UNASSIGNED: Background Multiple gene mutations in thyroid nodules are rare. The presence of several oncogenic mutations could be associated with aggressive biological behavior of @entity5 . @entity1 findings A 60-year-old female presented to her physician after she felt a lump in her neck. On ultrasound, she was found to have a 1.4 x 0.8 x 1.3 cm nodule in the isthmus and a 0.5 x 0.6 x 0.6 cm nodule with irregular margins and hypoechogenicity in the right thyroid lobe, warranting fine needle aspiration (FNA). Cytological examination of the smaller nodule yielded a diagnosis of atypia of undetermined significance (AUS/FLUS, Bethesda Category III). The aspirate was submitted for molecular testing using the next generation sequencing ThyroSeq   v2 panel. The test revealed four distinct mutations: @entity817 ( @entity8554 ), @entity2215 ( @entity10207 ), @entity10160 ( @entity23938 ) and @entity584 ( @entity29837 ). Presence of multiple oncogenic mutations in the FNA specimen was highly indicative of @entity5 , and suggestive of a @entity5 with propensity towards more aggressive biological behavior. Four weeks after the FNA results were available, the @entity1 underwent total thyroidectomy. This was followed by radioactive @entity1496 ablation after the final pathology revealed a 0.5 cm thyroid @entity1377 with @entity5295 and positive resection margins (pT3 stage). SUMMARY: Herein we report the first case of four mutations preoperatively detected in a sub-centimeter thyroid nodule that was confirmed to be a @entity3557 with aggressive biological behavior. Conclusions The judicious indication of FNA and use of molecular screening can potentially help in predicting @entity146 of small sized @entity259 and in identifying @entity1 who may benefit from early and more extensive therapy.

Multiple Mutations Detected Preoperatively May Predict Aggressive Behavior of XXXX and Guide Management - A Case Report.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient'] @entity1377 :: ('MESH:D002291', 'Disease') :: ['papillary carcinoma'] @entity1496 :: ('MESH:D007455', 'Chemical') :: ['iodine'] @entity3557 :: ('MESH:C536915', 'Disease') :: ['papillary thyroid cancer'] @entity10207 :: ('c|SUB|C|228|T', 'DNAMutation') :: ['C228T'] @entity146 :: ('MESH:D001523', 'Disease') :: ['aggressive behavior'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumors', 'cancer'] @entity584 :: ('207', 'Gene') :: ['AKT1'] @entity23938 :: ('p|SUB|H|1047|R', 'ProteinMutation') :: ['p.H1047R'] @entity5295 :: ('MESH:D054908', 'Disease') :: ['extrathyroidal extension'] @entity8554 :: ('p|SUB|V|600|E', 'ProteinMutation') :: ['p.V600E'] @entity259 :: ('MESH:D013964', 'Disease') :: ['thyroid cancers'] @entity29837 :: ('p|SUB|E|17|K', 'ProteinMutation') :: ['p.E17K'] @entity817 :: ('673', 'Gene') :: ['BRAF'] @entity2215 :: ('7015', 'Gene') :: ['TERT'] @entity10160 :: ('5290', 'Gene') :: ['PIK3CA']
@entity3557 :: (MESH:C536915,Disease) :: ['Papillary Thyroid Cancer']
