Background: Obesity is a disease, acknowledged by WHO, characterized as an epidemic in a worldwide range, particularly in Western countries. Childhood obesity, lately, has raised major concerns. Among the complex factors contributing to obesity, environmental factors, such as endocrine disruptors, are gaining attention as emerging contributors to obesity. Summary: Toxicants, such as bisphenol A, phthalates, perfluoroalkyl and polyfluoroalkyl substances, heavy metals, and pesticides, have been associated with increases in the incidence of obesity in human populations, animals, and cellular models. These EDCs, called obesogens, disrupt the endocrine system across multiple pathways. They influence appetite, promote inflammation, disrupt the ecology and function of the gut microbiome, and induce transgenerational epigenetic changes. At the cellular level, they act as agonists of peroxisome proliferator-activated receptor γ, steroid, and aryl hydrocarbon receptors. Key Messages: Children are exposed to obesogens through multiple metabolic pathways, which contribute directly and indirectly to the development of obesity. Despite the increasing evidence, more studies are needed to identify additional obesogens and elucidate their mechanisms of action to minimize exposure to pediatric and adolescent populations.

Complete Androgen Insensitivity Syndrome (CAIS) is a rare genetic condition by mutations in the androgen receptor (AR) gene resulting in target issue resistance to androgens and a female phenotype in genetically male individuals. A 16-year-old phenotypically female individual presented to our clinic with primary amenorrhea. Her clinical evaluation showed normal female external genitalia, Tanner III breast development and sparse pubic and axillary hair (Tanner stage II). Hormonal assessment revealed increased concentrations of Luteinizing Hormone (LH), Testosterone and Antimüllerian Hormone (AMH). Image studies detected no uterus or gonads, but a blind vagina and the karyotype was 46, XY. These findings suggested the diagnosis of CAIS, and genetic testing of the AR gene revealed a rare pathogenic mutation of cytosine to adenine (c.2612C>A) replacing alanine with glutamic acid at position 871 (p.Ala871Glu) in the AR, previously described once in two adult sisters. The patient underwent gonadectomy and received hormonal replacement therapy. This study expands the AR mutation database and shows the complexity and the importance of prompt diagnosis, proper management, and follow-up for CAIS patients, underlining the need for standardized protocols.

Background/Objectives: Structural incomplete response (SIR) (persistence/recurrence) may occur in 2–6% of low-risk differentiated thyroid cancer (DTC)-cases and in 67–75% of high risk. Regarding locoregional disease, surgery is the optimal therapeutic modality if the smallest dimension of the targeted node is ≥8 mm or ≥10 mm (central or lateral compartment). In the presence of smaller nodes, contraindications or the patient’s unwillingness for reoperation, active surveillance (AS) or minimally invasive treatments (MITs) may be considered. Methods: We retrospectively studied eight DTC patients with SIR confirmed by ultrasound (U/S)-guided fine-needle aspiration cytology (FNAC) and the measurement of Thyroglobulin (Tg) in the washout fluid. Fourteen malignant lesions were ablated by radiofrequency (RF). We assessed prior to RF ablation (RFA) and consecutively at one month, three months and, then, every three months the volume of each lesion, serum Tg and Anti-Tg antibodies and calculated the volume reduction ratio (VRR). Results: Patients were followed for a mean period of 13.25 months (range: 4–24) after RFA was performed. The targeted lesions reduced significantly from a median volume of 0.24 mL (range: 0.09–0.9) to 0.02 mL (range: 0–0.03) (p < 0.05), with a median VRR of 94.5% (range: 78–100%) and concomitant significant biochemical remission (decrease in serum Tg from a median of 1.05 ng/mL to 0.2 ng/mL, p < 0.05). In one patient with an aggressive radioiodine (RAI)-refractory histological variant, re-recurrence was documented, which was successfully re-ablated by RF. In two patients, Horner syndrome was diagnosed as an RFA complication, which was totally resolved within six months. Conclusions: RFA may be considered as an effective and safe MIT in selective DTC patients with SIR, especially in cases of smaller lesions. Additional prospective studies are needed, including aggressive DTC histological variants towards a tailored therapeutic approach.

Background/Objectives: Structural incomplete response (SIR) (persistence/recurrence) may occur in 2-6% of low-risk differentiated thyroid cancer (DTC)-cases and in 67-75% of high-risk. Regarding locoregional disease, surgery is the optimal therapeutic modality if, the smallest dimension of the targeted node is ≥8mm or ≥10mm (central or lateral compartment). In the presence of smaller nodes, contraindications or, patient’s unwillingness for reoperation, active surveillance (AS) or minimally invasive treatments (MIT), may be considered. Methods: We retrospectively studied eight DTC patients with SIR confirmed by ultrasound (U/S)-guided fine-needle aspiration cytology (FNAC) and measurement of Thyroglobulin (Tg) in the washout fluid. 14 malignant lesions were ablated by radiofrequency (RF). We assessed prior to RF ablation (RFA) and consecutively at one month, three months and then every three months the volume of each lesion, serum Tg and AntiTg antibodies and calculated the volume reduction ratio (VRR). Results: Patients were followed for a mean period of 13.25 months (range: 4-24) after RFA was performed. The targeted lesions reduced significantly from a median volume of 0.24 mL (range: 0.09-0.9) to 0.02 mL (range: 0-0.03) (p<0.05), with a median VRR of 94.5% (range: 78-100%) and concomitant significant biochemical remission (decrease of serum Tg from a median of 1.05 ng/mL to 0.2 ng/mL, p<0.05). In one patient with an aggressive RAI-refractory histological variant re-recurrence was documented which was successfully re-ablated by RF. In two patients Horner syndrome was diagnosed as an RFA complication which was totally resolved within six months. Conclusions: RFA may be considered as an effective and safe MIT in selective DTC patients with SIR, especially in cases of smaller lesions. Additional prospective studies are needed including aggressive DTC histological variants towards a tailored therapeutic approach.