• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.16-20
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• 2015

Background and Objectives : In papillary thyroid carcinoma (PTC), multiplicity and central or lateral lymph node metastases significantly affect the recurrence. This study was carried out to evaluate the clinical and histological characteristics of PTC according to the tumor size. Materials and Method : Between January 1, 2009 and December 31, 2014, 12,269 PTC patients underwent thyroid surgery at the Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea. We analyzed pathologic findings and clinical features according to the size of tumor Results : The mean size of tumor was $0.89{\pm}0.70cm$. The Central and lateral compartment metastases were observed 64.7% and 37.6% on the range that the primary tumor size is 1cm. There was a significant association between the PTC primary tumor size and multiplicity and cervical neck metastasis (p<0.001). Conclusion : The PTC primary tumor size for prediction of multiplicity and neck node metastasis can be helpful in optimization of the surgical extent for each patient.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.3
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• pp.103-113
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• 2013

Objectives: Thyroid cancer is the most common cancer for female in Korea. This study aims to report the effects of Korean medicine on complications after total thyroidectomy and neck dissection in the papillary thyroid carcinoma. Methods: The 3 patients with papillary thyroid carcinoma were treated by Korean medicine such as acupuncture, moxibustion and pharmacopuncture therapy. We evaluated the results of treatments by change of symptoms. Results: After treatments such as acupuncture, moxibustion and pharmacopuncture therapy except herb medicine, the symptoms of complications after total thyroidectomy and neck dissection were improved. Conclusions: This study shows that Korean medicine has effects on complications after total thyroidectomy and neck dissection in the papillary thyroid carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2341-2344
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• 2014

Background: p53 protein expression has been detected immunohistochemically in papillary thyroid carcinoma(PTC). We investigated the relations between its expression and clinicopathologic features and its significance as a diagnostic marker. Materials and Methods: We compared and evaluated 93 patients in whom thyroidectomy with lymph node dissection had been performed to treat PTC for clinicopathologic significance and 102 patients with 23 papillary thyroid overt carcinomas (POC), 57 papillary thyroid microcarcinomas(PMC), 5 follicular adenomas (FA), 5 Hashimoto's thyroiditis (HT) and 12 nodular hyperplasias (NH) for significance as a diagnostic marker. Expression of p53 protein was evaluated immunohistochemically in sections of paraffinembedded tissue. Results: Statistical analysis showed significantly different expression of p53 in PTC versus other benign thyroid lesions (BTL).The diagnostic sensitivity and specificity were 85.0% and 72.7%, respectively. Overexpression of p53 protein was observed in 44 of the 93 PTC cases (47.3%), but no significant correlation between p53 protein overexpression and clinicopathologic features (age, size, multiplicity, lymph node metastasis, extrathyroidal extension and vascular invasion) was noted. Conclusions: p53 is valuable to distinguish PTC from other BTL, but there is no correlation between p53 protein overexpression and clinicopathologic features.

• The Korean Journal of Cytopathology
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• v.17 no.2
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• pp.116-119
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• 2006

The diagnosis of papillary thyroid cancer is generally based on the findings of intranuclear cytoplasmic inclusions and nuclear grooves. Although anisokaryosis and poikilokaryosis, in papillary thyroid cancer, are not distinct when compared to other cancers, cytological examination can provide useful preoperative information. Our study evaluated the diagnostic role of computer-assisted image analysis for the pre-surgical assessment of papillary thyroid carcinoma. Thyroid aspirates from twenty female patients who were histologically confirmed to have both papillary carcinoma and benign nodules were studied. Different populations of 50 benign cells and 50 malignant cells were analyzed. Five morphometric parameters were selected for analysis: nuclear area, perimeter, maximum length, maximum width and intensity standard variation. The values obtained for papillary carcinomas were higher than the surrounding benign nodules as follows: nuclear area 63.5 vs. 36.1 (p=0.000), nuclear perimeter were 29.4 vs. 22.0 (p=0.000), maximum length 9.6 vs. 7.1 (p=0.000), maximum width 8.2 vs. 6.3 (p=0.000), the ratio between maximal length and maximal width 1.16 vs. 1.13 (p=0.000), the standard variation of intensity 14.9 vs. 15.9 (p=0.101) respectively. Therefore, morphometric information can be helpful for the differential cytological diagnosis of papillary thyroid carcinoma.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.746-759
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• 2021

