**Meet the editor**

Laura Sterian Ward was born in Bucarest, Romenia, but emigrated to Brasil where she graduated from the Federal University of São Paulo (UNIFESP) ) - Escola Paulista de Medicina in 1979. She completed her residency in Clinical Endocrinology in the Hospital São Paulo, in 1981; received her master degree in 1985, and her PhD from the same UNIFESP in 1992. She further

specialized in thyroidology. During the years 1995-1997, Prof Ward developed a Post-Doctoral Fellowship program in Cancer Molecular Genetics at the University of Cincinnati, USA, under the supervision of Prof James A. Fagin. She is currently an Associated Professor of Medicine at the State University of Campinas- UNICAMP, in Campinas, São Paulo and the Chief of the Laboratory of Cancer Molecular Genetics in this University. Prof Ward published 109 articles in peer reviewed international medical journals, 91 included in the ISI database where they are quoted more than 800 times. She already was the editor of one book on thyroid diseases and helped editing three other books, wrote 40 books chapters and has participated with more than 200 presentations in both Brazilian and international congresses. In addition, teaching and supervising medical and research students represents an important aspect of her academic activities having supervised the accomplishment of 10 PhD`s and 21 Masters from UNICAMP. In the year 2011, Prof Ward was awarded the Latin American Thyroid Association prize.

Contents

**Preface IX** 

Chapter 1 **Introduction to Thyroid:** 

Evren Bursuk

Anne Charrié

Carles Zafon

Chapter 4 **Thyroid Neoplasm 45** 

Chapter 5 **Thyroid Growth Factors 77** 

Chapter 3 **Papillary Thyroid Microcarcinoma –** 

Chapter 2 **The Thyroglobulin:** 

**Anatomy and Functions 3** 

**Part 1 Evaluating the Thyroid Gland and Its Diseases 1** 

**A Technically Challenging Assay for a Marker of Choice During the Follow-Up of Differentiated Thyroid Cancer 23** 

Augusto Taccaliti, Gioia Palmonella, Francesca Silvetti and Marco Boscaro

Chapter 6 **Vascular Endothelial Growth Factor (VEGF) and Epidermal Growth Factor (EGF) in Papillary Thyroid Cancer 87** 

Chapter 7 **Immune Profile and Signal Transduction** 

Adriano Namo Cury

Aleksander Konturek and Marcin Barczynski

Aleksander Konturek and Marcin Barczynski

Chapter 8 **Estrogen Signaling and Thyrocyte Proliferation 109** 

**Do Classical Staging Systems Need to Be Changed? 33** 

**of T-Cell Receptor in Autoimmune Thyroid Diseases 95** 

Valeria Gabriela Antico Arciuch and Antonio Di Cristofano

### Contents

#### **Preface XI**



#### **Part 2 Treatment of Thyroid and Parathyroid Diseases 133**


#### **Part 3 Psychiatric Disturbances Associated to Thyroid Diseases 237**


### Preface

Thyroid and parathyroid diseases are among the most frequent conditions we have to deal with in a clinical setting. Both nodular and autoimmune diseases affecting these glands have increased remarkably over the past decades. The widespread use of cross‐ sectional imaging and the introduction of neck ultrasonography have led to a thyroid nodule epidemics and the diagnostic of neck lesions in half of the population. Consequently, many patients with microscopic papillary thyroid cancers of uncertain clinical significance are submitted to surgeries that may, perhaps, be unnecessary. Differentiated thyroid cancer is the fastest‐growing cancer in women; it increased 2.4% per year during 1980 to 1997 and 6.5% per year during 1997 to 2006 in the USA according to the National Cancer Instituteʹs Surveillance Epidemiology and End Results (SEER). On the other hand, the refinement of new approaches for surveillance of patients with an established diagnosis of thyroid cancer is leading to the observation that many patients, previously thought to be cured, have evidence of minimal residual disease, a condition with which we still do not know how to manage properly.

**Evaluating the Thyroid Gland and its Diseases section** includes useful information into the anatomy and functions of the thyroid gland; the thyroid neoplasm and its most challenging type, the papillary thyroid microcarcinoma; the use and technical peculiarities of thyroglobulin dosages and fine aspiration citology. In addition, important articles approach basic aspects of thyroid carcinogenesis, namely growth factors, angiogenesis, and the importance of estrogen signaling on thyrocyte proliferation.

The increase in autoimmune thyroid diseases has been no less remarkable than that of thyroid nodules, but it is more difficult to document. However, there are evidences indicating that around 5‐10% of the population suffers from a thyroid dysfunction, mostly autoimmune hypothyroidism. A beautiful article from Dr Cury explains to the reader how our immune system copes with the modifications associated to autoimmune thyroid diseases.

Thyroid disease can affect your mood, causing either anxiety or depression, and a second section of the book, **Psychiatric disturbances associated to thyroid diseases,** groups three very interesting articles approaching the psychiatric disturbances and the psychosocial aspects associated to thyroid diseases.

#### X Preface

Finally, the third section, **Treatment of Thyroid and Parathyroid Diseases,** is designed mostly to the young practitioner. In fact, the field of thyroid and parathyroid surgery as well as thyroid diseases treatment modalities have undergone rapid change in the past few years with the advent of new techniques and the appearing of new basic and clinical evidences. Also, we need to understand how hormone analogs may affect our glands and a hole chapter is devoted to this subject.

The burden of thyroid and parathyroid diseases continue to increase and a better knowledge of these pathologies molecular, epidemiological and clinical behavior is essential in order to better manage our patients.

Thyroid and Parathyroid diseases aims to provide meaningful information to the practitioner through the eyes of though leaders in the discipline who have contributed their time and expertise to this effort. It is not a comprehensive textbook but rater a carefully chosen collection of very important topics written and illustrated in a form that hopefully will please all, the clinicians, the surgeons, the pathologists, the radiologists and all the fans of the head and neck diseases.

Hope you enjoy it!

**Laura Sterian Ward** Associate Professor of Medicine at the Faculty of Medical Sciences, State University of Campinas, Brazil

X Preface

Finally, the third section, **Treatment of Thyroid and Parathyroid Diseases,** is designed mostly to the young practitioner. In fact, the field of thyroid and parathyroid surgery as well as thyroid diseases treatment modalities have undergone rapid change in the past few years with the advent of new techniques and the appearing of new basic and clinical evidences. Also, we need to understand how hormone analogs may

The burden of thyroid and parathyroid diseases continue to increase and a better knowledge of these pathologies molecular, epidemiological and clinical behavior is

Thyroid and Parathyroid diseases aims to provide meaningful information to the practitioner through the eyes of though leaders in the discipline who have contributed their time and expertise to this effort. It is not a comprehensive textbook but rater a carefully chosen collection of very important topics written and illustrated in a form that hopefully will please all, the clinicians, the surgeons, the pathologists, the

Associate Professor of Medicine at the Faculty of Medical Sciences,

**Laura Sterian Ward**

Brazil

State University of Campinas,

affect our glands and a hole chapter is devoted to this subject.

radiologists and all the fans of the head and neck diseases.

essential in order to better manage our patients.

Hope you enjoy it!

**Part 1** 

**Evaluating the Thyroid Gland and Its Diseases** 
