<1 cm WDT-UMP, FT-UMP. Kakudo K et al, Pathol Int,2009, Endocr J, 2011 and Pathol Int, 2012

Transcription

1

2 <1 cm WDT-UMP, FT-UMP Kakudo K et al, Pathol Int,2009, Endocr J, 2011 and Pathol Int, 2012

3

4 Follicular thyroid carcinoma with capsular invasion alone: Nonthreatening malignancy. Van Heerden JA : Surgery 112: , 1992.

5 Liu J et al: Follicular variant of papillary thyroid carcinoma: a clinocopathologic study of a problematic entity. Cancer, 107: , Bai Y et al: Subclassification of non-solid-type papillary thyroid carcinoma, identification of high-risk group in common type. Cancer Sci, , 2008.

6 Piana S et al : Encapsulated well-differentiated follicular-patterned thyroid carcinoma do not play a significant role in the fatality rate from thyroid carcinoma. Am J Surg Pathol, 34: , Piana ( WDT-UMP 6 FT-UMP

7 Piana S et al : Encapsulated well-differentiated follicular-patterned thyroid carcinoma do not play a significant role in the fatality rate from thyroid carcinoma. Am J Surg Pathol, 34: , Piana ( WDT-UMP 6 FT-UMP

8

9

10

11 ᾐ ṇᖖ ⓶ ๓ ኚ 働僕傹傹傱僯 ங㢌 㠀ᾐ ቃ ኚ傎๓㥑 ኚ 働僕Ⰻ 僎ᝏ 僔ቃ 僕像傹僑储僱僔僆僳催傱凱 僑傰傷僱 ᙧ Ꮫ僎Oncogenes Koorstra JB et al: Widespread activation of the DNA damage response in human pancreatic intraepithelial neoplasia. Mod Pathol, 22: , 2009.

12 Fig 6 TFF3 T/G ratios in thyroid tumor tissues to set the cut-off value Yamada and Takano: Measurement of TFF3 mrna in aspirates from thyroid nodules using mesh filtration: The first clinical trial in 130 cases: Endocr J, 2012

13 Fig 6 TFF3 T/G ratios in thyroid tumor tissues to set the cut-off value Yamada and Takano: Measurement of TFF3 mrna in aspirates from thyroid nodules using mesh filtration: The first clinical trial in 130 cases: Endocr J, 2012

14 <1 cm WDT-UMP, FT-UMP Kakudo K et al, Pathol Int,2009, Endocri J, 2011 and Pathol Int, 2012

15

16 , 1996.

17 WDC-NOS well differentiated carcinoma, NOS WDT-UMP well differentiated tumour of uncertain malignant potential FT-UMP follicular cell tumor of uncertain malignant potential, Williams ED: Guest Editorial: Two proposal regarding the terminology of thyroid tumors. Int J Surg Pathol, 8: , 2000.

18 2. WDT-UMP 4. FT-UMP <1cm,N0,Ex0 Endocri J, 2011 and Pathol Int, 2012

19 Letter from a USA patient (2012/09/10, 22:32) Dear Dr. Kakudo, I am a patient diagnosed with an encapsulated, mutation-negative, non-invasive thyroid cancer in 2011 at UPMC. I am writing to you to thank you for writing and publishing your recent pieces on the encapsulated variants of PTC. Like many patients, when I was diagnosed I really had no idea of exactly what I was being diagnosed with, as I had no way of contextualizing it. It seems that UPMC treats classic encapsulated PTC the same as garden variety non-encapsulated PTC, and so I was treated with 50 mci of RI, even though my pathology report showed no spread and my stimulated tg was undetectable. I had no idea that there was any controversy about this lesion until I did a google search about it and saw your papers. As you wrote about in your paper, the psychological burden of receiving a cancer diagnosis is considerable, especially when you are unable as a patient to properly contextualize what you have been diagnosed with. Since I saw your papers I conferred with a second pathologist from Boston who affirmed that the diagnosis of these very low grade lesions is subjective and sometimes amounts to a suggestion from the pathologist. I was very surprised that I would be treated at UPMC in the same manner as those patients who had, for example, a mutation positive non-encapsulated tumor. UPMC s molecular testing basically didn t help me at all since the suspicious FNA result lead to a total thyroidectomy. ************************* (2012/09/13, 23:16) Thank you for your advice and wishes. I hope that pathologists and endocrinologists in the rest of the world take serious notice of your research. I wish that I had seen your papers earlier. I would have felt a lot better and would not have taken the RI treatment.

20 Daniels GH, What if many follicular variant papillary thyroid carcinomas are not malignant? A review of follicular variant papillary thyroid carcinoma and a proposal for a new classification. End Pract, 17: , 2011., by Daniels GH, 2011.

21 Daniels GH, What if many follicular variant papillary thyroid carcinomas are not Classification malignant? A of review thyroid of follicular variant cell tumors: papillary with thyroid special carcinoma reference and to a proposal for a borderline new classification. lesions, End Endocrine Pract, 17: J, 59:1-12, , 2011., by Daniels GH, 2011.

22 papillary microcarcinoma It is defined as <1cm in the 5 th edition and <2cm in the 6 th edition of AJCC/UICC TNM classification.

23 Zuo H et al: A review of 227 cases of small papillary thyroid carcinoma. EJSO, 33: , Multifocal lesions: 80/227 (35%) Extrathyroid invasion:ex0 131 (58%) Ex1 90 (40%) Ex2 6 (3%) LN metastasis: N0 66/189 (35%) N1a 49/189 (26%) N1b 74/189 (39%) Local recurrence: 9 (4%) Distant metastasis: 1(lung) (0.44%) Ex0,N0

24 An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid 13: , Three distinctly different kinds of papillary microcarcinoma should be recognized: Our treatment strategies and outcomes. World J Surg 34: , Ex0,N0

25

26