21 results on '"Arpaia, D"'
Search Results
2. Ultimobranchial Body Remnants (Solid Cell Nests) as a Pitfall in Thyroid Pathology
- Author
-
Bellevicine, C., Ippolito, S., Arpaia, D., Ciancia, G., Pettinato, G., Troncone, G., and Biondi, B.
- Published
- 2012
3. Multifocality in sporadic medullary thyroid carcinoma: An international multicenter study
- Author
-
Essig, G.F., Jr. Porter, K. Schneider, D. Arpaia, D. Lindsey, S.C. Busonero, G. Fineberg, D. Fruci, B. Boelaert, K. Smit, J.W. Meijer, J.A.A. Duntas, L.H. Sharma, N. Costante, G. Filetti, S. Sippel, R.S. Biondi, B. Topliss, D.J. Pacini, F. Maciel, R.M.B. Walz, P.C. Kloos, R.T.
- Abstract
Background: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC, given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. This study assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to assess more accurately the risks associated with alternative surgical approaches. Methods: A retrospective chart review of sMTC patients from 11 institutions over 29 years (1983-2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed. Results: Patients from four continents and seven countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing, while the remaining 18.8%demonstrated a negative family history and nomanifestations ofMEN2 syndromes other thanMTC. Bilateral disease was identified in 17/306 (5.6%) patients, while multifocal disease was noted in 50/312 (16.0%) sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) cases ( p < 0.001). No geographic differences in focality were identified. Conclusions: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard of care for initial surgery, as less complete thyroid surgery may fail to address fully the primary site of disease. Whether ipsilateral tumor focality should be an independent factor determining the need for completion thyroidectomy when sMTC is diagnosed after hemithyroidectomy remains to be determined.
- Published
- 2016
4. Nuove formulazioni liquide per la terapia sostitutiva con L-tiroxina
- Author
-
BIONDI, BERNADETTE, Ippolito S, Arpaia D, Pierce C., Francesco Orio e Marcello Orio, Biondi, Bernadette, Ippolito, S, Arpaia, D, and Pierce, C.
- Published
- 2012
5. Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study
- Author
-
Essig, G.F., Jr., Porter, K., Schneider, D., Arpaia, D., Lindsey, S.C., Busonero, G., Fineberg, D., Fruci, B., Boelaert, K., Smit, J.W.A., Meijer, J.A., Duntas, L.H., Sharma, N., Costante, G., Filetti, S., Sippel, R.S., Biondi, B., Topliss, D.J., Pacini, F., Maciel, R.M., Walz, P.C., Kloos, R.T., Essig, G.F., Jr., Porter, K., Schneider, D., Arpaia, D., Lindsey, S.C., Busonero, G., Fineberg, D., Fruci, B., Boelaert, K., Smit, J.W.A., Meijer, J.A., Duntas, L.H., Sharma, N., Costante, G., Filetti, S., Sippel, R.S., Biondi, B., Topliss, D.J., Pacini, F., Maciel, R.M., Walz, P.C., and Kloos, R.T.
- Abstract
Item does not contain fulltext, BACKGROUND: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC, given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. This study assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to assess more accurately the risks associated with alternative surgical approaches. METHODS: A retrospective chart review of sMTC patients from 11 institutions over 29 years (1983-2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed. RESULTS: Patients from four continents and seven countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing, while the remaining 18.8% demonstrated a negative family history and no manifestations of MEN2 syndromes other than MTC. Bilateral disease was identified in 17/306 (5.6%) patients, while multifocal disease was noted in 50/312 (16.0%) sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) cases (p < 0.001). No geographic differences in focality were identified. CONCLUSIONS: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard o
- Published
- 2016
6. Prevalence of autoimmune Thyroiditis in an Italian multiple sclerosis cohort
- Author
-
Montella, S., primary, Orefice, G., additional, Biondi, B., additional, Cerillo, I., additional, Orefice, N.S., additional, Arpaia, D., additional, Ippolito, S., additional, and Carrieri, P.B., additional
- Published
- 2013
- Full Text
- View/download PDF
7. AIDS-related knowledge and behaviours among teen-agers, Italy, 1990
- Author
-
Lorenzetti, P, Rossi, P, Armignacco, L, DE STEFANO, C, Ferrara, P, Iannicelli, G, Sangalli, M, Zaccarelli, M, Belloni, A, Castelli, Francesco, Parisi, A., Morandi, N, Morando, A., Stagnaro, R., Amati, M., Battucci, S., Beretta, A., Paggi, G., Salassa, B., Germinario, C., Iacobellis, O., Lo Caputo, S., Aiazzi, C., Milio, D., Rubino, M., Scasso, A., Gosetti, G., Alongi, M., Arpaia, D., Cicconi, G., De Zardo, F., Napolitani, E., Greco, D., Pezzotti, P., Salmaso, S., and Tozzi, A.
