Article Full blood count, blood chemistry, and serum thyroglobulin levels were normal. 2005 Sep;55(9):574-9. doi: 10.1111/j.1440-1827.2005.01871.x. surg case rep 4, 34 (2018). The thyroid nodules on thyroid US gradually increased in number and size. A follicular adenoma is a common neoplasm of the thyroid gland. All patients were female, and the average age at detection of thyroid lesions was 56.2 years old. A case of superficial angiomyxoma; is this case Carney’s complex? In two autopsy series, the incidence of thyroid adenoma was 3 and 4.3% [ 1, 2 ]. A follicular adenoma is a tumor of the thyroid that is benign and is completely surrounded by the capsule. Nat Genet. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Multiple nodules of varying sizes are typically found in both lobes. Privacy, Help In a multinodular thyroid, it is rather difficult to distinguish between a (polyclonal) hyperplastic … Solitary follicular nodules have been unequivocally shown to be monoclonal (24,25,26) and in the absence of invasive behaviour or of markers of papillary carcinoma, these lesions are considered to be benign. Jpn J Diagn Pathol. Thyroid adenomas are mostly follicular adenomas. Hanna WC, Ponsky TA, Trachiotis GD, Knoll SM. Prevention and treatment information (HHS). statement and J Pediat Dermatol. Clinical features [9] Often presents as a slow-growing solitary nodule; Patients are typically euthyroid. 1985;64:270–83. CAS Thyroid carcinomas can develop in the background of a variety of follicular thyroid lesions in CNC patients despite biochemical euthyroid status and no palpable mass. Follicular adenoma is a cause of neoplasm in the thyroid gland. Eur J Endocrinol. The correlation between TSH value and occurrence of thyroid cancer has not been demonstrated in CNC patients, but the adenylate cyclase-PKA pathway located downstream of the TSH receptor may be involved in the development of thyroid cancer. They typically present as a solitary thyroid nodule or in association with nodular hyperplasia or thyroiditis. The CNC patients with PRKAR1A genetic mutation were more susceptible to the occurrence of thyroid tumors, and about two thirds of these cases showed thyroid disorder in infancy or adolescence [2, 5]. 1). We thank Dr. Kouji Miyazaki for reviewing the manuscript. c Nodular hyperplasia had colloid-filled follicles of variable size. Most CNC patients in Japan initially visited a dermatologist or endocrine physician, ultimately leading to a later CNC diagnosis. Three years after a colectomy he died of multiple metastases. The authors declare that they have no competing interests. Article Carney complex: an update. Thyroid adenoma is a benign lesion of the thyroid gland. Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms. … The age at onset of thyroid cancer in two Japanese CNC patients was 72 and 73 years old, in whom PRKAR1A mutation was negative in one and not available in the other. Although calcification can be seen in both benign and malignant processes, it is the ultrasound feature most closely associated with malignancy 1. This trend reflects the chief complaints of these CNC patients, which were Cushing sign (33%), palpation of the subcutaneous or breast tumor (27%), and pigment deposition of the skin (24%). Nodular hyperplasia was scattered in the background of the follicular adenomas (H & E stain x2 objective, FA: follicular adenoma, NH: nodular hyperplasia, C: capsule). Symptoms of thyroid adenomas that have advanced are similar to the symptoms of hyperthyroidism. Correa R, Salpea P, Stratakis CA. It is important to exclude malignancies from the differential diagnosis because thyroid carcinoma mimics adenoma. Fadare O, Parkash V, Fiedler PN, Mayerson AB, Asiyanbola B. Pathol Int. Carney JA, Gordon H, Carpenter PC, Shenoy BV, Go VL. Reviewer “A” discloses no financial relationships. FOIA She had been taking thiamazole for 25 years for hyperthyroidism. The resected specimen is shown in Fig. No Shinkei Geka. Google Scholar. Meanwhile, osteochondromyxoma, psammomatous melanotic schwannoma, and blue nevi were rare in Japan. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. J Toyonaka Muni Hosp. A case of Carney complex. When used without additional qualifiers, this term typically refers to a conventional type of follicular adenoma. Keranmu A, Zheng H, Wu Y, Zhao J, Xu X, Liu F, Cai S, Wang Y, Xu Y. Autopsy revealed that the metastatic colonic carcinoma was located in a thyroid follicular adenoma. PubMed Google Scholar. Colonic adenocarcinoma metastatic to the thyroid: report of a case. Endocr Surg. Activated PKA promotes phosphorylation of CREB (cAMP response element-binding protein) that relates to the copying of cells, metabolism, and cell cycle progress. Follicular thyroid adenoma is a commonly found benign neoplasm of the thyroid consisting of differentiated follicular cells. However, it is reported in association with tumors like hyalinizing trabecular adenoma, follicular adenoma, follicular carcinoma, and … Section Editor Herbert Chen discloses research funding received from Novartis. They typically present as a solitary thyroid nodule or in association with nodular hyperplasia or thyroiditis. Thi… Multiple approaches are often needed to treat carcinoma including therapy using radioactive iodine as well as surgery to remove most of the carcinoma. Cite this article. Cookies policy. From that time on, she received