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Clinical–Pathological Features and Treatment Outcome of Patients With Hobnail Variant Papillary Thyroid Carcinoma
Papillary thyroid carcinoma (PTC) with hobnail areas above 30% is classified as hobnail variant (HVPTC). Although it is widely accepted that HVPTC has a worse outcome than classical PTC, it is unclear whether PTC with hobnail features below 30% is as aggressive as HVPTC. We gathered the largest mono...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926070/ https://www.ncbi.nlm.nih.gov/pubmed/35311230 http://dx.doi.org/10.3389/fendo.2022.842424 |
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author | Poma, Anello Marcello Macerola, Elisabetta Proietti, Agnese Vignali, Paola Sparavelli, Rebecca Torregrossa, Liborio Matrone, Antonio Basolo, Alessio Elisei, Rossella Santini, Ferruccio Ugolini, Clara |
author_facet | Poma, Anello Marcello Macerola, Elisabetta Proietti, Agnese Vignali, Paola Sparavelli, Rebecca Torregrossa, Liborio Matrone, Antonio Basolo, Alessio Elisei, Rossella Santini, Ferruccio Ugolini, Clara |
author_sort | Poma, Anello Marcello |
collection | PubMed |
description | Papillary thyroid carcinoma (PTC) with hobnail areas above 30% is classified as hobnail variant (HVPTC). Although it is widely accepted that HVPTC has a worse outcome than classical PTC, it is unclear whether PTC with hobnail features below 30% is as aggressive as HVPTC. We gathered the largest mono-institutional series of PTC with hobnail areas and HVPTC to evaluate differences in terms of pathological features of aggressiveness, molecular profile, and treatment outcome. A total of 99 PTC with hobnail features above 5% were retrospectively selected; 34 of them met the criteria for HVPTC (0.4% of all PTC diagnosed at our institution). All tumors showed high rates of extra-thyroidal extension (40.4%), lymph node metastasis (68.1% of patients with lymphadenectomy), and vascular emboli (49.5%), with no differences according to the 30% cutoff. On the other hand, distant metastases were present in HVPTC only (9.4%). Also, advanced age, advanced disease stage, and TERT promoter mutation were associated with HVPTC. More than half of the patients with follow-up had structural or biochemical persistence after 1 year from surgery. Structural persistence was significantly more common in patients with HVPTC (37.5% vs. 8.7%), while no differences were observed considering structural and biochemical persistence together. The presence of hobnail features identifies locally aggressive tumors, and, consequently, it should be always acknowledged in the pathological report. However, tumors with more than 30% hobnail areas frequently present TERT promoter mutations, advanced disease stage, and structural persistence after radioiodine ablation. |
format | Online Article Text |
id | pubmed-8926070 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89260702022-03-17 Clinical–Pathological Features and Treatment Outcome of Patients With Hobnail Variant Papillary Thyroid Carcinoma Poma, Anello Marcello Macerola, Elisabetta Proietti, Agnese Vignali, Paola Sparavelli, Rebecca Torregrossa, Liborio Matrone, Antonio Basolo, Alessio Elisei, Rossella Santini, Ferruccio Ugolini, Clara Front Endocrinol (Lausanne) Endocrinology Papillary thyroid carcinoma (PTC) with hobnail areas above 30% is classified as hobnail variant (HVPTC). Although it is widely accepted that HVPTC has a worse outcome than classical PTC, it is unclear whether PTC with hobnail features below 30% is as aggressive as HVPTC. We gathered the largest mono-institutional series of PTC with hobnail areas and HVPTC to evaluate differences in terms of pathological features of aggressiveness, molecular profile, and treatment outcome. A total of 99 PTC with hobnail features above 5% were retrospectively selected; 34 of them met the criteria for HVPTC (0.4% of all PTC diagnosed at our institution). All tumors showed high rates of extra-thyroidal extension (40.4%), lymph node metastasis (68.1% of patients with lymphadenectomy), and vascular emboli (49.5%), with no differences according to the 30% cutoff. On the other hand, distant metastases were present in HVPTC only (9.4%). Also, advanced age, advanced disease stage, and TERT promoter mutation were associated with HVPTC. More than half of the patients with follow-up had structural or biochemical persistence after 1 year from surgery. Structural persistence was significantly more common in patients with HVPTC (37.5% vs. 8.7%), while no differences were observed considering structural and biochemical persistence together. The presence of hobnail features identifies locally aggressive tumors, and, consequently, it should be always acknowledged in the pathological report. However, tumors with more than 30% hobnail areas frequently present TERT promoter mutations, advanced disease stage, and structural persistence after radioiodine ablation. Frontiers Media S.A. 2022-03-02 /pmc/articles/PMC8926070/ /pubmed/35311230 http://dx.doi.org/10.3389/fendo.2022.842424 Text en Copyright © 2022 Poma, Macerola, Proietti, Vignali, Sparavelli, Torregrossa, Matrone, Basolo, Elisei, Santini and Ugolini https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Poma, Anello Marcello Macerola, Elisabetta Proietti, Agnese Vignali, Paola Sparavelli, Rebecca Torregrossa, Liborio Matrone, Antonio Basolo, Alessio Elisei, Rossella Santini, Ferruccio Ugolini, Clara Clinical–Pathological Features and Treatment Outcome of Patients With Hobnail Variant Papillary Thyroid Carcinoma |
title | Clinical–Pathological Features and Treatment Outcome of Patients With Hobnail Variant Papillary Thyroid Carcinoma |
title_full | Clinical–Pathological Features and Treatment Outcome of Patients With Hobnail Variant Papillary Thyroid Carcinoma |
title_fullStr | Clinical–Pathological Features and Treatment Outcome of Patients With Hobnail Variant Papillary Thyroid Carcinoma |
title_full_unstemmed | Clinical–Pathological Features and Treatment Outcome of Patients With Hobnail Variant Papillary Thyroid Carcinoma |
title_short | Clinical–Pathological Features and Treatment Outcome of Patients With Hobnail Variant Papillary Thyroid Carcinoma |
title_sort | clinical–pathological features and treatment outcome of patients with hobnail variant papillary thyroid carcinoma |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926070/ https://www.ncbi.nlm.nih.gov/pubmed/35311230 http://dx.doi.org/10.3389/fendo.2022.842424 |
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