- Published
- 1991
8. Severe Hypothyroidism due to the Loss of Therapeutic Efficacy of l-Thyroxine in a Patient with Esophageal Complication Associated with Systemic Sclerosis
- Author
-
Amato de Paulis, Antonio Lobasso, Francesca Wanda Rossi, Letizia Barbieri, Liliana Nappi, Bernadette Biondi, Serena Ippolito, Debora Arpaia, Carmela Peirce, Lobasso, A, Nappi, L, Barbieri, L, Peirce, C, Ippolito, S, Arpaia, D, Rossi, Fw, de Paulis, A, and Biondi, B.
- Subjects
medicine.medical_specialty ,Pathology ,endocrine system ,Malabsorption ,endocrine system diseases ,systemic sclerosis ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Case Report ,Gastroenterology ,Asymptomatic ,Pericardial effusion ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Thyroiditis ,hypothyrodism ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,L-Thyroxine, systemic sclerosis , poor absorption ,Internal medicine ,medicine ,Adverse effect ,skin and connective tissue diseases ,lcsh:RC648-665 ,integumentary system ,business.industry ,autoimmunity ,sclerosis systemic ,medicine.disease ,Anti-thyroid autoantibodies ,030220 oncology & carcinogenesis ,medicine.symptom ,Thyroid function ,Complication ,business ,hashomoto thyroiditis ,l-thyroxine liquid formulation - Abstract
Background: Thyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with systemic autoimmune diseases as Systemic Sclerosis (SSc). Serum TSH levels are higher in SSc patients with more severe skin diseases and a worse modified Rodnan skin score (mRSS). Asymptomatic esophageal involvement due to SSc has never been described as a cause of severe hypothyroidism due to L-T4 malabsorption in patients with HT and SSc. Case report: Here we report a case of a 56-year-old female affected by both SSc and Hashimoto's thyroiditis (HT) who developed severe hypothyroidism due to the loss of therapeutic efficacy of L-thyroxine (L-T4). Therapeutic failure resulted from the altered L-T4 absorption because of SSc esophageal complications. Clinical findings improved after the administration of oral liquid L-T4. Thyroid function completely normalized with a full clinical recovery, the disappearance of the pericardial effusion and the improvement of the pulmonary pressure. Conclusion: A recognition of a poor absorption is crucial in patients with hypothyroidism and SSc to reduce the risk of the subsequent adverse events. This case suggests the importance of clinical and laboratory surveillance in patients with SSc and HT because the systemic complications of these dysfunctions may worsen the prognosis of hypothyroid SSc/HT patients.
- Published
- 2017
9. How do etiological factors can explain the different clinical features of patients with differentiated thyroid cancer and their histopathological findings?
