• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1250-1254
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• 2020

The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is uncommon. Herein, we report a rare case of DSPTC in a 9-year-old girl who initially presented with a painless diffuse goiter. Thyroid peroxidase antibody testing yielded positive results, and the initial clinical diagnosis was Hashimoto's thyroiditis. However, thyroid ultrasonography revealed characteristic findings of DSPTC, which was confirmed through the postoperative histopathological diagnosis. Although thyroid cancers are rare in the pediatric population, DSPTC should be included in the differential diagnosis of goiter in these patients. Moreover, ultrasonography may prevent a diagnostic delay and facilitate the detection of a concomitant malignancy.

• Korean Journal of Head & Neck Oncology
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• v.9 no.2
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• pp.175-182
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• 1993

유두상 갑상선암의 대부분은 서서히 진행하는 양호한 임상경과를 보이나, 일부는 저등급 혹은 미분화 갑상선암으로 전환되는 생물학적 특성을 보인다. 저자는 유두상 갑상선암 환자 358예를 적용된 치료방법과 치료결과를 분석하여 논란이 되고 있는 치료방법들 중에서 적절한 치료방법을 찾고자 본 연구를 시도하였다.% 568예중 동측엽절제술 및 협부 절제술 혹은 갑상선 아전 절제술 220예, 갑상선 전 절제술 혹은 근전절제술 143예, 종양적출술 5예였고, 이중 115예는 여러가지 형태의 경부 곽청술이 추가되었고, 150예는 수술후 방사성 동위원소 치료까지 추가되었다. 또 전 환자에서 TSH 억제를 위한 갑상선 호르몬 투여를 하였다. 추적 기간은 5년에서 12년까지 평균 8.5년이었다. Cady와 Rossia AMES Scoring system에 따라 저위험군과 고위험군으로 나누어 재발율과 사망율을 산출한 결과 저위험군 255예중 재발율 11.0%, 사망율 0.4%, 고위험군 65예중 재발율 36.9%, 사망율 20.0%을 보여 고위험군에서 현격히 불량한 예후를 나타내었다. 따라서 저자들은 유두상 갑상선암의 치료방법 선택은 일률적인 치료방법 보다는 환자 개인의 임상적 특성, 병기 등을 고려하여 저위험군에서는 소극적 수술을, 고위험군에서는 적극적인 수술과 수술후 보조치료를 시행하는 것이 바람직하다고 사료되었다.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.6
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• pp.543-556
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• 2009

Purpose: We studied the patterns of FDG uptake of primary papillary thyroid microcarcinoma (PTMCa) lesions and benign thyroid nodules in dual time point $^{18}F$-FDG PET/CT imaging. Materials and Methods: Consecutive 134 patients (154 lesions) with PTMCa and 49 patients (61 nodules) with benign thyroid nodules equal to or less than 1.0 cm who underwent dual time point $^{18}F$-FDG PET/CT study before surgery were enrolled. We calculated the maximum standardized uptake value of PTMCa and benign nodules in both time points, and percent change of SUVmax (${\Delta}%SUVmax$) and lesion to background ratio of SUVmax (${\Delta}L:B$% ratio) between both time points. The mean time interval between scans was $23.4{\pm}4.4$ minutes (thyroid to thyroid interval: $10.7{\pm}4.4$ minutes). Results: The mean of SUVmax of PTMCa was increased from $4.9{\pm}4.3$ to $5.3{\pm}4.7$ (p<0.001) and ${\Delta}%SUVmax$ was $12.3{\pm}23.6%$. But, the mean of SUVmax of benign nodules was no definite change ($2.1{\pm}1.0$ to $2.1{\pm}1.3$, p=0.686) and ${\Delta}%SUVmax$ was $-0.3{\pm}20.5%$. Of the 154 PTMCa, 100 nodules (64.9%) showed an increase in SUVmax over time, while 19 (31.1%) of the 61 benign thyroid nodules showed an increase (p<0.001). The dual time point $^{18}F$-FDG PET/CT found more PTMCa in visual assessment (62.3% vs. 76.6%, p=0.006), even in smaller than 0.5 cm (38.6% vs. 60.0%, p=0.011). Conclusion: Dual time time $^{18}F$-FDG PET/CT imaging was more useful than single time point $^{18}F$-FDG PET/CT imaging for distinction between PTMCa and benign nodule, especially when nodule showed equivocal or negative findings in single time point $^{18}F$-FDG PET/CT imaging or was smaller than 0.5 cm.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.235-240
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• 1996

