• Journal of Biomedical Engineering Research
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• v.22 no.3
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• pp.217-222
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• 2001

This paper proposes the new method based on fuzzy logic which recognizes between normal, and abnormal(two types of abnormal : follicular neoplastic, and papillary neoplastic) of thyroid gland cells from pre-obtained 16 feature parameters of image data. This paper applies the genetic algorithms to obtain the dominant feature parameters which have a great influence on discrimination between normal and abnormal cells. This paper shows the effectiveness of proposed method to 240 thyroid gland cells(60 normal cells, 120 follicular neoplastic cells and 60 papillary neoplastic cells) and new dominant feature parameters obtained by genetic algorithms. As a consequence of using the proposed method, average recognition rate of 88.75 % was obtained.

• The Korean Journal of Nuclear Medicine
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• v.36 no.1
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• pp.87-89
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• 2002

A 30 year-old female patient with papillary thyroid carcinoma received her fifth radioiodine ablation therapy after the subtotal thyroidectomy. The scan, which was peformed one week after the last therapy, revealed residual uptake in the thyroid bed and uptake in the anterior mediastinum suggesting metastasis. However, further evaluation of the thorax with chest CT and camera-based FDG PET confirmed normal thymus without metastatic focus. Occasionally thymus remains intact in adult and has avidity for I-131 and FDG. Therefore, normal thymus (instead of metastasis) should be considered in patients with well differentiated thyroid carcinoma and anterior mediastinal radioiodine uptake.

• Korean Journal of Radiology
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• v.25 no.6
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• pp.559-564
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• 2024

Incidental pancreatic cystic lesions are a common challenge encountered by diagnostic radiologists. Specifically, given the prevalence of benign pancreatic cystic lesions, determining when to recommend aggressive actions such as surgical resection or endoscopic ultrasound with sampling is difficult. In this article, we review the common types of cystic pancreatic lesions including serous cystadenoma, intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm with imaging examples of each. We also discuss high-risk or worrisome imaging features that warrant a referral to a surgeon or endoscopist and provid several examples of these features. These imaging features adhere to the latest guidelines from the International Consensus Guidelines, American Gastroenterological Association (2015), American College of Gastroenterology (2018), American College of Radiology (2010, 2017), and European Guidelines (2013, 2018). Our focused article addresses the imaging dilemma of managing incidental cystic pancreatic lesions, weighing the options between imaging follow-up and aggressive interventions.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.326-328
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• 2017

Background: Pancreatic cancer is a highly aggressive solid tumor. Patients with metastases from pancreatic cancer have poor survival rates. Here, we report the outcomes of 6 patients for whom resection of lung metastases was performed after a pancreatectomy to treat pancreatic cancer. Methods: We retrospectively reviewed the perioperative clinical data of patients with lung metastases resulting from primary pancreatic cancer who were treated with lung resection between 2008 and 2015. We report 6 cases where lung resection was performed to treat lung metastases after a pancreatectomy. Results: The number of lung metastases was 1 in 5 cases and 2 in 1 case. The surgical procedures performed to treat the lung metastases included 4 wedge resections and 2 lobectomies. The cell type of the primary tumor and metastases was tubular adenocarcinoma in 5 cases and intraductal papillary-mucinous carcinoma in 1 case. All 6 patients survived with a mean follow-up period of 65.6 months, although the disease recurred in 2 patients. Conclusion: Resection of lung metastases resulting from primary pancreatic cancer may lengthen survival, provided the patient can tolerate surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5153-5155
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• 2013

Background: Because of the gender disparity in the incidence of thyroid cancer, this study aimed to determine the association between reproductive factors and thyroid cancer. Methods: A total of 10,767 eligible women from the Khon Kaen Cohort, recruited and interviewed between 1990 and 2001, were followed up until 2011. The data were linked to the Khon Kaen Population-Based Cancer Registry to detect thyroid cancer cases. Results: There was 17 thyroid cancer cases detected, an incidence of 11.2 per 100,000 person-years, of which 70.6 % were papillary tumors. The incidence was apparently greater among those with an early age of menarche, nulligravida women, and oral contraceptive users. Conlusions: There was a trend for thyroid cancer to develop in relation to longer estrogen exposure. This evidence is inconclusive but warrants further investigation.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.103-108
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• 2014

