CARCINOMA MEDULAR DE TIROIDES

LUISA FERNANDA MATIZ PULIDOV SEMESTREENFERMERIA

Es una neoplasia neuroendocrina

La historia natural de la MTC se caracteriza por los ganglios linfáticos y metástasis a distancia, por lo que el tratamiento quirúrgico completo a menudo es imposible.

GLANDULA TIROIDEA

http://www.google.com.co/imgres?imgurl=http://www.thyroidcancersupport.com/l-tiroxina.jpg&imgrefurl=http://cancerdetyroidemiami.com/&usg=__ABteFmypIhOe9xu1Jwuup06lR00=&h=339&w=400&sz=11&hl=es&start=159&zoom=1&tbnid=nlvuOqwB1rQL1M:&tbnh=115&tbnw=159&ei=Ld1fTbr8M9K_tgfMv7CIDA&prev=/images%3Fq%3Dcarcinoma%2Bde%2Btiroides%26hl%3Des%26biw%3D1276%26bih%3D527%26gbv%3D2%26tbs%3Disch:10%2C2822&itbs=1&iact=hc&vpx=989&vpy=152&dur=704&hovh=207&hovw=244&tx=171&ty=128&oei=gNlfTafUK5StgQfLldSxAQ&page=8&ndsp=21&ved=1t:429,r:6,s:159&biw=1276&bih=527

El cáncer medular de tiroides familiar (CMTF) es una neoplasia poco frecuente de la glándula tiroidea, cuyo origen es el resultado de una mutación en el protoncogén RET.

INFLITRACION METASTASICA TIROIDEA

http://www.seom.org/bancoimagenes/masmir/index.php/Infiltraci-n-metast-sica-tiroidea-y-traqueal-por-carcinoma-renal-de-c-lulas-claras

Es un método imagenológico utilizado para observar la tiroides, una glándula ubicada en el cuello que regula el metabolismo.

Una ecografía de la tiroides generalmente se realiza cuando la persona presenta una tumoración en dicha glándula. El examen puede ayudar a diferenciar entre un saco que contiene líquido ( quiste) y tejido anormal que puede ser canceroso o no (un tumor).

Desde el punto de vista epidemiológico, la denominación de cáncer de tiroides (CT) incluye todos los tumores derivados de células tiroideas. Quedan, por tanto, excluidos los linfomas y los sarcomas.

La elevación de la concentración sérica de calcitonina proporciona un marcador de enfermedad residual o recidivante. En todos los pacientes con MTC está justificado investigar la existencia de mutaciones del gen RET.

Computed tomography with intravenous contrast showed a supraglottic mass

Tomado de: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964737/figure/F1/

Es principalmente quirúrgico. A diferencia de los tumores derivados de las células foliculares de la tiroides, estos tumores no captan yodo radiactivo. La radioterapia externa y la quimioterapia pueden ofrecer un efecto paliativo en los pacientes en los que la enfermedad esté avanzada.

ARTICULO 1

Tomado de: http://www.google.com.co/imgres?imgurl=http://medicinayenfermedad.com/wp-content/uploads/2009/07/cancer-de-tiroides.jpg&imgrefurl=http://neurodifusion.org/noticias/salud-medicina/65-oncologia/1426-aceptadas-para-su-evaluacion-en-eeuu-y-la-ue-las-solicitudes-de-registro-de-vandetanib-para-el-cancer-medular-de-tiroides-avanzado.html&usg=__nWH02Bldn7vFs1l7t_TqbLcAN5k=&h=320&w=400&sz=16&hl=es&start=67&zoom=1&tbnid=JdG_YfIwNJVdFM:&tbnh=108&tbnw=135&ei=oNVfTbyCPMOftwe-0amlDA&prev=/images%3Fq%3Dcarcinoma%2Bmedular%2Bde%2Btiroides%26hl%3Des%26biw%3D1276%26bih%3D527%26gbv%3D2%26tbs%3Disch:10%2C1317&itbs=1&iact=hc&vpx=256&vpy=127&dur=1074&hovh=201&hovw=251&tx=126&ty=131&oei=ZdNfTZXNBc6Utwfsl8XcCw&page=4&ndsp=23&ved=1t:429,r:8,s:67&biw=1276&bih=527