- Author
-
Bernadette Biondi, Marina Caputo, Carmela Peirce, Gianluca Aimaretti, Debora Arpaia, Loredana Pagano, Serena Ippolito, Flavia Prodam, Chiara Mele, Giuseppe Ciancia, Guido Valente, Maria Teresa Samà, Pagano, . L., Mele, C, Arpaia, D, Samà, Mt, Caputo, M, Ippolito, S, Peirce, C, Prodam, F, Valente, G., Ciancia, Giuseppe, Aimaretti, G, and Biondi, Bernadette
- Subjects
Adult ,Male ,medicine.medical_specialty ,Carcinogenesis ,Endocrinology, Diabetes and Metabolism ,Thyroid Gland ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Gastroenterology ,Group A ,Group B ,Thyroiditis ,Clinical–histopathological feature ,Thyroid cancer ,Body Mass Index ,Papillary thyroid cancer ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Humans ,Thyroid Neoplasms ,Aged ,Retrospective Studies ,business.industry ,Thyroid ,Tumourigenesis induction ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,Environmental factor ,Surgery ,Cancer registry ,medicine.anatomical_structure ,Italy ,030220 oncology & carcinogenesis ,Female ,business ,Body mass index - Abstract
The aim was to retrospectively analyse the clinical–histopathological characteristics of patients with newly diagnosis of differentiated thyroid cancer (DTC) referred to two Italian centres, one in Northern and the other in Southern Italy, between 2000 and 2013. 1081 patients were included and subdivided into two groups: group A (474 patients from Novara) and group B (607 patients from Naples). The group A came from the industrial area of Novara, while the Group B came from the areas around Vesuvius and Campi Flegrei. The two groups were comparable for iodine levels, body mass index, diagnostic timing and clinical procedures. For all patients, demographic and clinical data were collected. No difference was found in gender, whereas the age at diagnosis was later in the group A (group A 53.1 ± 15.16 years, group B 41.9 ± 14.25 years, p < 0.001). In both groups, the most frequent histotype was papillary thyroid cancer (PTC) with prevalence of follicular variant in group A (p < 0.0001) and classical variant in group B (p < 0.0001). Aggressive histological features were mainly seen in group A (bilaterality p < 0.0001, multifocality p < 0.0001 and thyroid capsular invasion p < 0.0001). Microcarcinomas were more frequent in group A (p < 0.0001) but mostly characterized by bilaterality (p < 0.001) and multifocality (p < 0.04). In both groups, tumour-associated thyroiditis showed a significant increase over the years (group A p < 0.05, group B p < 0.04). Environmental factors could justify the differences found in our study. These preliminary data should stimulate the need for an Italian Cancer Registry of DTC in order to allow an epidemiological characterization, allowing the identification of specific etiological factors and an improvement in the management of the disease
- Published
- 2017
10. Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study
- Author
-
Kristien Boelaert, Bernadette Biondi, Rebecca S. Sippel, David F. Schneider, Susan C. Lindsey, Kyle Porter, Furio Pacini, Giulia Busonero, Richard T. Kloos, Johannes W. A. Smit, Johannes Arnoldus Anthonius Meijer, Neil Sharma, Sebastiano Filetti, Leonidas H. Duntas, Duncan J. Topliss, Daniel Fineberg, Barbara Fruci, Patrick C. Walz, Garth F. Essig, Giuseppe Costante, Debora Arpaia, Rui M. B. Maciel, Essig, GF Jr, Porter, K, Schneider, D, Arpaia, D, Lindsey, Sc, Busonero, G, Fineberg, D, Fruci, B, Boelaert, K, Smit, Jw, Meijer, Ja, Duntas, Lh, Sharma, N, Costante, G, Filetti, S, Sippel, R, Biondi, Bernadette, Topliss, Dj, Pacini, F, Maciel, Rm, Walz, Pc, and Kloos, Rt
- Subjects
Adult ,medicine.medical_specialty ,Pediatrics ,Biopsy ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Thyroid Gland ,030209 endocrinology & metabolism ,Thyroid Lobectomy ,Multiple endocrine neoplasia type 2 ,medicine.disease_cause ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,Cohort Studies ,Thyroid carcinoma ,surgery ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,medullary thyroid carcinoma ,Prevalence ,medicine ,Humans ,Thyroid Neoplasms ,human ,Thyroid neoplasm ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Thyroidectomy ,Retrospective cohort study ,Neck dissection ,Thyroid Cancer and Nodules ,Middle Aged ,multifocality ,medicine.disease ,Carcinoma, Neuroendocrine ,Tumor Burden ,Surgery ,Medullary carcinoma ,Carcinoma, Medullary ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Neoplasm Recurrence, Local ,business ,thyroid neoplasm - Abstract
Item does not contain fulltext BACKGROUND: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC, given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. This study assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to assess more accurately the risks associated with alternative surgical approaches. METHODS: A retrospective chart review of sMTC patients from 11 institutions over 29 years (1983-2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed. RESULTS: Patients from four continents and seven countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing, while the remaining 18.8% demonstrated a negative family history and no manifestations of MEN2 syndromes other than MTC. Bilateral disease was identified in 17/306 (5.6%) patients, while multifocal disease was noted in 50/312 (16.0%) sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) cases (p < 0.001). No geographic differences in focality were identified. CONCLUSIONS: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard of care for initial surgery, as less complete thyroid surgery may fail to address fully the primary site of disease. Whether ipsilateral tumor focality should be an independent factor determining the need for completion thyroidectomy when sMTC is diagnosed after hemithyroidectomy remains to be determined.
