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Related Concept Videos

Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
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The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

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Multifocality in well-differentiated thyroid carcinomas calls for total thyroidectomy.

Haggi Mazeh1, Yacov Samet, David Hochstein

  • 1Department of Surgery, Hadassah, Hebrew University Medical Center, Mount Scopus and Hebrew University, Hadassah Medical School, Jerusalem, State of Israel. haggi.mazeh@gmail.com

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Multifocal papillary thyroid cancer (PTC) is common, affecting 57% of patients. Lesions often spread to the other thyroid lobe, regardless of tumor size, highlighting the need for thorough gland examination.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Pathology

Background:

  • Multifocality is a key consideration for papillary thyroid cancer (PTC) surgical recommendations.
  • Understanding multifocal PTC (mPTC) spread patterns is crucial for effective treatment planning.

Purpose of the Study:

  • To determine the incidence of multifocal PTC (mPTC) in patients undergoing total thyroidectomy.
  • To characterize the spread patterns of mPTC, including contralateral lobe involvement.

Main Methods:

  • Retrospective review of 289 total thyroidectomies performed between 2003 and 2008.
  • Collection and analysis of demographic, clinical, and histopathological data.

Main Results:

  • Multifocal PTC (mPTC) was identified in 150 patients (57%).
  • Contralateral lobe lesions were present in 71% of mPTC cases.
  • Multifocality rates did not significantly differ by gender, pathology type, or tumor size (≤1 cm).
  • Examination of entire gland sections revealed a significantly higher incidence of contralateral disease compared to representative sections (P = .04).

Conclusions:

  • Multifocal and contralateral lesions are frequent in PTC.
  • The incidence of mPTC is independent of tumor size.
  • Comprehensive entire gland examination is essential for accurate mPTC assessment.