Endocrinology and Metabolism

Original Articles

Thyroid
Adequate Dose of Levothyroxine for Thyroid-Stimulating Hormone Suppression after Total Thyroidectomy in Patients with Differentiated Thyroid Cancer: Hyun Jin Ryu, Min Sun Choi, Hyunju Park, Tae Hyuk Kim, Jae Hoon Chung, So Young Park, Sun Wook Kim; Endocrinol Metab. 2024;39(4):615-621. Published online August 7, 2024; DOI: https://doi.org/10.3803/EnM.2023.1896

5,213 View
133 Download
6 Web of Science
5 Crossref

Background
The adequate dose of levothyroxine (LT4) for patients who have undergone total thyroidectomy (TT) for differentiated thyroid cancer (DTC) is uncertain. We evaluated the LT4 dose required to achieve mild thyroid-stimulating hormone (TSH) suppression in DTC patients after TT.
Methods
The electronic medical records of patients who underwent TT for DTC and received mild TSH suppression therapy were reviewed. Linear regression analysis was performed to evaluate the association between LT4 dose (μg/kg) and an ordinal group divided by body mass index (BMI). We also evaluated the trend in LT4 doses among groups divided by BMI and age.
Results
In total, 123 patients achieved mild TSH suppression (0.1 to 0.5 mIU/L). The BMI variable was divided into three categories: <23 kg/m² (n=46), ≥23 and <25 kg/m² (n=30), and ≥25 kg/m² (n=47). In the linear regression analysis, BMI was negatively associated with the LT4 dose after adjusting for age and sex (P<0.001). The LT4 doses required to achieve mild TSH suppression based on the BMI categories were 1.86, 1.71, and 1.71 μg/kg, respectively (P for trend <0.001). Further analysis with groups divided by age and BMI revealed that a higher BMI was related to a lower LT4 dose, especially in younger patients aged 20 to 39 (P for trend=0.011).
Conclusion
The study results suggest an appropriate LT4 dose for mild TSH suppression after TT based on body weight in patients with DTC. Considering body weight, BMI, and age in estimating LT4 doses might help to achieve the target TSH level promptly.

Citations

Citations to this article as recorded by

Effects of 131I and TSH suppression therapy on METTL3, METTL14 levels and recurrence in thyroid cancer
Li-Guo Yang
American Journal of Cancer Research.2025; 15(1): 42. CrossRef
Developing a machine learning-based predictive model for levothyroxine dosage estimation in hypothyroid patients: a retrospective study
Tran Thi Ngan, Dang Huong Tra, Ngo Thi Quynh Mai, Hoang Van Dung, Nguyen Van Khai, Pham Van Linh, Nguyen Thi Thu Phuong
Frontiers in Endocrinology.2025;[Epub] CrossRef
Tailoring TSH suppression in differentiated thyroid carcinoma: evidence, controversies, and future directions
Xinxin Song, Xin Zhi, Linxue Qian
Endocrine.2025; 89(1): 1. CrossRef
Risk of Osteoporotic Fractures among Patients with Thyroid Cancer: A Nationwide Population-Based Cohort Study
Eu Jeong Ku, Won Sang Yoo, Yu Been Hwang, Subin Jang, Jooyoung Lee, Shinje Moon, Eun Kyung Lee, Hwa Young Ahn
Endocrinology and Metabolism.2025; 40(2): 225. CrossRef
Levothyroxine Dosing for Thyroid-Stimulating Hormone Suppression in Patients with Differentiated Thyroid Cancer after Total Thyroidectomy
Mijin Kim
Endocrinology and Metabolism.2024; 39(4): 576. CrossRef

Thyroid
Clinical Manifestations of Malignant Struma Ovarii: A Retrospective Case Series in a Tertiary Hospital in Korea: Hyun Jin Ryu, Da Eun Leem, Ji Hyun Yoo, Tae Hyuk Kim, Sun Wook Kim, Jae Hoon Chung; Endocrinol Metab. 2024;39(3):461-467. Published online May 9, 2024; DOI: https://doi.org/10.3803/EnM.2023.1863