- Published
- 2016
11. Spindle epithelial tumor with thymus-like differentiation (SETTLE): clinical-pathological features, differential pathological diagnosis and therapy
- Author
-
Elena Vigliar, Giancarlo Troncone, Debora Arpaia, Carmela Peirce, Bernadette Biondi, Serena Ippolito, Claudio Bellevicine, Giuseppe Ciancia, Ippolito, S., Bellevicine, C., Arpaia, D., Peirce, C., Ciancia, G., Vigliar, E., Troncone, G., and Biondi, Bernadette
- Subjects
Pathology ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Neck mass ,030209 endocrinology & metabolism ,Malignancy ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Biopsy ,medicine ,Humans ,Neoplasms, Glandular and Epithelial ,Thyroid Neoplasms ,Spindle epithelial tumor with thymus-like differentiation , Prognosis, Treatment ,medicine.diagnostic_test ,business.industry ,Thyroidectomy ,Mediastinum ,Cell Differentiation ,medicine.disease ,Radiation therapy ,Fine-needle aspiration ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Differential diagnosis ,medicine.symptom ,business - Abstract
Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a very rare tumor of the thyroid gland. An algorithm for the diagnosis and treatment of SETTLE has yet to be established. The aim of this study was to identify all case reports of SETTLE and to compare the clinical-pathological features and therapy of the cases identified. We performed a PubMed search for case reports of SETTLE in English published up to November 2014 in which "SETTLE" and "Spindle epithelial tumor with thymus-like differentiation" were keywords. We identified 35 articles for a total of 42 cases. We found that SETTLE usually occurs in children and adolescents as an asymptomatic neck mass. Thyroid function tests and tumor markers are invariably within normal range in all patients, and fine needle aspiration biopsy is rarely diagnostic for SETTLE. All 42 patients had undergone thyroidectomy. After surgical resection, chemotherapy (adjuvant or first/second-line treatment) and/or radiotherapy were administered to control tumor growth in cases with metastatic involvement. Although SETTLE presents a low-grade malignancy, it can metastasize to lymph nodes, the mediastinum, lung, vertebrae, and kidney even many years after the initial diagnosis. SETTLE may have a good prognosis if appropriately treated at initial presentation and if patients undergo long-term monitoring with regular clinical and morphological evaluations.
