Tiroid Kanserlerine Genel Bakış
Özet
Tiroid kanseri, tiroid parankimal hücrelerinin malignitesidir, klinik davranışları sessiz ve yavaş ilerleyen tümörlerden yüksek ölüm oranlarına sahip agresif tümörlere kadar oldukça değişkendir. Tiroid kanseri, tüm malignitelerin %1 ila %3’ünü oluşturur. Son yıllarda insidansında belirgin artış izlenmektedir. Kadın cinsiyet, ailede tiroid kanseri öyküsü ve çocukluk döneminde tiroid bezinin radyasyona maruz kalması temel risk faktörleridir. Tiroid kanserinde birçok mutasyon, translokasyon tanımlanmıştır. Çoğu sporadiktir, en sık görülen bulgu boyunda şişlik ya da boyun görüntülemesinde tesadüfen saptanan tiroid nodülleridir. Tiroid malignitelerinin %90 ile 95'ini papiller, foliküler ve onkositik karsinom oluşturur. Dünya Sağlık Örgütü 2022 yılında, tümör histolojisine ek olarak neoplastik hücrelerin moleküler özelliklerinin de dahil edildiği yeni bir sınıflama oluşturmuştur. Bu sınıflamada tiroid kanserleri ‘Benign’, ‘Düşük Riskli’ ve ‘Malign’ olarak 3 ana tanısal grupta incelenir.
Tiroid kanserinin klinik davranışları sessiz ve yavaş ilerleyen tümörlerden yüksek ölüm oranlarına sahip oldukça agresif tümörlere kadar oldukça değişkendir. İleri evre tiroid kanseri için çeşitli yeni tedavi seçenekleri bulunurken, düşük riskli tiroid kanserlerinin ise aşırı agresif tedavi edildiğine yönelik kanıtlar da vardır. Bu nedenle, tiroid kanseri türlerinin ve tedavisinin tam olarak anlaşılması, hastaya uygun tedavinin uygulanmasında büyük önem taşımaktadır.
Bu bölümde tiroid kanserlerine genel bakış ve tiroid kanserlerinin sınıflamasının temellerinden bahsedilecek, ileri bölümlerde her bir tümör detaylı olarak anlatılacaktır.
Referanslar
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71: 209-249
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015 Jan-Feb;65(1):5-29.
Franceschi S, Boyle P, Maisonneuve P, La Vecchia C, Burt AD, Kerr DJ, MacFarlane GJ. The epidemiology of thyroid carcinoma. Crit Rev Oncog. 1993;4(1):25-52.
Siegel, RL, Miller, KD, Fuchs, HE, Jemal, A. Cancer statistics, 2022. CA Cancer J Clin. 2022.
Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006 May 10;295(18):2164-7.
Enewold L, Zhu K, Ron E, Marrogi AJ, Stojadinovic A, Peoples GE, et al. Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980–2005. Cancer Epidemiol Biomarkers Prev. 2009;18(3):784–91.
Miranda-Filho A, Lortet-Tieulent J, Bray F, Cao B, Franceschi S, Vaccarella S, Dal Maso L. Thyroid cancer incidence trends by histology in 25 countries: a population-based study. Lancet Diabetes Endocrinol. 2021 Apr;9(4):225-234.
Davies L, Ouellette M, Hunter M, Welch HG. The increasing incidence of small thyroid cancers: where are the cases coming from? Laryngoscope. 2010 Dec;120(12):2446-51.
Noone AM, Cronin KA, Altekruse SF, Howlader N, Lewis DR, Petkov VI, Penberthy L. Cancer Incidence and Survival Trends by Subtype Using Data from the Surveillance Epidemiology and End Results Program, 1992-2013. Cancer Epidemiol Biomarkers Prev. 2017 Apr;26(4):632-641.
Christofer Juhlin C, Mete O, Baloch ZW. The 2022 WHO classification of thyroid tumors: novel concepts in nomenclature and grading. Endocr Relat Cancer. 2022 Dec 22;30(2):e220293
Nikiforov YE, Nikiforova MN. Molecular genetics and diagnosis of thyroid cancer. Nat Rev Endocrinol. 2011 Aug 30;7(10):569-80.
Galanti MR, Ekbom A, Grimelius L, Yuen J. Parental cancer and risk of papillary and follicular thyroid carcinoma. Br J Cancer. 1997;75(3):451-6.
