FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 352:2406-2412 June 9, 2005 Number 23 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Perspective by Utiger, R. D. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article PubMed Citation

ABSTRACT

Background Papillary thyroid carcinoma is frequently multifocal. We investigated whether noncontiguous tumor foci arise from intraglandular metastases from a single primary tumor or originate as unrelated clones derived from independent precursors.

Methods Using a polymerase-chain-reaction assay involving the human androgen receptor gene (HUMARA), we analyzed the patterns of X-chromosome inactivation of multiple distinct foci of well-differentiated multifocal papillary thyroid cancer from 17 women.

Results Multiple thyroid tumor foci from 10 of 17 patients yielded DNA of adequate quality and were heterozygous for the HUMARA polymorphism and hence suitable for analysis. A single X chromosome was inactivated in each focus, consistent with its monoclonality. When the specific monoclonal configurations of each patient's discrete tumor foci were compared, discordant patterns indicative of independent origins were observed among the tumors from five patients; results in the remaining five were consistent with either a shared or independent clonal origin.

Conclusions Individual tumor foci in patients with multifocal papillary thyroid cancer often arise as independent tumors.

Source Information

From the Center for Molecular Medicine and Division of Endocrinology and Metabolism, University of Connecticut School of Medicine, Farmington (T.M.S., A.A.); the Department of Pathology, Johns Hopkins Medical Institutions, Baltimore (W.H.W.); and the Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore (P.W.L.).

Address reprint requests to Dr. Arnold at the Center for Molecular Medicine, University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030-3101, or at molecularmedicine{at}uchc.edu.

Full Text of this Article

Related Letters:

Multifocal Papillary Thyroid Carcinoma
Gemsenjäger E. W., Heitz P. U., Schweizer I., DeVries J. H., Ladenson P. W., Arnold A., Westra W. H.
Extract | Full Text | PDF  
N Engl J Med 2005; 353:1067-1068, Sep 8, 2005. Correspondence

This article has been cited by other articles:

• Lin, X., Finkelstein, S. D, Zhu, B., Silverman, J. F (2008). Molecular analysis of multifocal papillary thyroid carcinoma. J Mol Endocrinol 41: 195-203 [Abstract] [Full Text]  
• Frumkin, D., Wasserstrom, A., Itzkovitz, S., Stern, T., Harmelin, A., Eilam, R., Rechavi, G., Shapiro, E. (2008). Cell Lineage Analysis of a Mouse Tumor. Cancer Res. 68: 5924-5931 [Abstract] [Full Text]  
• Shrime, M. G., Goldstein, D. P., Seaberg, R. M., Sawka, A. M., Rotstein, L., Freeman, J. L., Gullane, P. J. (2007). Cost-effective Management of Low-Risk Papillary Thyroid Carcinoma. Arch Otolaryngol Head Neck Surg 133: 1245-1253 [Abstract] [Full Text]  
• Giannini, R., Ugolini, C., Lupi, C., Proietti, A., Elisei, R., Salvatore, G., Berti, P., Materazzi, G., Miccoli, P., Santoro, M., Basolo, F. (2007). The Heterogeneous Distribution of BRAF Mutation Supports the Independent Clonal Origin of Distinct Tumor Foci in Multifocal Papillary Thyroid Carcinoma. J. Clin. Endocrinol. Metab. 92: 3511-3516 [Abstract] [Full Text]  
• Maier, J., van Steeg, H., van Oostrom, C., Karger, S., Paschke, R., Krohn, K. (2006). Deoxyribonucleic Acid Damage and Spontaneous Mutagenesis in the Thyroid Gland of Rats and Mice. Endocrinology 147: 3391-3397 [Abstract] [Full Text]  
• Roti, E., Rossi, R., Trasforini, G., Bertelli, F., Ambrosio, M. R., Busutti, L., Pearce, E. N., Braverman, L. E., degli Uberti, E. C. (2006). Clinical and Histological Characteristics of Papillary Thyroid Microcarcinoma: Results of a Retrospective Study in 243 Patients. J. Clin. Endocrinol. Metab. 91: 2171-2178 [Abstract] [Full Text]  
• Mazzaferri, E. L. (2006). Managing small thyroid cancers.. JAMA 295: 2179-2182 [Full Text]  
• McCarthy, R. P., Wang, M., Jones, T. D., Strate, R. W., Cheng, L. (2006). Molecular Evidence for the Same Clonal Origin of Multifocal Papillary Thyroid Carcinomas. Clin. Cancer Res. 12: 2414-2418 [Abstract] [Full Text]  
• Yu, X.-M., Lo, C.-Y., Chan, W.-F., Lam, K.-Y., Leung, P., Luk, J. M. (2005). Increased Expression of Vascular Endothelial Growth Factor C in Papillary Thyroid Carcinoma Correlates with Cervical Lymph Node Metastases. Clin. Cancer Res. 11: 8063-8069 [Abstract] [Full Text]  
• Gemsenjager, E. W., Heitz, P. U., Schweizer, I., DeVries, J. H., Ladenson, P. W., Arnold, A., Westra, W. H. (2005). Multifocal Papillary Thyroid Carcinoma. NEJM 353: 1067-1068 [Full Text]  
• (2005). Endocrinology & Metabolism News, July 2005. J. Clin. Endocrinol. Metab. 90: 17a-17a [Full Text]