• Title/Summary/Keyword: Medullary thyroid carcinoma

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A novel RET mutation identified in a patient with pheochromocytoma and renal cell carcinoma

  • Kwon, Jae Wan;Jung, Eui Dal;Jeon, Eon Ju;Park, Jung Kyu;Lee, Joon Kee;Cho, Chang Ho
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.446-453
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    • 2018
  • Pheochromocytomas might be sporadic or genetic. Genetic pheochromocytoma is associated with multiple endocrine neoplasia (MEN) type 2A, MEN type 2B, and von Hippel-Lindau (VHL) disease. RET mutations are identified in more than 90% of index cases of MEN2 and familial medullary thyroid cancer and in about 4-12% of apparent sporadic cases. Here, we report a 54-year-old man presenting with pheochromocytoma and renal cell carcinoma, who was identified as having a novel missense RET mutation.

A Clinical Study of Surgically Treated 194 Cases of the Thyroid Cancer (외과적 절제술로 치험한 갑상선암 194예의 임상적 고찰)

  • Lee Suk-Jae;Kim Sung-Bae;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.50-55
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    • 2002
  • Objectives: Thyroid cancer is the most common endocrine malignancy with favorable histologic and prognostic characteristics. Total or near total thyroidectomy has been used as a standard surgical procedure. The aims of this study are to determine the extent of resection of thyroid gland and to find the influencing factors of lymph node metastasis. Materials and Methods: The authors reviewed the records of 194 patients of thyroid cancer surgically treated at Department of General Surgery, Inje University Busan Paik Hospital from January, 1996 to December, 2000. Pathologic classifications, surgical procedures, and lymph node metastasis were analyzed. Results: There were 163 women and 31 men. The age ranged from 12 to 79 years old (mean age 43.2 years). The histological classifications of 194 cases revealed papillary cancer in 171 cases (88.1%), follicular cancer in 17 cases (8.8%), undifferentiated cancer in 3 cases (1.6%), medullary cancer in 2 cases (1.0%) and mixed cancer in 1 case (0.5%). Among the 194 patients, lobectomy was perfomed in 31 patients, subtotal thyroidectomy in 30 patients, near total thyroidectomy in 82 patients and total thyroidectomy in 51 patients. In the subgroup of papillary carcinoma 141 cases with lymph node dissection, lymph node metastasis had no statistical significance according to sex, age and primary tumor size. Conclusions: The mainly performed surgical procedures were total thyroidectomy and near total thyroidectomy. In thyroid cancer surgery, the extent of resection was influenced by age, differentiation and primary tumor size. The lymph node dissection should be decided by lymph node metastasis identified by preoperative radiologic evaluation or intraoperative lymph node findings.

Expression of Sodium-Iodide Symporter (NIS) in Thyroid Nodules: Comparison of RT-PCR and Immunohistochemical Staining Methods (갑상선 결절에서 Sodium Iodide Symporter (NIS)의 발현: RT-PCR방법과 면역조직화학염색법의 비교)

  • Bae, Sang-Kyun;Lee, Kang-Dae;Chang, Hee-Kyung
    • 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.

Scintigraphic Evaluation of Multiple Endocrine Neoplasia Type 2 (MEN Type 2) (MEN Type 2 (Sipple's Syndrome)의 신티그램 소견)

  • Lee, Jae-Tae;Lee, Kyu-Bo;Whang, Kee-Suk;Kim, Bo-Wan;Lee, In-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.122-128
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    • 1991
  • Multiple endocrine neoplasia type 2 (MEN type 2, Sipple's syndrome) is a rare disorder characterized by the association of medullary carcinoma of the thyroid, parathyroid hyperplasia and can be diagonsed in early stage of the disease by meticulous screening tests of the family. This case report describes the location and categorization of tumors using $^{99m}Tc-pertechnetate,\;^{131}I-NaI,\;^{99m}Tc-pentavalent(V)$, DMSA $^{131}I-MIBG$ scans in two cases of MEN type 2 occurred in a 32-year old women and her 29-year old brother. In MEN type 2, we think, combined use of $^{99m}Tc-(V)-DMSA,\;^{99m}Tc-pertechnetate\;and\;^{131}I-MIBG$ may be useful for the categorization of tumor mass lesions and planning appropriate therapy.

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Clinical Usefulness of I-123 MIBG Scintigraphy with Early Planar and SPECT Image in The Diagnosis of Neuroendocrine Tumors (신경내분비종양 진단에 있어서 I-123 MIBG 조기 평면 영상과 SPECT 영상의 임상적 유용성)