- Published
- 2016
12. Ultimobranchial Body Remnants (Solid Cell Nests) as a Pitfall in Thyroid Pathology
- Author
-
Guido Pettinato, Giancarlo Troncone, Debora Arpaia, Claudio Bellevicine, Giuseppe Ciancia, Bernadette Biondi, Serena Ippolito, Bellevicine, Claudio, Ippolito, S, Arpaia, D, Ciancia, G, Pettinato, Guido, Troncone, Giancarlo, and Biondi, Bernadette
- Subjects
Male ,endocrine system ,medicine.medical_specialty ,Pathology ,Neoplasm, Residual ,Goiter ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Hashimoto Disease ,Ultimobranchial Body ,Biochemistry ,Diagnosis, Differential ,Endocrinology ,Internal medicine ,Ultimopharyngeal body ,medicine ,Animals ,Humans ,Euthyroid ,Thyroid Neoplasms ,Thyroid cancer ,Completion thyroidectomy ,Pathology, Clinical ,business.industry ,Thyroid disease ,Carcinoma ,Biochemistry (medical) ,Thyroid ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,medicine.anatomical_structure ,Research Design ,Thyroid Cancer, Papillary ,Thyroidectomy ,Histopathology ,business - Abstract
We report the history of a pitfall in thyroid histopathology of a 47-yr-old man with a euthyroid nodular goiter involving the right lobe. The ultrasound-guided fineneedle aspiration of the dominant (3 cm) nodule, showing benign-appearing follicular cells, colloid, and scattered Hurthle cells, was consistent with a benign hyperplastic nodule (1). Because the left lobe had not shown evidence of nodular disease, the patient was submitted to a right lobectomy. The pathologist described a heavy lymphoplasmacyticbackgroundwithoccasionalgerminalcenter formation, as observed in Hashimoto thyroiditis, and a microscopic ( 1cm) follicularproliferationofepithelial thyroidcellswhose nucleidisplayedmembrane irregularityandchromatinclearing with occasional grooves. Thus, a histological report of a follicular variant of papillary microcarcinoma was issued. The patient underwent a completion thyroidectomy at the Federico II UniversityofNaples.At thatoccasion, thecompletesetofslides from both surgeries was reviewed by expert pathologists in the field of thyroid disease.
- Published
- 2012
13. Under the shadow of Vesuvius: a risk for thyroid cancer?
- Author
-
Maria Triassi, Giuseppe Ciancia, Debora Arpaia, Serena Ippolito, Paolo Montuori, Bernadette Biondi, Guido Pettinato, Biondi, Bernadette, Arpaia, D, Montuori, Paolo, Ciancia, G, Ippolito, S, Pettinato, Guido, and Triassi, Maria
- Subjects
Risk ,Pathology ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Volcanic Eruptions ,medicine.disease ,Endocrinology ,medicine ,Humans ,Thyroid Neoplasms ,Radiology ,business ,Thyroid cancer ,Shadow (psychology) - Abstract
Our study was prompted by the observation that a large number of patients with DTC attending our hospital were from the area around the volcano Mt. Vesuvius (Campania, Italy). In an attempt to shed light on a possible association between volcanoes and DTC, we retrospectively examined 500 new cases admitted to the University of Federico II of Naples in Campania from 2000 to 2009. Age, sex, tumor size, lymph-node invasion, distant metastases, and cancer histotype were analyzed. We recorded the place of birth and of residence of each patient.In conclusion, we found a higher risk of papillary thyroid cancer and an earlier onset of this disease in the Vesuvius area than in other areas of Campania, although the risk was not as high as around Mt. Etna
- Published
- 2012
14. Treatment of refractory and severe hypothyroidism with sublingual levothyroxine in liquid formulation.
- Author
-
Peirce C, Ippolito S, Lanas A, Pesce M, Pontieri G, Arpaia D, Sarnelli G, and Biondi B
- Subjects
- Administration, Sublingual, Adult, Female, Humans, Thyrotropin blood, Thyroxine administration & dosage, Thyroxine blood, Treatment Outcome, Hypothyroidism drug therapy, Thyroxine therapeutic use
- Published
- 2018
- Full Text
- View/download PDF
15. Severe Hypothyroidism due to the Loss of Therapeutic Efficacy of l-Thyroxine in a Patient with Esophageal Complication Associated with Systemic Sclerosis.
