Thyroid cancer and other thyroid disorders:
Gespeichert in:
Format: | Buch |
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Sprache: | English |
Veröffentlicht: |
Philadelphia, Pa.
Elsevier
2014
|
Schriftenreihe: | Endocrinology and metabolism clinics of North America
43,2 |
Online-Zugang: | Inhaltsverzeichnis |
Beschreibung: | XVIII S., S. 331 - 645 Ill., graph. Darst. |
ISBN: | 9780323299190 |
Internformat
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245 | 1 | 0 | |a Thyroid cancer and other thyroid disorders |c ed. Kenneth D. Burman ; Jacqueline Jonklaas |
264 | 1 | |a Philadelphia, Pa. |b Elsevier |c 2014 | |
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Datensatz im Suchindex
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adam_text | Titel: Thyroid cancer and other thyroid disorders
Autor: Burman, Kenneth D
Jahr: 2014
Contents
Foreword: Thyroid Cancer and Other Thyroid Disorders
Derek LeRoith
Preface: Thyroid Cancer and Other Thyroid Disorders
Kenneth D. Burman and Jacqueline Jonklaas
How to Manage Patients with Differentiated Thyroid Cancer and a Rising Serum
Thyroglobulin Level
Rossella Elisei, Laura Agate, David Viola, Antonio Matrone, Agnese Biagini,
and Eleonora Molinaro
Serum thyroglobulin (sTg) is the marker for monitoring persistence/recur-
rence of differentiated thyroid cancer, in patients without sTg antibodies.
Patients with undetectable basal sTg or peak sTg 2 ng/mL are cured
with low risk to recur. Newly detectable level of sTg indicates the recur-
rence. The significance of increasing sTg in patients treated with emithyr-
oidectomy or total-thyroidectomy but not ablated with radioiodine is
undefined. A doubling time 1 year may be a poor prognostic factor, but
this is more relevant in cases with high levels of sTg. Because of its sensi-
tivity, neck ultrasound should be performed at any visit, especially when an
increased sTg is seen.
Molecular Diagnostics for Thyroid Nodules: The Current State of Affairs
Sann Yu Mon and Steven P. Hodak
Molecular diagnostics offers great promise for the evaluation of cytologi-
cally indeterminate thyroid nodules. Numerous molecular genetic and
immunohistochemical tests have been developed that may be performed
on thyroid specimens obtained during standard fine-needle aspiration,
some of which may greatly improve diagnostic yield. A sound understand-
ing of the diagnostic performance of these tests, and how they can en-
hance clinical practice, is important. This article reviews the diagnostic
utility of immunohistochemical and molecular testing for the clinical
assessment of thyroid nodules, and makes recommendations about
how these tests can be integrated into clinical practice for patients with
cytologically indeterminate thyroid nodules.
Thyrotropin in the Development and Management of Differentiated
Thyroid Cancer
Donald S.A. McLeod
Thyrotropin (TSH) is the major regulator and growth factor of the thyroid.
TSH may be important in the development of human thyroid cancer, with
both suggestive animal models and clinical evidence, although definitive
proof Is still required. Applications for TSH in thyroid cancer management
include TSH stimulation of radioiodine uptake, enhancement of bio-
chemical monitoring through thyroglobulin measurement, and long-term
suppression of TSH with supraphysioiogic levothyroxine. This review
synthesizes current knowledge of TSH in both the development and
management of differentiated thyroid cancer.
Initial Radioiodine Administration: When to Use It and How to Select the Dose 385
Giuseppe Esposito
All published guidelines on the use of radioactive iodine for the treatment
of well-differentiated thyroid cancer agree that an individualized assess-
ment of the risk of cancer-related mortality and of disease recurrence
should direct the decision of whether radioiodine treatment is needed
and how much to administer. At the author s institution, they mostly follow
the American Thyroid Association s risk stratification system, with the
addition of a category of very-low-risk patients that do not receive radio-
active iodine.