Brain metastasis is extremely rare in thyroid papillary carcinoma which has an indolent clinical course and results in good prognosis. A 24-year-old man presenting with seizure attack is described. He had been treated under the diagnosis of thyroid papillary carcinoma with total thyroidectomy, postoperative internal radiation with radioactive iodine, and thyroid hormone replacement. Although $^{99m}$Tc brain spect and $^{131}$I whole body scan did not revealed any significant lesion, brain CT and MRI showed lcm sized mass in frontal lobe. Stereotactic craniotomy and removal of the tumor, which was histologically proven metastatic lesion from thyroid papillary carcinoma, was done with satisfactory improvement.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.3
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• pp.1260-1269
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• 2011

The purpose of this study was to determine postoperative quality of life(QoL), thyroid specific symptoms(TSSs), self care compliance, anxiety and depression in patients with papillary thyroid cancer and to identify factors influencing their postoperative QoL. 154 patients were surveyed using structured questionnaires and data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression with SPSS/WIN 18.0 program. The mean score of postoperative QoL in the subjects was 2.72 and the postoperative QoL score of social/family well being subscale showed the lowest score. Most of the subjects suffered from TSSs such as fatigue, cold intolerance, and mood swings. The most frequent activity for self care compliance was taking thyroid hormone(100%) and OPD follow up was the second activity(99.4%). Anxiety score was 45.3 indicating a medium level however 63% of the subjects were evaluated as depression status. Postoperative QoL in thyroid papillary cancer patients showed significantly negative correlations to TSSs, anxiety, and depression (r=-.573, p<.001; r=-.739, p<.001; r=-.742, p<.001). The factors influencing postoperative QoL were TSSs, anxiety, and depression, which explained about 64.9% of the variance. Thus to improve postoperative QoL in patients with papillary thyroid cancer, health care providers should relieve negative emotions related to long term cancer management, develop the support system and provide practical information to apply patients' physical, and psychological symptoms control.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.511-515
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• 2004

Purpose: The sodium-iodide symporter (NIS) expression is an important factor in determining the sensitivity of radioiodine therapy in well-differentiated thyroid cancers. Several previous studies for the expression of NIS in thyroid tissues show diverse results. To investigate whether there is difference between methods in determining the expression of NIS in thyroid tissues of patients with thyroid nodules, we measured the expression ot NIS using two different methods (RT-PCR and immunoshistochemical staining) and compared the results. Materials & Methods: We measured the expression of NIS by reverse transcriptase-polymerase chain reaction (RT-PCR) and also by immunohistochemical staining using anti-NIS antibody in thyroid cancers and other benign thyroid diseases. We compared the results of each method. We included 19 papillary carcinomas, 1 follicular carcinoma, 7 medullary carcinoma, 4 adenomas and 7 nodular hyperplasias. Results: By RT-PCR analysis, 10 of 19 papillary carcinomas expressed NIS, but 1 follicular cancer didn't express NIS. By immunohistochemical staining, 15 of 19 papaillary carcinomas express NIS, but 1 follicular lancer didn't express NIS. There was a significant correlation between the semiquautitative results of RT-PCR and immunohistochemical staining of NIS expression. (p<0.01) Conclusion: Our data demonstrated that the expression of NIS in thyroid cancers and other benign diseases investigated by RT-PCR and immunohistochemical staining correlated well each other. However, by immunohistochemical staining, more NIS expression was found.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.29-35
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• 2015

