{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:27:34Z","timestamp":1792718854589,"version":"4.5.0"},"reference-count":39,"publisher":"Bioscientifica","issue":"10","content-domain":{"domain":["erc.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7,14]]},"abstract":"<jats:p>\n                    Thyroid cancer surveillance (TCS) with ultrasound (US) is advised for\n                    <jats:italic>PTEN<\/jats:italic>\n                    hamartoma tumour syndrome (PHTS) patients due to increased thyroid cancer (TC) risk. However, data supporting TCS guidelines are scarce. We aimed to assess the detection and yield of annual TCS with US in adult PHTS patients without a TC history and to evaluate the impact of a reduced US interval on the TCS yield. A retrospective cohort study was conducted, including adult PHTS patients and medical record data between 2005 and 2021. The yield from annual TCS was compared with hypothetical biennial and triennial TCS after two initial US with annual interval by counting delayed detection of nodular growth, thyroid adenoma, and TC. During 279 follow-up years, 84 patients (median age 40 years) underwent 349 US. Thyroidectomy was performed in 6\/84 (7%) patients, revealing a minimally invasive follicular TC in one patient aged 22 and a thyroid adenoma in two patients aged 21 and 53. Multiple thyroid nodules were diagnosed in 73\/84 (87%) patients (median age 36 years). Nodular growth was detected in 9\/56 (16%) patients, and its detection would have been delayed in 4\u20137% US rounds with biennial TCS, and in 2\u20136% US rounds with triennial TCS. US-based thyroiditis and indeterminate non-malignant lymph nodes were found in 8\/74 (11%) and 7\/72 (10%) patients, respectively. Following our findings combined with the literature, we propose starting TCS before age 18 and reducing the follow-up frequency after the initial two US from annual to biennial if no suspicious findings are detected.\n                  <\/jats:p>","DOI":"10.1530\/erc-23-0009","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T18:48:51Z","timestamp":1689360531000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":8,"title":["Detection and yield of thyroid cancer surveillance in adults with PTEN hamartoma tumour syndrome"],"prefix":"10.1530","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5742-8011","authenticated-orcid":true,"given":"Meggie M C M","family":"Drissen","sequence":"first","affiliation":[{"name":"Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet R","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romana T","family":"Netea-Maier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Gotthardt","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2393-8141","authenticated-orcid":true,"given":"Nicoline","family":"Hoogerbrugge","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Endocrine Practice","first-page":"148","article-title":"Active surveillance for low-risk differentiated thyroid cancer","volume":"29","author":"Ahmadi","year":"2022","unstructured":"Ahmadi S & Alexander EK2022Active surveillance for low-risk differentiated thyroid cancer. Endocrine Practice29148\u2013153. (https:\/\/doi.org\/10.1016\/j.eprac.2022.10.005)"},{"key":"bib2","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"4642","article-title":"Differential Growth Rates of Benign vs. malignant thyroid Nodules","volume":"102","author":"Angell","year":"2017","unstructured":"Angell TEVyas CMMedici MWang ZBarletta JABenson CBCibas ESCho NLDoherty GMDoubilet PM, 2017Differential Growth Rates of Benign vs. malignant thyroid Nodules. Journal of Clinical Endocrinology and Metabolism1024642\u20134647. (https:\/\/doi.org\/10.1210\/jc.2017-01832)"},{"key":"bib3","series-title":"Hormone Research in Paediatrics","first-page":"634","article-title":"The clinical spectrum