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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...

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Autores principales: Poma, Anello Marcello, Macerola, Elisabetta, Proietti, Agnese, Vignali, Paola, Sparavelli, Rebecca, Torregrossa, Liborio, Matrone, Antonio, Basolo, Alessio, Elisei, Rossella, Santini, Ferruccio, Ugolini, Clara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
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.
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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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