- Author
-
Lobasso A, Nappi L, Barbieri L, Peirce C, Ippolito S, Arpaia D, Rossi FW, de Paulis A, and Biondi B
- Abstract
Background: Thyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with systemic autoimmune diseases as systemic sclerosis (SSc). Serum TSH levels are higher in SSc patients with more severe skin diseases and a worse modified Rodnan skin score. Asymptomatic esophageal involvement due to SSc has never been described as a cause of severe hypothyroidism due to l-thyroxine (l-T4) malabsorption in patients with Hashimoto's thyroiditis (HT) and SSc., Case Report: Here, we report a case of a 56-year-old female affected by both SSc and HT who developed severe hypothyroidism due to the loss of therapeutic efficacy of l-T4. Therapeutic failure resulted from the altered l-T4 absorption because of SSc esophageal complications. Clinical findings improved after the administration of oral liquid l-T4. Thyroid function completely normalized with a full clinical recovery, the disappearance of the pericardial effusion and the improvement of the pulmonary pressure., Conclusion: A recognition of a poor absorption is crucial in patients with hypothyroidism and SSc to reduce the risk of the subsequent adverse events. This case suggests the importance of clinical and laboratory surveillance in patients with SSc and HT because the systemic complications of these dysfunctions may worsen the prognosis of hypothyroid SSc/HT patients.
- Published
- 2017
- Full Text
- View/download PDF
16. Importance of recombinant human thyrotropin as an adjuvant in the radioiodine treatment of thyroid cancer.
- Author
-
Arpaia D, Ippolito S, Peirce C, Pontieri G, and Biondi B
- Abstract
Introduction: Radioiodine (RAI) therapy for treatment of differentiated thyroid cancer (DTC) requires high serum thyroid-stimulating hormone (TSH) levels to induce a sufficient iodine uptake within thyroid cells. Recombinant Human TSH (rhTSH) induces an exogenous TSH level increase without LT4 withdrawal. It is a valid alternative to LT4-withdrawal (LT4-W) to achieve the TSH levels required for RAI therapy. According to the recent American Thyroid Association (ATA) guidelines, candidates for RAI therapy should be selected based on their DTC risk of recurrence. Areas covered: In this review, we report the studies assessing the effects of rhTSH on RAI ablation compared to thyroid hormone withdrawal in patients with thyroid cancer at different ATA risk of recurrence. We focus our attention on high risk patients and metastatic disease in which RAI treatment is routinely recommended although there are few controversial data about the best possible way of preparing for it. Expert commentary: rhTSH-aided therapy is associated to a better quality of life and to a lower body radiation exposure. Several studies have reported an equivalent efficacy of RAI ablation after TSH stimulation with rhTSH or LT4-W in patients with DTC at low and intermediate risk of recurrence. Although more studies are required, the results are promising even in patients with high risk DTC and metastatic disease.
- Published
- 2017
- Full Text
- View/download PDF
17. How do etiological factors can explain the different clinical features of patients with differentiated thyroid cancer and their histopathological findings?
- Author
-
Pagano L, Mele C, Arpaia D, Samà MT, Caputo M, Ippolito S, Peirce C, Prodam F, Valente G, Ciancia G, Aimaretti G, and Biondi B
- Subjects
- Adult, Aged, Body Mass Index, Carcinogenesis pathology, Female, Humans, Italy, Male, Middle Aged, Retrospective Studies, Carcinoma, Papillary pathology, Carcinoma, Papillary, Follicular pathology, Thyroid Gland pathology, Thyroid Neoplasms pathology
- Abstract
The aim was to retrospectively analyse the clinical-histopathological characteristics of patients with newly diagnosis of differentiated thyroid cancer (DTC) referred to two Italian centres, one in Northern and the other in Southern Italy, between 2000 and 2013. 1081 patients were included and subdivided into two groups: group A (474 patients from Novara) and group B (607 patients from Naples). The group A came from the industrial area of Novara, while the Group B came from the areas around Vesuvius and Campi Flegrei. The two groups were comparable for iodine levels, body mass index, diagnostic timing and clinical procedures. For all patients, demographic and clinical data were collected. No difference was found in gender, whereas the age at diagnosis was later in the group A (group A 53.1 ± 15.16 years, group B 41.9 ± 14.25 years, p < 0.001). In both groups, the most frequent histotype was papillary thyroid cancer (PTC) with prevalence of follicular variant in group A (p < 0.0001) and classical variant in group B (p < 0.0001). Aggressive histological features were mainly seen in group A (bilaterality p < 0.0001, multifocality p < 0.0001 and thyroid capsular invasion p < 0.0001). Microcarcinomas were more frequent in group A (p < 0.0001) but mostly characterized by bilaterality (p < 0.001) and multifocality (p < 0.04). In both groups, tumour-associated thyroiditis showed a significant increase over the years (group A p < 0.05, group B p < 0.04). Environmental factors could justify the differences found in our study. These preliminary data should stimulate the need for an Italian Cancer Registry of DTC in order to allow an epidemiological characterization, allowing the identification of specific etiological factors and an improvement in the management of the disease.
