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Gabriella Fontanini - One of the best experts on this subject based on the ideXlab platform.

  • kif5b ret rearrangement in a carcinoma of the thyroid gland a case report of a fatal disease
    The Journal of Clinical Endocrinology and Metabolism, 2017
    Co-Authors: David Viola, Carlotta Giani, Eleonora Molinaro, Laura Agate, Nicla Borrelli, Raffaele Ciampi, Clara Ugolini, Antonio Chella, Salvatore Mazzeo, Gabriella Fontanini
    Abstract:

    Background: The diffuse sclerosing variant of papillary thyroid cancer (DSV-PTC) is a rare variant of papillary thyroid cancer (PTC) with different clinicopathological features compared with conventional PTC. Case: An advanced DSV-PTC was diagnosed in a 39-year-old man. The radioiodine posttherapeutic whole-body-scan showed only an uptake in the central neck, whereas the computerized tomography showed multiple latero-cervical and Mediastinum Lymph Node metastases, a single and spiculated lung lesion and multiple bilateral cerebellum metastases. The patient died after 6 months from the initial diagnosis. The histological revision of the thyroid tumor confirmed the diagnosis of DSV-PTC, and its molecular analysis revealed a KIF5B/RET rearrangement that, until now, was described only in a minority of lung adenocarcinoma. Other 18 cases of DSV-PTC were then studied for the presence of KIF5B/RET rearrangement, but all of them were negative. Conclusions: This was a case of DSV-PTC positive for KIF5B/RET rearrangement, but considering that this alteration has been described only in lung adenocarcinoma and that the clinical course was more typical of lung carcinoma, we cannot completely rule out the possibility that this was a metastatic lesion from a lung tumor mimicking a DSV-PTC. As an alternative, we can also hypothesize that this was a case of fusion of two tumoral tissues deriving from a DSV-PTC and a metastasis of a KIF5B/RET positive lung adenocarcinoma. The question of whether the molecular findings, particularly when specifically reported only in some subtypes of human tumors, can overcome the morphological diagnosis is a matter of discussion.

  • KIF5B/RET Rearrangement in a Carcinoma of the Thyroid Gland: A Case Report of a Fatal Disease.
    The Journal of Clinical Endocrinology and Metabolism, 2017
    Co-Authors: David Viola, Carlotta Giani, Eleonora Molinaro, Laura Agate, Nicla Borrelli, Raffaele Ciampi, Clara Ugolini, Antonio Chella, Salvatore Mazzeo, Gabriella Fontanini
    Abstract:

    Background: The diffuse sclerosing variant of papillary thyroid cancer (DSV-PTC) is a rare variant of papillary thyroid cancer (PTC) with different clinicopathological features compared with conventional PTC. Case: An advanced DSV-PTC was diagnosed in a 39-year-old man. The radioiodine posttherapeutic whole-body-scan showed only an uptake in the central neck, whereas the computerized tomography showed multiple latero-cervical and Mediastinum Lymph Node metastases, a single and spiculated lung lesion and multiple bilateral cerebellum metastases. The patient died after 6 months from the initial diagnosis. The histological revision of the thyroid tumor confirmed the diagnosis of DSV-PTC, and its molecular analysis revealed a KIF5B/RET rearrangement that, until now, was described only in a minority of lung adenocarcinoma. Other 18 cases of DSV-PTC were then studied for the presence of KIF5B/RET rearrangement, but all of them were negative. Conclusions: This was a case of DSV-PTC positive for KIF5B/RET rearrangement, but considering that this alteration has been described only in lung adenocarcinoma and that the clinical course was more typical of lung carcinoma, we cannot completely rule out the possibility that this was a metastatic lesion from a lung tumor mimicking a DSV-PTC. As an alternative, we can also hypothesize that this was a case of fusion of two tumoral tissues deriving from a DSV-PTC and a metastasis of a KIF5B/RET positive lung adenocarcinoma. The question of whether the molecular findings, particularly when specifically reported only in some subtypes of human tumors, can overcome the morphological diagnosis is a matter of discussion.

David Viola - One of the best experts on this subject based on the ideXlab platform.

  • kif5b ret rearrangement in a carcinoma of the thyroid gland a case report of a fatal disease
    The Journal of Clinical Endocrinology and Metabolism, 2017
    Co-Authors: David Viola, Carlotta Giani, Eleonora Molinaro, Laura Agate, Nicla Borrelli, Raffaele Ciampi, Clara Ugolini, Antonio Chella, Salvatore Mazzeo, Gabriella Fontanini
    Abstract:

    Background: The diffuse sclerosing variant of papillary thyroid cancer (DSV-PTC) is a rare variant of papillary thyroid cancer (PTC) with different clinicopathological features compared with conventional PTC. Case: An advanced DSV-PTC was diagnosed in a 39-year-old man. The radioiodine posttherapeutic whole-body-scan showed only an uptake in the central neck, whereas the computerized tomography showed multiple latero-cervical and Mediastinum Lymph Node metastases, a single and spiculated lung lesion and multiple bilateral cerebellum metastases. The patient died after 6 months from the initial diagnosis. The histological revision of the thyroid tumor confirmed the diagnosis of DSV-PTC, and its molecular analysis revealed a KIF5B/RET rearrangement that, until now, was described only in a minority of lung adenocarcinoma. Other 18 cases of DSV-PTC were then studied for the presence of KIF5B/RET rearrangement, but all of them were negative. Conclusions: This was a case of DSV-PTC positive for KIF5B/RET rearrangement, but considering that this alteration has been described only in lung adenocarcinoma and that the clinical course was more typical of lung carcinoma, we cannot completely rule out the possibility that this was a metastatic lesion from a lung tumor mimicking a DSV-PTC. As an alternative, we can also hypothesize that this was a case of fusion of two tumoral tissues deriving from a DSV-PTC and a metastasis of a KIF5B/RET positive lung adenocarcinoma. The question of whether the molecular findings, particularly when specifically reported only in some subtypes of human tumors, can overcome the morphological diagnosis is a matter of discussion.

