• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.287-292
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• 1997

We report 22 cases of well -differentiated thyroid carcinoma infiltrating the upper airway tract. This retrospective study was undertaken to evaluate the prognosis md to determine optimal therapy for thyroid carcinoma adhering to or invading the trachea or larynx from 1984.3 to 1996.12. The treatment was individualized depending on the extent of the cancer. There were 12 cases dissected free by an laryngotracheal shaving, 7 cases removed by an tracheal resection with end to end anastomosis, 3 cases removed by an total laryngectomy. In all of these cases, we performed a total thyroidectomy with an accompanying neck dissection. There were no major complications during the operation. Over the 5-years observation period, 11 patients are alive without a sign of recurrence, 4 Patients are alive with recurrence, 7 died of thyroid carcinoma; 2 of 12 in an laryngotracheal shaving cases, 2 of 7 in an tracheal resection with end to end anastomosis case, 3 of 3 in an total laryngectomy case. The result showed an radical operation for thyroid carcinoma invading the laryngotrachea improves the survival rate, but limits improving the cure rate, and the invasion of the thrchea or larynx must be treated whenever possible by an total resection followed by radioiodine and external beam radiation.

• 대한두경부종양학회:학술대회논문집
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• 2008.11a
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• pp.268-268
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• 2008

• Endocrinology and Metabolism
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• v.33 no.4
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• pp.459-465
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• 2018

Background: Differentiated thyroid carcinoma (DTC) shows a very good prognosis, but older patients have a higher recurrence rate and those show poor prognosis than younger patients. The aim of this study was to determine the clinical outcomes of thyroid cancer patients who experienced recurrence in old age according to the treatment strategy used. Methods: This retrospective observational cohort study was conducted at Asan Medical Center, Seoul, Korea. Among DTC patients with no evidence of disease after initial treatment, we enrolled 86 patients who experienced recurrence at an age >65 years from 1994 to 2012. Sixty-nine patients had local recurrence and 17 patients showed distant metastasis. Results: The mean age of patients at recurrence was 72 years. Patients were followed up for a median of 4.1 years after recurrence. Sixty-three of the 69 patients with local recurrence received additional treatment, while the other six received conservative care. The cancer-specific mortality rate was 15.5% in the local recurrence group. Airway problems were the main cause of death in patients who did not receive further treatment for local recurrence. Among the 17 patients with distant metastasis, 10 underwent specific treatment for metastasis and seven received only supportive management. Seven of those 17 patients died, and the cancer-specific mortality rate was 35% in the distant metastasis group. Conclusion: The overall cancer-specific mortality rate was 20% in DTC patients in whom recurrence was first detected at an age >65 years. Mortality due to uncontrolled local disease occurred frequently in patients who did not receive definitive management for recurrence.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.64-68
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• 2000

Objectives: With the recent advances and increasing use of imaging techniques in examination of the neck, the incidence of incidentally discovered thyroid carcinoma has been increasing. This study was carried out to evaluate the clinicopathologic characteristics of incidental thyroid carcinomas and to find optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1988 to Aug. 1998, 1,053 patients were operated on for thyroid cancer, of whom 127(12.1%) had incidentally discovered thyroid cancers which were identified during routine health checkups(n=40), diagnostic procedures for unrelated medical conditions(n=39) and mass screening for thyroid cancer(n=48). The preoperative diagnosis was obtained by ultrasound-guided FNAB and the extent of surgery was determined based on frozen section examinations, as well as prognostic factors and gross findings at the time of surgery. Results: There were 6 men and 121 women with a mean age of 45.9 years. Histopathological diagnosis included papillary carcinomas(n=1l9), follicular carcinomas(n=6), poorly differentiated carcinoma(n=l) and medullary carcinoma(n=1). Thirty patients(23.6%) had multifocallesions. The mean diameter of the tumors was 1.1 cm(0.2-3.4 cm). Capsular invasions were found in 53 patients(41.7%) and nodal metastases in 41(32.3%). The surgical procedures used were: 90 less-than total thyroidectomies and 37 total thyroidectomies with central neck node dissection. Lateral neck dissection was added in 5 patients. According to TNM staging, 79 patients(63.2%) were at stage I, 15(12.0%) at stage II, 31(24.8%) at stage III and 0(0.0%) at stage IV. By AMES scoring system, 102 patients(81.6%) were in the low-risk group and 23(18.4%) in the high-risk group. And by MACIS scoring system, 103(86.6%) of 119 papillary thyroid cancer patients were less than 6. Conclusions: The clinicopathological characteristics of incidentally discovered thyroid carcinomas are similar to ordinary thyroid carcinomas. The treatment of choice should be individualized based on the particular clinical situation encountered, as in ordinary thyroid carcinomas.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.178-182
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• 2005

Insular carcinoma(poorly differentiated thyroid cancer) is defined as a aggressive, follicular-derived thyroid carcinoma with behavior intermediate between follicular/papillary and anaplastic carcinomas. It was described by Carcangiu in 1984, but its prognosis, classification and the origin is not yet clear. And preoperative fine needle aspiration cytology of insular carcinoma has not been satisfactory. We experienced a case of advanced thyroid insular carcinoma with invasion of the sternum. So we intend to present the case with a review of the related literatures.