CARCINOMA DE TIROIDES

Titulo:Medullary Thyroid Carcinoma: Targeted Therapies and Future

Directions Autores: Scott N. Pinchot,

Muthusamy Kunnimalaiyaan, Rebecca S. Sippel, and Herbert Chen

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2798103/?tool=pubmed

ABSTRACTMedullary thyroid cancer (MTC) is a rare neuroendocrine neoplasm that accounts for approximately 5% of all thyroid malignancies. The natural history of MTC is characterized by early lymph node and distant metastases, making complete surgical cure often impossible. Conventional chemotherapy and external beam radiation have been largely ineffective in altering the natural history of MTC. Therefore, there is a great need to develop novel therapeutic strategies to affect symptom control and reduce tumor burden in patients with widely disseminated disease. Here, we review several pathways which have been shown to be vital in MTC tumorigenesis and focus on the pathways of interest for which targeted drug therapies are currently being developed.

• El cáncer medular de tiroides (CMT) es una neoplasia neuroendocrina poco común que representa aproximadamente el 5% de todos los cánceres de tiroides. La historia natural de la MTC se caracteriza por los ganglios linfáticos temprana y metástasis a distancia, por lo que la cura quirúrgica completa a menudo imposible. La quimioterapia convencional y la radioterapia de haz externo han sido en gran parte ineficaz para alterar la historia natural de la MTC. Por lo tanto, hay una gran necesidad de desarrollar nuevas estrategias terapéuticas para afectar el control de los síntomas y reducir la carga tumoral en pacientes con enfermedad ampliamente diseminada. En este artículo examinamos algunas vías que han demostrado ser fundamental en la tumorigénesis MTC y centrarse en las vías de interés para los que las terapias dirigidas de drogas se están desarrollando actualmente.

Carcinoma medular de tiroides

http://www.google.com.co/imgres?imgurl=http://www.intramed.net/UserFiles/imagenes/cuello5.JPG&imgrefurl=http://www.intramed.net/ira.asp%3FcontenidoID%3D60800&usg=__5k3dxGUlDJuyiOfrnYpUUp1uPU8=&h=812&w=675&sz=96&hl=es&start=112&zoom=1&tbnid=7pX4Lmr0oYvcxM:&tbnh=116&tbnw=94&ei=UtxfTcDfIcm2tgfElI31Cw&prev=/images%3Fq%3Dcarcinoma%2Bde%2Btiroides%26hl%3Des%26biw%3D1276%26bih%3D527%26gbv%3D2%26tbs%3Disch:10%2C1947&itbs=1&iact=hc&vpx=561&vpy=185&dur=4011&hovh=246&hovw=205&tx=96&ty=146&oei=gNlfTafUK5StgQfLldSxAQ&page=6&ndsp=23&ved=1t:429,r:3,s:112&biw=1276&bih=527

ARTICULO 2

TITULO:Diagnosis of medullary thyroid cancer

AUTORES:Stefania Marchisotta and Furio Pacini

LINK:http://www.ncbi.nlm.nih.gov/pmc/articles/PM2920710/?tool=pubmed

Ecografia tiroideaTomado de: http://www.galenored.com/drabalderas/?content=10

ABSTRACT• Medullary thyroid cancer (MTC) accounts for 5-

10% of all thyroid cancers. The majority of medullary thyroid cancers are sporadic, but 25% of cases are inherited as a result of germline mutations in the RET proto-oncogene. In sporadic cases MTC presents as a thyroid nodule discovered at palpation or at thyroid ultrasonography, and is indistinguishable from thyroid nodules of different histology.

• Since effective treatment of MTC is only possible when the tumour is limited to the thyroid gland, early discovery has a decisive impact on how radical initial surgical treatment needs to be. Recent data suggest that in sporadic cases, early discovery of thyroid nodular disease is possible when screening serum calcitonin measurement, while screening for germline RET proto-oncogene mutations is fundamental in first degree relatives of patients with hereditary MTC.

RESUMEN

ECOGRAFIA TIROIDEA

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• El cáncer Medular de tiroides (MTC) representa el 5-10% de todos los cánceres de tiroides.

• La mayoría de los cánceres medulares de tiroides son esporádicos, pero el 25% de los casos se heredan como consecuencia de mutaciones.

El tratamiento eficaz de la MTC es sólo posible cuando el tumor está limitado a la glándula tiroides, el descubrimiento precoz tiene un impacto decisivo en la radicalidad del tratamiento quirúrgico inicial.