  • KIF5B/RET Rearrangement in a Carcinoma of the Thyroid Gland: A Case Report of a Fatal Disease.
    The Journal of Clinical Endocrinology and Metabolism, 2017
    Co-Authors: David Viola, Carlotta Giani, Eleonora Molinaro, Laura Agate, Nicla Borrelli, Raffaele Ciampi, Clara Ugolini, Antonio Chella, Salvatore Mazzeo, Gabriella Fontanini
    Abstract:

    Background: The diffuse sclerosing variant of papillary thyroid cancer (DSV-PTC) is a rare variant of papillary thyroid cancer (PTC) with different clinicopathological features compared with conventional PTC. Case: An advanced DSV-PTC was diagnosed in a 39-year-old man. The radioiodine posttherapeutic whole-body-scan showed only an uptake in the central neck, whereas the computerized tomography showed multiple latero-cervical and Mediastinum Lymph Node metastases, a single and spiculated lung lesion and multiple bilateral cerebellum metastases. The patient died after 6 months from the initial diagnosis. The histological revision of the thyroid tumor confirmed the diagnosis of DSV-PTC, and its molecular analysis revealed a KIF5B/RET rearrangement that, until now, was described only in a minority of lung adenocarcinoma. Other 18 cases of DSV-PTC were then studied for the presence of KIF5B/RET rearrangement, but all of them were negative. Conclusions: This was a case of DSV-PTC positive for KIF5B/RET rearrangement, but considering that this alteration has been described only in lung adenocarcinoma and that the clinical course was more typical of lung carcinoma, we cannot completely rule out the possibility that this was a metastatic lesion from a lung tumor mimicking a DSV-PTC. As an alternative, we can also hypothesize that this was a case of fusion of two tumoral tissues deriving from a DSV-PTC and a metastasis of a KIF5B/RET positive lung adenocarcinoma. The question of whether the molecular findings, particularly when specifically reported only in some subtypes of human tumors, can overcome the morphological diagnosis is a matter of discussion.

Bing Cui - One of the best experts on this subject based on the ideXlab platform.

  • CT Scan Directed Transbronchial Needle Aspiration Biopsy for Mediastinal Nodes
    Chest, 1998
    Co-Authors: Fu Rong, Bing Cui
    Abstract:

    Study objectives This study was performed to determine whether transbronchial needle aspiration (TBNA) biopsy under CT guidance can increase its diagnostic yield so that this technique can be used for staging of lung cancer at our institution. Study design After an initial unacceptable low yield of TBNA on the first 10 patients (20% positive), we switched the biopsy procedure from the bronchoscopy suite to the CT room. After each passage of the needle to the Mediastinum Lymph Node, CT scan was performed to locate the tip of the needle. If the initial attempt was not successful, TBNA was repeated at the same setting until CT documented that the tip of the needle was exactly inside the Lymph Node. Result A total of 49 patients with 69 Mediastinum adenopathies were enrolled in this study. There were 31 patients with malignant mediastinal adenopathy proven by TBNA (60% sensitivity). Fifteen patients showed normal results of needle aspiration despite the presence of primary lung cancer. Three patients showed mediastinal abscesses. Conclusion Despite numerous successful reports in the literature, the general application of the TBNA procedure appears to be limited because of its low sensitivity, although this could be due to numerous factors. However, using CT guidance to be sure that the tip of the needle is exactly inside the Node can increase its sensitivity markedly. It may also increase the specificity of normal results of TBNA biopsy.

Marcus Feith - One of the best experts on this subject based on the ideXlab platform.

  • Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer)
    World Journal of Surgery, 2003
    Co-Authors: J. Rüdiger Siewert, Hubert J. Stein, Marcus Feith
    Abstract:

    Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of Lymphadenectomy to the upper Mediastinum. Lymph Node metastases in the upper Mediastinum, however, usually indicate advanced Lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy.

  • Surgical approach to invasive adenocarcinoma of the distal esophagus (Barrett's cancer).
    World journal of surgery, 2003
    Co-Authors: J. Rüdiger Siewert, Hubert J. Stein, Marcus Feith
    Abstract:

    Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of Lymphadenectomy to the upper Mediastinum. Lymph Node metastases in the upper Mediastinum, however, usually indicate advanced Lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy.

Ruan Xiao-ming - One of the best experts on this subject based on the ideXlab platform.

  • Evaluation of imaging Mediastinum Lymph Node staging of non-small cell lung cancer
    Chinese clinical oncology, 2005
    Co-Authors: Ruan Xiao-ming
    Abstract:

    Objective:To determine the performance characteristics of CT scanning, positron emission tomography(PET) scanning, endoscopic ultrasound(EUS) for staging the Mediastinum of the patients whom the non-small cell lung cancer (NSCLC) was diagnosed with pathology. Methods:Evaluating the staging results of CT scanning, PET scanning, or EUS in 56 NSCLC patients with pathologic confirmation. Results:The sensitivities and specificities for staging the Mediastinum were as follows: for CT scanning: sensitivity, 57%; specificity, 82%; for PET scanning: sensitivity, 84%;specificity, 90%; and for EUS sensitivity, 76%; specificity, 70%. Conclusion:PET scanning is more accurate than CT scanning or EUS for detecting mediastinal metastases of NSCLC.