Robbins J, Schneider AB. Thyroid cancer following exposure to radioactive iodine. Rev Endocr Metab Disord. 2000 Apr;1(3):197-203.
Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J obes Relat Metab Disord J Int Assoc Study Obes. 1998;22(1):39– 47
Cho A, Chang Y, Ahn J, Shin H, Ryu S. Cigarette smoking and thyroid cancer risk: a cohort study. Br J Cancer. 2018 Aug;119(5):638- 645.
LeClair K, Bell KJL, Furuya-Kanamori L, Doi SA, Francis DO, Davies L. Evaluation of Gender Inequity in Thyroid Cancer Diagnosis: Differences by Sex in US Thyroid Cancer Incidence Compared With a Meta-analysis of Subclinical Thyroid Cancer Rates at Autopsy. JAMA Intern Med. 2021 Oct 01;181(10):1351-1358.
Fagin JA. How thyroid tumors start and why it matters: kinase mutants as targets for solid cancer pharmacotherapy. J Endocrinol. 2004 Nov;183(2):249-56.
Carling T, Udelsman R. Thyroid cancer. Annu Rev Med. 2014;65:125-37.
Cancer Genome Atlas Research Network. Integrated genomic characterization of papillary thyroid carcinoma. Cell. 2014 Oct 23;159(3):676-90.
Raman P, Koenig RJ. Pax-8-PPAR-γ fusion protein in thyroid carcinoma. Nat Rev Endocrinol. 2014 Oct;10(10):616-23.
Nikiforova MN, Wald AI, Roy S, Durso MB, Nikiforov YE. Targeted next-generation sequencing panel (ThyroSeq) for detection of mutations in thyroid cancer. J Clin Endocrinol Metab. 2013 Nov;98(11):E1852-60.
Santarpia L, El-Naggar AK, Cote GJ, Myers JN, Sherman SI. Phosphatidylinositol 3-kinase/akt and ras/raf-mitogen-activated protein kinase pathway mutations in anaplastic thyroid cancer. J Clin Endocrinol Metab. 2008 Jan;93(1):278-84.
Hou P, Liu D, Shan Y, Hu S, Studeman K, Condouris S, Wang Y, Trink A, El-Naggar AK, Tallini G, Vasko V, Xing M. Genetic alterations and their relationship in the phosphatidylinositol 3-kinase/Akt pathway in thyroid cancer. Clin Cancer Res. 2007 Feb 15;13(4):1161-70.
Landa I, Ganly I, Chan TA, Mitsutake N, Matsuse M, Ibrahimpasic T, Ghossein RA, Fagin JA. Frequent somatic TERT promoter mutations in thyroid cancer: higher prevalence in advanced forms of the disease. J Clin Endocrinol Metab. 2013 Sep;98(9):E1562-6.
Alexander EK, Kennedy GC, Ba loch ZW, Cibas ES, Chudova D, Diggans J, et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med. 2012;367(8):705.
Glikson M, Feigin RD, Libson E, Rubinow A. Anaplastic thyroid carcinoma in a retrosternal goiter presenting as fever of unknown origin. Am J Med. 1990 Jan;88(1):81-2.
Chang TC, Liaw KY, Kuo SH, Chang CC, Chen FW. Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis. Taiwan Yi Xue Hui Za Zhi. 1989 Jun;88(6):551-6.
Alexander EK, Kennedy GC, Baloch ZW, Cibas ES, Chudova D, Diggans J, et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med. 2012;367(8):705–15.
Deveci MS, Deveci G, LiVolsi VA, Gupta PK, Baloch ZW. Concordance between thyroid nodule sizes measured by ultrasound and gross pathology examination: effect on patient management. Diagn Cytopathol. 2007;35(9):579–83.
Haymart MR, Cayo M, Chen H. Papillary thyroid microcarcinomas: big decisions for a small tumor. Ann Surg Oncol. 2009;16(11):3132–9
Silverberg SG, Vidone RA. Adenoma and carcinoma of the thyroid. Cancer. 1966;19:1053–1062.
Bisi H, Fernandes VS, de Camargo RY, et al. The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma. Cancer. 1989;64:1888–1893.
Mete O & Asa SL 2012 Pitfalls in the diagnosis of follicular epithelial proliferations of the thyroid. Advances in Anatomic Pathology 19 363–373.
Asa SL, Erickson LA & Mete O 2022 The next steps for endocrine pathology. Endocrine Pathology 33 228–230.