of PTEN hamartoma tumor syndrome: exploring the value of thyroid surveillance","volume":"93","author":"Baran","year":"2020","unstructured":"Baran JATsai SDIsaza ABrodeur GMMacFarland SPZelley KAdams DMFranco AT & Bauer AJ2020The clinical spectrum of PTEN hamartoma tumor syndrome: exploring the value of thyroid surveillance. Hormone Research in Paediatrics93634\u2013642. (https:\/\/doi.org\/10.1159\/000515731)"},{"key":"bib4","series-title":"Journal of Medical Genetics","first-page":"255","article-title":"High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome","volume":"50","author":"Bubien","year":"2013","unstructured":"Bubien VBonnet FBrouste VHoppe SBarouk-Simonet EDavid AEdery PBottani ALayet VCaron O, 2013High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome. Journal of Medical Genetics50255\u2013263. (https:\/\/doi.org\/10.1136\/jmedgenet-2012-101339)"},{"key":"bib5","series-title":"Thyroid","first-page":"351","article-title":"Active surveillance versus thyroid surgery for differentiated thyroid cancer: a systematic review","volume":"32","author":"Chou","year":"2022","unstructured":"Chou RDana THaymart MLeung AMTufano RPSosa JA & Ringel MD2022Active surveillance versus thyroid surgery for differentiated thyroid cancer: a systematic review. Thyroid32351\u2013367. (https:\/\/doi.org\/10.1089\/thy.2021.0539)"},{"key":"bib6","series-title":"Thyroid","first-page":"1341","article-title":"The 2017 Bethesda system for reporting thyroid cytopathology","volume":"27","author":"Cibas","year":"2017","unstructured":"Cibas ES & Ali SZ2017The 2017 Bethesda system for reporting thyroid cytopathology. Thyroid271341\u20131346. (https:\/\/doi.org\/10.1089\/thy.2017.0500)"},{"key":"bib7","series-title":"Cancer Treatment Reviews","first-page":"9","article-title":"Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis?","volume":"41","author":"Clement","year":"2015","unstructured":"Clement SCKremer LCLinks TPMulder RLRonckers CMvan Eck-Smit BLvan Rijn RRvan der Pal HJTissing WJJanssens GO, 2015Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis?Cancer Treatment Reviews419\u201316. (https:\/\/doi.org\/10.1016\/j.ctrv.2014.10.009)"},{"key":"bib8","series-title":"PTEN Hamartoma Tumour Syndrome National Guideline, Version 1.0","year":"2015","unstructured":"Dutch Society of ClinicalGenetics2015PTEN Hamartoma Tumour Syndrome National Guideline, Version 1.0. Vereniging Klinische Genetica Nederland (VKGN). (available at: https:\/\/richtlijnendatabase.nl\/gerelateerde_documenten\/f\/22306\/IKNL%20richtlijn%20PTEN%20Hamartoom%20Tumor%20Syndroom.pdf)"},{"key":"bib9","series-title":"Translational Oncology","first-page":"361","article-title":"PTEN hamartoma tumor syndrome and immune dysregulation","volume":"12","author":"Eissing","year":"2019","unstructured":"Eissing MRipken LSchreibelt GWestdorp HLigtenberg MNetea-Maier RNetea MGde Vries IJM & Hoogerbrugge N2019PTEN hamartoma tumor syndrome and immune dysregulation. Translational Oncology12361\u2013367. (https:\/\/doi.org\/10.1016\/j.tranon.2018.11.003)"},{"key":"bib10","series-title":"International Journal of Clinical Oncology","first-page":"231","article-title":"Increased risk of certain second primary malignancies in patients treated for well-differentiated thyroid cancer","volume":"21","author":"Hakala","year":"2016","unstructured":"Hakala TTSand JAJukkola AHuhtala HSMetso S & Kellokumpu-Lehtinen PL2016Increased risk of certain second primary malignancies in patients treated for well-differentiated thyroid cancer. International Journal of Clinical Oncology21231\u2013239. (https:\/\/doi.org\/10.1007\/s10147-015-0904-6)"},{"key":"bib11","series-title":"Thyroid","first-page":"1","article-title":"2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer","volume":"26","author":"Haugen","year":"2016","unstructured":"Haugen BRAlexander