• Korean Journal of Head & Neck Oncology
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• v.40 no.1
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• pp.7-13
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• 2024

The current standard of treatment for differentiated thyroid cancer is surgical resection followed by radioactive iodine therapy according to the recurrence risk. However, external beam radiotherapy may be recommended in limited cases where surgical resection is impossible or residual gross lesion remains or the aforementioned standard therapy is deemed insufficient in achieving local control. We report a case of 59 year old patient who presented with advanced papillary thyroid carcinoma of right neck but was unable to receive surgical resection due to underlying Eisenmenger syndrome. He received radiation therapy of 67.5 Gy in 30 fractions with palliative aim with no further treatment and has been maintaining long-term stable disease state for 38 months. Herein, we report a rare case of palliative aim radiation therapy alone for advanced papillary thyroid carcinoma with literature review.

• Nutrition Research and Practice
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• v.10 no.2
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• pp.167-174
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• 2016

BACKGROUND/OBJECTIVES: Despite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake. SUBJECTS/METHODS: A total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before $^{131}I$ administration. RESULTS: The median iodine intake was $290{\mu}g/day$ on the usual diet and $63.2{\mu}g/day$ on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake. CONCLUSION: Iodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.2
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• pp.102-107
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• 2015

Purpose Serum Thyroglobulin measurement is a major tool for the follow-up of differentiated thyroid cancer (DTC) patients. Thyroglobulin is Normal thyroid tissue, or thyroid cancer tissue produced only. Thyroid hormone to a halt without Tg differentiation of thyroid cancer recurrence just by measuring how to decide whether there was increasing expectations if I can do it instead. Therefore, in excellent sensitivity Tg new inspection of the functional sensitivity by measuring the looked to evaluate the usefulness of reagents. Thyroidectomy is measuring the numbers Tg (total thyroidectomy) remaining thyroid ablation and radioactive iodine (radioactive iodine remnant ablation, RRA) DTC in patients being diagnosed with or help predict the remaining early detection of thyroid cancer recurrence. Materials and Methods Agent that I'm currently using Tg of the measurements of low clinical specimen for a second drainage of the three (0.08 0.17, 0.98, ng/mL) within the scope of the dilute magnification (2, 4, 8, 16, 32 times) by dilute Intraassy (n=10) and Interassay (n=10) out in no time. Concentration value according to the coefficient of variation and the mean and standard deviation of each measurement (Coefficient of variation, CV) the absolute value of the measured values that corresponds to 20 percent target a coefficient of variation of CV Find the value of the concentration of the functional sensitivity measurement did. Also, analytical sensitivity with recovery rates, Dilution test inspections, and interrelationship, compared. Results Sensitivity is an excellent analytical sensitivity within the prosecutor kit Tg 0.006 ng/mL, and core analytical sensitivity, conducted by the 0.006 ng/mL to same conclusion. Be rather high to 142 percent recovery rate was 60 to measurement and functional sensitivity, 0.01766 ng/mL(Intraassay n=10) was measured at. CBC is relatively good correlation as ($R^2=0.949$) the correlation. Conclusion Recently ultrasensitive thyroglobulin this clinically important indicators of the previous kit and demands are lower than sensitivity to the measurement results. Therefore, ultrasensitive thyroglobulin test is correlated that there would be useful in value in nuclear medicine the thyroid gland.

• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.339-345
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• 1997

To evaluate the effectiveness of I-131 in ablation of residual thyroid tissue, we analyzed 350 patients with thyroid cancer who were treated with various doses of I-131 after surgery for thyroid cancer Two hundred fifty five patients were treated with 1.1GBq(30mCi) of I-131 for ablation of remnant thyroid and one hundred seventeen patients received more than 2.8GBq(75mCi) of I-131. We determined the effectiveness of ablation by following I-131 whole body scan. Absent visible uptake or minimal uptake in thyroid tissue were considered as successful ablation. Of 255 patients who received doses of 30mCi I-131 therapy, 131 patients(51%) showed successful ablation of residual thyroid tissue with $2.6{\pm}1.7$ times of I-131 therapy. Of 117 patients who received doses of the more than 75mCi I-131, 84 patients(72%) had successful remnant thyroid ablation with $1.6{\pm}1.1$ times of I-131 therapy, According to the extent of surgery, successful ablation rates were 78%, 62%, 54%, 33% in patients who underwent total thyroidectomy, subtotal thyroidectomy, lobectomy and isthmectomy, lobectomy or tumorectomy, respectively. This study showed that ablation of remnant thyroid after surgery with 30mCi I-131 was successful only in 50%. Therefore, in cases of patients with high risk for recurrence, we recommend high dose I-131 for ablation of remnant after total thyroidectomy.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.35-39
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• 2011

Objectives The high sensitivity of ultrasound and thyroglobulin determination for follow-up of differentiated thyroid cancer allows early detection of nonpalpable recurrences. Intraoperative localization of these small foci in previously dissected necks is a surgical challenge. We assessed the safety and effectiveness of ultrasound-guided tattooing (US-tattoo) with a charcoal suspension for localizing nonpalpable cervical recurrences after thyroidectomy for thyroid cancer. Subjects and Methods Between March 2009 and December 2010, we retrospectively reviewed 19 patients who underwent US-tattoo with injection of a charcoal suspension for recurrent thyroid papillary cancer on central neck compartment after thyroidectomy. All patients underwent the surgical dissection after US-tattoo. The complications and effectiveness of US-tattoo were evaluated. Results The technical success rate of US-tattoo for suspicious lesions was 100%. There was no complication with regard to US-tattoo. During surgery, all but one tattooed lesions were detected by surgeons. On final pathologic reports, all recurrence lesions but two cases were successfully removed. Conclusion Preoperative US-tattoo is a safe and effective method for successful reoperation of central neck compartment recurrences after thyroidectomy.