Screening for medullary carcinoma of the thyroid

Niederle, Bruno

doi:10.1002/bjs.9652

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…As MTC does not respond to conventional therapy, novel treatment options are needed (1, 2, 8, 23) and compounds targeting the RET kinase are currently under investigation (24). Although promising results were achieved with other cancers, the response rates for MTC were low (25).…”

Section: Discussionmentioning

confidence: 99%

Anti-tumor effects of shikonin derivatives on human medullary thyroid carcinoma cells

Hasenoehrl

Schwach

Ghaffari-Tabrizi-Wizsy

et al. 2017

Endocrine Connections

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New treatment options are needed for medullary thyroid carcinoma (MTC), a highly metastasizing neuroendocrine tumor that is resistant to standard radiotherapy and chemotherapy. We show that the following shikonin derivatives inhibit cell proliferation and cell viability of the MTC cell line TT: acetylshikonin, β,β-dimethylacrylshikonin, shikonin and a petroleum ether extract of the roots of Onosma paniculata containing several shikonin derivatives. The unsubstituted shikonin derivative was found to be the most effective compound with an IC50 of 1.1 µM. The cell viability of normal human skin fibroblasts, however, was not affected by the tested substances, indicating that shikonin derivatives might be selectively toxic for cancer cells. We further report that migration and invasion of TT cells were inhibited at non-toxic concentrations. Finally, shikonin was tested in vivo using the chick chorioallantoic membrane assay, where it significantly reduced tumor growth by inhibiting cell proliferation and inducing apoptosis. In summary, our results suggest that shikonin derivatives have the potential for the treatment of medullary thyroid carcinomas.

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Section: Discussionmentioning

confidence: 99%

Anti-tumor effects of shikonin derivatives on human medullary thyroid carcinoma cells

Hasenoehrl

Schwach

Ghaffari-Tabrizi-Wizsy

et al. 2017

Endocrine Connections

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“…It has been suggested that pentagastrin-stimulated CT values higher than 100 pg/mL is a strong evidence for MTC ( 8 ). However, a lot of discussion is still present regarding the peak value of serum CT after calcium stimulation test ( 8 , 9 ). Niederle B suggested that, although experience with use of calcium for stimulation of CT has been limited, stimulated peaks of over 100 pg/mL should raise the surgical option ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Patients with papillary thyroid carcinoma associated with high stimulated serum calcitonin levels

Ünlühızarcı¹,

Akgün²,

Öz

et al. 2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Among various substances produced by C-cells, the most important one is calcitonin (CT) that is used for detection, post-operative follow-up and evaluation of individuals at risk of developing medullary thyroid carcinoma (MTC). However, the role of serum CT measurement in the evaluation of thyroid nodules has been widely discussed, and there is still no consensus about the role of CT in the initial evaluation of all thyroid nodules. Two patients with thyroid nodules whose fine-needle aspiration results were compatible with benign cytology besides having mildly elevated basal serum calcitonin levels were reported. Calcitonin responses (peak levels were 313 and 229 pg/mL, respectively) to calcium stimulation test were compatible with the possible diagnosis of MTC. However, the final diagnosis was papillary thyroid carcinoma of the thyroid gland. There are limited numbers of case reports showing such an increased serum calcitonin responses to calcium stimulation test associated with papillary or follicular thyroid carcinoma of the thyroid. We suggest to measure serum CT level once and in case of normal levels, no further CT measurement is necessary. Physicians should keep in mind that thyroid carcinomas other than MTCs may also be associated with high serum CT levels.Learning points:Although serum calcitonin is a valuable tumor marker for MTC, it is well known that mild elevations may be seen in some other diseases such as Hashimoto thyroiditis, neuroendocrine tumors or due to medications such as proton pump inhibitors, calcium salts, beta blockers and glucocorticoids.Those two cases indicate that high calcitonin responses to calcium stimulation test, mimicking MTC, may also be seen in patients with papillary thyroid carcinoma although the mechanism is not clear.

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“…The latter is identified frequently (>60%); and has been 77,78). Because MTC is generally considered a lethal tumor, it is recommended that first degree relatives of the affected family member should undergo genetic screen; a positive result should be followed be prophylactic total thyroidectomy (24, [79][80][81][82]. Most endocrinologists and pediatric endocrinologists recommend total thyroidectomy before the age of six in children found to have "aggressive" RET mutations in their germline (19,24,79,83).…”

Section: Clinical Presentation and Geneticsmentioning

confidence: 99%

C-cells and their associated lesions and conditions: a pathologists perspective

Baloch¹,

LiVolsi²

2015

TJPATH

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This paper updates the histopathology and cytopathology of thyroid tumors and proliferations derived from the para-follicular or C cells. Beginning with an historical over view, including the recognition of medullary thyroid carcinoma as a distinct histologic entity, its relationship to the hormone, calcitonin, (which was discovered in the same decade) and to thyroid C cells, medullary carcinoma and its variants are reviewed. The molecular biology of the tumors and the associated mutations in the tumors (somatic mutations) are discussed. Additionally the genetic features (germline mutations) including familial clusters and associations with other endocrine and neuroendocrine lesions are reviewed. Screening for the tumor and its precursors is included with a review of the latest American Thyroid Association guidelines for treatment as well as timing and approach to surgery. Tabular data of specific germline mutations and their relationships to tumor virulence, and prognosis are illustrated. Precursor and early C cell lesions such as C-cell hyperplasia and micro-medullary carcinoma are discussed. Difficulties and controversies in the definition of C-cell proliferations which are neoplastic and those which are "reactive" are reviewed. The entity of medullary microcarcinoma or medullary microcarcinoma is illustrated and the distinction between C cell nodules and microcarcinoma is defined using the latest available criteria. Finally the latest approved chemotherapeutic agents and their results in metastatic medullary thyroid carcinoma are included.

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Screening for medullary carcinoma of the thyroid

Abstract: Could potentially reduce mortality and morbidity

Cited by 6 publications

References 11 publications

Anti-tumor effects of shikonin derivatives on human medullary thyroid carcinoma cells

Anti-tumor effects of shikonin derivatives on human medullary thyroid carcinoma cells

Patients with papillary thyroid carcinoma associated with high stimulated serum calcitonin levels

C-cells and their associated lesions and conditions: a pathologists perspective

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