minocycline and Thyroid-Neoplasms

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

A 22-year-old woman with a "hot" thyroid nodule who was being treated with minocycline for severe acne vulgaris is presented. A partial thyroidectomy specimen revealed a black adenoma. Microscopically, the black pigment was found in the follicular cells and the colloid of the adenoma. The pigment was bleached with potassium permanganate and was Fontana-Masson stain positive. It was negative for iron, periodic acid-Schiff, and acid-fast Ziehl-Neelsen stains. All these feature suggest a melanin-like pigment. However, electron microscopic examination revealed a dense osmophilic material present within the lysosomes of the follicular cells. No melanosomes were present. Twenty-six previously reported cases are reviewed, and the possible mechanisms for the deposition of the pigment in the adenoma and its relation to minocycline degradation products are discussed.

Topics: Acne Vulgaris; Adenoma; Adult; Anti-Bacterial Agents; Female; Histocytochemistry; Humans; Microscopy, Electron; Minocycline; Pigmentation; Thyroid Neoplasms

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 this case to further document in the literature morphologic changes encountered in a black thyroid gland. It is only through an expanding data base that future conclusions may be reached regarding the role, if any, of minocycline in some of these alterations.

Topics: Adenoma; Adult; Female; Humans; Minocycline; Pigmentation Disorders; Thyroid Function Tests; Thyroid Neoplasms

A woman in her 70s with a history of chronic minocycline use presented with complaints of a non-tender posterior neck mass. A thyroid gland ultrasound showed a highly suspicious right thyroid nodule. A total thyroidectomy revealed darkened discolouration of the thyroid gland and tracheal cartilage. The pathology report showed dark brown granules representing melanin. Chronic minocycline usage is known to cause pigmentation of nails, teeth, bones and the thyroid gland. Our case highlights the importance of recognising that long-term use of minocycline can cause discolouration of the thyroid and tracheal cartilage. Current case studies do not show any adverse health effects associated with black thyroid and tracheal cartilage. For patients who are to undergo neck surgery, physicians need to be aware of this side effect, and that further intervention, such as surgical resection, may not be required.

Topics: Cartilage; Female; Humans; Minocycline; Neck; Thyroid Gland; Thyroid Neoplasms; Thyroidectomy

Black thyroid is characterized by a rare pigment change observed almost exclusively in patients taking minocycline. We present the case of a 72-year-old man diagnosed with T3N3bM0 stage IVB hypopharyngeal squamous cell carcinoma who had been taking minocycline for approximately 18 months as a treatment for prurigo chronica multiformis. Initial treatment consisted of total pharyngolaryngoesophagectomy, bilateral neck dissection, total thyroidectomy, pharyngeal reconstruction using a free jejunal autograft, and creation of a permanent tracheostoma. During surgery, black discoloration of the thyroid and trachea was observed. Postoperative histological findings confirmed the black discoloration, with deposits of dark-brown, melanin-like granules observed in the thyroid, trachea, thyroid cartilage, and cricoid cartilage. Therefore, the black discoloration of the thyroid associated with the use of minocycline can extend to the thyroid cartilage, cricoid cartilage, and trachea. This information is important for surgeons to recognize in order to prevent unnecessary resection due to misdiagnosis.

Topics: Aged; Cricoid Cartilage; Humans; Hypopharyngeal Neoplasms; Male; Minocycline; Pigmentation; Plastic Surgery Procedures; Thyroid Cartilage; Thyroid Gland; Thyroid Neoplasms; Trachea

Topics: Acne Vulgaris; Female; Humans; Middle Aged; Minocycline; Pigmentation; Thyroid Cancer, Papillary; Thyroid Gland; Thyroid Neoplasms; Thyroidectomy; Time Factors

Topics: Adenocarcinoma, Follicular; Animals; Anti-Bacterial Agents; Autopsy; Diagnosis, Differential; Dog Diseases; Dogs; Hyperpigmentation; Lameness, Animal; Male; Minocycline; Thyroid Neoplasms

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

Topics: Acne Vulgaris; Adenoma; Humans; Male; Middle Aged; Minocycline; Pigmentation; Thyroid Neoplasms

We previously showed that the in vivo anticancer effects of a combination of manumycin (a farnesyltransferase inhibitor) and paclitaxel (a microtubule inhibitor) against anaplastic thyroid carcinoma (ATC) were partially due to inhibition of angiogenesis. In this study, we investigated the effect of adding minocycline (a matrix metalloproteinase inhibitor) to manumycin and paclitaxel against human ATC cells xenografted in nude mice. The triple-drug combination resulted in the lowest average tumor growth rate, and it conferred significantly better survival than manumycin alone, paclitaxel alone, or manumycin plus paclitaxel. In conclusion, this novel combination deserves further investigation in the treatment of ATC.

Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Enzyme Inhibitors; Farnesyltranstransferase; Humans; Matrix Metalloproteinase Inhibitors; Mice; Mice, Inbred BALB C; Mice, Nude; Minocycline; Neoplasm Transplantation; Paclitaxel; Polyenes; Polyunsaturated Alkamides; Thyroid Neoplasms; Transplantation, Heterologous

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

Topics: Adenoma, Oxyphilic; Adult; Anti-Bacterial Agents; Female; Humans; Minocycline; Pigmentation; Thyroid Neoplasms

Topics: Adult; Anti-Bacterial Agents; Female; Humans; Male; Middle Aged; 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