Controversies in familial thyroid cancer 2014

Abstract

Controversies in familial thyroid cancer 2014Thyroid cancer is the sixth most common cancer in women, and the majority of patients with thyroid cancer has sporadic disease. However, about 25% of patients with medullary thyroid cancer and 5% with papillary thyroid cancer have familial tumors. Currently, there are numerous controversies regarding the mode of inheritance, tumor behavior, extent of surgical resection for optimal results, coexisting thyroid pathology, risk of other cancers, and extent of postoperative treatment of patients with familial thyroid cancer. This review aimed to give insight to surgeons on this interesting topic.

Current Knowledge about the Impact of Microgravity on Gene Regulation

“…Unlike other common cancers, thyroid cancer usually occurs at younger ages and affects women two to three times more often than men, and thus becomes the second most common cancer in women under the age of 40 [ 170 ]. However, papillary thyroid carcinoma (PTC), which is common and occurs at a younger age, is easily treatable compared to follicular thyroid cancer and medullary thyroid cancer.…”

Papillary Thyroid Cancer Affecting Multiple Family Members: A Case Report and Literature Review of Familial Nonmedullary Thyroid Cancer

“…ere is no consensus on whether two [2,9,13,14] or three [15][16][17][18] first-degree relatives of a family are the minimum required number to define FNMTC, as SNMTC is very common and it can affect more than one individual in a family. Charkes [5] found that in families with 2 affected individuals, 62-69% of the cases are sporadic, while in families with ≥3 affected members, less than 6% of the cases are sporadic.…”

“…(1) To be directed to at-risk individuals (2) To be able to discover the disease early in its course (3) at early detection of the disease impacts the outcome (4) To be cost-effective Currently, the best available screening method is the ultrasound neck [2,14,19,57], as there is no genetic test to definitely diagnose FNMTC and, for example, guide prophylactic thyroidectomy similar to familial medullary thyroid cancer [2].In addition, physical examination alone can miss many cases with nodular thyroid disease [19,35]. Klubo-Gwiezdzinska et al reported screening of 109 at-risk individuals, of which 55 (50.5%) had thyroid nodules detected by ultrasound; however, only 7 cases (7/55 � 12.7%) were palpable on physical examination.…”

“…e youngest diagnosed patient with FNMTC was aged 8 years [13]. Some authors [14] recommended starting ultrasound screening from the age of 18 years and performing ultrasound screening yearly afterward, while others advised screening from the age of 10 years [2].…”

“…Papillary thyroid cancer (PTC) is the most common primary thyroid malignancy and accounts for more than 80% of thyroid cancers [1]. Most PTC cases are sporadic; however, 5-10% are familial [2,3], and like the sporadic form, females are 2-3 times more affected than males [4][5][6]. Familial PTC (FPTC) is the most common type of familial nonmedullary thyroid cancer (FNMTC) [7], which is identified, in most studies, when two or more first-degree relatives are diagnosed with the condition in the absence of a history of familial syndromes or risk factors that are commonly associated with NMTC [8][9][10][11].…”