CARCINOMA MEDULAR DE TIROIDES

Tomado de: http://www.google.com.co/imgres?imgurl=http://escuela.med.puc.cl/paginas/cursos/tercero/anatomiapatologica/imagenes_ap/fotos937-941/940.jpg&imgrefurl=http://escuela.med.puc.cl/paginas/cursos/tercero/anatomiapatologica/imagenes_ap/patologia937-941.html&usg=__sEjUs_MA4VAX-SCcbCETDDQQZ8E=&h=640&w=421&sz=47&hl=es&start=0&zoom=1&tbnid=waSLwSlvV_Q1_M:&tbnh=119&tbnw=91&ei=ZdNfTZXNBc6Utwfsl8XcCw&prev=/images%3Fq%3Dcarcinoma%2Bmedular%2Bde%2Btiroides%26hl%3Des%26biw%3D1276%26bih%3D527%26gbv%3D2%26tbs%3Disch:1&itbs=1&iact=hc&vpx=121&vpy=70&dur=3173&hovh=277&hovw=182&tx=101&ty=139&oei=ZdNfTZXNBc6Utwfsl8XcCw&page=1&ndsp=23&ved=1t:429,r:0,s:0

ARTICULO 3

• TITULOMedullary Thyroid Cancer: Molecular Biology

and Novel Molecular Therapies

• AUTORES:Mehtap Cakira, b, Ashley B. Grossman

LINK:http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=000220827

CANCER DE TIROIDES

Tomado de:http://www.google.com.co/imgres?imgurl=http://www.cancerhumano.com/wp-content/uploads/2010/11/esquema-del-cancer-de-tiroides.jpg&imgrefurl=http://www.cancerhumano.com/cancer-de-tiroides&usg=__VxjqYlQGsxhLofBJu3CZQTQEDcE=&h=388&w=366&sz=22&hl=es&start=0&zoom=1&tbnid=KzGH_uBtVWYYxM:&tbnh=118&tbnw=111&ei=I9ZfTYL0FpCbtwed5fHtCw&prev=/images%3Fq%3DCANCER%2BDE%2BTIROIDES%26hl%3Des%26biw%3D1276%26bih%3D527%26gbv%3D2%26tbs%3Disch:1&itbs=1&iact=hc&vpx=114&vpy=85&dur=2654&hovh=231&hovw=218&tx=131&ty=112&oei=I9ZfTYL0FpCbtwed5fHtCw&page=1&ndsp=24&ved=1t:429,r:0,s:0

Medullary thyroid cancer (MTC) arises from neural-crest-derived parafollicular C cells of the thyroid gland and accounts for approximately 4% of all thyroid cancers. Up to 25–30% of MTC cases occur as inherited disorders while the remaining cases represent the sporadic form of the disease. In this review, the structure and signalling properties of the RET proto-oncogene in its wild-type and mutant forms, and its role in hereditary and sporadic MTC, are discussed.

A full data search was performed through PubMed over the years 2000–2008 with the key words ‘medullary thyroid cancer, treatment, molecular biology, RET, molecular mechanism’, and all relevant publications have been included, together with selected publications prior to that date.

ARTICULO 4

TITULO:Medullary carcinoma in a lingual thyroid

AUTORES:Yaday S, Singh I, Singh J, Aggarwal N

LINK:• http://smj.sma.org.sg/4903/4903cr9.pdf

ABSTRACT

• Total ectopia of thyroid is a rare phenomenon and malignant change in an ectopic thyroid is even rarer. We report a case of medullary carcinoma in a total ectopic lingual thyroid occurring in a 45-year-old woman who presented with dysphagia, plummy voice and a round sessile mass at the base of the tongue. The mass was extirpated using Trotter's midline approach.

• Upon examination, it was found to be medullary carcinoma in an ectopic thyroid. Permanent substitution therapy with thyroxine secured the euthyroid status of the patient. The embrylogical basis and a review of literature regarding carcinomatous change in an ectopic thyroid are also discussed. There is a need to investigate for an ectopic thyroid, or even total ectopia, in the case of any smooth mass found at the base of the tongue

ARTICULO 5

• TITULO:Papillary Microcarcinoma of the Thyroid: Predicting

Factors of Lateral Neck Node Metastasis• AUTORES

Jin Young Kwak, MD1, Eun-Kyung Kim, MD1, Min Jung Kim, MD1, Eun Ju Son, MD1, Woong Youn Chung, MD2, Cheong Soo Park, MD2, and Kee-Hyun Nam, MD2

• LINK:http://biblioteca.fucsalud.edu.co:2068/content/1605347056637027/fulltext.pdf

ABSTRACT

Background. Preoperative prediction of lateral lymph node metastasis (LNM) is important to prevent recurrence; however, there are few published data in predicting factors of lateral LNM before surgery. The present study investigated the factors affecting LNM in patients with papillary thyroid microcarcinoma (PTMC).

