• Title/Summary/Keyword: 유두상 갑상선 암

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The Analysis of Central Cervical Lymph Nodes in Papillary Thyroid Carcinoma with Preoperative No Lymph Node Metastasis (림프절 전이가 발견되지 않은(cN0) 유두상 갑상선 암의 중앙 경부 림프절 분석)

  • Kim, Yun-Jung;Ha, Tae-Kwun;Ryu, Sung-Mock;Kim, Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.2
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    • pp.183-186
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    • 2010
  • Purpose : Papillary thyroid carcinoma (PTC) is known for malignant tumor which has a favorable prognosis and long-term survival. Although the prognosis for patients with PTC is generally good, PTC tends to have highly metastatic property. The purpose of this study was to analyze the central compartment lymph node in papillary thyroid cancer with no lymph node metastasis clinically and to assess the significance of prophylactic node dissection. Methods : A retrospective review was carried out in 394 patients with PTC who underwent surgery for the period from January 2004 to December 2006. The positive rate of the lymph node metastasis was analyzed. The relations between the central compartment lymph nodes and the patients' age, gender, tumor size, exrathyroidal extension(ETE), multifocality, and bilaterality were comparatively analyzed in PTC patients with preoperative no lymph node metastasis. Results : The enrolled patients were 40 male and 354 female cases. The 118 cases of them were found to have cervical lymph node metastasis. The mean age was 46 years(range, 15-77years). Tumor size(p=0.000), ETE(p=0.001), multifocality(p=0.014), and bilaterality(p=0.001) were significantly related factors for cervical lymph node metastasis clinically in papillary thyroid cancer. However, age and gender were not significantly related with lymph node metastasis. Conclusion : Although no lymph node metastasis clinically, prophylactic neck node dissection can be performed to avoid risks of local recurrence and reoperation in the light of PTC nature. The pathological status and high positive rate of central compartment lymph node relate to tumor size and extrathyroidal extension. Close surveillance for nodal status is required in follow-up.

Papillary Thyroid Carcinoma in Renal Allograft Recipients (신장이식후 발생한 유두상 갑상선암)

  • Lee, Jan-Dee;Hong, Hyeop;Jeong, Jong-Ju;Nam, Kee-Hyun;Chung, Woong-Youn;Soh, Euy-Young;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.64-68
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    • 2008
  • Purpose:The chronic use of immunosuppressive therapy in transplant recipients can increase the long-term risk of carcinoma. The aim of this study was to determine the incidence, biological behaviors, and treatment outcomes in PTC(papillary thyroid carcinoma) in renal allograft recipients. Material and Methods:The present study examined the incidence and biological behavior of PTCs in RA recipients. A total of 1,739 RA patients treated between January 1986 and December 1999 were followed-up for a median 137(84-238) months. During the follow-up period, 129(7.4%) recipients were identified as having posttransplant malignancies. Of those, 12(0.7%) had PTCs, and these comprised six male and six female patients with a median age of 41(23-57) years. Results:Nine cases(incidentalomas) were diagnosed based on ultrasonography(US) screening. Eight of those nine were TNM stage I, and two of the three clinical carcinomas were TNM stage IVa. During a median follow-up of 94(18-159) months, two(16.7%) PTC patients developed loco-regional recurrence, but no patients showed distant metastasis. Posttransplant PTC showed no gender bias, and was often associated with aggressive lymphatic metastasis. However, most incidentalomas showed a favorable treatment outcome. Conclusion:In conclusion, routine surveillance of the thyroid gland using US screening is recommended to ensure early detection, treatment and favorable prognosis in RA patients with PTC.

Thyroid Hemiagenesis Associated with Papillary Thyroid Carcinoma : Report of a Case and Review of the Literature (갑상선 편측형성부전에 동반된 유두 갑상선암 1예)

  • Lee, Yong-Sang;Yun, Ji-Sup;Jeong, Jong-Ju;Nam, Kee-Hyun;Chung, Woong-Youn;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.161-164
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    • 2007
  • Thyroid hemiagenesis is a rare anomaly, which is the result of failure of embryologic development of a lobe of thyroid gland. It is more frequently found in the left lobe and in female patients. We, herein, report an extremely rare case of thyroid hemiagenesis associated with papillary thyroid carcinoma. A 69-year-old female presented with an incidentally discovered thyroid nodule in the right thyroid during a routine medical check-up. Ultrasonography(US) and computed tomography(CT) disclosed $0.7{\times}0.5cm\;and\;2.8{\times}2.2cm$ sized nodules in the right thyroid. The left thyroid, however, was not seen in the imaging studies of US and CT. Fine-needle aspiration of the small and large nodules showed papillary thyroid carcinoma and adenomatous hyperplasia, respectively. The patient underwent a right total thyroidectomy with central compartment node dissection. The operative findings and histologic examination confirmed the absence of the left thyroid associated with papillary thyroid carcinoma and ademonatous hyperplasia of the right thyroid.

