• Title/Summary/Keyword: Papillary carcinoma of thyroid

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Patholgic Finding and Surgical Consideration in Micropapillary Carcinoma of the Thyroid (갑상선 미세유두암의 병리학적 소견 및 수술적 고려)

  • Lee, Hyun-Chul;Kim, Woon-Won;Oh, Sang-Hoon;Kim, Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.2
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    • pp.189-193
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    • 2008
  • Objectives:The incidence of micropapillary thyroid carcinoma(MPC) which is very good prognosis is increasing due to ultrasonography and accurate fine neede aspiration cytology. MPC defined papillary thyroid carcinoma below 1cm. According to the size, histophaothogic feature is different, lymph node metastasis and capsular invasion occur occasionally. So, we consider different treatment according to the size of MPC. Matrials and Methods:We reviewed and analyzed the record of 216 MPC patients operated at department of general surgery Busan Paik Hospital since 1995 January to 2005 Desember retrospectively. Result:The sex ratio was 1:9.29(male;21, female;195). Total thyroidectomy 20cases(9.3%), subtotal thyroidectomy 141cases(65%), lobectomy 52cases(24%), completion operation 3cases(1.4%) were done. Combined diseases were follicular carcinoma 4cases, follicular adenoma 11cases, thyroiditis 46cases, nodular hyperplasia 44cases. Lymph node metastasis 56cases and capsular invasion 56cases were presented. Group A(<5mm) was 53cases, group B(5-10mm) was 163cases. Group B showed higher lymph node metastasis and capsular invasion(P<0.05). Multiple carcinoma Showed higher capsular invasion than single carcinoma (P<0.05). Complications were post operative bleeding 1case, husky voice 1case, hypocalcemia 1case. Conclusion:We can consider more extensive operation in 5-10mm of MPC patients.

Two Cases of Incidentally Found Paratracheal Bronchogenic Cysts in Adult. (성인에서 우연히 발견된 경부 기관지원성 낭종 2예)

  • Hong, Soo-Won;Shim, Youn-Sang;Lee, Guk-Haeng;Mo, Jeong-A;Lee, Soo-Jung;Koh, Jae-Soo
    • Korean Journal of Bronchoesophagology
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    • v.14 no.1
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    • pp.54-58
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    • 2008
  • Bronchogenic cysts are rare congenital anomalies of the tracheobronchial tree. Most cases present within the mediastinum or pulmonary parenchyma without a patent connection to the tracheobronchial tree or digestive tract in the pediatric age group. Cervical bronchogenic cysts in adults are rare. In this report, we describe two cases of incidentally found paratracheal bronchogenic cysts that presented as asymptomatic neck masses in a 66-year-old female with papillary thyroid carcinoma and in a 59-year-old male of Catleman's disease.

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The Role of CT as a Preoperative Evaluation of Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma (갑상선 유두암의 외측 경부림프절 전이에 대한 수술 전 평가로서 CT의 역할)

  • Seok, Jungirl;Kim, Hyung Gu;Kim, Yoonjoong;Han, Kyu-Hee;Ahn, Soon-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.37-40
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    • 2013
  • Background and Objectives : To assess the usefulness of computed tomography image before papillary thyroid cancer surgery, focus on confirmation of lateral cervical lymph node metastasis not detected by ultrasonography. Material and Methods : From January 2008 to May 2009, total 150 patients who had undergone thyroid surgery and been confirmed papillary thyroid cancer pathologically were enrolled. They had taken neck computed tomography following the ultrasonography. Results : Computed tomography had found suspicious metastatic lateral neck lesion in 13 patients. After the image study, lateral neck lymph node dissection had been included in their surgical plan. Of these, only 7 cases were confirmed pathologically lateral neck lymph node metastasis(positive predictive value=0.54). Taken as whole 150 patients, additionally 4.7% of patients confirmed lateral neck lymph node metastasis by preoperative computed tomography. Conclusion : If preoperative ultrasonography was performed precisely, additional benefits that could be achieved by computed tomography were not much.

A Clinical Study on Surgical Thyroid Nodules (외과적 갑상선 결절에 대한 임상적 고찰)

  • Park Hyeon-Jung;Moon Sang-Eun
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.2
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    • pp.234-243
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    • 1993
  • The thyroid nodules are the most common endocrine disease requiring surgical management. Up to date, various diagnostic techniques and surgical management have been developed. Authors analysed 2285 cases of thyroid nodules who were treated at Department of Surgery, Pusan National University for the duration of 10 years from January 1980 to December 1989 and the results obtained were summerized as follows: 1) Patients were composed of 1727 cases(75.8%) of benign nodule and 558 cases(24.5%) of malignant nodule. Benign nodule was prevalent in forth and fifth decade comparing with malignant nodule was sixth and fifth decade. The sexual distribution revealed female preponderance with 1:10.8 in benign nodule and 1:9.3 in malignant nodule. 2) The histopathologic classfication of benign nodule in decreasing order of frequency were follicular adenoma 1009 cases(54.8%), adenomatous goiter 573 cases(33.3%), simple cyst 65 cases(3.8%), and Hashimoto's thyroiditis 52 cases(3.0%). The malignant disease were papillary adenocarcinoma 460 cases(82.4%), follicular adenocarcinoma 69 cases(12.4%), undifferentiated carcinoma 13 cases (2.0%), and medullary carcinoma 7 cases(1.0%). 3) Fine needle aspiration cytology was performed in 1758 cases and it showed 80.5% of sensitivity, 96.5% of specificity, 19.5% of false negative and 80% of accuracy. 4) The location of nodule was 87.7%, in unilateral, 12.2% in bilateral. 5) On the radioiodine scanning, the incidence of benign nodule with cold nodule was 83.9% and the incidence of benign nodule with hot nodule was 7.5%. The incidence of thyroid carcinoma with cold nodule was 88.3% and the incidence of thyroid carcinoma with hot nodule was 4.6%. 6) Most cases of benign nodules were treated with lobectomy 82.6%, subtotal thyroidectomy 10.1% and subtotal lobectomy 3.0%. Malignant nodules were treated with lobectomy and/or isthmusectomy 37.6%, total thyroidectomy 17.7%, subtotal thyroidectomy 15.4%, and any thyroidectomy and neck dissection 13.5%. 7) Postoperative complications were developed in 3.8% of benign nodules and 13.8% of malignant nodules.