Parma J, Duprez L, Van Sande J, Cochaux P, Gervy C, Mockel J, Dumont J & Vassart G 1993 Somatic mutations in the thyrotropin receptor gene cause hyperfunctioning thyroid adenomas. Nature 365 649–651.
Gozu HI, Lublinghoff J, Bircan R & Paschke R 2010 Genetics and phenomics of inherited and sporadic non-autoimmune hyperthyroidism. Molecular and Cellular Endocrinology 322 125–134.
Kamilaris CDC, Faucz FR, Voutetakis A & Stratakis CA 2019 Carney complex. Experimental and Clinical Endocrinology & Diabetes 127 156–164.
Nosé V, Gill A, Teijeiro JMC, Perren A & Erickson L 2022 Overview of the 2022 WHO classification of familial endocrine tumor syndromes. Endocrine Pathology 33 197–227.
Juhlin CC, Stenman A & Zedenius J 2021 Macrofollicular variant follicular thyroid tumors are DICER1 mutated and exhibit distinct histological features. Histopathology 79 661–666.
Hodak S, Tuttle RM, Maytal G, Nikiforov YE & Randolph G 2016 Changing the cancer diagnosis: the case of follicular variant of papillary thyroid cancer-primum non nocere and NIFTP. Thyroid 26 869–871.
Thompson LD 2016 Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma: a name change to Noninvasive Follicular thyroid neoplasm with Papillary-like Nuclear Features would help prevent overtreatment. Modern Pathology 29 698–707.
Nikiforova MN, Nikitski AV, Panebianco F, Kaya C, Yip L, Williams M, Chiosea SI, Seethala RR, Roy S, Condello V, et al. 2019 GLIS rearrangement is a genomic hallmark of hyalinizing trabecular tumor of the thyroid gland. Thyroid 29 161–173.
Çakır B. 2020, Tiroid Kanseri Güncel Yaklaşım, Türkiye Endokrinoloji ve Metabolizma Derneği, Ankara,
Kebebew E, Weng J, Bauer J, Ranvier G, Clark OH, Duh QY, Shibru D, Bastian B & Griffin A 2007 The prevalence and prognostic value of BRAF mutation in thyroid cancer. Annals of Surgery 246 466–471.
Hiltzik D, Carlson DL, Tuttle RM, Chuai S, Ishill N, Shaha A, Shah JP, Singh B & Ghossein RA 2006 Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis: a clinicopathologic study of 58 patients. Cancer 106 1286–1295.
Gnemmi V, Renaud F, Do Cao C, Salleron J, Lion G, Wemeau JL, Copin MC, Carnaille B, Leteurtre E, Pattou F, et al. 2014 Poorly differentiated thyroid carcinomas: application of the Turin proposal provides prognostic results similar to those from the assessment of high-grade features. Histopathology 64 263–273.
Asa SL. The current classification of thyroid cancer. Endocrinol Metab Clin N Am 2019; 1-22.
Volante M, Collini P, Nikiforov YE, Sakamoto A, Kakudo K, Katoh R, Lloyd RV, LiVolsi VA, Papotti M, Sobrinho-Simoes M, et al. 2007 Poorly differentiated thyroid carcinoma: the Turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach. American Journal of Surgical Pathology 31 1256–1264.
Wells SA Jr, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid 2015; 25:567.
Saad MF, Ordonez NG, Rashid RK, et al. Medullary carcinoma of the thyroid. A study of the clinical features and prognostic factors in 161 patients. Medicine (Baltimore) 1984; 63:319.
Dottorini ME, Assi A, Sironi M, et al. Multivariate analysis of patients with medullary thyroid carcinoma. Prognostic significance and impact on treatment of clinical and pathologic variables. Cancer 1996; 77:1556.
Gagel RF, Hoff AO, Cote GJ. Medullary thyroid carcinoma. In: Werner & Ingbar's The Thyroid, 9th, Braverman LE, Utiger RD (Eds), Lippincott Williams & Wilkins, Philadelphia 2005. p.967.
Pacini F, Castagna MG, Cipri C, Schlumberger M. Medullary thyroid carcinoma. Clin Oncol (R Coll Radiol) 2010; 22:475.
Chintamani, Kulshreshtha P, Singh J, et al. Is an aggressive approach justified in the management of an aggressive cancer--the squamous cell carcinoma of thyroid? International seminars in surgical oncology : ISSO. 2007;4:8.