A Case of Skin Metastasis from Papillary Thyroid Carcinoma (유두상 갑상선암의 피부전이 1예)

  • Lim Chi-Young;Lee Jan-Dee;Nam Kee-Hyun;Kwhan Ji-Eun;Chang Hang-Seok;Chung Woong-Yoon;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.174-177
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    • 2005
  • Skin metastasis from papillary thyroid carcinoma is extremely rare. Due to similar histopathologic features, it is difficult to differentiate skin metastatic papillary thyroid carcinoma and some primary skin neoplasms without a clinical history. However, most of metastatic skin lesions showed a strong reactivity to the antithyroglobulin antibodies unlike primary skin neoplasms. Metastatic skin lesions must be completely removed and radiotherapy can be added. Investigators reported that prognosis of skin metastases from thyroid carcinoma is dismal and the average survival after it's diagnosis was only 19 months because distant metastases were often discovered at diagnosis of skin metastasis or during follow-up period. We report a case of skin metastasis from tall cell variant of papillary thyroid carcinoma. In our case, the anti thyroglobulin antibodies measured from cystic fluid from a skin lesion was more than 2000 IU/ml. Skin metastasis was diagnosed at 20 months after primary surgery for thyroid cancer and brain metastasis at 12 months after diagnosis of skin metastasis. Although skin metastasis is an ominous prognostic indicator in patients with thyroid carcinoma, a radical treatment for skin lesions and early diagnosis of distant metastasis could provide a chance to the patients to improve their survival.

A Clinical Study on 3 Cases of Complications after Total Thyroidectomy and Neck Dissection in the Papillary Thyroid Carcinoma (유두상 갑상선암 환자의 갑상선절제술 후 합병증에 대한 임상경과 보고 3례)

  • Park, Eun-Young;Gwen, Hyoung-Geun;Kong, Bok-Chul;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.26 no.3
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    • pp.103-113
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    • 2013
  • Objectives: Thyroid cancer is the most common cancer for female in Korea. This study aims to report the effects of Korean medicine on complications after total thyroidectomy and neck dissection in the papillary thyroid carcinoma. Methods: The 3 patients with papillary thyroid carcinoma were treated by Korean medicine such as acupuncture, moxibustion and pharmacopuncture therapy. We evaluated the results of treatments by change of symptoms. Results: After treatments such as acupuncture, moxibustion and pharmacopuncture therapy except herb medicine, the symptoms of complications after total thyroidectomy and neck dissection were improved. Conclusions: This study shows that Korean medicine has effects on complications after total thyroidectomy and neck dissection in the papillary thyroid carcinoma.

Thyroid Carcinoma Coexisting with Myasthenia Gravis : Report of 2 Cases (중증 근무력증과 동반된 유두상 갑상선암 2예)

  • Lim Chi-Young;Lee Jan-Dee;Nam Kee-Hyun;Jang Hang-Seok;Kim Hae-Ryoung;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.1
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    • pp.32-34
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    • 2005
  • Myasthenia gravis with thymoma is associated with an increased risk of second malignancy, but concurrence of myasthenia gravis and thyroid carcinoma is rarely seen. In the treatment, it is emphasized to operate in two stage to avoid myasthenic crisis after surgery. In general, a thyroid cancer surgery is performed after controlling yasthenia gravis by means of thymectomy or medical treatment with steroids and anticholine esterase. We experienced two cases of thyroid carcinoma coexisting with myasthenia gravis, which is thought to be true first report in Korea.