EKBible KCDoherty GMMandel SJNikiforov YEPacini FRandolph GWSawka AMSchlumberger M, 20162015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid261\u2013133. (https:\/\/doi.org\/10.1089\/thy.2015.0020)"},{"key":"bib12","series-title":"Gastroenterology","first-page":"1093","article-title":"Autoimmunity, intestinal lymphoid hyperplasia, and defects in mucosal B-cell homeostasis in patients with PTEN hamartoma tumor syndrome","volume":"142","author":"Heindl","year":"2012","unstructured":"Heindl MH\u00e4ndel NNgeow JKionke JWittekind CKamprad MRensing\u2013Ehl AEhl SReifenberger JLoddenkemper C, 2012Autoimmunity, intestinal lymphoid hyperplasia, and defects in mucosal B-cell homeostasis in patients with PTEN hamartoma tumor syndrome. Gastroenterology1421093\u20131096.e6. (https:\/\/doi.org\/10.1053\/j.gastro.2012.01.011)"},{"key":"bib14","series-title":"Clinical Genetics","first-page":"219","article-title":"A review on age-related cancer risks in PTEN hamartoma tumor syndrome","volume":"99","author":"Hendricks","year":"2021","unstructured":"Hendricks LAJHoogerbrugge NSchuurs-Hoeijmakers JHM & Vos JR2021A review on age-related cancer risks in PTEN hamartoma tumor syndrome. Clinical Genetics99219\u2013225. (https:\/\/doi.org\/10.1111\/cge.13875)"},{"key":"bib13","series-title":"Journal of the National Cancer Institute","first-page":"93","article-title":"Cancer risks by sex and variant type in PTEN hamartoma tumor syndrome","volume":"115","author":"Hendricks","year":"2023","unstructured":"Hendricks LAJHoogerbrugge NMensenkamp ARBrunet JLleuger-Pujol RH\u00f8berg-Vetti HTveit Haavind MInnella GTurchetti DAretz S, 2023Cancer risks by sex and variant type in PTEN hamartoma tumor syndrome. Journal of the National Cancer Institute11593\u2013103. (https:\/\/doi.org\/10.1093\/jnci\/djac188)"},{"key":"bib15","series-title":"European Thyroid Journal","first-page":"234","article-title":"Recommendations on surveillance for differentiated thyroid carcinoma in children with PTEN hamartoma tumor syndrome","volume":"9","author":"Jonker","year":"2020","unstructured":"Jonker LALebbink CAJongmans MCJNievelstein RAJMerks JHMNieveen van Dijkum EJMLinks TPHoogerbrugge Nvan Trotsenburg ASP & van Santen HM2020Recommendations on surveillance for differentiated thyroid carcinoma in children with PTEN hamartoma tumor syndrome. European Thyroid Journal9234\u2013242. (https:\/\/doi.org\/10.1159\/000508872)"},{"key":"bib16","series-title":"Thyroid","first-page":"575","article-title":"The risk of second cancers after diagnosis of primary thyroid cancer is elevated in thyroid microcarcinomas","volume":"23","author":"Kim","year":"2013","unstructured":"Kim CBi XPan DChen YCarling TMa SUdelsman R & Zhang Y2013The risk of second cancers after diagnosis of primary thyroid cancer is elevated in thyroid microcarcinomas. Thyroid23575\u2013582. (https:\/\/doi.org\/10.1089\/thy.2011.0406)"},{"key":"bib17","series-title":"Surgery","first-page":"1201","article-title":"Should patients with Cowden syndrome undergo prophylactic thyroidectomy?","volume":"152","author":"Milas","year":"2012","unstructured":"Milas MMester JMetzger RShin JMitchell JBerber ESiperstein AE & Eng C2012Should patients with Cowden syndrome undergo prophylactic thyroidectomy?Surgery1521201\u20131210. (https:\/\/doi.org\/10.1016\/j.surg.2012.08.055)"},{"key":"bib18","series-title":"Cancer Cytopathology","first-page":"470","article-title":"Does a higher American College of Radiology thyroid Imaging Reporting and Data System (ACR TI-RADS) score forecast an increased risk of malignancy? A correlation study of ACR TI-RADS with FNA cytology in the evaluation of thyroid nodules","volume":"128","author":"Modi","year":"2020","unstructured":"Modi LSun WShafizadeh NNegron RYee-Chang MZhou FSimsir ASheth S & Brandler TC2020Does a higher American College of Radiology