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Fine Needle Aspiration Cytology of Parathyroid Neoplasms - A Review of Three Cases - (부갑상샘 종양의 세침흡인 세포소견 -3예 보고-)

  • Kim, Lucia;Han, Jee-Young;Park, In-Suh;Choi, Suk-Jin;Kim, Joon-Mee;Chu, Young-Chae
    • The Korean Journal of Cytopathology
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    • v.18 no.1
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    • pp.74-80
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    • 2007
  • Parathyroid tumors may be difficult to distinguish from thyroid follicular lesions, especially when a tumor is nonfunctioning. We report here two cases of asymptomatic parathyroid carcinoma preoperatively misdiagnosed as thyroid follicular lesions, and one case of parathyroid adenoma showing hyperparathyroidism, and review the cytologic features favoring the diagnosis of parathyroid neoplasm. The cytologic findings that are characterized by clean background, monomorphic small cells, cohesive three-dimensional papillary clusters, small tight clusters with scattered naked nuclei, and well-defined clear cytoplasm favor a diagnosis for the parathyroid lesions. Cytologic findings such as macrofollicular structure, presence of colloid and macrophages, and presence of perivacuolar cytoplasmic granules on May-Grunwald-Giemsa stain support a diagnosis of a thyroid follicular lesion. The cytomorphology of parathyroid tumors is so variable that the distinction from a thyroid lesion cannot be based on the presence or absence of a single feature only but on the cytologic features as a whole.

Surgical Treatment of Thyroid Carcinoma - A Relation between Prognostic Factors and Survival Rate - (갑상선암의 외과적 치료 - 예후인자와 생존율의 관계)

  • Kim Jae-Hong;Oh Sang-Hoon;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.187-199
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    • 1997
  • Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

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Relationship between the Expression of VEGF, HIF-1α, E-cadherin, p53 and Stage in Papillary Thyroid Carcinoma (유두상 갑상선암에서 VEGF, HIF-1α, E-cadherin, p53의 발현과 병기의 관련성 연구)

  • Kim, Jong-Sam;Na, Baeg-Ju;Lee, Moo-Sik;Kim, Chul-Woung;Jeong, Gye-Rim
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.3
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    • pp.1133-1138
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    • 2010
  • The purpose of our study was to evaluate the correlation between expression of VEGF, HIF-$1{\alpha}$, E-cadherin, and p53 and pathologic stage. We retrospectively reviewed the medical records of the 101 patients who underwent surgery of thyroid nodules from 2000 to 2007. Expression of VEGF, HIF-$1{\alpha}$, E-cadherin, and p53 were examinated immunohistochemically. Papillary thyroid carcinoma in this study included 54 cases of more than 45 years old. Each expression of VEGF, HIF-$1{\alpha}$, E-cadherin, and p53 was analysed. Only expression loss of E-cadherin was associated with the stage. High HIF-1 expression was significantly associated with VEGF immunoreactivity (p<0.05). Expression loss of E-cadherin was independent unfavorable factors. It is suggested that high HIF-$1{\alpha}$ expression may be associated with intratumoral neovascularization possibly through HIF-VEGF pathway.

Well Differentiated Thyroid Carcinoma with Insular Component (Insular Component가 공존한 고분화 갑상선암)

  • Chung Woong-Yoon;Shim Jeong-Yun;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.74-80
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    • 1997
  • We have experienced 5 cases of unusual well differentiated thyroid carcinoma with insular component during the past 5 years. 4 cases were presented with cervical masses but I case (patient 2.) was initiallty with lung and brain metastasis. The tumors from 4 cases showed invasive growths but that of 1 cases(patient 1.) showed intrathyroidal. Total thyroidectomy and cervical lymphnode dissection(CCND or RND) was performed in 4 cases but only RND was performed in spite of mediastinal metastasis of the tumor in patient 5 under the patient's choice. During the follow-up period, we also performed radical nephrectomy and metastatectomy for the kidney and iliac bone metastasis respectively, in patint 2. Microcsopically, the tumors showed the insular growth patterns, focally(less than 50%) in 3 cases and predominantly(more than 75%) in 2 cases. And the insular componentas were combined with papillary carcinoma in 2 cases and follicular carcinoma in 3 cases. Cervical lymphnode metastases were confirmed in 4 cases. Patient 2 died of disease with metastases to lung, brain, bone and kidney, 52 months after initial therapy. Patient 1, 3 and 4 are alive and have no recurrence and distant metastasis. Patient 5 is also alive with the mediastinal metastasis. In our experience, the well differentiated thyroid carcinomas with insular component showed characteristic histologic features, aggressive behavior in initial presentation and unfavorable prognosis regardless of the percentage of the insular component.

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