목적 : 국소 재발한 진행된 갑상선 유두암의 치료로 수술 후 외부방사선의 역할을 알아보고자 하였다. 대상 및 방법 : 원자력병원에서 2000년 1월부터 2012년 2월까지 사이버나이프 혹은 외부방사선 치료를 받은 수술과 방사선요오드 치료 후 국소 재발한 진행된 갑상선 유두암 환자 13 명을 대상으로 하였다. 경과관찰 기간 동안 국소 및 부위 재발이 발생환 환자는 6 명이었다. 몇몇의 위험인자를 찾기 위해서 Kaplan-Meier method와 log-rank test를 이용하여 성별, 종양단계, 방사선 치료 전 수술 횟수, 방사선요오드치료 횟수, 수술 후 잔존 암의 여부, 원격전이에 대해 단변량 분석하였다. 결과 : 방사선 치료 후 평균 추적관찰기관은 53.8개월(범위, 36 ~ 108개월)이고 그중 남자는 4 명이었다. 1년, 2년의 무진행 생존률은 각각 76.9와 53.8%였다. 단병량 분석은 성별과 잔존 암여부(p = 0.0475 and p = 0.0475, 각각)에 따라 무진행 생존률이 진행한 그룹과 진행하지 않은 그룹 사이에 유의한 차이가 있다는 것을 보여줬다. 결론 : 외부 방사선 치료 전에 잔존 암이 없었던 환자의 100%에서 국소 및 부위 재발이 일어나지 않았다. 외부방사선 치료는 수술과 방사선요오드 치료에 반응하지 않는 환자 중 수술 후 잔존 암이 없는 경우에 효과적인 치료 방법이 될 수 있다.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.594-599
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• 1995

Although papillary carcinoma of the thyroid generally follows an indolent course characterized by slow growth and the absence of distant metastases, several available reports suggest that metastasis to bone and/or lung parenchyma may occur infrequently. But pleural metastases are known to be very rare, so there have been only two case reports about the pleural metastases of papillary thyroid carcinoma in the literatures. Even the case of occult papillary thyroid carcinoma presenting as a metastatic pleural effusion has been never been reported. Recently we experienced a case with the chief complaint of dyspnea due to massive pleural effusion, the cytologic examination of which revealed the papillary carcinoma with psamomma bodies. The examination of the thyroid revealed no definite primary tumor. The total thyroidectomy was done with the plan of post-operative radioactive iodine treatment and the pathologic result confirmed the occult papillary microcarcinoma as expected. With the present case report, the extension of the clinical spectrum. of metastatic papillary carcinoma of the thyroid is expected.

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.224-230
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• 2004

Background: To determine the various sonographic findings in a papillary carcinoma of the thyroid. Materials and Methods: 48 patients with a proven papillary carcinoma of the thyroid were involved. The sonographic features analyzed were the size, shape, content, margin, internal echo, and calcification pattern. Results: Common sonographic features of a papillary carcinoma include the hypoechoic texture (94%), an ill defined margin (81%), a solid nodule (100%), irregular shape (48%), and microcalcifications (35%), or no calcifications (42%). The uncommon features included a hyperechoic or mixed echo texture, cystic elements, a well defined margin, and a coarse or peripheral calcifications. Conclusion: Ill-defined hypoechoic solid nodule with microcalcification is a characteristic ultrasonographic finding of a thyroid papillary carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.25-32
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• 1993

The nodular hyperplasia of the thyroid is a common thyriod disease. Nodular hyperplasia does rarely progress to thyroid cancer. The differentiation of a nodular hyperplasia from a neoplasm may be simple or difficult, both clinically and anatomically. The papillary carcinoma of the thyroid is the most common type of thyroid malignancies. There were few studies about cytogenetic observation in thyroid cancer. But only one case of banding observation in nodular hyperplasia have been reported. In order to compare the chromosomal changes in the thyroid cancer and the noncancerous thyroid disease, we performed cytogenetic analysis in two papillary carcinoma and two nodular hyperplasia after cell culture. The chromosomal pattern of the nodular hyperplasia found was very heterogenous but no clonal abnormaly in both cases was observed. Case I : A modal chromosomal number was in 42-46 range. Chromosome 8, 19, 21. 22 were commonly lost. 9 structural anomalities among 51 analysed cells were observed but they were not clonal. Case II: A modal chromosomal number was 43. Chromosome 17 and 19 were commonly lossed. Common cytogenetic characters of this two nodular hyperplasia are hypodiploidity and very heterogenous chromosomal pattern. The result about the papillary carcinoma are as follow. In one case some numerical and structural chromosomal changes were observed. But they were not clonal abnormality. In another case the chromosomal pattern found was very heterogenous with a clonal abnormality of del(11)(q23). The modal number was 46. The del(11)(q23) a chromosomal change in papillary carcinoma of the thyroid have previously been reported(Eva Olah et al. 1989). We suggest that 11q deletion may be important role to pathogenesis of papillary carcinoma of the thyroid. According to this results, we could not find out specific differences about chromosomal changes and any relationship between the papillary carcinoma and the nodular hyperplasia.