thyroid Imaging Reporting and Data System (ACR TI-RADS) score forecast an increased risk of malignancy? A correlation study of ACR TI-RADS with FNA cytology in the evaluation of thyroid nodules. Cancer Cytopathology128470\u2013481. (https:\/\/doi.org\/10.1002\/cncy.22254)"},{"key":"bib19","series-title":"Endocrinology and Metabolism (Seoul, Korea)","first-page":"473","article-title":"Associations between Hashimoto thyroiditis and clinical outcomes of papillary thyroid cancer: a meta-analysis of observational studies","volume":"33","author":"Moon","year":"2018","unstructured":"Moon SChung HSYu JMYoo HJPark JHKim DS & Park YJ2018Associations between Hashimoto thyroiditis and clinical outcomes of papillary thyroid cancer: a meta-analysis of observational studies. Endocrinology and Metabolism (Seoul, Korea)33473\u2013484. (https:\/\/doi.org\/10.3803\/EnM.2018.33.4.473)"},{"key":"bib20","series-title":"Genetic\/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, version 1.2022","year":"2022","unstructured":"National Comprehensive Cancer Network2022. Genetic\/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, version 1.2022. Plymouth Meeting, PA, USA: NCCN. (available at: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/genetics_bop.pdf)"},{"key":"bib21","series-title":"European Journal of Human Genetics","first-page":"267","article-title":"Novel PTEN mutations in patients with Cowden disease: absence of clear genotype-phenotype correlations","volume":"7","author":"Nelen","year":"1999","unstructured":"Nelen MRKremer HKonings IBSchoute Fvan Essen AJKoch RWoods CGFryns JPHamel BHoefsloot LH, 1999Novel PTEN mutations in patients with Cowden disease: absence of clear genotype-phenotype correlations. European Journal of Human Genetics7267\u2013273. (https:\/\/doi.org\/10.1038\/sj.ejhg.5200289)"},{"key":"bib22","series-title":"Endocrine Practice","first-page":"1029","article-title":"Thyroid nodule growth as a predictor of malignancy","volume":"25","author":"O'Connell","year":"2019","unstructured":"O'Connell KClark AHopman W & Lakoff J2019Thyroid nodule growth as a predictor of malignancy. Endocrine Practice251029\u20131034. (https:\/\/doi.org\/10.4158\/EP-2019-0049)"},{"key":"bib24","series-title":"Journal of Medical Genetics","first-page":"505","article-title":"Predicting PTEN mutations: an evaluation of Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome clinical features","volume":"48","author":"Pilarski","year":"2011","unstructured":"Pilarski RStephens JANoss RFisher JL & Prior TW2011Predicting PTEN mutations: an evaluation of Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome clinical features. Journal of Medical Genetics48505\u2013512. (https:\/\/doi.org\/10.1136\/jmg.2011.088807)"},{"key":"bib23","series-title":"Cancers","first-page":"844","article-title":"PTEN hamartoma tumor syndrome: a clinical overview","volume":"11","author":"Pilarski","year":"2019","unstructured":"Pilarski R2019PTEN hamartoma tumor syndrome: a clinical overview. Cancers11844. (https:\/\/doi.org\/10.3390\/cancers11060844)"},{"key":"bib25","series-title":"Thyroid","first-page":"1094","article-title":"Development and progression of thyroid disease in PTEN hamartoma tumor syndrome: refined surveillance recommendations","volume":"32","author":"Plitt","year":"2022","unstructured":"Plitt GBrewer TYehia LJin JShin J & Eng C2022Development and progression of thyroid disease in PTEN hamartoma tumor syndrome: refined surveillance recommendations. Thyroid321094\u20131100. (https:\/\/doi.org\/10.1089\/thy.2022.0181)"},{"key":"bib26","series-title":"Hereditary Cancer in Clinical Practice","first-page":"6","article-title":"Cancer and Lhermitte-Duclos disease are common in Cowden syndrome patients","volume":"8","author":"Riegert-Johnson","year":"2010","unstructured":"Riegert-Johnson DLGleeson FCRoberts