Relationship between the Expression of VEGF, HIF-$1{\alpha}$, E-cadherin, p53 and Stage in Papillary Thyroid Carcinoma (유두상(乳頭像) 갑상선암(甲狀腺癌)에서 VEGF, HIF-$1{\alpha}$, E-cadherin, p53의 발현(發現)과 병기(病期)의 관련성(關聯性) 연구(硏究))

  • Kim, Jong-Sam;Na, Baeg-Ju;Lee, Moo-Sik;Kim, Chul-Woung;Jeong, Gye-Rim
    • Proceedings of the KAIS Fall Conference
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    • 2009.05a
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    • pp.335-338
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    • 2009
  • 본 연구에서는 HIF-$1{\alpha}$의 과발현은 VEGF의 발현과 유의한 상관 관계가 있음을 보여 주었다. 그리고, HIF-$1{\alpha}$의 과발현과 E-cadherin의 발현 사이에도 연관성은 있었지만 통계적인 유의성은 없었다. 종양의 병기와 VEGF, HIF-$1{\alpha}$, E-cadherin, p53의 상관성을 살펴본 결과 E-cadherin에서만 유의성이 관찰되었다. 갑상샘 유두암종에서 HIF-$1{\alpha}$의 발현이 종양의 증식과 관련된 단백, 특히 맥관형성과 관련된 단백인 VEGF의 발현, p53의 축적 및 E-cadherin의 발현소실과의 관계, 그리고 병리학적 표지자와의 관련성을 조사하고, 갑상샘 유두암종 환자의 수술후 예후와의 관계를 알고자 하였다.

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Synchronous Presentation of Papillary Thyroid Cancer and Malignant Lymphoma (경부 악성 림프종과 동반된 유두상 갑상선암)

  • Chang Hang-Seok;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.253-259
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    • 1998
  • The increasing risk of subsequent malignancy after treatment of malignant lymphoma is well known, which is mainly due to longer survival of these patients. Radiotherapy at an early stage of Hodgkin's disease or non-Hodgkin's lymphoma is accepted to be associated with future occurrence of secondary thyroid cancer. Nevertheless, the synchronous presentation of these malignancies is extremely rare. Well differentiated thyroid cancer, a slow-growing tumor that responds to therapy with surgery and radioactive iodine, is associated with prolonged survival. therefore, it is important to make this diagnosis in patients who show evidence of malignant lymphoma. Furthermore, appropriate treatment must be considered for thyroid cancer to improve the prognosis of these patients. We herein reported 4 cases of synchronous thyroid cancer and malignant lymphoma in patients who had not previously recieved radiotherapy or chemotherapy.

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Unilateral Diaphragmatic Paralysis after Thyroid Surgery (갑상선 수술 후 발생한 편측 횡격막 마비 1예)

  • Byun, Jong Kyu;Rhee, Sang Youl;Kim, Yu Jin;Um, Yu Jin;Kim, Seul Ki;Son, Jung Il;Chin, Sang Ouk;Chon, Suk;Kim, Woo-Shik;Kim, Joo Young;Lee, Byoung Wook;Woo, Jeong-Taek;Kim, Young Seol
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.2
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    • pp.74-78
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    • 2014
  • 갑상선 암 진단과 치료기술이 발전하면서 최근 그 수술 건 수가 급격하게 증가하고 있다. 하지만이와 관련된 합병증과 부작용을 면밀하게 평가해야 할 필요 역시 점차 늘어나고 있다. 갑상선 암 수술 후 발생할 수 있는 드문 합병증의 하나로 횡격막 신경마비(phrenic nerve paralysis)가 있다. 이러한 횡격막신경마비는 대부분 증상이 경미하고 쉽게 호전되어 임상적으로 크게 중요하게 다루어지지 않았다. 하지만, 갑상선 수술 후 갑작스런 호흡곤란이 발생한다면 횡격막 신경마비에 의한 횡격막 마비(diaphragmatic paralysis)와 관련되었을 가능성을 놓치지 말아야 한다. 저자들은 최근 갑상선암 수술 후 발생한 호흡곤란으로 2년 동안 심각한 호흡곤란을 호소하던 73세 여자환자에서 투시촬영(fluoroscopy) 상 편측으로 상승되고 운동성이 저하된 횡격막을 확인하여 일측성 횡격막신경마비(Unilateral phrenic nerve paralysis)를 확진 하였다. 갑상선수술 후 발생하는 일측 횡경막 신경마비는 임상에서 드물게 관찰되는 수술 합병증이기에 환자는 상당기간 이에 대한 감별이 제대로 이루어지지 않았다. 우리는 횡격막 마비의 조기 진단과 적극적인 치료를 통하여 심한 호흡곤란을 호소하는 환자의 증상 및 병의 경과를 호전 시킬 수 있었다.