Cho JK, Woo SH, Park J, Kim MJ, Jeong HS. Primary squamous cell carcinomas in the thyroid gland: an individual participant data meta-analysis. Cancer medicine. 2014;3:1396-1403.
Syed MI, Stewart M, Syed S, et al. Squamous cell carcinoma of the thyroid gland: primary or secondary disease? The Journal of laryngology and otology. 2011;125:3-9.
Barczynski M, Jamski J, Cichon S, Barczynski M, Sulowicz W. [Diagnosis, treatment and prognosis in cases of renal clear cell carcinoma metastases into the thyroid gland]. Przeglad lekarski. 2000;57:157- 159.
Lam KY, Lo CY. Metastatic tumors of the thyroid gland: a study of 79 cases in Chinese patients. Archives of pathology & laboratory medicine. 1998;122:37-41.
Zhang L, Liu Y, Li X, Gao W, Zheng C. Metastases to the thyroid gland: A report of 32 cases in PUMCH. Medicine. 2017;96:e7927.
Referanslar
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71: 209-249
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015 Jan-Feb;65(1):5-29.
Franceschi S, Boyle P, Maisonneuve P, La Vecchia C, Burt AD, Kerr DJ, MacFarlane GJ. The epidemiology of thyroid carcinoma. Crit Rev Oncog. 1993;4(1):25-52.
Siegel, RL, Miller, KD, Fuchs, HE, Jemal, A. Cancer statistics, 2022. CA Cancer J Clin. 2022.
Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006 May 10;295(18):2164-7.
Enewold L, Zhu K, Ron E, Marrogi AJ, Stojadinovic A, Peoples GE, et al. Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980–2005. Cancer Epidemiol Biomarkers Prev. 2009;18(3):784–91.
Miranda-Filho A, Lortet-Tieulent J, Bray F, Cao B, Franceschi S, Vaccarella S, Dal Maso L. Thyroid cancer incidence trends by histology in 25 countries: a population-based study. Lancet Diabetes Endocrinol. 2021 Apr;9(4):225-234.
Davies L, Ouellette M, Hunter M, Welch HG. The increasing incidence of small thyroid cancers: where are the cases coming from? Laryngoscope. 2010 Dec;120(12):2446-51.
Noone AM, Cronin KA, Altekruse SF, Howlader N, Lewis DR, Petkov VI, Penberthy L. Cancer Incidence and Survival Trends by Subtype Using Data from the Surveillance Epidemiology and End Results Program, 1992-2013. Cancer Epidemiol Biomarkers Prev. 2017 Apr;26(4):632-641.
Christofer Juhlin C, Mete O, Baloch ZW. The 2022 WHO classification of thyroid tumors: novel concepts in nomenclature and grading. Endocr Relat Cancer. 2022 Dec 22;30(2):e220293
Nikiforov YE, Nikiforova MN. Molecular genetics and diagnosis of thyroid cancer. Nat Rev Endocrinol. 2011 Aug 30;7(10):569-80.
Galanti MR, Ekbom A, Grimelius L, Yuen J. Parental cancer and risk of papillary and follicular thyroid carcinoma. Br J Cancer. 1997;75(3):451-6.
Robbins J, Schneider AB. Thyroid cancer following exposure to radioactive iodine. Rev Endocr Metab Disord. 2000 Apr;1(3):197-203.
Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J obes Relat Metab Disord J Int Assoc Study Obes. 1998;22(1):39– 47
Cho A, Chang Y, Ahn J, Shin H, Ryu S. Cigarette smoking and thyroid cancer risk: a cohort study. Br J Cancer. 2018 Aug;119(5):638- 645.
LeClair K, Bell KJL, Furuya-Kanamori L, Doi SA, Francis DO, Davies L. Evaluation of Gender Inequity in Thyroid Cancer Diagnosis: Differences by Sex in US Thyroid Cancer Incidence Compared With a Meta-analysis of Subclinical Thyroid Cancer Rates at Autopsy. JAMA Intern Med. 2021 Oct 01;181(10):1351-1358.
Fagin JA. How thyroid tumors start and why it matters: kinase mutants as targets for solid cancer pharmacotherapy. J Endocrinol. 2004 Nov;183(2):249-56.
Carling T, Udelsman R. Thyroid cancer. Annu Rev Med. 2014;65:125-37.