MTholen KYoungborg LBullock M & Boardman LA2010Cancer and Lhermitte-Duclos disease are common in Cowden syndrome patients. Hereditary Cancer in Clinical Practice86. (https:\/\/doi.org\/10.1186\/1897-4287-8-6)"},{"key":"bib27","series-title":"European Thyroid Journal","first-page":"225","article-title":"European Thyroid Association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS","volume":"6","author":"Russ","year":"2017","unstructured":"Russ GBonnema SJErdogan MFDurante CNgu R & Leenhardt L2017European Thyroid Association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS. European Thyroid Journal6225\u2013237. (https:\/\/doi.org\/10.1159\/000478927)"},{"key":"bib28","series-title":"Surgery","first-page":"1194","article-title":"Prospective screening in familial nonmedullary thyroid cancer","volume":"154","author":"Sadowski","year":"2013","unstructured":"Sadowski SMHe MGesuwan KGulati NCeli FMerino MJNilubol N & Kebebew E2013Prospective screening in familial nonmedullary thyroid cancer. Surgery1541194\u20131198. (https:\/\/doi.org\/10.1016\/j.surg.2013.06.019)"},{"key":"bib29","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"e1121","article-title":"Natural history of thyroid disease in children with PTEN hamartoma tumor syndrome","volume":"106","author":"Smith","year":"2020","unstructured":"Smith JRLiu EChurch AJAsch ECherella CESrivastava SKamihara J & Wassner AJ2020Natural history of thyroid disease in children with PTEN hamartoma tumor syndrome. Journal of Clinical Endocrinology and Metabolism106e1121\u2013e1130. (https:\/\/doi.org\/10.1210\/clinem\/dgaa944)"},{"key":"bib30","series-title":"European Thyroid Journal","first-page":"243","article-title":"Occurrence and natural history of thyroid cancer in patients with Cowden syndrome","volume":"9","author":"Szabo Yamashita","year":"2020","unstructured":"Szabo Yamashita TBaky FJMcKenzie TJThompson GBFarley DRLyden ML & Dy BM2020Occurrence and natural history of thyroid cancer in patients with Cowden syndrome. European Thyroid Journal9243\u2013246. (https:\/\/doi.org\/10.1159\/000506422)"},{"key":"bib31","series-title":"American Journal of Human Genetics","first-page":"42","article-title":"A clinical scoring system for selection of patients for PTEN mutation testing is proposed on the basis of a prospective study of 3042 probands","volume":"88","author":"Tan","year":"2011","unstructured":"Tan MHMester JPeterson CYang YChen JLRybicki LAMilas KPederson HRemzi BOrloff MS, 2011A clinical scoring system for selection of patients for PTEN mutation testing is proposed on the basis of a prospective study of 3042 probands. American Journal of Human Genetics8842\u201356. (https:\/\/doi.org\/10.1016\/j.ajhg.2010.11.013)"},{"key":"bib32","series-title":"Clinical Cancer Research","first-page":"400","article-title":"Lifetime cancer risks in individuals with germline PTEN mutations","volume":"18","author":"Tan","year":"2012","unstructured":"Tan MHMester JLNgeow JRybicki LAOrloff MS & Eng C2012Lifetime cancer risks in individuals with germline PTEN mutations. Clinical Cancer Research18400\u2013407. (https:\/\/doi.org\/10.1158\/1078-0432.CCR-11-2283)"},{"key":"bib33","series-title":"Journal of the American College of Radiology","first-page":"587","article-title":"ACR thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS committee","volume":"14","author":"Tessler","year":"2017","unstructured":"Tessler FNMiddleton WDGrant EGHoang JKBerland LLTeefey SACronan JJBeland MDDesser TSFrates MC, 2017ACR thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS committee. Journal of the American College of Radiology14587\u2013595. (https:\/\/doi.org\/10.1016\/j.jacr.2017.01.046)"},{"key":"bib34","series-title":"European Journal of Human Genetics","first-page":"1387","article-title":"Cancer Surveillance Guideline for individuals with