annual brain MRI, abdominal CT, and thyroid US examinations. The adjacent thyroid tissue will usually be compressed. Springer Nature. Anatomy and histology of the thyroid gland. Metastatic carcinoma to the thyroid gland: a single institution 20-year experience and review of the literature. Four of 5 Japanese CNC patients with thyroid lesion underwent a partial thyroidectomy, 2 with cancer and 2 with adenoma, histologically. Her follicular thyroid nodules gradually increased in number and size. PubMed A case of cutaneous myxoma. Other follicular adenomas may have almost no chance of being cancers, but overproduce thyroid hormone, and need treatment to prevent harmful effects of hyperthyroidism on the bones, heart and other tissues. CAS She was diagnosed with follicular adenoma, and she started to take levothyroxine. a Multiple follicular adenomas with a thick fibrous capsule were found in the bilateral lobes. Manage cookies/Do not sell my data we use in the preference centre. Genetic studies showed no mutation in the PRKAR1A (protein kinase A regulatory subunit 1-α) gene. Google Scholar. Google Scholar. Stratakis CA, Kirschner LS, Carney JA. Follicular neoplasms of the thyroid gland include benign follicular adenoma and follicular carcinoma. She had been operated on 10 years earlier to extirpate a left atrial myxoma (Fig. 2013 Sep;24(3):116-24. doi: 10.1007/s12022-013-9257-8. Ando Y, Suma A, Yahata Y, Tsujimoto M, Noguchi M. A case of Carney complex syndrome. Follicular Adenoma- Thyroid. Diagnostic criteria for CNC were proposed by Stratakis CA in 2001 (Table 1) [3]. Thyroid follicular adenoma ranges in diameter from 3 cm on an average, but sometimes is larger (up to 10 cm) or smaller. Thyroid follicular adenoma Follicular adenoma is a kind of non-malignant tumor that appears in the endocrine gland named thyroid. PRKAR1A gene encodes the regulatory subunit type 1-α of protein kinase A (PKA, cAMP-dependent protein kinase). Mutations of the gene encoding the protein kinase A type I-alpha regulatory subunit in patients with the Carney complex. Our patient underwent surgery because the thyroid nodules gradually increased in number and size on follow-up thyroid US examinations. Half of CNC is inherited in an autosomal dominant fashion, and the rest is sporadic. 2006 Jan;141(1):93-6. doi: 10.1001/archsurg.141.1.93. 2000;26(1):89–92. Case Rep Pathol. Isolated thyroid metastasis revealed an unknown lung adenocarcinoma: a case report. These tumours are often round and firm and may be felt as a lump in the front of the neck. Epidemiological data are not very reliable because follicular adenomas occur most frequently in females in the 5th or 6th decade of life, when nodular goiter is relatively frequent, in particular in iodine-deficient regions. He died 14 months after admission due to the carcinoma. Autopsy revealed that the metastatic colonic carcinoma was located in a thyroid follicular adenoma. Pract Dermatol. Khalil J, Elomrani F, Benoulaid M, Elkacemi H, Kebdani T, Errihani H, Benjaafar N. J Med Case Rep. 2015 Sep 27;9:221. doi: 10.1186/s13256-015-0663-z. Follicular nodules are the most commonly encountered problems in the surgical pathology of the thyroid. The surface of the thyroid gland was rugged and slightly hard. PRKAR1A (protein kinase A regulatory subunit 1-α) was identified in 2000 as a causative gene of CNC type 1 but has not been identified in CNC type 2 [1]. Carney complex (CNC) is a familial tumor syndrome first reported by J. Aidan Carney in 1985. It included multiple nodules with a maximal size of 4.0cm in diameter, Histology of the thyroid gland. Seven of the 10 CNC cases which included the PRKAR1A genetic test showed PRKAR1A genetic mutation (Table 3), and these patients were younger than those without the mutation (mutation group 26.6 ± 20.2 years old, no mutation group 64.3 ± 11.7 years old, p = 0.0339). Multiple gene microarray studies suggest that benign and malignant follicular thyroid neoplasms have different gene expression profiles. Google Scholar. During the evaluation, a 1.5cm follicular cyst in the left … 2020 May 6;20(1):136. doi: 10.1186/s12876-020-01286-z. J Clin Endocrinol Metab. PRKAR1A genetic mutation helps with CNC diagnosis, and it is included in the supplementary diagnostic criteria. Accessibility The second case was a 51-year-old man with primary lung adenocarcinoma. Most of them had the characteristics of the oxyphilic cell variant. Nakashima T, Iwasa M, Kanamori H, Ushikoshi H, Kawasaki M, Nishigaki K, et al. 2002;29:790–6. The first was an 82-year-old man with sigmoid colon adenocarcinoma. 2017;45(3):225–31. Worldwide, up to 60% of CNC patients had thyroid nodules; nonspecific cystic disease was present in 75%, follicular adenomas in 25%, and papillary or follicular carcinomas in up to 10% of the cases [5]. California Privacy Statement, Although CNC patients usually show thyroid function within the normal range, two Japanese cases with thyroid lesions, including our patient, had a high TSH level (Table 5). J Dermatol. By using this website, you agree to our 2016;48(7):774–80. Entrapment of thyroid follicles can cause confusion with a follicular cell adenoma, but C-cell adenomas are immunohistochemically positive for generic neuroendocrine markers, such as chromogranin and protein gene product 9.5 (PGP 9.5), and specifically for calcitonin.
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