• Methods. A retrospective cohort study was conducted with data obtained from 671 patients with PTMC between 2004 and 2006. We reviewed the clinical, ultrasound (US),

• and pathology records of patients and analyzed the association between lateral LNM and clinical factors, US features of PTMC, and pathologic features.

CELULAS NEOPLASICAS

http://www.google.com.co/imgres?imgurl=http://www.uninet.edu/conganat/autores/trabajos/T033/I007.JPG&imgrefurl=http://www.uninet.edu/conganat/autores/trabajos/T033/&usg=__kOvM9MoUT83cvW7LHdmFNkpk-D0=&h=507&w=768&sz=198&hl=es&start=68&zoom=1&tbnid=2SVslpFGTCpp3M:&tbnh=102&tbnw=155&ei=kdlfTd62ENCitgfNt-GcDA&prev=/images%3Fq%3Dcarcinoma%2Bde%2Btiroides%26hl%3Des%26biw%3D1276%26bih%3D527%26gbv%3D2%26tbs%3Disch:10%2C1076&itbs=1&biw=1276&bih=527&iact=rc&dur=1172&oei=gNlfTafUK5StgQfLldSxAQ&page=4&ndsp=22&ved=1t:429,r:3,s:68&tx=90&ty=68

• Results. The rate of lateral LNM was 3.7% in 671 PTMCs. We found a statistically significant association between lateral LNM and US features of PTMC (upper pole location, contact of[25% with the adjacent capsule, and presence of calcifications), and pathologic features (central LNM) in multivariate analysis (P\.05).

• Conclusions. In patients with PTMC, independent factors in predicting lateral LNM were US features of PTMC (upper pole location, [25% contact with the adjacent

• capsule, and presence of calcifications) and pathologic features (central LNM). When these US features are detected on preoperative US, lateral neck nodes should be

• meticulously evaluated by a multimodal approach.

LIBRO

Libro:Harrison MedicinaCapítulo 345. Trastornos que afectan a múltiples

sistemas endocrinos• Autores

Camilo Jimenez, Robert F. Gagel• Link• http://biblioteca.fucsalud.edu.co:2313/

content.aspx?aID=3746881#3746881

Tumor cells were strongly immunopositive for chromogranin (anti-chromogranin, original magnification ×400).

Tomado de:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964737/figure/F4/

CARCINOMA MEDULAR DE TIROIDES

• El MTC hereditario es un trastorno multicéntrico. Deberá efectuarse tiroidectomía total con disección de ganglios linfáticos centrales a todos los niños portadores del gen mutante. La tiroidectomía subtotal deja abierta la posibilidad a una transformación posterior de las células C residuales.

BOCIO…..

Tomado de: http://www.google.com.co/imgres?imgurl=http://lomalindahealth.org/health-library/graphics/images/es/14060.jpg&imgrefurl=http://lomalindahealth.org/health-library/cirugias-y-procesos/34/100135.htm&usg=__v3XLNkBke0MbCvxdiq6JAaftyFw=&h=320&w=400&sz=6&hl=es&start=0&zoom=1&tbnid=3_NWe4PlWwhQZM:&tbnh=111&tbnw=137&ei=ethfTZS4Io2ctwf_3eT0Cw&prev=/images%3Fq%3DCANCER%2BDE%2BTIROIDES%26hl%3Des%26biw%3D1276%26bih%3D527%26gbv%3D2%26tbs%3Disch:1&itbs=1&iact=hc&vpx=222&vpy=215&dur=2083&hovh=201&hovw=251&tx=130&ty=124&oei=I9ZfTYL0FpCbtwed5fHtCw&page=1&ndsp=24&ved=1t:429,r:9,s:0

• El objetivo del tratamiento precoz es la curación, y una estrategia que no contemple este objetivo debe considerarse como una solución a corto plazo.

• En los adultos con un carcinoma medular de tiroides mayor de 1 cm son frecuentes las metástasis en ganglios linfáticos regionales