Update on Differentiated Thyroid Cancer Staging 401
Denise P. Momesso and R. Michael Tuttle
In this review, we demonstrate how initial estimates of the risk of disease-
specific mortality and recurrent/persistent disease should be used to guide
initial treatment recommendations and early management decisions and
to set appropriate patient expectations with regard to likely outcomes after
initial therapy of thyroid cancer. The use of ongoing risk stratification to
modify these initial risk estimates is also discussed. Novel response to
therapy definitions are proposed that can be used for ongoing risk stratifi-
cation in thyroid cancer patients treated with lobectomy or total thyroidec-
tomy without radioactive iodine remnant ablation.
Update on Medullary Thyroid Cancer 423
Mimi I. Hu, Anita K. Ying, and Camilo Jimenez
Medullary thyroid carcinoma (MTC) is a rare type of thyroid cancer,
demonstrating variable behavior from indolent disease to highly aggressive,
progressive disease. There are distinguishing phenotypic features of spo-
radic and hereditary MTC. Activation or overexpression of cell surface re-
ceptors and up-regulation of intracellular signaling pathways in hereditary
and sporadic MTC are involved in the disease pathogenesis. There has
been an exponential rise in clinical trials with investigational agents, leading
to approval of 2 medications for progressive, advanced MTC. Developments
in understanding the pathogenesis of MTC will hopefully lead to more effec-
tive and less toxic treatments of this rare but difficult to treat cancer.
Surgery for Thyroid Cancer 443
Gfenda G. Callender, Tobias Carting, Emily Christison-Lagay, and
Robert Udelsman
The incidence of thyroid cancer, particularly papillary thyroid cancer, is
rising at an epidemic rate. The mainstay of treatment of most patients
with thyroid cancer is surgery. Considerable controversy exists about
the extent of thyroid surgery and lymph node resection in patients with
thyroid cancer. Surgical experience in judgment and technique Is required
toachieve optimal patient outcomes. vto»Mo
Alternative Approaches to the Thyroid Gland
459
William S. Duke and David J. Terris
Advances in surgical technology and patient-driven demands have fueled
exploration into methods to improve cosmetic outcomes in thyroid sur-
gery. This exploration has produced 2 fundamentally different pathways
for reducing the visible thyroidectomy scar. Minimally invasive anterior
cervical approaches use small incisions hidden in natural skin creases
and reduce the overall extent of dissection required to remove the thyroid.
Remote access approaches remove the incision from the anterior neck
completely but require more extensive dissection to access the thyroid
compartment.
Persistent Posttreatment Fatigue in Thyroid Cancer Survivors: A Scoping Review 475
Anna M. Sawka, Asima Naeem, Jennifer Jones, Julia Lowe, Philip Segal,
Jeannette Goguen, Jeremy Gilbert, Afshan Zahedi, Catherine Kelly,
and Shereen Ezzat
The relevance of persistent posttreatment fatigue (PPF) to thyroid cancer
(TC) survivor populations is not known. This article presents a scoping
review, which is an overview of published research activity. Uncontrolled
data suggest that PPF Is one of the most common complaints in TC survi-
vors. Furthermore, statistically significantly worse levels of fatigue were
reported in TC survivors, compared with the general population or healthy
controls. There was some inconsistency among PPF risk factors. More re-
search is needed on PPF in TC survivors, including long-term prospective
cohort studies, research on fatigue severity prevalence, and randomized
controlled trials of treatment strategies.
Management of Graves Disease: An Overview and Comparison of Clinical Practice
Guidelines with Actual Practice Trends 495
Becky T. Muldoon, Vinh Q. Mai, and Henry B. Burch
Over the last century, much has been learned about the pathogenesis,
manifestations, and management of Graves disease leading to the estab-
lishment of evidence-based clinical practice guidelines. The joint clinical
practice guidelines from the American Thyroid Association and the Amer-
ican Association of Clinical Endocrinologists give recommendations on
both the diagnosis and treatment of hyperthyroidism. A survey of clinicians
performed that same year, however, revealed that current practices
diverge from these recently published guidelines in multiple areas. These
differences will need to be assessed serially to determine the impact of
the guidelines on future clinical practice and perhaps vice versa.
