title: Familial non-medullary thyroid carcinoma displays the features of clinical anticipation suggestive of a distinct biological entity.
abstract: Non-medullary thyroid carcinoma (NMTC) is mostly sporadic, but familial clustering is described. We aimed to compare the features of patients with sporadic and familial NMTC (FNMTC) patients and to assess whether FNMTC patients with parent-child relationship exhibit the 'anticipation' phenomenon (earlier age at disease onset and increased severity in successive generations). Among 300 NMTCs followed in the Section of Endocrinology (University of Siena, Italy), 34 (11.3%) patients, all with the papillary histotype, (16 kindred), met the criteria of FNMTC. Twenty-seven of them (79.4%) exhibited a parent-child relationship and seven (20.6%) a sibling relationship. These patients were compared with 235 patients with sporadic papillary thyroid cancer (PTCs). To analyze the features of FNMTC of the first and second generations, we cumulated the series of Siena with 32 additional FNMTC patients (15 kindred) from the Department of Endocrinology-Endocrine Oncology, Thessaloniki, Greece. Significant difference between sporadic PTC and FNMTC patients included more frequent tumor multifocality (P=0.001) and worse final outcome in FNMTC patients (P=0.001). Among 47 FNMTC with parent-child relationship, we found an earlier age at disease presentation (P<0.0001), diagnosis (P<0.0001), and disease onset (P=0.04) in the second generation when compared with the first generation. Patients in the second generation were more frequently males (P=0.02); their tumors were more frequently multifocal (P=0.003) and bilateral (P=0.01), had higher rate of lymph node metastases at surgery (P=0.02) and worse outcome (P=0.04) when compared with the first generation. In conclusion, FNMTC displays the features of clinical 'anticipation' with the second generation acquiring the disease at an earlier age and having more advanced disease at presentation.
authors.affiliation: Section of Endocrinology and Metabolism, Department of Internal Medicine, Endocrinology and Metabolism and Biochemistry, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100 Siena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Capezzone
authors.forename: S
authors.initials: S
authors.lastname: Marchisotta
authors.forename: S
authors.initials: S
authors.lastname: Cantara
authors.forename: G
authors.initials: G
authors.lastname: Busonero
authors.forename: L
authors.initials: L
authors.lastname: Brilli
authors.forename: K
authors.initials: K
authors.lastname: Pazaitou-Panayiotou
authors.forename: A F
authors.initials: AF
authors.lastname: Carli
authors.forename: G
authors.initials: G
authors.lastname: Caruso
authors.forename: P
authors.initials: P
authors.lastname: Toti
authors.forename: S
authors.initials: S
authors.lastname: Capitani
authors.forename: A
authors.initials: A
authors.lastname: Pammolli
authors.forename: F
authors.initials: F
authors.lastname: Pacini
mesh_terms: D018249:Adenoma, Oxyphilic / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult