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      Thyroid liposarcoma: a case report

      case-report

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          Abstract

          Objectives

          Thyroid liposarcoma is a rare tumor. Its low prevalence accounts for the scarcity of data in the literature, which consists mostly of small studies and case reports.

          Case presentation

          We present the case of a 60 years old male with no past medical or past surgical history and presented with neck discomfort and a large left thyroid nodule. Thyroid ultrasound and CT scan were performed and confirmed the existence of a thyroid nodule most probably inside the left inferior thyroid lobe. In the posterior mediastinum, two fatty formations were found. To complete, an MRI was performed, showing a mixed lesion, of the lower neck and upper chest. The patient underwent an extended resection which consisted of an en bloc resection of the lesion (left thyroid lobectomy and isthmus resection) by an anterior transverse cervical incision and a sternotomy. Tracheal and laryngeal shaving and esophageal shaving with resection of the esophageal muscularis was performed as well. The pathological evaluation of the specimen showed a grade II dedifferentiated liposarcoma with an inflammatory component.

          Conclusions

          Thyroid liposarcoma is a rare lesion of the thyroid. Its management requires an exhaustive workup followed by an en bloc resection of the lesion. Depending on the histology, postoperative radiation therapy may or may not be necessary.

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          Most cited references20

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          2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer: American Thyroid Association Anaplastic Thyroid Cancer Guidelines Task Force

          Background: Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Since the guidelines for the management of ATC by the American Thyroid Association were first published in 2012, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, and researchers on published evidence relating to the diagnosis and management of ATC. Methods: The specific clinical questions and topics addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of the Task Force members (authors of the guideline). Relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. Results: The guidelines include the diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, targeted/systemic therapy, supportive care during active therapy), approaches to advanced/metastatic disease, palliative care options, surveillance and long-term monitoring, and ethical issues, including end of life. The guidelines include 31 recommendations and 16 good practice statements. Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of ATC. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with ATC.
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            American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer.

            Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Rapid evaluation and establishment of treatment goals are imperative for optimum patient management and require a multidisciplinary team approach. Here we present guidelines for the management of ATC. The development of these guidelines was supported by the American Thyroid Association (ATA), which requested the authors, members the ATA Taskforce for ATC, to independently develop guidelines for ATC. Relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The quality and strength of recommendations were adapted from the Clinical Guidelines Committee of the American College of Physicians, which in turn was developed by the Grading of Recommendations Assessment, Development and Evaluation workshop. The guidelines include the diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, systemic therapy, supportive care during active therapy), approaches to advanced/metastatic disease, palliative care options, surveillance and long-term monitoring, and ethical issues including end of life. The guidelines include 65 recommendations. These are the first comprehensive guidelines for ATC and provide recommendations for management of this extremely aggressive malignancy. Patients with stage IVA/IVB resectable disease have the best prognosis, particularly if a multimodal approach (surgery, radiation, systemic therapy) is used, and some stage IVB unresectable patients may respond to aggressive therapy. Patients with stage IVC disease should be considered for a clinical trial or hospice/palliative care, depending upon their preference.
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              Liposarcoma: a study of 55 cases with a reassessment of its classification.

              H. Evans (1979)
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                Author and article information

                Contributors
                Journal
                Innov Surg Sci
                Innov Surg Sci
                iss
                iss
                Innovative Surgical Sciences
                De Gruyter
                2364-7485
                14 October 2022
                December 2022
                : 7
                : 3-4
                : 133-137
                Affiliations
                universityService de chirurgie endocrinienne, Hôpital Lyon Sud , Pierre Bénite, France
                deptDepartment of Surgery , universitySchool of Medicine, Tulane University , New Orleans, LA, USA
                universityRESHAPE Research on Healthcare Performance, INSERM U1290-UCBL 1 , Domaine Rockefeller, 8 Avenue Rockefeller, Lyon, France
                Author notes
                Corresponding author: Jean-christophe Lifante, MD, PhD, universityService de chirurgie endocrinienne, Hôpital Lyon Sud , Pierre Bénite, France, E-mail: Jean-christophe.lifante@ 123456chu-lyon.fr
                Article
                iss-2021-0037
                10.1515/iss-2021-0037
                9742268
                36561504
                b124a3b1-77f4-4006-9c9e-e70f29f9f3d2
                © 2022 the author(s), published by De Gruyter, Berlin/Boston

                This work is licensed under the Creative Commons Attribution 4.0 International License.

                History
                : 31 August 2021
                : 25 July 2022
                Page count
                Figures: 04, Tables: 00, References: 20, Pages: 05
                Categories
                Case Report

                sarcoma,thyroid liposarcoma,thyroid surgery
                sarcoma, thyroid liposarcoma, thyroid surgery

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