• 제목/요약/키워드: Cancer of thyroid

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갑상선유두상암에서 예방적 중심경부림프절제술은 생략할 수 있는가? (Is Prophylactic Central Node Dissection Omissible?)

  • 신성찬;이병주
    • 대한두경부종양학회지
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    • 제34권1호
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    • pp.1-7
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    • 2018
  • Papillary thyroid carcinoma has a good prognosis, but the frequency of locoregional lymph node metastasis is high and is known to occur stepwise fashion. Prophylactic central node dissection in papillary thyroid carcinoma is widely performed from the past. But, the pros and cons of the prophylactic central node dissection has been ongoing for a long time. In the American Thyroid Association management guideline for thyroid nodules and differentiated thyroid cancer, which is the most widely used, recommendations about prophylactic central node dissection has been changed in past ten years. In recent systematic review and meta-analysis, prophylactic central node dissection increases the rate of transient hypocalcemia and recurrent laryngeal nerve injury, but there is no difference in the frequency of permanent hypocalcemia or recurrent laryngeal nerve injury. Prophylactic central node dissection has not been shown to improve patient survival, but recurrence has been reported to decrease. According to a questionnaire survey of the members of Korean Scociety of Thyroid-Head and Neck Surgery, Korean doctors tend to perform the prophylactic central node dissection more aggressively than other countries. The reason for this is that Korea has a large number of thyroid surgeries and therefore surgeons are more experienced than other countries.

갑상선암 수술과 수술 전후 음성관리 (Perioperative Management of the Voice in Thyroid Cancer)

  • 윤소연;홍현준
    • 대한후두음성언어의학회지
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    • 제31권2호
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    • pp.49-55
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    • 2020
  • Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

Sjögren Syndrome after Radioiodine Therapy in Thyroid Cancer Patients

  • Lee, Hee Jin;Kim, Jae-Jeong;Kim, Young-Gun;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • 제43권3호
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    • pp.84-86
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    • 2018
  • Salivary and lacrimal gland dysfunction is relatively frequent after radioiodine therapy. In most cases this is a transient side effect, but in some patients it may persist for a long period or appear late. Radioiodine ($^{131}I$) therapy is often administered to patients following total thyroidectomy to treat well-differentiated follicular cell-derived thyroid cancer. In addition to the thyroid, $^{131}I$ accumulates in the salivary glands, giving rise to transient or permanent salivary gland damage. Salivary gland dysfunction following radioiodine therapy can be caused by radiation damage. But, it also may be associated with $Sj{\ddot{o}}gren$ syndrome (SS) developed after radioiodine therapy. It would be recommended that the evaluation for SS including anti-SSA/Ro and anti-SSB/La should be considered before and after radioiodine therapy.

Lack of CHEK2 Gene Mutations in Differentiated Thyroid Carcinoma Patients using High Resolution Melting Analysis

  • Fayaz, Shima;Fard-Esfahani, Pezhman;Torbati, Peyman Mohammadi
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.5019-5022
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    • 2014
  • Recently, mutations in the genes involved in cell cycle control, including CHEK2, are being considered as etiological factors in different kinds of cancers. The CHEK2 protein plays an important role in protecting damaged DNA from entering mitosis. In this study the potential effects of two common mutations $IVS2+1G{\rightarrow}A$ and Ile157Thr of CHEK2 gene in differentiated thyroid carcinoma (DTC) were evaluated. A total of 100 patients admitted to the Research Institute for Nuclear Medicine were diagnosed with DTC based on pathology reports of surgery samples. An additional 100 people were selected as a control group with no cancer history. PCR-HRM (high resolution melting) analysis was performed to deal with each of mutations in all case and control samples separately. During the analysis of $IVS2+1G{\rightarrow}A$ and Ile157Thr mutations of CHEK2 gene in the case and control groups, all the samples were identified as wild homozygote type. The finding suggests that $IVS2+1G{\rightarrow}A$ and Ile157Thr mutations of CHEK2 gene do not constitute a risk factor for DTC in the Iranian population. However, further studies with larger population are required to confirm the outcome.

