Prevalence and predictors of thyroid cancer among thyroid nodules: a retrospective cohort study of 1,000 patients.

INTRODUCTION: Thyroid cancer is increasing in incidence globally due either to early detection (overestimation) or true increment. A recent debate concerns multinodular goitre (MNG) or toxic goitres which have classically been considered at a lower risk for cancer. METHODS: In this study, we enrolled retrospectively all patients with nodular goitre treated at our tertiary hospital and analysed their data with the aim of detecting the rate of cancer among different types of nodular goitre. We also studied predictors of incidental malignancy among thyroidectomies. RESULTS: A predilection for solitary thyroid nodules (STNs) was found in women of younger age, with STNs tending to be larger in comparison with MNG in the same age group. However, both types of nodules were at equal risk of harbouring malignancy. Thyroid Imaging Reporting and Data System (TI-RADS) and Bethesda scores were the only dependent predictors of malignancy within thyroid nodules. CONCLUSION: The authors recommend management of both STNs and MNG using the same algorithm.

Medullary thyroid cancer: epidemiological pattern and factors contributing to recurrence and metastasis.

INTRODUCTION: Medullary thyroid carcinoma (MTC) is a neuroendocrine thyroid carcinoma with parafollicular C cell differentiation. It can occur in either sporadic or hereditary form. Surgery is still the only curative treatment. The efficacy of chemotherapy and radiotherapy is poor. METHODS: This was a retrospective study of 31 patients treated surgically for MTC in our oncology centre at Mansoura University between January 2008 and February 2019. RESULTS: The mean age at diagnosis was 39.9 years. The median pathological size was 4cm. Multifocal disease was found in 12 patients and extrathyroid extension in 3 cases. Twenty patients were pathologically node positive. The median number of positive lymph nodes was four. Seven cases were metastatic at diagnosis. Local recurrence occurred in six individuals while distant recurrence occurred only in one. The median time from surgery to local recurrence was 12 months. The estimated mean disease free survival was 56.5 months. Disease free survival was significantly related to age, metastasis and side of nodal spread. CONCLUSIONS: In our study cohort, the disease occurred predominantly in women and younger patients. Age, distant metastasis and nodal spread were the most significant prognostic factors. This study has also demonstrated that prognosis is not only affected by nodal involvement but also by side of involvement. The role of hemithyroidectomy in node negative unifocal disease with a small tumour size warrants further investigation.

Ovarian gastrointestinal stromal tumor: does this diagnosis exist?.

Gastrointestinal stromal tumors (GISTs) are rare gastrointestinal (GI ) tract tumors. Those tumors rarely arise extra intestinally; within omentum, mesentery, and rarely uterus. The authors report a case of myxoid variant of GIST arising in the ovary with no evidence of a primary tumor in the GI tract. Surgeons as well as gynecologists should bear this possibility in mind when managing pelvic masses.

Epidemiology and predictors of recurrence of Marjolin's ulcer: experience from Mansoura Universityxs.

INTRODUCTION Marjolin's ulcer (MU) is an uncommon malignancy occurring on top of old scars. Once thought to be more common in Caucasians, is now detected increasingly in Africa. METHODS This was a retrospective study of patients with MU attending a tertiary centre within Mansoura University (Egypt) from 2004 to 2015. An institutional-based registry of skin and soft-tissue malignancies in this period revealed 560 cases, from which there were 26 cases of MU. RESULTS The most common underlying cause of MU was burns (92% of patients), followed by trauma. A predilection towards males was detected. The latent period was 4-70 (median, 25) years. Recurrence occurred in 12 cases, with multiple recurrences occurring in 5 cases. MU recurrence was noted as early as 3 months and as late as 25 years after surgery. CONCLUSIONS Young patients with MU are at higher risk of recurrence and should be followed up closely. A thorough search for nodal metastasis (especially in those with high-grade tumours) should be done. Wide local excision and leaving wounds to heal by secondary intention seems to be a viable treatment option.