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    Coexistent Familial Nonmultiple Endocrine Neoplasia Medullary Thyroid Carcinoma and Papillary Thyroid Carcinoma Associated With RET Polymorphism
    (Lippincott Williams & Wilkins, 2010) Gül, Kamile; Özdemir, Didem; Uğraş, Serdar; İnançlı, Serap S.; Ersoy, Reyhan; Çakır, Bekir
    Familial nonmultiple endocrine neoplasia medullary thyroid cancer accounts for 10% to 15% of hereditary medullary thyroid carcinoma and is characterized by lack of accompanying endocrine or nonendocrine diseases. Simultaneous occurrence of medullary and papillary thyroid carcinoma in the same patient is rare and known as collision tumor. Here, the authors present familial nonmultiple endocrine neoplasia medullary thyroid cancer in 4 sisters, all having RET proto-oncogene polymorphism in exon 15 at codon 904 and 2 having additional polymorphism in exon 13 at codon 769. The index case had concomitant medullary and papillary thyroid carcinomas, which are suggested to be completely different tumors in terms of incidence, cell origin, histopathologic features and prognosis. Histopathologically, she also had Hashimoto thyroiditis in the remaining thyroid tissue and medullary thyroid carcinoma metastasis in 3 cervical lymph nodes. This case is the first in the literature to report coexistent familial nonmultiple endocrine neoplasia medullary thyroid cancer and papillary thyroid carcinoma related with a RET polymorphism (S904S in exon 15).
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    Comparison of Papillary Thyroid Microcarcinoma and Carcinoma
    (Turkiye Klinikleri, 2009) Gül, Kamile; Özdemir, Didem; Ersoy, Reyhan; Aydın, Cevdet; Erkan, Ali; Ersoy, Pamir Eren; Aydın, Raci; Uğraş, Serdar Nevzat; Çakır, Bekir
    Objective: The aim of this study is to evaluate some preoperative and postoperative clinical and histopathological characteristics of patients with papillary thyroid microcarcinoma (PTMC). We also compared these features with papillary thyroid carcinoma greater than 1 cm (PTC). Materials and Methods: We reviewed the clinical data of 224 patients who were diagnosed and treated for papillary thyroid carcinoma. Both the preoperative and postoperative features of patients were assessed. There were 132 patients with PTMC and 92 patients with PTC. Results: The mean age and the incidence of hyperthyroidism were higher in patients with PTMC compared to patients with PTC. There were also a higher number of patients operated for benign lesions in PTMC group. In histopathologic examination, mean tumor diameter was 5.8±2.8 mm in PTMC patients. Although, we found capsular invasion in 17.4%, vascular invasion in 1.5%, extrathyroidal extension in 3%, lymph node involvement in 3.8% and multifocality in 18.9% of PTMC patients, these percentages were significantly lower than in PTC patients. Tumor was detected incidentally in 37.1% and nonincidentally in 62.9% of PTMC patients. No significant difference was present between incidental and nonincidental PTMC in terms of age, sex, and histopathological findings. Anyway, tumor diameter was greater in nonincidental PTMC compared to incidental PTMC. Conclusions: Histopathological features of incidental and nonincidental PTMC did not differ, while there was a significant difference between PTMC and PTC in terms of tumoral characteristics. However, particularly multifocality and capsular invasion were present in a considerable number of PTMC patients. We suggest that patients with PTMC should also be managed like patients with PTC.
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    Preoperative and Postoperative Evaluation of Thyroid Disease in Patients Undergoing Surgical Treatment of Primary Hyperparathyroidism
    (Amer Assoc Clinical Endocrinologists, 2010) Gül, Kamile; Özdemir, Didem; Korukluoğlu, Birol; Ersoy, Pamir Eren; Aydın, Raci; Uğraş, Serdar Nevzat; Ersoy, Reyhan; Çakır, Bekir
    Objective: To evaluate the occurrence of thyroid disease in patients undergoing parathyroidectomy for primary hyperparathyroidism. Methods: In this case series, records of all parients with a diagnosis of primary hyperparathyrodism who underwent parathyroidectomy bewteen January 2005 and December 2008 in our clinic were analyzed retrospective Preoperatively, all patients were evaluated with ultrasonography and parathyroid scintigraphy, when needed, thryoid scintigraphy and ultrasound-guided fine-needle aspiration biopsy (FNAB) were used All patients underwent standard neck exploration Postoperative histopathologic findings of thyroid tissue were classified as nodular/multinodular hyperplasia. Hashimoto thyroiditis, papillary thyroid carcinoma, or normal Results: Fifty-one women and 9 men were included In the 60 patients, preoperative ultrasonography revealed thyroiditis (without nodules) in 13 (22%), a solitary nodule in 9 (15%) (coexistent with thyroditis in 7 patients), multinodular goiter in 24 (40%) (coexistent with thyroiditis in 5 patients), and normal findings in 14 (23%) Rates of thyroiditis and nodular goiter were 42% and 55%, respectively. Collectively, prevalence of thyroid disease was 77% Total thyroidectomy was performed in 27 patiens, and hemithyroidectomy was performed in 15 patients Indications for total thyroidectomy were nondiagnostic or suspecious FNAB results in 5 patients, hyperthyroidism in 4 patients, ultrasonography findings in 11 patients, and intraoperatively recognized suspicious nodularity in 7 patients Postoperatively, thyroid carcinoma was dragnosed in 9 patients (15%) Conclusions: Thyroid disease, particularly thyroid carcinoma, is common in patients with primary hyperparathyroidism This association should be considered when selecting the surgical procedure Intraoperative evaluation of the thyroid is as important as preoperative evaluation with ultrasonography and FNAB in patients with thyroid disease and primary hyperparathyroidism.