유즙분비가 있는 갑상선암 환자에서 I-131 치료 (Radioiodine Therapy in a Patient with Papillary Thyroid Carcinoma associated with Breast Uptake; Hyperprolactinemia due to Empty Sella Syndrome)

  • 배문선;박찬희;서정호;김경래
    • 대한핵의학회지
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    • 제32권1호
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    • pp.109-113
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    • 1998
  • 진단적 I-131 스캔에서 유방의 섭취는 주로 수유 여성에서 보인다고 알려져 있으나 수유 여부와는 관련 없이 나타나는 경우도 보고되어 있다. 갑상선 암으로 갑상선 절제술 후 I-131 치료를 위해 시행한 진단적 스캔에서 유방의 섭취를 보인 환자에서 고프로락틴 혈증에 의한 유류증의 발견 및 이를 근거로한 뇌 단층 촬영상 Empty sella가 진단되어 이를 bromocriptine으로 치료한 후, 유방 섭취의 소실이 확인 되어 I-131 치료를 시행한 경우가 있어 이를 보고하고자 한다.

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Spindle cell carcinoma of the tongue combined with double primary cancer of the thyroid gland: a case report

  • Kim, Tae-Hwan;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제42권4호
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    • pp.221-226
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    • 2016
  • Spindle cell carcinoma (SpCC) is referred to as a variant of oral squamous cell carcinoma. It is also known as "sarcomatoid squamous cell carcinoma" because it consists of normal squamous carcinoma cells with spindle-shaped cells that appear similar to a sarcoma. The term, "second primary tumor" (SPT) or "double primary tumor", is proposed for a second tumor that develops independently from the first. SPTs can present as either synchronous or metachronous lesions. Synchronous SPTs are defined as tumors occurring simultaneously or within 6 months after the first tumor. The patient in this case, whose primary tumor was in the tongue, was diagnosed with SpCC with metastases to both neck lymph nodes. This case also exhibited a second primary cancer as a synchronous lesion in the thyroid gland, which is uncommon. All carcinomas, both in the tongue and thyroid gland, were removed surgically, and especially in the tongue, an anterolateral thigh free flap was performed successfully to replace the defect.

Cancer Mortality and Incidence in Korean Semiconductor Workers

  • Lee, Hye-Eun;Kim, Eun-A;Park, Jung-Sun;Kang, Seong-Kyu
    • Safety and Health at Work
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    • 제2권2호
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    • pp.135-147
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    • 2011
  • Objectives: The purpose of this study was to evaluate cancer risks in the Korean semiconductor industry. Methods: A retrospective cohort study was performed in eight semiconductor factories between 1998 and 2008. The number of subjects was 113,443 for mortality and 108,443 for incidence. Standardized mortality ratios (SMR) and standardized incidence ratios (SIR) were calculated. Results: The SMR of leukemia was 0.39 (95% Confidence Interval 0.08-1.14) in males (2 cases) and 1.37 (0.55-2.81) in females (7 cases). The SMR of non-Hodgkin's lymphoma (NHL) was 1.33 (0.43-3.09, 5 cases) in males and 2.5 (0.68-6.40, 4 cases) in females. The SIR of leukemia was 0.69 (0.30-1.37, 8 cases) in males and 1.28 (0.61-2.36, 10 cases) in females. The SIR of NHL in females was 2.31 (1.23-3.95, 13 cases) and that of thyroid cancer in males was 2.11 (1.49-2.89, 38 cases). The excess incidence of NHL was significant in female assembly operators [SIR=3.15 (1.02-7.36, 5 cases)], but not significant in fabrication workers. The SIR of NHL in the group working for 1-5 years was higher than the SIR of NHL for those working for more than five years. The excess incidence of male thyroid cancer was observed in both office and manufacturing workers. Conclusion: There was no significant increase of leukemia in the Korean semiconductor industry. However, the incidence of NHL in females and thyroid cancer in males were significantly increased even though there was no definite association between work and those diseases in subgroup analysis according to work duration. This result should be interpreted cautiously, because the majority of the cohort was young and the number of cases was small.