Thyroid Disease and the Cardiovascular System 517
Sara Danzi and Irwin Klein
Thyroid hormones, specifically triiodothyronine (T3), have significant
effects on the heart and cardiovascular system. Hypothyroidism, hyper-
thyroidism, subclinical thyroid disease, and low T3 syndrome each cause
cardiac and cardiovascular abnormalities through both genomic and non-
genomic effects on cardiac myocytes and vascular smooth muscle cells,
in compromised health, such as occurs In heart disease, alterations in
thyroid hormone metabolism may further impair cardiac and cardiovascu-
lar function. Diagnosis and treatment of cardiac disease may benefit from
including analysis of thyroid hormone status, including serum total T3
levels.
Thyroid Disease and Cognition 529
Mary H. Samuels
Overt hypothyroidism and thyrotoxicosis are associated with significant
decrements in mood and cognitive function, and therapy usually leads to
improvement in these symptoms. In contrast, major affective or cognitive
dysfunction is not typical of subclinical thyroid disease. Subtle deficits in
specific cognitive domains (primarily working memory and executive func-
tion) likely exist in subclinical hypothyroidism and thyrotoxicosis, but these
are unlikely to cause major problems in most patients. Patients with mild
thyroid disease and significant distress related to mood or cognition
most likely have independent diagnoses that should be evaluated and
treated separately.
Ethical Issues in the Management of Thyroid Disease 545
M. Sara Rosenthal
The focus of this article is on clinical ethics issues in the thyroid disease
context. Clinical ethics is a subspecialty of bioethics that deals with bed-
side ethical dilemmas that specifically involve the provider-patient relation-
ship. Such issues include consent and capacity; weighing therapeutic
benefits against risks and side-effects; innovative therapies; end of life
care; unintended versus intentional harms to patients or patient popula-
tions; and healthcare access. This article will review core ethical principles
for practice, as well as the moral and legal requirements of informed con-
sent. It will then discuss the range of unique and universal ethical issues
and considerations that present in the management of autoimmune thyroid
disease and thyroid cancer.
Management of Recurrent Cervical Papillary Thyroid Cancer 565
Rachna M. Goyal, Jacqueline Jonklaas, and Kenneth D. Burman
Papillary thyroid cancer is one of the most common endocrine malignan-
cies, and it is often associated with an excellent prognosis. However, it
has been shown to recur in the lymph nodes in the neck. The management
of these lymph nodes remains controversial, and current treatment strate-
gies include observation, surgery, radioactive iodine ablation, and percu-
taneous ethanol injection. These various treatment modalities are
discussed in this article.
Thyroid Disorders During Pregnancy 573
Nisha Nathan and Shannon D. Sullivan
Thyroid disorders are common in pregnancy and in nonpregnant women of
childbearing age, but can be missed because of nonspecific symptoms
and normal changes in thyroid gland physiology during pregnancy. The
prevalence of overt hyperthyroidism complicating pregnancy has been
reported to range between 0.4% and 1.7%, and an estimated 2% to 3%
Contents
of women are hypothyroid during pregnancy. Abnormalities in maternal
thyroid function are associated with complications during pregnancy,
and may affect maternal and fetal outcomes. Thus it is important to identify
thyroid disorders before pregnancy or early in pregnancy so that appropri-
ate treatment can be initiated.
Index
599
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spellingShingle | Thyroid cancer and other thyroid disorders Endocrinology and metabolism clinics of North America |
title | Thyroid cancer and other thyroid disorders |
title_auth | Thyroid cancer and other thyroid disorders |
title_exact_search | Thyroid cancer and other thyroid disorders |
title_full | Thyroid cancer and other thyroid disorders ed. Kenneth D. Burman ; Jacqueline Jonklaas |
title_fullStr | Thyroid cancer and other thyroid disorders ed. Kenneth D. Burman ; Jacqueline Jonklaas |
title_full_unstemmed | Thyroid cancer and other thyroid disorders ed. Kenneth D. Burman ; Jacqueline Jonklaas |
title_short | Thyroid cancer and other thyroid disorders |
title_sort | thyroid cancer and other thyroid disorders |
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