3,689 View
122 Download
5 Web of Science
4 Crossref

Abstract PDF PubReader ePub

Background
Malignant struma ovarii (MSO) is a very rare disease in which thyroid cancer originates from the ovary. Because it is rare for endocrinologists to encounter patients with MSO, endocrinologists may have a limited understanding of the disease. Therefore, we analyzed and introduced its incidence and clinical course in a tertiary hospital in Korea.
Methods
We retrospectively investigated the clinical data of 170 patients who underwent surgery for struma ovarii at the Department of Obstetrics and Gynecology of Samsung Medical Center from 1994 to May 2023.
Results
Among 170 patients with struma ovarii, 15 (8.8%) were diagnosed with MSO. The median age of patients with MSO was 48 years (range, 30 to 74), and the median tumor size was 3.3 cm (range, 0.5 to 11.0). Papillary thyroid carcinoma (46.7%) was the most common subtypes followed by follicular thyroid carcinoma (26.7%). All patients were diagnosed after surgery, with no predictions from preoperative imaging. The surgical extent of gynecological surgery was variable. Four patients (26.7%) underwent thyroidectomy for thyroid cancer, while one underwent total thyroidectomy and radioactive iodine therapy for MSO with peritoneal metastasis. Except for one patient who underwent hemithyroidectomy, thyroid stimulating hormone suppression therapy was performed in four patients. Only 53% of MSO patients were consulted by an endocrinologist. With a median follow-up period of 33 months (range, 4 to 156), 11 patients remained disease-free, one experienced progression with peritoneal seeding, and the remaining one was in treatment. There have been no recurrences or deaths due to MSO.
Conclusion
An endocrinologist should be involved in establishing a therapeutic plan for MSO, for which the overall prognosis is generally favorable.

Citations

Citations to this article as recorded by

Struma ovarii—diagnostic and treatment strategy: a case report
Mohammed Alnaggar, Mueataz A. Mahyoub, Nabil Alshargabi, Li Gong
Journal of Medical Case Reports.2025;[Epub] CrossRef
Successful Management and Long-term Survival of Malignant Struma Ovarii with Radioactive Iodine Therapy
Nimmagadda Ajit, Zakir Ali Abubacker, Prathyusha Bikkina, CB Virupakshappa
Indian Journal of Nuclear Medicine.2025; 40(2): 109. CrossRef
Diagnostic Value of Nuclear Hybrid Imaging in Malignant Struma Ovarii: A Systematic Review of Case Reports
Claudiu Peștean, Doina Piciu
Diagnostics.2024; 14(23): 2630. CrossRef
The Role of Radioiodine Therapy in Differentiated Thyroid Cancer Arising from Struma Ovarii: A Systematic Review
Pietro Bellini, Francesco Dondi, Valentina Zilioli, Elisa Gatta, Maria Cavadini, Carlo Cappelli, Gian Luca Viganò, Francesco Bertagna
Journal of Clinical Medicine.2024; 13(24): 7729. CrossRef

Thyroid
Identification of Mutations in the Thyroxine-Binding Globulin (TBG) Gene in Patients with TBG Deficiency in Korea: Jung Heo, Sang-Mi Kim, Hyun Jin Ryu, Hyunju Park, Tae Hyuk Kim, Jae Hoon Chung, Hyung-Doo Park, Sun Wook Kim; Endocrinol Metab. 2022;37(6):870-878. Published online December 7, 2022; DOI: https://doi.org/10.3803/EnM.2022.1591

4,200 View
213 Download
1 Web of Science
1 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Thyroxine-binding globulin (TBG) is a major transporter protein for thyroid hormones. The serpin family A member 7 (SERPINA7) gene codes for TBG, and mutations of the SERPINA7 gene result in TBG deficiency. Although more than 40 mutations have been reported in several countries, only a few studies of TBG deficiency and SERPINA7 gene mutation have been performed in Korea. The aim of this study is to review the clinical presentations and laboratory findings of patients with TBG deficiency and to investigate the types of SERPINA7 gene mutation.
Methods
Five unrelated Korean adults with TBG deficiency attending endocrinology clinic underwent SERPINA7 gene sequencing. Four patients harbored a SERPINA7 gene mutation. Serum thyroid hormones, anti-microsomal antibodies, and TBG were measured. Genomic DNA was extracted from whole blood. All exons and intron-exon boundaries of the TBG gene were amplified and sequencing was performed.
Results
Two patients were heterozygous females, and the other two were hemizygous males. One heterozygous female had coexisting hypothyroidism. The other heterozygous female was erroneously prescribed levothyroxine at a local clinic. One hemizygous male harbored a novel mutation, p.Phe269Cysfs*18, which caused TBG partial deficiency. Three patients had the p.Leu372Phefs*23 mutation, which is known as TBG-complete deficiency Japan (TBG-CDJ) and was also presented in previous mutation analyses in Korea.
Conclusion
This study presents four patients diagnosed with TBG deficiency and provides the results of SERPINA7 gene sequencing. One novel mutation, p.Phe269Cysfs*18, causing TBD-partial deficiency and three cases of TBG-CDJ were demonstrated. It is necessary to identify TBG deficiency to prevent improper treatment. Also, sequencing of the SERPINA7 gene would provide valuable information about the TBG variants in Korea.