Thyroglossal duct cyst (TGDC) carcinoma generally shows a favorable prognosis. If metastasis is present latently, it may not threaten the patient's life immediately. It has been shown, however, that larger than 1 cm papillary carcinoma (PC), level VI metastasis to the lymph node (LN), which is the nearest to the thyroid, independently predicts a worse prognosis. In the case presented herein, a 61-year-old female patient was diagnosed with an about 3 cm PC in the TGDC, particularly the columnar variant subtype, one of the aggressive variants. She had occult papillary thyroid microcarcinoma, but no LN metastasis. Even though she underwent the Sistrunk procedure and total thyroidectomy with central compartment neck dissection followed by high-dose radioactive iodine remnant ablation, however, the cancer cells spread to level IV neck LN, and finally to the lung. Therefore, when a patient is diagnosed with an aggressive histologic variant of PC in the TGDC, even without LN metastasis, the invasive surgical approach and close postoperative surveillance are necessary, with consideration of the risk of disease progression. Therefore, if it is possible to stratify the risk for patients, higher-risk patients can be offered a more invasive therapeutic approach.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2447-2451
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• 2015

Background: Human papillary thyroid carcinoma (PTC) is often associated with Hashimoto's thyroiditis (HT); their coexistence improves PTC prognosis. Osteopontin, a secreted glycoprotein, plays a role in cell survival, immunity, and tumor progression, its expression being associated with a poor prognosis and metastasis in several malignancies. Osteopontin overexpression correlates with aggressive clinicopathological features in PTC. Lymph node metastases and large tumor size positively correlate with osteopontin positivity. This study aimed to: (1) confirm osteopontin overexpression in human PTC samples; (2) compare osteopontin expression levels in PTC cases with and without HT; and (3) identify correlations between tumor aggressiveness and osteopontin expression levels. Materials and Methods: Plasma osteopontin was assessed in 45 patients with PTC, 22 patients with PTC and HT, and 24 healthy controls by enzyme-linked immunosorbent assay. Thyroid tissue osteopontin mRNA and protein levels were analyzed by reverse transcription-polymerase chain reaction and Western blotting, respectively. Results: Plasma osteopontin levels were significantly higher in PTC patients than in healthy controls. Plasma osteopontin, tissue osteopontin mRNA, and tissue osteopontin protein levels were significantly lower in patients with PTC and HT than in those with PTC alone. In advanced disease stage cases, osteopontin mRNA and protein expression levels were lower in patients with PTC and HT than in those with PTC alone. However, the osteopontin expression level was not significantly associated with the TNM stage. Conclusions: Plasma osteopontin, tissue osteopontin mRNA, and tissue osteopontin protein levels were significantly lower in patients with PTC and HT than in those with PTC alone, suggesting that HT attenuates PTC aggressiveness through negative regulation of osteopontin expression.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.260-264
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• 1997

Metastatic cancer presenting as a cervical cyst is uncommon, and often misdiagnosed as branchial cleft cyst. Authors experienced two cases which presented clinically with features of branchial cleft cyst, but were subsequently found to be metastatic cancer. Radiologic examination and fine needle aspiration biopsy proved to be non-diagnostic, and pathologic findings after surgical excision showed metastatic cancer. Further evaluation and examination were made to find out the primary focus, which revealed tonsillar squamous cell cancer and thyroid papillary cancer in each case. When cervical cysts are noted in aged patients, it is mandatory to rule out metastatic cancer until it is proven otherwise. Surgical excision and pathologic diagnosis should be always accompanied to make correct diagnosis and further treatment.

• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.138-142
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• 2015

L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the $7^{th}$ RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.241-246
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• 1997

It has become evident in recent years that parathyroid adenoma and well differentiated thyroid cancer occur together more than would be expected by chance alone. However, the association between them is not well understood. We have experienced 4 cases of coexistent parathyroid adenoma and well-differentiated thyroid cancer during the past 16 years. None of them had a familial incidence or a history of radiation exposure. Three cases showed symptomatic hypercalcemia(including renal stones, bone pain, joint pain) and in two of them(patient 1 and patient 2), thyroid abnormalities were detected preoperatively by neck ultrasonography or neck CT for evaluation of parathyroid lesions. However, in patient 3, a parathyoid humor was identified and removed incidentally during the course of thyroidectomy. In 3 cases, surgeries for thyroid carcinoma and parathyroid adenoma were performed during the same exploration of the neck, but in patient 4, thyroidectomy preceded parathyroidectomy; The interval between thyroidectomy and subsequent parathyroidectomy was 11 yeras. The thyroid tumors in 3 cases were papillary carcinoma, the sizes of which ranged from 1.0 cm to 1.5 cm in greatest diameter. The remaining case(patient 4) was minimal invasive follicular carcinoma. Total or near-total thyroidectomy with various types of cervical lymphnode dissection and bilateral neck exploration for the parathyroid lesion was performed in 3 cases with papillary carcinoma. Ipsilateral lobectomy and contralateral partial thyroidectomy with consequent unilateral neck exploration for the parathyroid tumor was performed in the case of follicular cancer. In our experience, parathyroid adenoma and well-differentiated thyroid carcinomas can be coexistent and we felt that the attention to the hypercalcemic patients would be needed for detection of this rare condition.