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Molecular Pathology and Diagnostics of Thyroid and Parathyroid Malignancies

  • Rodney E. Shackelford
  • Jason SavellEmail author
Chapter
Part of the Cancer Growth and Progression book series (CAGP, volume 16)

Abstract

Malignancies of the thyroid and parathyroid glands are rare oncologic entities that range in clinical behavior from relatively indolent to extremely aggressive malignancies. Presently, establishing a diagnosis and prognosis for thyroid and parathyroid malignancies largely depends on histology supplemented with immunohistochemical analysis. Over the past 20 years, different histologic subtypes of thyroid cancer have been shown to carry specific genetic alterations, which are often preferentially associated with, or unique to, each subtype. In many cases, these genetic alterations have been analyzed via molecular-genetic testing techniques to help establish a diagnosis in cases where histology and immunohistochemistry alone cannot. In addition, such testing has occasionally been used to determine prognosis. Presently, clinical molecular diagnostic testing is not performed on parathyroid tumors. However, differences between parathyroid hyperplasia, adenomas, and carcinomas have been detected via molecular testing. With additional research, these differences may become more fully understood and applied to molecular diagnostics. Thus, although presently not extensively employed, molecular diagnostics of the thyroid and parathyroid are likely to become increasingly important in determining the diagnosis and prognosis of these malignancies, especially for histologically difficult cases. Furthermore, pharmacologic inhibitors of many of the oncogenes mutated in these malignancies are being developed. With time, molecular diagnostic testing for these mutations is likely to be implemented to aid in choosing optimal chemotherapeutic treatment regimens.

Keywords

Thyroid Parathyroid Malignancies Tumor papillary Follicular Medullary BRAF RAS RET Molecular diagnostics NTRK1 PAX8-PPAR gamma 

Abbreviations

ACT

Anaplastic carcinoma of the thyroid

ASA

Allele-specific amplification

ATC

Anaplastic thyroid cancer

FA

Follicular adenomas

FC

Follicular carcinoma

FCT

Follicular carcinoma of the thyroid

FMTC

Familial medullary thyroid cancer

FNA

Fine needle aspirations

HRM

High-resolution melting

HT

Hashimoto’s thyroiditis

IR

Ionizing radiation

MEN

Multiple endocrine neoplasia

MTC

Medullary thyroid cancer

PA

Parathyroid adenoma

PC

Parathyroid carcinoma

PCR

Polymerase chair chain reaction

PTC

Papillary thyroid carcinoma

SSCP

Single-strand conformational polymorphism

STAT

Shifted termination assay technology

TC

Thyroid cancers

TSH

Thyroid-stimulating hormone

Notes

Acknowledgement

We would like to thank Miss Jennifer Burton for her help in manuscript preparation and proofreading.

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineTulane University School of MedicineNew OrleansUSA
  2. 2.H. Lee Moffitt Cancer Center and Research Institute and University of South FloridaTampaUSA

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