Thin-layer cytology improves the diagnostic accuracy of thyroid FNA and offers the possibility of performing new techniques, such as immunocytochemistry, on the same sample in order to detect malignancy as well as the type and origin of thyroid gland neoplasms.

Background: Thyroid carcinoma has been reported in patients operated for different types of hyperthyroidism and the probability of a hot nodule being malignant seems to be low. The aim of the present study was to explore the relationship between thyroid cancer, hyperthyroidism and outcome in a large cohort of patients who presented to a tertiary cancer centre in Northern Greece. Patients: Among 720 patients treated for thyroid cancer, 60 had a concomitant diagnosis of hyperthyroidism due to Graves' disease (nZ14), solitary autonomous adenoma (nZ17), or multinodular goiter (nZ29). Adverse prognostic factors were common in patients with a previous history of hyperthyroidism at the time of diagnosis of thyroid cancer, including cases where the cancer was discovered coincidentally after thyroid surgery for hyperthyroidism and cases where tumor size was more than 10 mm. Results: In 10 out of 17 patients with hyperthyroidism due to solitary autonomous adenomas, the tumor was located within the hot nodule and two of these patients developed local and distant metastases and died from the disease 4 and 15 years after thyroidectomy. Conclusion: Clinicians managing patients with hyperthyroidism need to be aware of the possible increased risk of thyroid cancer in this patient group.

The purpose of this study was to evaluate the bone mineral density (BMD) of 50 patients aged 9-28 years, with thalassemia major and to assess the alterations of bone density in a 4-year follow-up study. They were measured with a DPX densitometer at the lumbar spine and femur area and divided into three groups: preadolescents, adolescents, and adults. All patients received calcium and vitamin D supplements, and 8 of the 50 received hormone replacement therapy (HRT). All patients had a significantly lower BMD compared with healthy subjects. Mean values of lumbar BMD of the three groups were 1.3, 2, and 3 standard deviations (SDs) lower than those of healthy subjects of the same age. All adolescent patients with normal gonadal function and those who received HRT showed an increase in BMD during the period of the study. Adult patients also showed an increase in bone density as long as the treatment lasted. However, adolescent and adult patients who had hypogonadotropic hypogonadism but could not get therapy showed a decrease in bone density. BMD of patients with thalassemia major shows a good index of bone status which should be evaluated, especially for the determination and follow-up of therapy.

Abstract. Brain metastasis is an uncommon complication of differentiated thyroid carcinoma. Even more, cerebellar metastases from papillary thyroid carcinoma (PTC) are exceptional. We report a 69-year-old male patient with infiltrative PTC who developed high levels of thyroglobulin (Tg) and deteriorated neurological symptoms four years after the initial diagnosis. Computerized tomography (CT) of the brain demonstrated a cerebellar mass and the patient underwent surgery. Pathology revealed metastasis from PTC. Immunochemistry was positive for Tg. The patient had no other sites of distant metastases. Although PTC has generally a good prognosis, metastases to the cerebellum can occur, even as the first metastatic site, despite the fact that appropriate therapy (surgery, radioactive iodine therapy, TSH suppression therapy, chemotherapy and external radiotherapy) had been given for the primary tumour. We report a patient with PTC who developed a mass in the right cerebellar hemisphere proved to be a metastasis from PTC despite the fact that total thyroidectomy, ablation therapy with radioactive iodine, external radiation therapy and chemotherapy had been given for the primary tumour. It is important to underline that in our patient no other distant metastases could be established. To our knowledge, only in one other case cerebellum was the site of the first and solitary distant metastasis from PTC [7]. Case ReportA 69-year-old male patient was referred to our clinic in June 1998 for further evaluation and treatment after a fine needle aspiration cytology of a thyroid nodule suggestive of PTC. The patient had no personal or family history of thyroid disease and no previous history of head and neck irradiation.When seen in clinic, he was in good general condition. He complained of hoarseness, dyspnea and productive cough of one year's duration. Clinical examination revealed a palpable mass in the central

Patients with advanced or metastatic prostate cancer (PC), a partially hormone-resistant disease, will require some form of hormonal manipulations or some new therapeutic modalities. Octreotide, as somatostatin (SST) analogs, has been found to inhibit the growth of experimental PCs via several mechanisms, as indirect antihormonal and direct antimitogenic actions, mainly due to inhibition of SST receptor subtypes (SSTR-1–5). Sporadic clinical trials with octreotide (alone or with a complete antiandrogen blockade) treatment of patients with advanced stage D2 PC demonstrated promising results. Unfortunately, at present these clinical trials have some disadvantages and leave some uncertainty with regard to the trial design, the SSTR subtype determination and tumor localization with SSTR scintigraphy before the start of a selective SST analog, and finally the randomization in groups according to hormone resistance, dosage regimen and route of administration.