Citations

Citations to this article as recorded by

Development and basic performance verification of a rapid homogeneous bioassay for agonistic antibodies against the thyroid-stimulating hormone receptor
Motoki Hoshina, Shiomi Ojima, Atsushi Kawasaki, Kosuke Doi, Satoshi Ohta, Asuka Inoue, Hiroshi Murayama
Journal of Immunological Methods.2024; 528: 113655. CrossRef

Thyroid
Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients: Heera Yang, Hyunju Park, Hyun Jin Ryu, Jung Heo, Jung-Sun Kim, Young Lyun Oh, Jun-Ho Choe, Jung Han Kim, Jee Soo Kim, Hye Won Jang, Tae Hyuk Kim, Sun Wook Kim, Jae Hoon Chung; Endocrinol Metab. 2022;37(4):652-663. Published online July 22, 2022; DOI: https://doi.org/10.3803/EnM.2022.1477

7,401 View
252 Download
23 Web of Science
29 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Telomerase reverse transcriptase (TERT) promoter mutations are associated with increased recurrence and mortality in patients with thyroid carcinoma. Previous studies on TERT promoter mutations were retrospectively conducted on a limited number of patients.
Methods
We prospectively collected data on all consecutive patients who underwent thyroid carcinoma surgery between January 2019 and December 2020 at the Samsung Medical Center, Seoul, Korea. We included 2,092 patients with thyroid carcinoma.
Results
Of 2,092 patients, 72 patients (3.4%) had TERT promoter mutations. However, the frequency of TERT promoter mutations was 0.5% in papillary thyroid microcarcinoma (PTMC) ≤1 cm and it was 5.8% in papillary thyroid carcinoma (PTC) >1 cm. The frequency of TERT promoter mutations was significantly associated with older age at diagnosis (odds ratio [OR], 1.12; P<0.001), larger primary tumor size (OR, 2.02; P<0.001), and aggressive histological type (OR, 7.78 in follicular thyroid carcinoma; OR, 10.33 in poorly differentiated thyroid carcinoma; OR, 45.92 in anaplastic thyroid carcinoma; P<0.001). Advanced T stage, advanced N stage, and distant metastasis at diagnosis were highly prevalent in mutated thyroid cancers. However, initial distant metastasis was not present in patients with TERT promoter mutations in PTMC. Although the C228T mutation was more highly detected than the C250T mutation (64 cases vs. 7 cases), there were no significant clinicopathological differences.
Conclusion
This study is the first attempt to investigate the frequency of TERT promoter mutations in a real-world setting. The frequency of TERT promoter mutations in PTC was lower than expected, and in PTMC, young patients, and female patients, the frequency was very low.

