{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:05:48Z","timestamp":1793833548419,"version":"4.6.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011789","name":"Department of Science and Technology of Jilin Province","doi-asserted-by":"publisher","award":["no.20190201225JC"],"award-info":[{"award-number":["no.20190201225JC"]}],"id":[{"id":"10.13039\/501100011789","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Synopsis for table of contents<\/jats:title><jats:p>An exceptional number of synchronous MTC\/PTC in the same thyroid gland is presented. This may be the most numerous case series reported in the literature. Synchronous PTC\/MTC in the same thyroid gland were classified into 4 subtypes and the clinical and pathological aspects as well as the results are presented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>The synchronous occurrence of multiple neoplastic processes in the thyroid gland is unusual. We investigated the clinicopathological features of 30 medullary thyroid carcinomas (MTC) in association with papillary (PTC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Retrospective analysis of operated patients for thyroid tumors. Synchronous PTC\/MTC in the same thyroid gland were classified into 4 subtypes: (type I) True mixed MTC\/PTC, MTC and PTC closely intermingled. (Type II) Collision MTC\/PTC, i.e. tumors that meet at the same site, invade each other and appear as a single mass in the thyroid gland, i.e. MTC and PTC merge. (Type III) Synchronous anatomically separate tumors in the same thyroid lobe, i.e. separated from each other by non-tumorous thyroid parenchyma. (Type IV) Synchronous tumors occurring in separate anatomical lobes or in the isthmus. Clinical and pathological data were reviewed. Location: Department of thyroid surgery, China-Japan Union Hospital, Jilin University. Time frame: 14 years (June 2008-November 2022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty patients were identified with an overall prevalence of 28621 (0.1%). 17 (56.7%) were male, 13 (43.3%) female, mean age 51.3 \u00b1 11.0 years, mean BMI 23.6 \u00b1 3.6kg\/m<jats:sup>2<\/jats:sup>. Mean duration of symptoms was 11.2 \u00b1 18.4 months. Mean calcitonin level was 133.7 \u00b1 196.4 pg\/ml. Fine needle aspiration (FNA) was offered in 21 cases: 9 (42.9%) were suspected carcinoma, 9 (42.9%) PTC, 1 (4.8%) MTC, 2 (9.4%) MTC\/PTC. Pathology revealed type I 4 (13.3%), type II 2 (6.7%), type III 14 (46.7%), type IV 10 (33.3%). The mean diameter of MTC was 1.6 \u00b1 2.0cm, 18 (60%) were micro-MTC. The mean diameter of PTC was 0.9 \u00b1 1.9\u00a0cm, 26 (86.7%) were micro-PTC. In 16 (53.3%) micro-PTC\/-MTC occurred in synchronous sequence. Four patients had a recurrence: 2 had to be re-operated due to MTC recurrence, 2 died due to distant metastases (bone, liver).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report an exceptional number of MTC\/PTC in the same thyroid gland. This may be the most numerous case series reported in the literature. The clinical and pathological aspects as well as the results are presented.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2023.1153248","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T07:26:35Z","timestamp":1680247595000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Thirty synchronous medullary and papillary thyroid carcinomas"],"prefix":"10.3389","volume":"14","author":[{"given":"Daqi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunlin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Chi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengqiu","family":"Sui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianlorenzo","family":"Dionigi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","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","journal-title":"Thyroid"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1677\/erc.1.00901","article-title":"Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumour: report of three cases with molecular analysis and review of the literature","volume":"12","author":"Rossi","year":"2005","journal-title":"Endocr Relat Canc"},{"key":"B3","article-title":"Synchronous papillary thyroid carcinoma and medullary thyroid carcinoma - a pitfall waiting to happen","volume":"39","author":"Tang","year":"2017","journal-title":"Malays J Pathol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2727.141520","article-title":"Mixed medullary - papillary carcinoma thyroid an uncommon variant of thyroid carcinoma","volume":"6","author":"Jain","year":"2014","journal-title":"J Lab Phys"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0274","article-title":"The Bethesda system for reporting thyroid cytopathology","volume":"19","author":"Cibas","year":"2009","journal-title":"Thyroid"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21388","article-title":"The eighth edition AJCC cancer staging manual continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-017-1200-x","article-title":"Collision and composite tumors; 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