갑상선암 및 난소암 병력을 가진 좌측 경부 종물을 주소로 내원한 환자 1례에 대한 증례 보고 (A Case Report of Patient with Left Neck Mass and a History of Thyroid and Ovarian Cancer in Head and Neck)

  • 정용준;오경호;권순영
    • 대한두경부종양학회지
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    • 제36권2호
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    • pp.73-77
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    • 2020
  • Ovarian cancer is common malignant disease with high mortality in the female. However, lymph node metastasis in the head and neck of ovarian cancer is very rare than in para-aortic, pelvic lymph node. A 49-year-old female patient came to our clinic with a left neck mass. After total thyroidectomy and left selective neck dissection for the cervical neck level II, III, IV, V, VI for ovarian cancer and thyroid cancer, she had already undergone chemotherapy (Paclitaxel+Carboplatin) 18 month ago. CT scan showed only lymph node enlargement in left neck level II. Positron emission tomography-computed tomography (PET-CT) revealed a hypermetabolic lesion in same area but no other hypermetabolic lesion, especially in the pelvic and abdominal cavity. Fine needle aspiration cytology revealed metastatic carcinoma. The serum level of CA-125 was elevated to 43.8U/mL, whereas other tumor markers (CA 19-9, CEA) were in the normal range. She underwent a revision of selective neck lymph node dissection for the cervical neck levels I, II, and III, and on the review of surgical pathology, metastatic carcinoma was suspected. Thus, we performed immunohistochemical staining for the tissue; as a result, it was finally diagnosed as metastatic ovarian cancer (positive for CK7, ER and PR, and negative for CK20). Adjuvant chemotherapy (Paclitaxel+Carboplatin) was planned on the tumor board, and the patient successfully received chemotherapy.

전립선암의 방사선 치료 시 주변 정상장기 피폭선량을 이용한 암발생확률 평가 (Evaluation of Cancer Incidence Rate using Exposure Dose to Surrounding Normal Organs during Radiation Therapy for Prostate Cancer)

  • 이주아
    • 한국방사선학회논문지
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    • 제16권3호
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    • pp.351-356
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    • 2022
  • 전립선암의 방사선치료 시 사용되는 세기조절방사선치료와 부피적회전방사선치료시 발생하는 광중성자선량을 측정하여, 암 발생률을 평가하며 기초자료를 제공하고자 하였다. Rando phantom에 중성자 측정용 광자극발광선량계를 복부와 갑상선에 위치시킨 상태에서 발생하는 광중성자선량을 측정하였다. 연구결과 세기조절방사선치료(7 portal)가 부피적회전방사선치료보다 복부와 갑상선 위치에서 모두 높게 측정되었다. ICRP 103의 명목위험계수를 이용하여 암 발생확률을 평가하였을 때, 세기조절방사선치료시 대장과 갑상선의 피폭으로 인한 암발생확률은 1,000명 당 9.9명 이었으며, 부피적회전방사선치료시는 1,000명 당 3.5명이었다. ALARA(As low as reasonably archievable)원칙에 의거하여 방사선치료계획 수립에 있어서 정상장기들의 피폭선량의 최소화를 위한 가이드라인이 되리라 사료된다.

유두상 갑상선암과 동반된 기능성 낭종성 부갑상선 선종 1예 (A Case of Functionary Cystic Parathyroid Adenoma with Papillary Thyroid Carcinoma)

  • 장우진;정현희;박상현;손세훈;윤지성;이형우;원규장;조인호
    • Journal of Yeungnam Medical Science
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    • 제27권2호
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    • pp.139-145
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    • 2010
  • Cystic parathyroid adenoma is one of rare causes of hyperparathyroidism, and tends to cause increased serum level of parathyroid hormone, alkaline phosphate and serum calcium level similar to when compared to those of solid adenoma. The possibility of a coincidental appearance of primary hyperparathyrodism and nonmedullary thyroid cancer is rare, and often neglected. A 40-year-old female presented with constipation and weight loss for 3 months. The serum calcium, phosphate and alkaline phosphate were 16.6 mg/dl, 2.2 mg/dl and 505 IU/L respectively and serum parathyroid hormone level was 1556.2 pg/mL. Neck US showed mixed nodules at both thyroid lobes, and PET-CT showed a right thyroid nodule without FDG uptake. The patient was diagnosed of primary hyperparathyroidism and underwent parathyroidectomy and a total thyroidectomy. Histopathologic results revealed parathyroid adenoma with cystic change (2 cm greater diameter) in the right lower parathyroid gland and coexistent papillary carcinoma of the right lobe of thyroid gland (infiltrating, 0.3 cm in greater diameter). She remained well and serum calcium, phosphate, parathyroid hormone level were normalized within 24 hours.

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