  • Shin, Jung-Woo;Ryu, Jin-Sook;Won, Kyoung-Sook;Choi, Yun-Young;Kim, Hee-Jung;Yang, Seoung-Oh;Lee, Hee-Kyung;Suh, Yong-Sup
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.516-523
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    • 1996
  • The purpose of this study was to evaluate the clinical usefulness of I-123 MIBG scintigraphy with early planar and SPECT image in the diagnosis of neuroendocrine tumors. We reviewed I-123 MIBG scintigraphies of 21 patients who had been suspected to have neuroendocrine tumors by CT or MRI findings. Early 4 hour planar and SPECT images were obtained in all patients and delayed (13-24 hour) planar images were performed in 17 patients. Final diagnoses were made by surgery, biopsy, or clinical follow up. Twelve patients were confirmed to have neuroendocrine tumors. With 4 hour planar and SPECT images, there were 9 true positives(6 pheochromocytomas, 1 paraganglioma, 1 neuroblastoma, and 1 medullary cancer of the thyroid), 8 true negatives(1 adrenal cortical adenoma, 1 malignant fibrous histiocytoma, 1 adenoma in colon and 5 benign nonfunctioning adrenal tumors), 1 false positive(hepatocellular carcinoma) and 3 false negatives(1 recurred medullary cancer of the thyroid, 1 liver metastasis of carcinoid tumor and 1 ganglioneuroma). The sensitivity and specificity of I-123 MIBG scintigraphy were 75% and 89%, respectively. SPECT images provided good anatomical correlation with CT or MRI. Delayed images showed increased tumor to background ratio in 5 out of 8 true positive patients, but did not change the diagnosis. In conclusion, early 4 hour images with I-123 MIBG is clinically convenient and useful method in the detection of neuroendocrine tumors, and SPECT images can provide good anatomical correlation with CT or MRI.

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A Clinical Study on Nodular Thyroid Disease (결절성 갑상선 질환에 대한 임상적 고찰)

  • Lee Gyu-Joon;Park Soon-Tae;Ha Woo-Song;Kwon Soo-In;Choi Sang-Kyeon;Hong Soon-Chan;Lee Young-Joon;Lee Young-Jae
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.244-252
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    • 1998
  • The thyroid nodules are the most common endocrine disease requiring surgical management. We perfomed a clinical study of 298 cases with thyroid nodules, who were admitted to and operated at the Department of Surgery, College of Medicine, Gyeong sang National University from January 1987 to April 1997 and the results were summarized as follows: 1) Patients were composed of 214 cases(71.8%) of benign nodule and 84 cases(28.2%) of malignant nodule. Benign and malignant nodules were prevalent in fifth decade. 2) The sex distribution showed a preponderance of females with ratio of 5.88:1 in benign nodule and 11:1 in malignant nodule. 3) The nodules were located in the right lobe(134 cases, 44.9%), the left lobe(121 cases, 40.6%), both lobes(34 cases, 11.4%), and isthmus(8 cases, 2.7%). The possibility of malignancy was higher in the solid rather than cystic lesions. 4) Radioactive iodine scintiscans were perfomed in 273 cases and revealed cold nodules in 237 cases(86.8%), 58 of these cases(24.4%) were malignant. 5) According to the histopathologic classification, benign nodules included follicular adenomas 136 cases(63.5%), adenomatous goiters 67 cases(31.3%), Hurthle cell adenomas 4 cases(1.9%), cysts 3 cases(1.4%) and thyroiditis 4 cases(1.4%). In malignant nodules, papillary carcinomas 72 cases(85.7%), follicular carcinoma 8 cases(9.5%), undifferentiated carcinoma 2 cases(2.4%), medullary carcinoma 1 case(1.2%) and malignant lymphoma 1 case(1.2%). 6) The most commonly performed operative procedure was a lobectomy with isthmusectomy(85.5%) for bengn nodules and a total thyroidectomy(51.2%) for malignant nodules. 7) The rate of complications was higher in the cases with malignant nodules(20.2%) than in the benign cases(0.5%). The recurrence rate was 8.3%(7 cases).

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The Clinical Role of $^{99m}Tc$-(V)-DMSA Imaging in Patients with Head and Neck Cancer (두경부 종양에서 $^{99m}Tc$-(V)-DMSA 영상술의 진단적 유용성)

  • Bae, Sun-Kun;Lee, Jae-Tae;Park, June-Sik;Park, In-Kyu;Hyun, Dong-Woo;Lee, Young-Hak;Kim, Jeong-Gyun;Ahn, Byeong-Cheal;Choi, Ji-Yong;Sohn, Sang-Gyun;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.526-532
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    • 1995
  • Introduction : $^{99m}Tc$-(V)-DMSA is a tumor seeking agent that has been used to image medullary carcinoma of thyroid, soft tissue sarcoma and lung cancer. This study was designed to assess the clinical role of $^{99m}Tc$-(V)-DMSA in the diagnosis of head and neck cancers. We has evaluated the diagnostic efficacy of planar and SPECT imaging using $^{99m}Tc$-(V)-DMSA. Patients and Method : Sixty-eight patients with head and neck mass were included in this study. All subjects were diagnosed by biopsy or surgery. Planar and SPECT images were obtained at 2 or 3 hour after intravenous injection of 740 MBq(20 mCi) $^{99m}Tc$-(V)-DMSA. Seventeen patients also underwent SPECT in aging using dual head camera. Result : The diagnostic sensitivity of $^{99m}Tc$-(V)-DMSA planar and SPECT imaging was 65% and 90%, and specificity was 80% and 66%, respectively. The sensitivity of planar imaging in squamous cell carcinoma was similar to overall sensitivity Six metastatic lesion were first diagnosed by scintigraphy. But benign lesions such as Kikuchi syndrome, tuberculous lymphadenitis also revealed increased uptake. Conclusion : $^{99m}Tc$-(V)-DMSA imaging seems to be a promising method in the evaluation of patients with head and neck mass. We recommend SPECT imaging to delineate anatomic localization of the lesion.

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