Cancer Genome Atlas Research Network. Integrated genomic characterization of papillary thyroid carcinoma. Cell. 2014 Oct 23;159(3):676-90.
Raman P, Koenig RJ. Pax-8-PPAR-γ fusion protein in thyroid carcinoma. Nat Rev Endocrinol. 2014 Oct;10(10):616-23.
Nikiforova MN, Wald AI, Roy S, Durso MB, Nikiforov YE. Targeted next-generation sequencing panel (ThyroSeq) for detection of mutations in thyroid cancer. J Clin Endocrinol Metab. 2013 Nov;98(11):E1852-60.
Santarpia L, El-Naggar AK, Cote GJ, Myers JN, Sherman SI. Phosphatidylinositol 3-kinase/akt and ras/raf-mitogen-activated protein kinase pathway mutations in anaplastic thyroid cancer. J Clin Endocrinol Metab. 2008 Jan;93(1):278-84.
Hou P, Liu D, Shan Y, Hu S, Studeman K, Condouris S, Wang Y, Trink A, El-Naggar AK, Tallini G, Vasko V, Xing M. Genetic alterations and their relationship in the phosphatidylinositol 3-kinase/Akt pathway in thyroid cancer. Clin Cancer Res. 2007 Feb 15;13(4):1161-70.
Landa I, Ganly I, Chan TA, Mitsutake N, Matsuse M, Ibrahimpasic T, Ghossein RA, Fagin JA. Frequent somatic TERT promoter mutations in thyroid cancer: higher prevalence in advanced forms of the disease. J Clin Endocrinol Metab. 2013 Sep;98(9):E1562-6.
Alexander EK, Kennedy GC, Ba loch ZW, Cibas ES, Chudova D, Diggans J, et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med. 2012;367(8):705.
Glikson M, Feigin RD, Libson E, Rubinow A. Anaplastic thyroid carcinoma in a retrosternal goiter presenting as fever of unknown origin. Am J Med. 1990 Jan;88(1):81-2.
Chang TC, Liaw KY, Kuo SH, Chang CC, Chen FW. Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis. Taiwan Yi Xue Hui Za Zhi. 1989 Jun;88(6):551-6.
Alexander EK, Kennedy GC, Baloch ZW, Cibas ES, Chudova D, Diggans J, et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med. 2012;367(8):705–15.
Deveci MS, Deveci G, LiVolsi VA, Gupta PK, Baloch ZW. Concordance between thyroid nodule sizes measured by ultrasound and gross pathology examination: effect on patient management. Diagn Cytopathol. 2007;35(9):579–83.
Haymart MR, Cayo M, Chen H. Papillary thyroid microcarcinomas: big decisions for a small tumor. Ann Surg Oncol. 2009;16(11):3132–9
Silverberg SG, Vidone RA. Adenoma and carcinoma of the thyroid. Cancer. 1966;19:1053–1062.
Bisi H, Fernandes VS, de Camargo RY, et al. The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma. Cancer. 1989;64:1888–1893.
Mete O & Asa SL 2012 Pitfalls in the diagnosis of follicular epithelial proliferations of the thyroid. Advances in Anatomic Pathology 19 363–373.
Asa SL, Erickson LA & Mete O 2022 The next steps for endocrine pathology. Endocrine Pathology 33 228–230.
Parma J, Duprez L, Van Sande J, Cochaux P, Gervy C, Mockel J, Dumont J & Vassart G 1993 Somatic mutations in the thyrotropin receptor gene cause hyperfunctioning thyroid adenomas. Nature 365 649–651.
Gozu HI, Lublinghoff J, Bircan R & Paschke R 2010 Genetics and phenomics of inherited and sporadic non-autoimmune hyperthyroidism. Molecular and Cellular Endocrinology 322 125–134.
Kamilaris CDC, Faucz FR, Voutetakis A & Stratakis CA 2019 Carney complex. Experimental and Clinical Endocrinology & Diabetes 127 156–164.
Nosé V, Gill A, Teijeiro JMC, Perren A & Erickson L 2022 Overview of the 2022 WHO classification of familial endocrine tumor syndromes. Endocrine Pathology 33 197–227.
Juhlin CC, Stenman A & Zedenius J 2021 Macrofollicular variant follicular thyroid tumors are DICER1 mutated and exhibit distinct histological features. Histopathology 79 661–666.
