THYROIDAND PARATHYROIDDISEASES– NEWINSIGHTSINTO SOMEOLDAND SOMENEWISSUES  EditedbyLauraSterianWard          Thyroid and Parathyroid Diseases – New Insights into Some Old and Some New Issues Edited by Laura Sterian Ward Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. 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Publishing Process Manager Ana Skalamera Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Thyroid and Parathyroid Diseases – New Insights into Some Old and Some New Issues, Edited by Laura Sterian Ward p. cm. ISBN 978-953-51-0221-2  Contents Preface IX Part 1 Evaluating the Thyroid Gland and Its Diseases 1 Chapter 1 Introduction to Thyroid: Anatomy and Functions 3 Evren Bursuk Chapter 2 The Thyroglobulin: A Technically Challenging Assay for a Marker of Choice During the Follow-Up of Differentiated Thyroid Cancer 23 Anne Charrié Chapter 3 Papillary Thyroid Microcarcinoma – Do Classical Staging Systems Need to Be Changed? 33 Carles Zafon Chapter 4 Thyroid Neoplasm 45 Augusto Taccaliti, Gioia Palmonella, Francesca Silvetti and Marco Boscaro Chapter 5 Thyroid Growth Factors 77 Aleksander Konturek and Marcin Barczynski Chapter 6 Vascular Endothelial Growth Factor (VEGF) and Epidermal Growth Factor (EGF) in Papillary Thyroid Cancer 87 Aleksander Konturek and Marcin Barczynski Chapter 7 Immune Profile and Signal Transduction of T-Cell Receptor in Autoimmune Thyroid Diseases 95 Adriano Namo Cury Chapter 8 Estrogen Signaling and Thyrocyte Proliferation 109 Valeria Gabriela Antico Arciuch and Antonio Di Cristofano VI Contents Chapter 9 Suspicious Thyroid Fine Needle Aspiration Aspiration Biopsy: TSH as a Malignancy Marker? 125 Renata Boldrin de Araujo, Célia Regina Nogueira, Jose Vicente Tagliarini, Emanuel Celice Castilho, Mariângela de Alencar Marques, Yoshio Kiy, Lidia R. Carvalho and Gláucia M. F. S. Mazeto Part 2 Treatment of Thyroid and Parathyroid Diseases 133 Chapter 10 Minimally-Invasive Parathyroid Surgery 135 David Rosen, Joseph Sciarrino and Edmund A. Pribitkin Chapter 11 Management of Primary Hyperparathyroidism: ‘Past, Present and Future’ 147 Sanoop K. Zachariah Chapter 12 Treatment Modalities in Thyroid Dysfunction 171 R. King and R.A. Ajjan Chapter 13 New Technologies in Thyroid Surgery 189 Bahri Çakabay and Ali Çaparlar Chapter 14 Management of Primary Hyperparathyroidism 203 Jessica Rose and Marlon A. Guerrero Chapter 15 Synthetic and Plant Derived Thyroid Hormone Analogs 221 Suzana T. Cunha Lima, Travis L. Merrigan and Edson D. Rodrigues Part 3 Psychiatric Disturbances Associated to Thyroid Diseases 237 Chapter 16 Thyroid and Parathyroid Diseases and Psychiatric Disturbance 239 A. Lobo-Escolar, A. Campayo, C.H. Gómez-Biel and A. Lobo Chapter 17 Depressive Disorders and Thyroid Function 259 A. Verónica Araya, Teresa Massardo, Jenny Fiedler, Luis Risco, Juan C. Quintana and Claudio Liberman Chapter 18 Psychosocial Factors in Patients with Thyroid Disease 279 Petra Mandincová   Preface  Thyroid and para thy roiddiseasesare amongthe most frequent conditions we have to deal with in a clinical setti ng. Both nodular and autoimmun e  diseases aff ecting these glands haveincreasedre markablyove rthepast decades.Thewidespreadus eof cross‐ sectional imaging and the introduction of neck ultrasonography have led to a thyroid nodule epidem i c s  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 surger i es that  may, perhaps, be unnecessary. Differentiated thyroidcanceristhe fastes t‐growingcancer inwo men;it increased2.4 % peryear during 1980to1997and6.5%peryearduring1997to2006inth e USAaccording to the National Cancer Instituteʹs Surveillance Epidemiology and End Results (SEER). Ontheotherhand,therefinementofnewapproa chesforsurveillanceof patientswithan establisheddiagnosisofthyroid cancerisleading totheobservat ionthatmanypatients, pre vious lytho ughttobecured,haveevide nceof minimalresidu al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  . THYROID AND PARATHYROID DISEASES – NEW INSIGHTS INTO  SOME OLD AND  SOME NEW ISSUES  Edited by Laura Sterian Ward          Thyroid and Parathyroid Diseases – New Insights into. Larynx Thyroid gland Isthmus Trachea Thyroid and Parathyroid Diseases – New Insights into Some Old and Some New Issues 4 gland is wrapped up by a fibrosis capsule named thyroid. The thyroid. be obtained from orders@intechweb.org Thyroid and Parathyroid Diseases – New Insights into Some Old and Some New Issues, Edited by Laura Sterian Ward p. cm. ISBN 978-953-51-0221-2 