1,721,067 research outputs found
Response to Letter to the Editor: Active Surveillance in Papillary Thyroid Microcarcinomas is Feasible and Safe: Experience at a Single Italian Center
NUT midline carcinoma of the head and neck: current perspectives
NUT midline carcinoma (NMC) is a rare and aggressive subtype of squamous carcinoma that typically arises from midline supradiaphragmatic structures, frequently from the head and neck area. NMC is genetically driven by a chromosomal rearrangement involving the NUT gene, which forms oncoproteins considered major pathogenic drivers of cellular transformation. Diagnosis of NMC has been made remarkably easier with the availability of a commercial antibody against NUT, and can be established through positive nuclear immunohistochemical staining. Although NMC remains an underrecognized malignancy, in recent years there has appeared to be increasing awareness of disease and frequency of diagnosis in adults. To date, a standard treatment for head and neck NMC has not been established and a multimodal approach with systemic chemotherapy, surgery and radiation therapy is currently adopted in clinical practice. Recently, BET inhibitors and histone deacetylase inhibitors have emerged as two promising classes of targeted agents, currently investigated in clinical trials for adults with head and neck NMC. At the same time, combination approaches and novel targeted agents, such as next-generation BET inhibitors and CDK9 inhibitors, have shown preclinical activity. The present review explores the clinical pathological characteristics of NMC of the head and neck and presents the current state of the art on diagnosis, prognosis, and treatment of this rare but lethal disease
Carcinoma tiroideo e gravidanza.
La gestione del carcinoma tiroideo in gravidanza comporta scelte terapeutiche importanti in considerazione dei potenziali rischi per la paziente e per il feto. La maggior parte delle donne in gravidanza affette da carcinoma tiroideo differenziato può effettuare il trattamento chirurgico dopo il parto. In questi casi è opportuno monitorare il nodulo mediante l’ecografia del collo e la funzionalità tiroidea ed eseguire terapia con L-tiroxina. Qualora si decida di intervenire durante la gravidanza, è opportuno che l’intervento venga eseguito nel secondo trimestre
Meccanismi di azione dei principali farmaci utilizzati nel trattamento dei carcinomi tiroidei
Clinical impact of molecular techniques for the presurgical diagnosis of differentiated thyroid cancer diagnosis
Introduction: The gold standard for the presurgical diagnosis of thyroid cancer is fine needle aspiration cytology. In about 30% of cases a final diagnosis is not obtained and surgical treatment is required for diagnostic/therapeutic purposes. To avoid unnecessary thyroidectomies, methods based on molecular markers analysis have been explored over the last 10 years. Areas covered: The present review introduces the limits of the cytological diagnosis of thyroid nodules and describes the molecular techniques for the presurgical diagnosis of these nodules focusing on the use of the Thyroseq-V2 (Rule in) and Afirma (Rule out) tests. Expert commentary: These two types of tests have been clinically applied and validated; however they are still confined to specialized laboratories, either academic or private, and not yet routinely used. The evidence of a positive cost-benefit analysis should encourage to set up molecular pathology laboratories to apply new molecular testing(s). In the meantime, clinical judgment, which must take into consideration several parameters including the age of the patient, the size and number of the nodule(s), the ultrasound pattern and the risk level for malignancy, should guide the decision to operate or to follow up the evolution of the nodule
BRCA in Gastrointestinal Cancers: Current Treatments and Future Perspectives
A strong association between pancreatic cancer and BRCA1 and BRCA2 mutations is documented. Based on promising results of breast and ovarian cancers, several clinical trials with poly (ADP-ribose) polymerase inhibitors (PARPi) are ongoing for gastrointestinal (GI) malignancies, especially for pancreatic cancer. Indeed, the POLO trial results provide promising and awaited changes for the pancreatic cancer therapeutic landscape. Contrariwise, for other gastrointestinal tumors, the rationale is currently only alleged. The role of BRCA mutation in gastrointestinal cancers is the subject of this review. In particular, we aim to provide the latest updates about novel therapeutic strategies that, exploiting DNA repair defects, promise to shape the future therapeutic scenario of GI cancers
Pros and cons of an aggressive initial treatment with surgery and radioiodine treatment in minimally invasive follicular thyroid carcinoma
BACKGROUND: Currently, surgery alone is the gold standard treatment for minimally invasive follicular thyroid cancer (mi-FTC). CASE PRESENTATION: A case of a mi-FTC diagnosed in 1994 was treated with total thyroidectomy and radioiodine (RAI) ablation, according to the therapeutic algorithm used at that time. Nevertheless, he had a recurrence with distant metastasis after 24 years from the initial treatment. CONCLUSION: Total thyroidectomy and RAI ablation might have delayed the development of distant metastasis but they were not sufficient to avoid disease recurrence. Certainly, remnant ablation simplified the follow-up and the monitoring of serum thyroglobulin allowed the early detection of the biochemical recurrence, but didn’t change the outcome of the disease. Moreover, because of this early detection the patient was exposed to useless biochemical and imaging examinations. The aim of this report is to discuss the pros and cons of an aggressive treatment of a patient with mi-FTC
Re: "Symptomatic Biliary Disorders During Lenvatinib Treatment for Thyroid Cancer: An Underestimated Problem" by Nervo et al
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