Author: Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉Estimated cost of surgical management of papillary thyroid microcarcinoma was equivalent to the cost of 16.2 years of active surveillance.

👉El costo estimado del tratamiento quirúrgico del microcarcinoma papilar de tiroides fue equivalente al costo de 16.2 años de vigilancia activa.

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉La mayoría de los nódulos tiroideos son benignos y muchos no justifican la biopsia.
👉 Sin embargo, se puede recomendar una biopsia basada en una combinación de factores que incluyen el tamaño y la apariencia del nódulo.
👉 Una biopsia generalmente se realiza usando un ultrasonido para guiar una pequeña aguja hacia el nódulo para aspirar las células.

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉Most thyroid nodules are benign, and many do not warrant biopsy.

👉However, a biopsy may be recommended based on a combination of factors including the size and appearance of the nodule.

👉A biopsy is usually performed using an ultrasound to guide a small needle into the nodule to aspirate cells.

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉Rodrigo Arrangoiz MS, MD, FACS es especialista en Cirugía de Tumores de Cabeza y Cuello / Cirugía Endocrina y Cirugía Oncológica compleja:

👉Fue egresado como Médico General de la Universidad Anahuac:Graduado Suma Cum Laude.

👉Es miembro de Sociedad Quirúrgica S.C.:

Que es el único grupo quirúrgico en México en donde todos los socios se entrenaron en las mejores instituciones académicas de los Estados Unidos de América.

👉El Doctor Arrangoiz es experto en el manejo del:

Cáncer de Tiroides:Cáncer papilar de tiroides

Cáncer folicular de tiroides

Cáncer medular de tiroides

Cáncer anaplásico de tiroides

Patología Quirúrgica de Tiroides:Bocio multi nodular no toxico sintomático Bocio multi nodular toxicoHipertiroidismo

Hiperparatiroidismo:Hiperparatiroidismo primarioHiperparatiroidismo secundarioHiperparatiroidismo terciario

👉Tumores de Cabeza y Cuello:Cancer de la cavidad oral

Cáncer de faringe:

Nasofaringe

Orofaringe

Hipofaringe

Cáncer Laringeo:

Cáncer supraglótico

Cáncer glótico

Cancer subglótico

Cáncer de glándulas salivales:

Glándula Parótida

Glándula submandibular

Glándula sublingual

Glándulas salivales menores

Cáncer de piel de la cabeza y cuello:

Melanoma

Carcinoma basocelular

Carcinoma epidermoide

Carcinoma de Merkel

Dermatofibrosacroma Protuberans

Cáncer de Mama.

Cáncer de piel:

Melanoma

Carcinoma basocelular

Carcinoma epidermoide

Carcinoma de Merkel

Dermatofibrosacroma Protuberans

👉Fue entrenado en las mejores instituciones académicas de los Estados Unidos.

👉Mantiene certificaciones por los Consejos de Cirugía General y Cirugía Oncológica en México y en los Estados Unidos de América.

👉Su entrenamiento incluyó:Cirugía General y Gastrointestinal:

Michigan State University (2004 – 2010)

Cirugía Oncológica / Tumores de Cabeza y Cuello / Cirugía Endocrina:Fox Chase Cancer Center en Filadelfia (2010 al 2012)

Maestría en Ciencias (Clinical Research for Health Professionals):Drexel University (Filadelfia) (2010 – 2012)

Cirugía de Tumores de Cabeza y Cuello / Cirugía Endocrina (2014 al 2016):IFHNOS / Memorial Sloan Kettering Cancer Center

👉Ha participado en múltiples cursos y congresos como Conferencista y Profesor Invitado

👉Some hereditary syndromes increase the chances of developing thyroid cancers.

👉These include familial adenomatous polyposis, Cowden’s syndrome, and multiple endocrine neoplasia syndromes, along with others.

👉Genetic counselors are professionals who can determine if screening is appropriate.

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉Pathologic nipple discharge usually is unilateral, presents from a single duct, and is spontaneous, bloody, or serous.

👉Physiologic nipple discharge can be green or white, bilateral, from multiple ducts, or present only with manual expression of the breast.

👉When pathologic discharge is present, the most common etiology remains a benign intraductal papilloma.

👉Mammography in this setting is limited by its low sensitivity for intraductal lesions.

👉Ultrasound in conjunction with mammography can improve sensitivity for intraductal masses but imaging alone cannot reliably distinguish benign from malignant lesions.

👉When imaging identifies an abnormal finding in the setting of nipple discharge, needle biopsy is helpful to determine etiology and guide future excision.

👉When imaging work-up is otherwise negative, investigators have attempted to identify patients with nipple discharge in whom operation can be avoided.

👉One study showed 192 patients with unilateral, single duct, spontaneous, bloody, or serous nipple discharge and a normal mammogram had a less than 3% chance of malignancy. When they had a normal subareolar ultrasound as well, no patient had a cancer, but the numbers were small.

👉On the other hand, a separate study found conflicting results as researchers identified cancer in 10% of patients who had normal physical examination, mammography, and ultrasound. The same group found that when additional evaluation was done with cytology, ductography, or MRI, 7% (19/287) of patients were still diagnosed with cancer on duct excision.

👉Ductogram is a challenging technique that requires breast imaging expertise. It is often helpful in localizing an intraductal lesion and guiding percutaneous vacuum-assisted or surgical removal, but it does not reliably exclude a malignant lesion.

