BOOK
Thyroid Cancer: Current Diagnosis, Management, and Prognostication, An Issue of Otolaryngologic Clinics of North America, E-Book
(2014)
Additional Information
Book Details
Abstract
This Otolaryngologic Clinics' publication’s intent is to provide standard and state of the art clinician performed thyroid ultrasound and ultrasound guided FNA technique. The subject area is evolving rapidly with new technologies being incorporated. This title integrates thyroid cytology, FNA and Ultrasound Guided FNA with inclusion of diagnostic molecular testing. Clinical Thyroid Molecular Testing has ushered in a new era to the diagnosis, management and prognostication of thyroid nodules. The discussion of this highly clinically applicable subject is described in terms of diagnostic process. This is a thyroid neoplasm clinical “game changer” for the General Otolaryngologist, Head and Neck Surgeon, General Surgeon, Endocrinologist, Pathologist, and Radiologist. This testing maximizes the number of patients who have cancer to receive the correct therapeutic surgery appropriately and minimizes the number of patients who do not need surgery (and avoid the potential complications and surgery) because they do not have cancer. Surgical management and prognostication have far reaching implications with fine needle aspiration driven molecular markers. Some topics include: Clinical evaluation of the thyroid nodule; Thyroid cytology; Clinician performed thyroid ultrasound; Clinician performed thyroid ultrasound guided FNA; Thyroid cancer molecular laterations - what the surgeon should know; Thyroid cancer multi-gene expression - what the surgeon needs to know; Incorporating molecular testing into your thyroid practice - five experts discuss; and others.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Thyroid Cancer: CurrentDiagnosis, Management,and Prognostication | i | ||
Copyright | ii | ||
Contributors | v | ||
Contents | ix | ||
Otolaryngologic Clinics\rof North America | xii | ||
Correction | xiii | ||
Preface | xv | ||
Evidence-Based Evaluation of the Thyroid Nodule | 461 | ||
Key points | 461 | ||
The thyroid nodule—scope of the problem | 461 | ||
Patient presentation | 462 | ||
Assessment of risk factors | 464 | ||
Age | 464 | ||
Gender | 465 | ||
Radiation Exposure | 465 | ||
Family History and Cancer Syndromes | 465 | ||
Workup of the thyroid nodule | 466 | ||
TSH and Other Laboratory Tests | 466 | ||
Scintigraphy | 466 | ||
Ultrasound | 467 | ||
Needle Biopsy | 468 | ||
Molecular Markers | 469 | ||
Closing thoughts about thyroid nodule evaluation | 470 | ||
Risk of Death for the Patient Found to Have a Thyroid Cancer | 470 | ||
Active Monitoring of Small Nodules | 470 | ||
Limitations of Existing Guidelines on Thyroid Nodule Management | 470 | ||
References | 471 | ||
Thyroid Cytology | 475 | ||
Key points | 475 | ||
Introduction | 475 | ||
Nondiagnostic specimen | 476 | ||
Benign thyroid lesions | 476 | ||
Benign Follicular Nodule | 477 | ||
Thyroiditis | 477 | ||
Malignant thyroid lesions | 478 | ||
Papillary Carcinoma | 478 | ||
Medullary Carcinoma | 478 | ||
Poorly Differentiated Carcinoma | 480 | ||
Undifferentiated Anaplastic Carcinoma | 480 | ||
Lymphoma | 480 | ||
Metastatic Tumors to the Thyroid | 481 | ||
Indeterminate thyroid lesions | 482 | ||
Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance | 482 | ||
Follicular Neoplasm/Suspicious for Follicular Neoplasm | 483 | ||
Bethesda V Category (Suspicious for Malignancy) | 484 | ||
Ancillary Studies | 485 | ||
References | 488 | ||
Clinician-Performed Thyroid Ultrasound | 491 | ||
Key points | 491 | ||
Introduction | 491 | ||
Initial ultrasound training | 492 | ||
Obtaining adequate experience: validation and assessment of competency | 492 | ||
Essential equipment and the economics of clinic-based ultrasound | 494 | ||
Monitor | 495 | ||
Imaging Modes | 495 | ||
Cineloop Capabilities | 495 | ||
Transducer | 495 | ||
Output Modalities | 495 | ||
Peripherals | 495 | ||
Display Dynamic Range | 496 | ||
Frame Rate | 496 | ||
Bottom line on technical specifications | 496 | ||
Image documentation for medical billing | 496 | ||
The essential ultrasound findings | 497 | ||
Use of ultrasound in the operating room in the immediate preoperative setting | 500 | ||
Ultrasound in Thyroid Surgery | 500 | ||
Pre-incision Ultrasound | 502 | ||
Ultrasound for the N0 Neck | 503 | ||
Intraoperative Localization of Lymph Nodes | 504 | ||
Head and Neck Anatomic Landmarks | 504 | ||
Further readings | 505 | ||
References | 505 | ||
Clinician-Performed Thyroid Ultrasound-Guided Fine-Needle Aspiration | 509 | ||
Key points | 509 | ||
Introduction | 509 | ||
Ultrasound-guided FNA | 510 | ||
Thyroid FNA biopsy | 510 | ||
Technical aspects of USGFNA | 511 | ||
Summary | 517 | ||
Supplementary data | 517 | ||
References | 517 | ||
Surgical Diagnosis | 519 | ||
