A866 | Journal of the Endocrine Society | doi: 10.
1210/jendso/bvab048
<< differentiated carcinoma >>. Once the relevant works
had been listed and compared, the main findings of each
one were related and analyzed. Results: We found 15
studies between the years 1990 and 2019 that describe
187 patients with thyroid cancer and brain metastases; of
which 138 presented PTC, and 62% (58/93) were women.
The average age was 59 years. Patients who received mul-
timodal treatment (association of 2 or more therapies; one
of them, brain metastasis resection) had a longer survival,
with an average of 54 months, compared to monotherapy.
Discussion: Patients with PTC who also present BM re-
quire a multimodal therapy approach: when it is associated
with brain metastasis resection, better results are evident;
in contrast, when monotherapy is used, a limited perfor-
mance is observed, with poor results. Conclusion: Patients
with PTC who also present BM have better outcomes and
higher survival rate with a multimodal therapy approach,
including brain metastasis resection.
Thyroid
THYROID CANCER
Metabolic Factors Can Influence the Risk of
Differentiated Thyroid Cancer
Roxana-Ioana Dumitriu, MD, Iulia Florentina Burcea,
MD, Roxana Dusceac, MD, Simona Galoiu, MD, PhD,
Catalina Poiana, MD, PhD, FACE, CCD.
Carol Davila University of Medicine and Pharmacy, C I Parhon
Institute of Endocrinology, Bucharest, Romania.
Introduction: Worldwide, the increasing incidence of thy-
roid cancer, along with a parallel increase in obesity and
metabolic disorders, suggests that modifications of lifestyle
and environmental factors might explain the rise in thyroid
cancer incidence (1). Objective: To investigate the associ-
ation between metabolic syndrome and their elements and
their possible association with the risk of thyroid cancer.
Materials and Methods: We enrolled 200 patients, who
underwent total thyroidectomy for multinodular goiter
(Bethesda II-V categories on the basis of fine needle aspira-
tion biopsy cytological examination). We included subjects
with differentiated thyroid carcinoma, the ones with poorly
differentiated, anaplastic, medullary thyroid carcinomas
and secondary tumors were excluded from the analysis.
Patients were divided into two groups, according to the
post-surgical histological diagnosis: 60 patients diagnosed
with papillary or follicular thyroid cancer and 60 diagnosed
with benign thyroid disease. The patients had a mean age
of 56.9  years old and the majority were females (90%).
Relative risk of incident thyroid cancer was assessed by
preoperative levels of body mass index (BMI), blood pres-
sure, blood levels of glucose, cholesterol, triglycerides,
and the presence of metabolic syndrome (according to the
NCEP ATP III definition). The two groups had similar age,
gender distribution, smoking habit. Mean BMI was slightly
higher in the group with patients with differentiated thy-
roid cancer and the majority were obese (27.41 ± 5.38 kg/
m2versus 26.42  ± 5.18  kg/m2). The patients from the
differentiated thyroid cancer group showed a higher per-
centage of diabetes mellitus and impaired fasting glucose
compared to the second group (20% versus 13%), with mean
fasting blood sugar levels of 97  ± 2.69  mg/dl in the first
J Endocrine Soc, Volume 5, Issue Supplement_1, April-May 2021
group versus 73 ± 3.06 mg/dl in the second group. 30% of
the patients from the differentiated thyroid cancer group
presented criteria for metabolic syndrome. There was a
positive correlation between the presence of hyperten-
sion and the diagnosis of differentiated thyroid cancer
(p<0.05). Conclusion: Our study showed a potential asso-
ciation between metabolic risk factors and the diagnosis of
differentiated thyroid cancer. Besides the improvement of
diagnosis, thyroid cancer increasing incidence is probably
due to environmental factors and lifestyle modifications. As
a future perspective of this study and based on the hypo-
thesis of glucose dependency of many tumor types, another
therapeutic strategy can involve diet (low-carbohydrate,
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high-fat) in order to target metabolism in tumors and
alter the Walburg phenothype. Reference: (1). Mele, C.,
Samà, M.  et  al. (2019). Circulating adipokines and meta-
bolic setting in differentiated thyroid cancer, Endocrine
Connections, 8(7), 997-1006.
Thyroid
THYROID CANCER
Mildly Elevated Basal Calcitonin Level in Patients
With Thyroid Goiter: Using the Calcitonin
Measurement in Fine-Needle Aspirate Washout Fluid
of the Healthy Lobe to Define Medullary Thyroid
Cancer and Reactive C-Cell Hyperplasia.
Anastassia Chevais, MD, Alexander Mikheenkov, MD,
Dmitry Beltsevich, MD, PhD, Professor, Vladimir Vanushko, MD,
PhD, Professor, Galina A. Melnichenko, MD, PhD, Professor,
Elena Pokrovskaya, MD.
Endocrinology research centre, Moscow, Russian Federation.
Background: Mildly elevated basal calcitonin level (bCT),
that suggests a bCT increase up to 100 pg/ml, may testify
either medullary thyroid carcinoma (MTC) or reactive thy-
roid C-cell hyperplasia (CCH). The latter is observed under
many conditions such as hypercalcemia, hypergastrinemia,
thyroiditis, neuroendocrine tumors (NET), renal end-
stage kidney disease, obesity, and smoking. The research
is aimed at analyzing the clinical significance of the calci-
tonin measurement in the fine needle aspiration washout
fluid sample (FNA-CT) for screening certain patients with
nodular thyroidopathy and elevated bCT.
Patients and Methods: 70 patients with mildly elevated
bCT (for women 6-100 pg/ml, for men 19-100 pg/ml) un-
derwent ultrasound-guided FNA-CT measurement of the
thyroid nodules and healthy lobe tissue. After obtaining
a FNA-CT specimen, the needle was washed with 0.5  ml
of saline solution. The calcitonin (CT) was measured by
ECLIA (LIAISON XL).
Results: There were 51 females and 19 males, with a mean
age of 46.8 ± 14.4 years (range 16-81). The mean value of bCT
was 23.3 ± 19 pg/ml (range: 7-86.5). According to ultrasound,
66 patients (95%) presented with thyroid nodules, in 4 cases
previously identified nodes were not confirmed. The mean le-
sion size was 10.8 ± 4.9 mm (range: 4-26). Thyroid nodules
were evaluated by FNA biopsy which revealed according to
the Bethesda system category I in 6 cases, II - 44, III - 2, IV -
4, V - 6, and VI - 1. Analyzing FNA-CT results we identified
13 cases (18%) with MTC with low CT level of healthy lobe
tissue (1-89.6 pg/ml) and high CT level of the lesion (>2000
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