PTEN hamartoma tumour syndrome","volume":"28","author":"Tischkowitz","year":"2020","unstructured":"Tischkowitz MColas CPouwels SHoogerbrugge N, PHTS Guideline Development Group & European Reference Network GENTURIS2020Cancer Surveillance Guideline for individuals with PTEN hamartoma tumour syndrome. European Journal of Human Genetics281387\u20131393. (https:\/\/doi.org\/10.1038\/s41431-020-0651-7)"},{"key":"bib35","series-title":"Guidelines for Management for Tumour Risk in PTEN Hamartoma Syndrome, version 1.0","year":"2017","unstructured":"UK Cancer Genetics Group2017Guidelines for Management for Tumour Risk in PTEN Hamartoma Syndrome, version 1.0. London, UK: British Society for Genetic Medicine. (available at: https:\/\/www.ukcgg.org\/media\/10879\/pten_management_-_cgg_4may2017.pdf)"},{"key":"bib36","series-title":"Practice guidelines for the evaluation of pathogenicity and the reporting of sequence variants in clinical molecular genetics","author":"Wallis","year":"2013","unstructured":"Wallis YLPayne SJMcAnulty CBodmer DSister-mans ERobertson KMoore DAbbs SJDeans ZC & Devereau A2013Practice guidelines for the evaluation of pathogenicity and the reporting of sequence variants in clinical molecular genetics. UK Clinical Molecular Genetics Society, Dutch Society of Clinical Genetic Laboratory Specialists and Association for Clinical Genetic Science. (available at https:\/\/www.acgs.uk.com\/media\/10791\/evaluation_and_reporting_of_sequence_variants_bpgs_june_2013_-_finalpdf.pdf)"},{"key":"bib37","series-title":"JAMA Network Open","first-page":"e2118526","article-title":"Prevalence of Hashimoto thyroiditis in adults with papillary thyroid cancer and its association with cancer recurrence and outcomes","volume":"4","author":"Xu","year":"2021","unstructured":"Xu SHuang HQian JLiu YHuang YWang XLiu SXu Z & Liu J2021Prevalence of Hashimoto thyroiditis in adults with papillary thyroid cancer and its association with cancer recurrence and outcomes. JAMA Network Open4e2118526. (https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.18526)"},{"key":"bib38","series-title":"Annual Review of Medicine","first-page":"103","article-title":"The clinical spectrum of PTEN mutations","volume":"71","author":"Yehia","year":"2020","unstructured":"Yehia LKeel E & Eng C2020The clinical spectrum of PTEN mutations. Annual Review of Medicine71103\u2013116. (https:\/\/doi.org\/10.1146\/annurev-med-052218-125823)"},{"key":"bib39","series-title":"Endocrinology and Metabolism (Seoul, Korea)","first-page":"195","article-title":"Comparison of natural course between thyroid cancer nodules and thyroid benign nodules","volume":"34","author":"Yun","year":"2019","unstructured":"Yun KJHa JKim MHSeo YYKim MKKwon HSSong KHKang MI & Baek KH2019Comparison of natural course between thyroid cancer nodules and thyroid benign nodules. Endocrinology and Metabolism (Seoul, Korea)34195\u2013202. (https:\/\/doi.org\/10.3803\/EnM.2019.34.2.195)"}],"container-title":["Endocrine-Related Cancer"],"original-title":[],"link":[{"URL":"https:\/\/erc.bioscientifica.com\/view\/journals\/erc\/30\/10\/ERC-23-0009.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/erc.bioscientifica.com\/view\/journals\/erc\/30\/10\/ERC-23-0009.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/erc.bioscientifica.com\/view\/journals\/erc\/30\/10\/ERC-23-0009.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:56:31Z","timestamp":1784555791000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/erc\/article\/25743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,14]]},"references-count":39,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.1530\/erc-23-0009","relation":{},"ISSN":["1351-0088","1479-6821"],"issn-type":[{"value":"1351-0088","type":"print"},{"value":"1479-6821","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,14]]}}}