👉Negative imaging does not obviate the need for surgical excision in a woman with spontaneous, single duct, bloody nipple discharge.

👉The standard management for unilateral bloody nipple discharge that is without an imaging abnormality therefore remains duct excision that is selective of the offending duct or as a major duct excision.

👉When a retroareolar imaging abnormality is identified in the setting of nipple discharge it should be localized and removed.

👉Starting in October (Breast Cancer Awareness Month) Rodrigo Arrangoiz MS, MD, FACS member of Sociedad Quirúrgica S.C. will be writing daily post on breast diseases.

Rodrigo Arrangoiz MS, MD, FACS is surgical oncologist / breast cancer specialist and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

For more information visit: http://www.cirugiatiroides.com

#Arrangoiz

#Teacher

#Surgeon

#Cirujano

#BreastExpert

#BreastSurgeon

#CirujanodeMama

#ExpertoenCancerdeMama

#CancerdeMama

#SurgicalOncologist

#CirujanoOncologo

#CancerSurgeon

👉Most thyroid cancer is diagnosed at an early stage (localized or regional), which means confined to the thyroid or lymph nodes around the thyroid.

👉Both stages are typically associated with excellent survival rates of >95% (source: https://seer.cancer.gov)

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉Thyroid nodules are a common clinical problem.

👉Epidemiologic studies have shown the prevalence of palpable thyroid nodules to be approximately 5% in women and 1% in men living in iodine-sufficient parts of the world.

👉In contrast, high-resolution ultrasound (US) can detect thyroid nodules in 19% to 68% of randomly selected individuals, with higher frequencies in women and the elderly.

👉The clinical importance of thyroid nodules rests with the need to exclude thyroid cancer, which occurs in 7% to 15% of cases depending on age, sex, radiation exposure history, family history, and other factors.

👉Rodrigo Arrangoiz MS, MD, FACS a head and neck surgeon / endocrine surgeon / surgical oncologist and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

For more information visit: http://www.cirugiatiroides.com

#Arrangoiz

#Teacher

#Surgeon

#Cirujano

#ThyroidExpert

#ThyroidSurgeon

#CirujanodeTiroides

#ExpertoenTiroides

#ExpertoenParatiroides

#Paratiroides

#Hiperparatiroidismo

#CancerdeTiroides

#ThyroidCancer

#PapillaryThyroidCancer

#SurgicalOncologist

#CirujanoOncologo

#CancerSurgeon

#CirujanodeCancer

#HeadandNeckSurgeon

#CirugiaEndocrina

#CirujanodeTumoresdeCabezayCuello

#OralCavityCancer

#Melanoma

Introduction

👉Papillary thyroid cancer is the most common type of thyroid cancer making up to 70–80% of all thyroid cancer cases.

👉Papillary thyroid cancer can occur at any age, and its incidence has been increasing over the last few decades.

👉There are about 60,000 new cases of papillary thyroid cancer in the United States each year.

👉It is now ranked as the 8th most common cancer in women in the United States, and the most common cancer in women under the age of 25 years.

👉Being diagnosed with papillary thyroid cancer can be very scary at first, however papillary thyroid cancers are most often slow growing tumors, and most can be removed surgically.

👉Although slow-growing, papillary thyroid cancer can sometimes spread to the lymph nodes in the neck. Unlike some other tumors, positive lymph nodes do not usually worsen the generally excellent prognosis for.

👉The involved lymph nodes can be surgically removed along with the thyroid. Most people diagnosed with PTC will not die from it.

Risk factors for PTC

👉For most patients, we do not know the specific reason why they develop thyroid cancer, though it does appear to be more common in women, and is definitely seen in younger patients as well. It is important to note that some patients with multiple risk factors never develop thyroid cancer. In fact, most people who have thyroid cancer, have no obvious known risk factor. Known risk factors for papillary thyroid cancer include: 

👉Radiation exposure
Papillary thyroid cancer is more common in people who have a history of exposure to significant ionizing radiation. Radiation induced thyroid cancer can happen at anytime between a few years after exposure to as long as 30 to 50 years later. Radiation exposure is broken down into three major categories:

👉Childhood exposure
X-ray treatments were widely used in the 1940s and 1950s. This radiation was used to treat acne, enlarged tonsils, lymphomas, ringworm, enlarged thymus glands, and other ailments. X-rays were also used to measure foot sizes in shoe stores, and many people fondly remember seeing their “glowing green feet” and playing in these shoe fluoroscopes for hours while siblings were fitted for shoes. Children, younger than 15 years old, are most sensitive to radioactive damage to their thyroids.

👉Medical Therapy
Radiation therapy to the head, neck, and upper chest are an increasingly common cause of radiation induced thyroid cancer. Lymphoma, head and neck cancers, lung cancer, and breast cancer are some of the more common cancers that are associated with radiation exposure to the thyroid.

👉Environmental exposure
Thyroid cancer can be caused by radioactivity released from nuclear incidents such as the 1986 nuclear accident at the Chernobyl power plant in Russia. Many of the children in areas of Russia and the Eastern Block countries were inadvertently exposed to radiation and went on to develop thyroid cancer. Some people may also be exposed to radiation at work. However, routine X-ray exposure (for example dental X-rays, chest X-rays, mammograms) have NOT been shown to cause thyroid cancer.

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center