Thyroid cancer is more aggressive in elderly patients due to biological causes related to age, histotype, and the advanced stage at diagnosis. In the elderly, both the diagnosis and treatment of thyroid cancer impact quality of life. This review aimed to collect and discuss the different therapeutic approaches in elderly patients affected by thyroid cancer. Our analysis examined the therapeutic surgical approach according to age and how this affects the prognosis of patients with thyroid cancer, along with how iodine 131 therapy is tolerated and how effective it is. Furthermore, we investigated whether levothyroxine suppressive therapy is always necessary and safe in elderly patients with thyroid cancer and the safety and efficacy of systemic therapy in the elderly. We also intended to identify peculiar features of thyroid cancer in elderly subjects and to evaluate how the disease and its treatment affect their quality of life.

Inositols have demonstrated a role in cancer prevention and treatment in many kinds of neoplasms. Their molecular mechanisms vary from the regulation of survival and proliferative pathways to the modulation of immunity and oxidative stress. The dysregulation of many pathways and mechanisms regulated by inositols has been demonstrated in endocrine and neuroendocrine tumors but the role of inositol supplementation in this context has not been clarified. The aim of this review is to summarize the molecular basis of the possible role of inositols in endocrine and neuroendocrine tumors, proposing it as an adjuvant therapy.

Background: Several factors have been reported to influence the prognosis of medullary thyroid cancer (MTC). This study aimed to identify prognostic variables associated with progression-free survival (PFS) and overall survival (OS) in a cohort of patients treated at our institution. Patients and Methods: We performed a retrospective analysis of 107 consecutive patients with histologically confirmed MTC who were followed for at least 12 months. Demographic, clinical, and pathological data were retrieved from medical records. The association between baseline variables and survival outcomes was evaluated using univariate Cox proportional hazards regression models. The study was approved by the local ethics committee. Results: The median age at diagnosis was 56 years (range, 10–80 years), and 63% of the patients were female. Germline REarranged during Transfection (RET) mutations were identified in 10% of cases. The median follow-up duration was 100 months (range, 12–464 months). At diagnosis, disease stages were distributed as follows: stage I, 52%; stage II, 12%; stage III, 17%; and stage IV, 19%. Female patients showed significantly longer PFS compared with males (Hazard Ratio (HR) = 0.41, 95% Confidence Interval (CI) (0.21–0.82); p = 0.012). Factors associated with PFS by Cox regression models were post-operative serum calcitonin (CT) values after 1 and 3 months of surgery (HR = 0.08, 95% CI (0.03–0.20); p < 0.001; HR = 0.03, 95% CI (0.01–0.11); p < 0.001, respectively), Tumor, Node, and Metastasis (TNM) stage III–IV (HR = 16.86, 95% CI (5.87–48.44); p < 0.001), presence of lymph nodes metastasis at diagnosis (HR = 9.6, 95% CI (3.59–25.63); p < 0.001), multifocal disease (HR = 2.37, 95% CI (1.07–5.28); p = 0.034) and capsular invasion (HR = 10.72, 95% CI (4.45–25.87); p < 0.001). Factors associated with OS by Cox regression models were age at diagnosis (HR = 1.07, 95% CI (1.01–1.12); p = 0.019) and TNM Classification of Malignant Tumours stage III-IV (HR = 6.69, 95% CI (1.42–31.62); p = 0.016). Although lymph node metastasis and capsular invasion were not significantly associated with overall survival (p = 0.178 and p = 0.094, respectively), both variables showed a trend toward an association with OS. Conclusions: The study confirmed that post-operative serum CT values, male sex, lymph nodes metastasis at diagnosis, TNM stage III and IV and capsular invasion were all associated with a lower PFS. Factors associated with OS were age at diagnosis, presence of lymph nodes metastasis, TNM stage III–IV and capsular invasion.

Background: Solitary fibrous tumors are uncommon fibroblastic neoplasms. These tumors are characterized by the recurrent NAB2-STAT6 gene fusion, which is a hallmark of solitary fibrous tumors (SFTs), particularly those arising in the thoracic cavity. While SFTs are mostly found in the abdomen and pleura, they can occur in various locations, including the head and neck region (6% of cases of SFTs). Solitary fibrous tumors of the thyroid (SFTTs) are extremely rare, accounting for only 0.1% of all thyroid tumors. The gold standard imaging modality for thyroid tumors is ultrasonography, even though distinctive characteristics for these types of neoplasms are absent, making pre-operative diagnosis more challenging. Aim: The aim of this study is to perform a systematic literature review and to describe our case by analyzing the main clinical features, histological diagnostic features and treatments of this rare tumor, in order to clarify the behavior and molecular characteristics of SFTTs. Methods: A comprehensive systematic literature review was conducted according to the PRISMA guidelines for SFTTs. We searched the PubMed and EMBASE databases for articles published up to November 2025. The inclusion criteria include confirmed diagnosis of SFTT, while articles describing unrelated neoplasms or articles that were not in English were excluded. A standardized form was used to extract information on the imaging characteristics, histological diagnosis, treatment and outcome. Results: As of 2025, a total of 43 articles were selected, with 61 reported cases of SFTT in the English literature. Pre-operative diagnosis of SFTT is controversial and usually requires immunohistochemical confirmation. In our case, molecular analysis identified, for the first time, a NAB2ex6–STAT6ex17 fusion, contributing to the molecular characterization of this rare tumor. Conclusions: SFTTs are rare and difficult to diagnose; thus, they require a multidisciplinary approach for accurate diagnosis and management. The combination of imaging, cytology, histopathology, and molecular testing is essential in distinguishing SFTTs from other thyroid malignancies. Surgical excision remains the mainstay of treatment, and long-term follow-up is recommended due to the potential risk of recurrence or metastasis.

Objectives: Information prescriptions consist in making specific health care information available to patients on their disease from accredited sources, in order to help them understand and manage their disease, stimulating informed participation in health care. In the literature, a few studies have investigated the real effectiveness of prescribing information on the health management of oncological diseases. The scope of our pilot study was to investigate the effectiveness of information prescription, evaluating both patient satisfaction and perception, but also its possible impact on adherence to follow-up programs. Methods: Prospective pilot study enrolling patients with thyroid cancer. They received informative scientific material on thyroid cancer, dispensed by clinical librarians of the Institute's Library. Results: 101 patients were enrolled (81% were women with a total mean age of 49.39 years). 26% of patients accessed the institute’s library receiving patient information materials. Comparing data of people who completed the project with those who did not, no differences in sex, age and tumour characteristics were found. We found no statistical differences in terms of adherence to follow-up visits between the two groups of patients, but health information was able to effectively respond to the requests or needs of most patients. Participating patients have improved awareness and knowledge of their disease, patient-doctor relationships, adherence to treatment and communication with family members regarding their disease status, with a final positive impact on one’s psychological well-being and global satisfaction obtained in 65% of people. Conclusions: This is the first Italian study carried out in the field of oncological endocrinology, demonstrating the positive role health information has on patients’ psychological health and thyroid cancer knowledge.

Background: The current possible treatments of advanced medullary carcinoma (MTC) include different drugs belonging to the class of tyrosine kinase inhibitors (TKIs): vandetanib, cabozantinb, and selpercatinib. Although the effects of these TKIs have been well described in clinical trials, the real-practice evidence of the effectiveness and safety of these treatment is scant. This real-world case series aims to describe a niche of patients with advanced MTC treated with more than one TKI by focusing on treatment responses and any reported adverse events (AEs) and to provide additional insight on the individualized approach to the management of metastatic MTC. Methods: Five patients with a diagnosis of metastastic MTC, treated with at least two different molecules of TKIs, were retrospectively selected. Results: Three patients obtained a partial response (one with cabozantinb, one with selpercatinib, and one with vandetanib), and two patients obtained disease stability (both of them treated with all three TKIs, the first two lines discontinued for AEs). The AE profile agreed with the known clinical trials AEs except for non-neoplastic ascites related to selpercatinib and lung cavitations of non-neoplastic tissue related to cabozantinb. The latter was an AE never described so far in patients receiving TKIs. Conclusions: The best management of MTC relies on an individualized approach, keeping in mind and dealing with the potential toxicity in order to minimize the treatment withdrawal.