Hodak S, Tuttle RM, Maytal G, Nikiforov YE & Randolph G 2016 Changing the cancer diagnosis: the case of follicular variant of papillary thyroid cancer-primum non nocere and NIFTP. Thyroid 26 869–871.
Thompson LD 2016 Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma: a name change to Noninvasive Follicular thyroid neoplasm with Papillary-like Nuclear Features would help prevent overtreatment. Modern Pathology 29 698–707.
Nikiforova MN, Nikitski AV, Panebianco F, Kaya C, Yip L, Williams M, Chiosea SI, Seethala RR, Roy S, Condello V, et al. 2019 GLIS rearrangement is a genomic hallmark of hyalinizing trabecular tumor of the thyroid gland. Thyroid 29 161–173.
Çakır B. 2020, Tiroid Kanseri Güncel Yaklaşım, Türkiye Endokrinoloji ve Metabolizma Derneği, Ankara,
Kebebew E, Weng J, Bauer J, Ranvier G, Clark OH, Duh QY, Shibru D, Bastian B & Griffin A 2007 The prevalence and prognostic value of BRAF mutation in thyroid cancer. Annals of Surgery 246 466–471.
Hiltzik D, Carlson DL, Tuttle RM, Chuai S, Ishill N, Shaha A, Shah JP, Singh B & Ghossein RA 2006 Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis: a clinicopathologic study of 58 patients. Cancer 106 1286–1295.
Gnemmi V, Renaud F, Do Cao C, Salleron J, Lion G, Wemeau JL, Copin MC, Carnaille B, Leteurtre E, Pattou F, et al. 2014 Poorly differentiated thyroid carcinomas: application of the Turin proposal provides prognostic results similar to those from the assessment of high-grade features. Histopathology 64 263–273.
Asa SL. The current classification of thyroid cancer. Endocrinol Metab Clin N Am 2019; 1-22.
Volante M, Collini P, Nikiforov YE, Sakamoto A, Kakudo K, Katoh R, Lloyd RV, LiVolsi VA, Papotti M, Sobrinho-Simoes M, et al. 2007 Poorly differentiated thyroid carcinoma: the Turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach. American Journal of Surgical Pathology 31 1256–1264.
Wells SA Jr, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid 2015; 25:567.
Saad MF, Ordonez NG, Rashid RK, et al. Medullary carcinoma of the thyroid. A study of the clinical features and prognostic factors in 161 patients. Medicine (Baltimore) 1984; 63:319.
Dottorini ME, Assi A, Sironi M, et al. Multivariate analysis of patients with medullary thyroid carcinoma. Prognostic significance and impact on treatment of clinical and pathologic variables. Cancer 1996; 77:1556.
Gagel RF, Hoff AO, Cote GJ. Medullary thyroid carcinoma. In: Werner & Ingbar's The Thyroid, 9th, Braverman LE, Utiger RD (Eds), Lippincott Williams & Wilkins, Philadelphia 2005. p.967.
Pacini F, Castagna MG, Cipri C, Schlumberger M. Medullary thyroid carcinoma. Clin Oncol (R Coll Radiol) 2010; 22:475.
Chintamani, Kulshreshtha P, Singh J, et al. Is an aggressive approach justified in the management of an aggressive cancer--the squamous cell carcinoma of thyroid? International seminars in surgical oncology : ISSO. 2007;4:8.
Cho JK, Woo SH, Park J, Kim MJ, Jeong HS. Primary squamous cell carcinomas in the thyroid gland: an individual participant data meta-analysis. Cancer medicine. 2014;3:1396-1403.
Syed MI, Stewart M, Syed S, et al. Squamous cell carcinoma of the thyroid gland: primary or secondary disease? The Journal of laryngology and otology. 2011;125:3-9.
Barczynski M, Jamski J, Cichon S, Barczynski M, Sulowicz W. [Diagnosis, treatment and prognosis in cases of renal clear cell carcinoma metastases into the thyroid gland]. Przeglad lekarski. 2000;57:157- 159.
Lam KY, Lo CY. Metastatic tumors of the thyroid gland: a study of 79 cases in Chinese patients. Archives of pathology & laboratory medicine. 1998;122:37-41.
Zhang L, Liu Y, Li X, Gao W, Zheng C. Metastases to the thyroid gland: A report of 32 cases in PUMCH. Medicine. 2017;96:e7927.
