minocycline and Carcinoma--Papillary

Topics: Adult; Biopsy, Fine-Needle; Carcinoma; Carcinoma, Papillary; Diagnosis, Differential; Female; Humans; Hyperpigmentation; Immunohistochemistry; Minocycline; Thyroid Cancer, Papillary; Thyroid Gland; Thyroid Neoplasms; Thyroid Nodule; Thyroidectomy; Tomography, X-Ray Computed

We report a case of an unpigmented papillary carcinoma arising in a black thyroid induced by minocycline. Black thyroid syndrome is an unusual pigmented change seen almost exclusively in patients on minocycline, apparently resulting from an oxidative interaction between thyroid peroxidase and the drug. Twenty-six cases have previously been reported in the English literature, nine of which described an associated thyroid neoplasm. Four of these nine neoplasms were described as pale or hypopigmented. The nature of the lesion against the background of pigmentation suggests diminished function of the thyroid peroxidase in this clonal population.

Topics: Adult; Anti-Bacterial Agents; Biopsy, Needle; Carcinoma, Papillary; Female; Humans; Hypopigmentation; Minocycline; Pigmentation Disorders; Thyroid Diseases; Thyroid Neoplasms; Thyroidectomy

We report a rare case of black thyroid accompanied by papillary carcinoma in a patient with an extended history of minocycline treatment. A 78-year-old man was referred to our outpatient clinic with swelling in his neck. He had been taking minocycline for the previous 2 years and 7 months to treat chronic perianal pyoderma. Neck ultrasonography and computed tomography demonstrated a 3.5 × 3.7 × 5.0-cm nodule in the left thyroid lobe, and fine-needle aspiration cytology identified it as a papillary carcinoma. The patient underwent a total thyroidectomy and neck dissection. During the procedure, a distinct black discoloration of the thyroid parenchyma was observed. Histopathology confirmed both the black thyroid and the papillary carcinoma. Based on the thyroid gland's discoloration and the history of minocycline use, the patient was diagnosed with minocycline-induced black thyroid. He was symptom-free 20 months after surgery.

Topics: Aged; Anti-Bacterial Agents; Anus Diseases; Carcinoma; Carcinoma, Papillary; Humans; Male; Minocycline; Neck Dissection; Pigmentation Disorders; Pyoderma; Thyroid Cancer, Papillary; Thyroid Diseases; Thyroid Gland; Thyroid Neoplasms; Thyroidectomy; Treatment Outcome

We describe a 31-year-old woman who had ingested minocycline for 18 months prior to presenting with hyperthyroidism and a palpable thyroid nodule. There was no evidence of Graves' disease or autonomous nodule on thyroid scintigraphy, and a clinical diagnosis of thyroiditis was made. Fine-needle aspiration biopsy of the palpable lesion suggested papillary carcinoma, and the patient underwent a total thyroidectomy. Intraoperatively, the thyroid gland was found to have a striking black discoloration. Subsequent histological examination revealed the accumulation of pigment globules within the apical cytoplasm of the follicular cells, and associated findings of a drug-induced thyroiditis. The tumor nodule showed features of infarction and was felt to represent a necrotic papillary microcarcinoma. We postulate that in addition to causing black thyroid pigmentation, chronic minocycline use in our patient resulted in thyroiditis and subsequent hyperthyroidism. The papillary microcarcinoma was probably a coincidental finding.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Carcinoma, Papillary; Female; Humans; Hyperthyroidism; Incidental Findings; Minocycline; Thyroid Gland; Thyroid Neoplasms; Thyroiditis

Topics: Anti-Bacterial Agents; Biopsy, Fine-Needle; Carcinoma, Papillary; Humans; Minocycline; Pigmentation; Thyroid Diseases; Thyroid Gland; Thyroid Neoplasms

Long-term treatment with minocycline is occasionally associated with the development of black thyroid syndrome in which thyroid cancer is frequently found. Here, we report a patient with cutaneous, pulmonary and thyroid sarcoidosis who developed papillary thyroid carcinoma in the presence of a black thyroid syndrome after being treated with minocycline for 2.5 years.

Topics: Adult; Anti-Bacterial Agents; Carcinoma, Papillary; Female; Humans; Minocycline; Pigmentation; Sarcoidosis; Thyroid Neoplasms; Thyroidectomy

Bladder cancers have different angiogenic pathways distinguishing not only papillary from solid tumours, but even papillary superficial from papillary invasive ones, thus representing selective targets for antiangiogenic drugs.. The bacterial wall component tecogalan, inhibiting basic fibroblast growth factor (bFGF), the fumagillin derivative TNP-470, inhibiting vascular endothelial growth factor (VEGF), the distamycin A derivative PNU153429, and the tetracycline minocycline were administered to nude mice injected with the human bladder cancer cell lines 639V, causing bFGF-expressing papillary superficial tumours, or T24, causing VEGF-expressing papillary invasive tumours.. Tecogalan had no effect even on 639V tumour growth, where bFGF was unaffected. TNP-470 only had an effect on T24 tumours, delaying tumour appearance and growth and lowering VEGF; these effects were augmented by adding minocycline. PNU153429 had no effect on 639V tumours, and a slight effect on T24 tumours.. TNP-470 may represent a selective drug for the treatment of VEGF-expressing invasive papillary bladder tumours.

Topics: Angiogenesis Inhibitors; Animals; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Papillary; Cell Line, Tumor; Cyclohexanes; Distamycins; Female; Fibroblast Growth Factor 2; Humans; Male; Mice; Mice, Inbred BALB C; Mice, Nude; Minocycline; O-(Chloroacetylcarbamoyl)fumagillol; Polysaccharides, Bacterial; PPAR gamma; Sesquiterpenes; Urinary Bladder Neoplasms; Vascular Endothelial Growth Factor A

Topics: Adolescent; Carcinoma, Papillary; Humans; Male; Minocycline; Pigmentation; Thyroid Gland; Thyroid Neoplasms

Black pigmentation of the thyroid attributed to minocycline hydrochloride is known, but to our knowledge, pigmentation associated with antidepressants has not been reported. We studied four patients with papillary carcinoma associated with thyroid pigmentation; two had received minocycline therapy, and two had received long-term treatment with antidepressants. The thyroids of patients who had been treated with minocycline were black, with pigment primarily in nontumorous tissue. The thyroids associated with antidepressant therapy were dark red, with pigment in both tumorous and nontumorous tissue. All four cases were positive for periodic acid-Schiff, periodic acid-Schiff with diastase predigestion, and Schmorl's stains and negative for Prussian blue; the results differed from those found with Fontana's technique. Minocycline-related pigmentation appears to imply a role for the iodide peroxidase system in the accumulation of pigment, whereas pigmentation attributed to intake of antidepressants appears to result from lysosomal accumulation of the drug itself.

Topics: Adult; Antidepressive Agents; Carcinoma, Papillary; Female; Humans; Microscopy, Electron; Middle Aged; Minocycline; Pigmentation Disorders; Thyroid Diseases; Thyroid Neoplasms

Topics: Adult; Carcinoma, Papillary; Female; Head and Neck Neoplasms; Humans; Minocycline; Thyroid Gland; Thyroid Neoplasms

A case of papillary thyroid carcinoma occurring in a 27-year-old man with black thyroid syndrome is reported. The tumor, in contrast to the remaining thyroid, was not pigmented. The significance and potential utility of the differential pigmentation are discussed.

Topics: Adult; Carcinoma, Papillary; Humans; Male; Minocycline; Pigmentation Disorders; Thyroid Diseases; Thyroid Gland; Thyroid Neoplasms