: new developments in ultrasound
for predicting malignancy in thyroid nodules. J Clin
Endocrinol Metab. 2007;92:2917–22.
173. Som PM.Detection of metastasis in cervical lymph
nodes: CT and MR criteria and differential diagnosis. Am J Roentgenol. 1992;158(5):961–9.
174. Close LG, Merkel M, Vuitch MF, Reisch J, Schaefer
SD. Computed tomographic evaluation of regional
lymph node involvement in cancer of the oral cavity and oropharynx. Head Neck. 1989;11(4):309–17.
175. Dooms GC, Hricak H, Crooks LE, Higgins
CB. Magnetic resonance imaging of the
lymph nodes: comparison with CT. Radiology.
1984;153(3):719–28.
176. Friedman M, Shelton VK, Mafee M, Bellity P,
Grybauskas V, Skolnik E.Metastatic neck disease.
t.me/Dr_Mouayyad_AlbtousH
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