Thyroid nodules classified as Bethesda Category III, atypia of undetermined significance (AUS), present a significant clinical challenge due to their indeterminate risk of malignancy. Consequently, many patients undergo diagnostic lobectomy, often for benign disease, which could cause complications such as laryngeal nerve paralysis. This study aimed to evaluate the diagnostic utility of sonographic features, clinical characteristics, and the TI-RADS in predicting Papillary Thyroid Carcinoma (PTC) within this specific cytological subgroup. This retrospective study evaluated 309 adult patients with surgically resected AUS thyroid nodules at referral centers. Preoperative sonographic features, clinical characteristics, and biochemical profiles were analyzed and compared with the final histopathological diagnosis. Multivariable logistic regression and ROC curve analyses were utilized to identify independent predictors of malignancy and assess diagnostic performance. The post-operative malignancy rate was 37.5
Malignant struma ovarii (MSO) is a rare subtype of ovarian cancer. We aimed to evaluate the role of complete staging surgery (CSS) and adjuvant radioiodine therapy in this rare malignancy. MSO patients with sufficient information who were treated at the Cancer Hospital Institution of Chinese Academy of Medical Sciences were retrieved. We also considered studies published in English and listed on PubMed up to December, 2024. Studies were eligible for inclusion if they reported individual information of patients with MSO. Clinicopathological and follow-up data were retrospectively collected for each individual patient. Univariate and multivariate analyses were conducted to investigate potential prognostic factors. A total of 203 cases were enrolled in this analysis. MSO was mainly found in premenopausal women younger than 50 years. Most patients (68/93, 73.1
Abstract Background The influence of body mass index (BMI) on perioperative outcomes following total thyroidectomy (TT) remains controversial. We performed a systematic review and meta-analysis to evaluate the association between BMI and perioperative complications after TT. Methods Twelve observational studies including 22,145 patients undergoing elective TT were analyzed. BMI was categorized per WHO criteria. Primary outcomes were recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism. Secondary outcomes included operative time, length of stay (LOS), postoperative bleeding, and surgical site infection (SSI). Random-effects models were used. Results BMI was not associated with RLN palsy. Lower BMI was associated with higher rates of postoperative and transient hypoparathyroidism, while permanent hypoparathyroidism did not differ. Higher BMI was associated with longer operative time and increased postoperative bleeding. LOS and SSI were comparable between groups. Conclusions Total thyroidectomy appears to be safe in patients with elevated BMI, as no significant association was observed between BMI and the predefined primary outcomes of recurrent laryngeal nerve palsy or permanent hypoparathyroidism. Interestingly, patients with lower BMI experienced higher rates of postoperative and transient hypoparathyroidism. Higher BMI was associated with longer operative time and may be associated with an increased risk of postoperative bleeding. Therefore, particular attention should be paid to meticulous intraoperative hemostasis in patients with elevated BMI.
Graves’ disease (GD) is the autoimmune thyroid disorder leading to hyperthyroidism. It may be accompanied by a common extrathyroidal manifestation – Graves’ orbitopathy (GO). This study aimed to assess the oral health status of GD patients with and without orbitopathy. This is an observational study with consecutive enrolment. We included patients with GO or GD treated at the Department of Endocrinology, Metabolism and Internal Medicine in Poznan, Poland. The control group consists of age- and gender-matched volunteers. All subjects underwent a physical examination including comprehensive clinical dental examination: an evaluation of dentition status, oral hygiene, as well as periodontal condition, and laboratory assessment Additionally, participants completed a questionnaire regarding their oral hygiene practices. The GO group (n = 32) demonstrated greater variability in untreated caries and significantly more missing teeth (11 [4–18]) compared with both the GD group (n = 18) (0 [0–1]) and controls (n = 50) (1.5 [0–5]). Restorative treatment was also significantly less frequent in the GO group – the median number of filled teeth was much lower (4 [2–9]) compared with both the GD group (9 [8–11]) and controls (10 [8–13]). Moreover, the Approximal Plaque Index (API) was significantly higher in the GO group (0.59 [0.35–0.89]) compared with both the GD group (0.35 [0.23–0.43]) and controls (0.20 [0.14–0.31]). GO patients exhibit significantly poorer oral health status compared with both GD patients without orbitopathy and healthy controls. Therefore, targeted preventive and therapeutic strategies should be implemented.
Radical resection for locally advanced differentiated thyroid cancer (DTC) is challenging and associated with significant morbidity. This study aimed to evaluate the efficacy and safety of neoadjuvant apatinib (a multikinase inhibitor) and camrelizumab (a PD-1 inhibitor) in this setting. This was a single-center, single-arm, phase 2 trial. Eligible patients with locally advanced, unresectable or borderline-resectable DTC received neoadjuvant apatinib (250 mg daily) and camrelizumab (200 mg every two weeks) until surgery, disease progression or unacceptable toxicity. The primary endpoint was the objective response rate (ORR). Secondary endpoints included R0/R1 resection rate, disease control rate (DCR), and safety. Six patients were enrolled before the trial was terminated early due to the COVID-19 pandemic. Among five evaluable patients, the ORR was 60
