Thyroid No Surgery
My Molecular DNA Molecular Marker Paper presented at national meeting of American Association of Clinical Endocrinologists AACE
This is part of my continued interest in finding all the ways possible that make medical sense to continue to decrease in all forms of thyroid surgery when there is a first line alternative. Thyroid FNA, modern Thyroid cytopathology, Ethanol ablation,RFA,HIFU, Microwave MWA and now molecular markers and classifiers. The collection of markers and classifiers was by needle washout form the thyroid nodule biopsy. If this was not collected and saved with the initial biopsy a repeat was needed if the biopsy was indeterminate.Now Rossetta and Interpace are doing markers on the slides from the biopsy after the the biopsy was done. A circle around the suspicious cells and these labs can do markers from scratching off cells called “micro dissection”. Interpace adds a novel reflex classifier if the markers for cancer are not present.
This case showcases this new method in a complicated evaluation of a women Hashimoto’s thyroiditis with bilateral weak vocal cords,enlarging goiter and nodules, negative flow cytometry for lymphoma, and Intense positive PET/CT in the whole gland. KRAS cancer marker was found and even though it could all be Thyroiditis there was to many unknowns to not operate. It was just thyroiditis, as KRAS mutation is found in benign cases.