- Published
- 2017
- Full Text
- View/download PDF
18. Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study.
- Author
-
Essig GF Jr, Porter K, Schneider D, Arpaia D, Lindsey SC, Busonero G, Fineberg D, Fruci B, Boelaert K, Smit JW, Meijer JA, Duntas LH, Sharma N, Costante G, Filetti S, Sippel RS, Biondi B, Topliss DJ, Pacini F, Maciel RM, Walz PC, and Kloos RT
- Subjects
- Adult, Aged, Aged, 80 and over, Biopsy, Carcinoma, Medullary epidemiology, Carcinoma, Medullary prevention & control, Carcinoma, Medullary surgery, Carcinoma, Neuroendocrine epidemiology, Carcinoma, Neuroendocrine prevention & control, Carcinoma, Neuroendocrine surgery, Cohort Studies, Humans, Middle Aged, Neoplasm Recurrence, Local epidemiology, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Practice Guidelines as Topic, Prevalence, Retrospective Studies, Thyroid Gland surgery, Thyroid Neoplasms epidemiology, Thyroid Neoplasms prevention & control, Thyroid Neoplasms surgery, Thyroidectomy adverse effects, Tumor Burden, Young Adult, Carcinoma, Medullary pathology, Carcinoma, Neuroendocrine pathology, Neoplasm Recurrence, Local prevention & control, Thyroid Gland pathology, Thyroid Neoplasms pathology
- Abstract
Background: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC, given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. This study assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to assess more accurately the risks associated with alternative surgical approaches., Methods: A retrospective chart review of sMTC patients from 11 institutions over 29 years (1983-2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed., Results: Patients from four continents and seven countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing, while the remaining 18.8% demonstrated a negative family history and no manifestations of MEN2 syndromes other than MTC. Bilateral disease was identified in 17/306 (5.6%) patients, while multifocal disease was noted in 50/312 (16.0%) sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) cases (p < 0.001). No geographic differences in focality were identified., Conclusions: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard of care for initial surgery, as less complete thyroid surgery may fail to address fully the primary site of disease. Whether ipsilateral tumor focality should be an independent factor determining the need for completion thyroidectomy when sMTC is diagnosed after hemithyroidectomy remains to be determined.
- Published
- 2016
- Full Text
- View/download PDF
19. Recombinant Human Thyrotropin Improves Endothelial Coronary Flow Reserve in Thyroidectomized Patients with Differentiated Thyroid Cancer.