Citations

Citations to this article as recorded by

Prognostication with Thyroid GuidePx in the context of tall cell variants
Steven Craig, Cynthia Stretch, Caitlin Yeo, Jeremy Fan, Haley Pedersen, Young Joo Park, Adrian Harvey, Oliver F. Bathe
Surgery.2025; 177: 108882. CrossRef
Prognostic impact of fibrosclerotic changes in non-papillary, non-anaplastic, follicular cell-derived thyroid carcinomas
Giulia Orlando, Giulia Capella, Giulia Vocino Trucco, Elena Vissio, Jasna Metovic, Francesca Maletta, Marco Volante, Mauro Papotti
Virchows Archiv.2025;[Epub] CrossRef
Telomeres and telomerase in mesothelioma: Pathophysiology, biomarkers and emerging therapeutic strategies (Review)
Dimitrios Andreikos, Demetrios Spandidos, Vasiliki Georgakopoulou
International Journal of Oncology.2025;[Epub] CrossRef
The Influence of Glycolytic Enzyme Expression on the Aggressiveness of Papillary Thyroid Carcinoma Using TCGA Data
Won Woong Kim, Daham Kim, Jin Kyong Kim, Sang-Wook Kang, Jandee Lee, Jong Ju Jeong, Kee-Hyun Nam, Woong Youn Chung
Journal of Endocrine Surgery.2025; 25(1): 13. CrossRef
Allele frequency in thyroid cancer: mechanisms, challenges, and applications in cancer therapy
Jiayu Huang, Jiazhi Wang, Guangzhi Wang, Yongfu Zhao
Thyroid Research.2025;[Epub] CrossRef
The immortality mechanism of TERT promoter mutant cancers is self-reinforcing and reversible
Nicholas O. Stevers, Somang Kim, Jimmy Bo Yuan, Carter J. Barger, Chibo Hong, Olivia Lenzo, Andrew M. McKinney, Samuel H. Wu, Yu Jin Lee, Darwin W. Kwok, Abigail K. Suwala, Christina L. Appin, John D. Gordan, Annette M. Molinaro, Jun S. Song, Joseph F. Co
Molecular Cell.2025; 85(12): 2337. CrossRef
Exploring the role of TERT in thyroid Cancer: A systematic review
Thais Maloberti, Andrea Repaci, Laura Poppi, Floriana Jessica Di Paola, Giulia Calafato, Sara Coluccelli, Francesca Carosi, Alessandra Colapinto, Simone Colombero, Giacomo Credi, Giovanni Tallini, Maria A. Pantaleo, Margherita Nannini, Dario de Biase
Critical Reviews in Oncology/Hematology.2025; 213: 104792. CrossRef
Molecular Diagnosis of Thyroid Nodules Using Next‐Generation Sequencing in the Chinese Population
Hui Chen, Wei Liu, Yan Chen, Zhengzeng Jiang, Yuanyuan Ren, Jiajia Wu, Rui Liu, Min Zhu, Hongfeng Zhang, Yuan Ji, Suraiya Saleem
International Journal of Endocrinology.2025;[Epub] CrossRef
2025 Korean Thyroid Association Clinical Management Guideline on Active Surveillance for Low-Risk Papillary Thyroid Carcinoma
Eun Kyung Lee, Min Joo Kim, Seung Heon Kang, Bon Seok Koo, Kyungsik Kim, Mijin Kim, Bo Hyun Kim, Ji-hoon Kim, Shin Je Moon, Kyorim Back, Young Shin Song, Jong-hyuk Ahn, Hwa Young Ahn, Ho-Ryun Won, Won Sang Yoo, Min Kyoung Lee, Jeongmin Lee, Ji Ye Lee, Kyo
International Journal of Thyroidology.2025; 18(1): 30. CrossRef
TERT Promoter Mutations Frequency Across Race, Sex, and Cancer Type
Talal El Zarif, Marc Machaalani, Rashad Nawfal, Amin H Nassar, Wanling Xie, Toni K Choueiri, Mark Pomerantz
The Oncologist.2024; 29(1): 8. CrossRef
Gene mutations as predictors of central lymph mode metastasis in cN0 PTC: A meta‐analysis
Jiaqi Ji, Xinlong Shi
Clinical Genetics.2024; 105(2): 130. CrossRef
Risk stratification by combining common genetic mutations and TERT promoter methylation in papillary thyroid cancer
Ye Sang, Guanghui Hu, Junyu Xue, Mengke Chen, Shubin Hong, Rengyun Liu
Endocrine.2024; 85(1): 304. CrossRef
Shortened telomere length in peripheral blood leukocytes is associated with cumulative radioactive iodine doses in patients with differentiated thyroid carcinoma
Hoonsung Choi, Sun Wook Cho, Hwan Hee Kim, Ka Hee Yi, Do Joon Park, Young Joo Park
Cancer.2024; 130(12): 2215. CrossRef
2023 Update of the Korean Thyroid Association Guidelines for the Management of Thyroid Nodules
Eun Kyung Lee, Young Joo Park
Clinical Thyroidology®.2024; 36(4): 153. CrossRef
Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 5. Evaluation of Recurrence Risk Postoperatively and Initial Risk Stratification in Different
Eun Kyung Lee, Young Shin Song, Ho-Cheol Kang, Sun Wook Kim, Dong Gyu Na, Shin Je Moon, Dong-Jun Lim, Kyong Yeun Jung, Yun Jae Chung, Chan Kwon Jung, Young Joo Park
International Journal of Thyroidology.2024; 17(1): 68. CrossRef
Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules 2024
Young Joo Park, Eun Kyung Lee, Young Shin Song, Su Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung,
International Journal of Thyroidology.2024; 17(1): 208. CrossRef
Predictive biomarkers in thyroid cancer in the current molecular-morphology paradigm
Humberto Carvalho Carneiro, Rodrigo de Andrade Natal, Evelin Cavalcante Farias, Aline Almeida Bastos, Leila Guastapaglia, Alanna Mara Pinheiro Sobreira Bezerra, Ana Amélia Fialho de Oliveira Hoff
Surgical and Experimental Pathology.2024;[Epub] CrossRef
Catching the Silent Culprits: TERT Promoter Mutation Screening of Minimally Invasive Follicular and Oncocytic Thyroid Carcinoma in Clinical Practice
L. Samuel Hellgren, Adam Stenman, Kenbugul Jatta, Vincenzo Condello, Catharina Larsson, Jan Zedenius, C. Christofer Juhlin
Endocrine Pathology.2024; 35(4): 411. CrossRef
Association Between Gross Features and Coexistence of BRAFV600E and TERT Promoter Mutations in Papillary Thyroid Carcinomas: A Combined Analysis Incorporating Clinicopathologic Features
Thi Ngoc Anh Nguyen, Van Phu Thang Nguyen, Hirokazu Kurohama, Yuko Akazawa, Katsuya Matsuda, Zhanna Mussazhanova, Yuki Matsuoka, Kenichi Yokota, Shinya Satoh, Hiroyuki Yamashita, Thi Nhung Nguyen, Yerkerzhan Sailaubekova, Masahiro Nakashima
Thyroid®.2024; 34(12): 1476. CrossRef
Are TERT Promoter Mutations a Poor Prognostic Factor in Anaplastic Thyroid Carcinoma?
Hyun Jin Ryu, Young Lyun Oh, Jung Heo, Hyunju Park, Tae Hyuk Kim, Sun Wook Kim, Jae Hoon Chung
International Journal of Thyroidology.2024; 17(2): 286. CrossRef
A Machine Learning-Based Model for Preoperative Assessment and Malignancy Prediction in Patients with Atypia of Undetermined Significance Thyroid Nodules
Gilseong Moon, Jae Hyun Park, Taesic Lee, Jong Ho Yoon
Journal of Clinical Medicine.2024; 13(24): 7769. CrossRef
Deciphering the Functions of Telomerase Reverse Transcriptase in Head and Neck Cancer
Tsung-Jang Yeh, Chi-Wen Luo, Jeng-Shiun Du, Chien-Tzu Huang, Min-Hung Wang, Tzer-Ming Chuang, Yuh-Ching Gau, Shih-Feng Cho, Yi-Chang Liu, Hui-Hua Hsiao, Li-Tzong Chen, Mei-Ren Pan, Hui-Ching Wang, Sin-Hua Moi
Biomedicines.2023; 11(3): 691. CrossRef
2023 Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules
Young Joo Park, Eun Kyung Lee, Young Shin Song, Soo Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung
International Journal of Thyroidology.2023; 16(1): 1. CrossRef
Thyroid Cancer, Iodine, and Gene Mutation
Jae Hoon Chung
International Journal of Thyroidology.2023; 16(1): 89. CrossRef
Mortality rate and causes of death in papillary thyroid microcarcinoma
Jung Heo, Hyun Jin Ryu, Hyunju Park, Tae Hyuk Kim, Sun Wook Kim, Young Lyun Oh, Jae Hoon Chung
Endocrine.2023; 83(3): 671. CrossRef
TERT promoter mutations in thyroid cancer
Michiko Matsuse, Norisato Mitsutake
Endocrine Journal.2023; 70(11): 1035. CrossRef
TERT Promoter and BRAF V600E Mutations in Papillary Thyroid Cancer: A Single-Institution Experience in Korea
Min Jhi Kim, Jin Kyong Kim, Gi Jeong Kim, Sang-Wook Kang, Jandee Lee, Jong Ju Jeong, Woong Youn Chung, Daham Kim, Kee-Hyun Nam
Cancers.2022; 14(19): 4928. CrossRef
Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients (Endocrinol Metab 2022;37:652-63, Heera Yang et al.)
Hyunju Park, Jae Hoon Chung
Endocrinology and Metabolism.2022; 37(6): 949. CrossRef
Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients (Endocrinol Metab 2022;37:652-63, Heera Yang et al.)
Sue Youn Kim, Chan Kwon Jung
Endocrinology and Metabolism.2022; 37(6): 947. CrossRef

First
Prev
Page of 1
Next
Last

Search