Key points | 519 | ||
Overview | 519 | ||
Relevant anatomy and pathophysiology and their impact on risk prediction | 520 | ||
Clinical presentation/examination | 521 | ||
Available procedures and choice of procedure | 522 | ||
Planning primary thyroid surgery | 522 | ||
Planning neck dissection | 523 | ||
Diagnosis in the operating room | 524 | ||
Clinical outcomes in the literature | 525 | ||
Summary | 525 | ||
References | 526 | ||
Contemporary Surgical Techniques | 529 | ||
Key points | 529 | ||
Introduction | 529 | ||
Background and history | 530 | ||
Advantages and disadvantages of alternative approaches | 531 | ||
Approaches | 531 | ||
Minimally Invasive Anterior Cervical | 531 | ||
Minimally invasive video-assisted thyroidectomy | 531 | ||
Patient selection | 533 | ||
Minimally invasive nonendoscopic thyroidectomy | 534 | ||
Remote Access Endoscopic | 535 | ||
Chest/Breast approaches | 535 | ||
Axillary approaches | 536 | ||
Remote Access Robotic Procedures | 536 | ||
Bilateral axillo-breast approach | 537 | ||
Robotic axillary thyroidectomy | 538 | ||
Robotic facelift thyroidectomy | 538 | ||
Summary | 541 | ||
References | 541 | ||
Management of the Neck in Thyroid Cancer | 545 | ||
Key points | 545 | ||
Introduction | 545 | ||
Lymphadenectomy for thyroid cancer | 546 | ||
Central Lymph Node Compartment | 546 | ||
Lateral Node Involvement | 546 | ||
Prophylactic Neck Dissection | 547 | ||
Subtypes of Papillary Thyroid Carcinoma | 548 | ||
Clinical Application of Molecular Testing of Fine-needle Aspiration Specimens in Thyroid Nodules | 557 | ||
Key points | 557 | ||
Introduction | 557 | ||
Molecular causes of thyroid malignancies | 559 | ||
Papillary Thyroid Carcinoma | 559 | ||
FTC and FA | 560 | ||
Poorly Differentiated Thyroid Carcinomas | 561 | ||
Biomarkers used for tumor detection and prognostication | 561 | ||
Molecular Testing of FNAB Specimens | 561 | ||
BRAF | 561 | ||
RAS | 562 | ||
RET/PTC | 562 | ||
Panel testing | 563 | ||
Prognostication Using Biomarkers | 563 | ||
Genetic Analysis of Multifocal PTC | 565 | ||
Techniques for biomarker detection | 566 | ||
NGS | 566 | ||
Summary | 567 | ||
References | 567 | ||
Clinical Diagnostic Gene Expression Thyroid Testing | 573 | ||
Key points | 573 | ||
Thyroid cancer multigene expression classifiers: what the surgeon should know | 573 | ||
Introduction | 573 | ||
Cost, Morbidity, and Risk of Mortality from Surgery | 574 | ||
Regulation of Molecular Diagnostic Tests | 576 | ||
Veracyte Afirma GEC | 576 | ||
Analytical Validity | 578 | ||
Clinical Validity and Clinical Practice Experience | 579 | ||
Diagnostic application | 582 | ||
Clinical Decision-Making | 582 | ||
False Negative Results Are the Most Important Diagnostic Error | 583 | ||
Suspicious for Hürthle Cell Neoplasm Cytology | 583 | ||
Rare Neoplasms | 585 | ||
Clinical Utility and Cost-Effectiveness | 586 | ||
Future Directions | 587 | ||
Summary | 588 | ||
References | 588 | ||
The Prognostic Implications from Molecular Testing of Thyroid Cancer | 595 | ||
Key points | 595 | ||
Introduction | 595 | ||
Relevant pathophysiology | 596 | ||
Genetic Alteration of Mitogen-activated Protein Kinase Signaling Pathway | 596 | ||
BRAF Mutation | 597 | ||
RET/PTC Rearrangement | 597 | ||
RAS Mutation | 597 | ||
PAX8-PPAR Rearrangement | 598 | ||
Clinical presentation and examination | 598 | ||
Prognostic applications of molecular markers in thyroid cancer | 599 | ||
BRAF Mutation and Prognosis of Thyroid Cancer | 599 | ||
RAS Mutation, RET/PTC Rearrangement, PAX8/PPAR Rearrangement, and Prognosis of Thyroid Cancer | 599 | ||
TERT Promoter Mutations and Prognosis of Thyroid Cancer | 599 | ||
Therapeutic applications of molecular markers in thyroid cancer | 600 | ||
BRAF Mutation in the Management of Thyroid Cancer | 600 | ||
BRAF mutation, extrathyroidal extension, and multifocality | 600 | ||
BRAF mutation and lymph node metastasis | 600 | ||
BRAF mutation and distant metastasis | 601 | ||
BRAF mutation, and American Joint Commission for Cancer stage of disease | 601 | ||
RAS Mutation in the Management of Thyroid Cancer | 601 | ||
RET/PTC and PAX8/PPAR Rearrangement in the Management of Thyroid Cancer | 602 | ||
Implications of Molecular Markers for Targeted Therapy in the Management of Thyroid Cancer | 602 | ||
Future trends and conclusions | 602 | ||
References | 603 | ||
Decision Making for Diagnosis and Management | 609 | ||
Key points | 609 | ||
Introduction | 610 | ||
Cases for discussion | 612 | ||
Case 1: Incidentally Noted Thyroid Nodule on Carotid Ultrasound | 612 | ||
Bumpous | 613 | ||
Pribitkin | 614 | ||
Stack | 614 | ||
Bumpous | 614 | ||
Case 2: Asymptomatic Thyroid Mass | 615 | ||
Stack | 615 | ||
Bumpous | 616 | ||
Pribitkin | 616 | ||
Case 3: Rapidly Enlarging Thyroid Mass | 616 | ||
Stack | 616 | ||
Pribitkin | 617 | ||
Stack | 617 | ||
Bumpous | 617 | ||
Index | 625 |