- Author
-
Ippolito S, Ippolito R, Peirce C, Esposito R, Arpaia D, Santoro C, Pontieri G, Cocozza S, Galderisi M, and Biondi B
- Subjects
- Adult, Blood Pressure drug effects, Cell Differentiation, Combined Modality Therapy adverse effects, Echocardiography, Doppler drug effects, Female, Heart Rate drug effects, Hormone Replacement Therapy adverse effects, Humans, Injections, Intramuscular, Male, Recombinant Proteins administration & dosage, Recombinant Proteins metabolism, Recombinant Proteins pharmacokinetics, Stroke Volume drug effects, Thyroid Neoplasms pathology, Thyroid Neoplasms surgery, Thyroidectomy, Thyrotropin administration & dosage, Thyrotropin genetics, Thyrotropin metabolism, Thyroxine therapeutic use, Young Adult, Coronary Circulation drug effects, Endothelium, Vascular drug effects, Recombinant Proteins therapeutic use, Thyroid Neoplasms drug therapy, Thyrotropin therapeutic use
- Abstract
Background: The role of thyrotropin (TSH) on the cardiovascular system has been poorly investigated. It is unknown whether the changes in the vasculature associated with thyroid diseases result from altered thyroid hormone action or whether they are a consequence of a direct effect of TSH on endothelial cells. The present study was designed to evaluate the endothelial response of coronary flow to TSH in patients with differentiated thyroid cancer (DTC) without cardiovascular risk factors., Methods: The study population consisted of three men and seven women (M
age = 32.6 ± 8 years) who underwent total thyroidectomy for DTC. All were receiving therapy with L-thyroxine to maintain TSH within the reference range. No patient was obese, or had hypertension, diabetes, or dyslipidemia. Patients underwent standard echo-Doppler examination with evaluation of the coronary flow reserve (CFR) of the distal left anterior descending artery obtained by cold pressure test (CPT) before and 24 h after the second recombinant human TSH (rhTSH) injection., Results: Left ventricular morphology and systolic and diastolic function were normal in all patients. Levels of thyroid hormones and thyroglobulin and antithyroglobulin antibodies did not differ significantly pre- versus post-rhTSH treatment, whereas TSH levels were higher after rhTSH administration. Blood pressure and heart rate were not affected by rhTSH. Coronary flow peak velocity at rest (22.3 ± 6 vs 23.2 ± 8.7; p = 0.66) did not differ between baseline and 24 h after rhTSH, while post-CPT velocity (29.3 ± 6.8 vs 34.4 ± 10.9; p < 0.05) and the CFR were higher after rhTSH administration (1.32 ± 0.2 vs. 1.53 ± 0.2; p < 0.01)., Conclusions: rhTSH administration may improve the CFR after the non-pharmacological stressor CPT in DTC patients. The increase of coronary blood flow after rhTSH suggests that TSH may exert a protective effect on the coronary endothelium.- Published
- 2016
- Full Text
- View/download PDF
20. Spindle epithelial tumor with thymus-like differentiation (SETTLE): clinical-pathological features, differential pathological diagnosis and therapy.
- Author
-
Ippolito S, Bellevicine C, Arpaia D, Peirce C, Ciancia G, Vigliar E, Troncone G, and Biondi B
- Subjects
- Cell Differentiation, Diagnosis, Differential, Humans, Neoplasms, Glandular and Epithelial pathology, Thyroid Neoplasms pathology, Neoplasms, Glandular and Epithelial diagnosis, Neoplasms, Glandular and Epithelial therapy, Thyroid Neoplasms diagnosis, Thyroid Neoplasms therapy
- Abstract
Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a very rare tumor of the thyroid gland. An algorithm for the diagnosis and treatment of SETTLE has yet to be established. The aim of this study was to identify all case reports of SETTLE and to compare the clinical-pathological features and therapy of the cases identified. We performed a PubMed search for case reports of SETTLE in English published up to November 2014 in which "SETTLE" and "Spindle epithelial tumor with thymus-like differentiation" were keywords. We identified 35 articles for a total of 42 cases. We found that SETTLE usually occurs in children and adolescents as an asymptomatic neck mass. Thyroid function tests and tumor markers are invariably within normal range in all patients, and fine needle aspiration biopsy is rarely diagnostic for SETTLE. All 42 patients had undergone thyroidectomy. After surgical resection, chemotherapy (adjuvant or first/second-line treatment) and/or radiotherapy were administered to control tumor growth in cases with metastatic involvement. Although SETTLE presents a low-grade malignancy, it can metastasize to lymph nodes, the mediastinum, lung, vertebrae, and kidney even many years after the initial diagnosis. SETTLE may have a good prognosis if appropriately treated at initial presentation and if patients undergo long-term monitoring with regular clinical and morphological evaluations.
- Published
- 2016
- Full Text
- View/download PDF
21. Under the shadow of vesuvius: a risk for thyroid cancer?
- Author
-
Biondi B, Arpaia D, Montuori P, Ciancia G, Ippolito S, Pettinato G, and Triassi M
- Subjects
- Humans, Risk, Thyroid Neoplasms etiology, Volcanic Eruptions adverse effects
- Published
- 2012
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.