Objectives: This study assessed the effect of a combination of Korean medicine and immunotherapy on three papillary thyroid cancer patients following thyroidectomy. Methods: The three patients who underwent thyroidectomy received Korean medical treatments, including acupuncture, moxibustion, pharmacopuncture, and immunotherapy. To evaluate the patients, symptoms were measured using the Numerical Rating Scale (NRS) and Karnofsky Performance Status Scale (KPS). Blood tests, including thyroid function tests, were conducted during treatment. Results: After treatment, postoperative pain and general weakness were gradually alleviated. Conclusions: These cases provide evidence that treatment with a combination of Korean medicine and immunotherapy can have substantial benefits for postoperative complications following thyroidectomy.

• International journal of thyroidology
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• v.10 no.2
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• pp.127-132
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• 2017

Anaplastic transformation of differentiated thyroid cancer at distant metastatic sites is extremely rare and has a poor prognosis. It usually occurs in the thyroid gland or cervical lymph nodes. Here we report a case of anaplastic transformation arising at multiple distant metastatic sites including the lung, liver, adrenal gland, bone, and lymph nodes in a patient 3 years after total thyroidectomy for follicular thyroid cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2369-2374
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• 2016

Background: Differentiated thyroid cancer (DTC) is a cancer group that shares molecular and cellular origin but shows different clinical courses and prognoses. Several prognostic factors have been reported for predicting recurrence for individual patients. This literature review aimed to evaluate prognostic scores for predicting recurrence of DTC. Materials and Methods: A search of the MEDLINE database for articles published until December 2015 was carried out using the terms "thyroid neoplasms AND (recurrent OR persistent) AND (score OR model OR nomogram)". Studies were eligible for review if they indicated the development of prognostic scoring models, derived from a group of independent prognostic factors, in predicting disease recurrence in DTC patients. Results: Of the 308 articles obtained, five were eligible for evaluation. Two scoring models were developed for DTC including both papillary and follicular carcinoma, one for papillary carcinoma, and the other two for papillary microcarcinoma. The number of patients included in the score development cohort ranged from 59 to 1,669. The number of evaluated potential prognostic factors ranged from 4 to 25. Tumor-related factors were the most common factors included in the final scores, with cervical lymph node metastases being the most common. Only two studies showed internal validation of the derived score. Conclusions: There is a paucity of prognostic scores for predicting disease recurrence in patients with DTC, in particular for follicular thyroid carcinoma. Several limitations of the created scores were found. Performance of the scores has not been adequately studied. Comprehensive validation in multiple cohorts is recommended before widespread use.

• The Journal of Internal Korean Medicine
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• v.29 no.3
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• pp.827-834
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• 2008

Papillary thyroid carcinoma is the most common type of thyroid malignancy. It has better prognosis and rarer incidence of distant metastasis than other types of thyroid malignancy. However, once distant metastasis happens, its result will be bad. They mostly spread to the lungs and bones. and rarely to the brain. We report a patient with a papillary thyroid carcinoma metastasis to the lymph nodes. the ribs. the brain, and the lungs. The patient underwent total thyroidectomy, radioiodine ablation, rib partial resection, and lung wedge resection. However, upon progress of metastasis. the patient insisted on being treated with traditional Korean medical treatment using allergen-removed Rhus Verniciflua Stokes (A-RVS) instead of the conventional treatment including chemotherapy. The size of the tumor partly decreased, and the patient showed no side effects. This case report brings forth the importance of a thorough study in papillary thyroid carcinomas and their metastasis from the traditional Korean medical point of view, along with the long-term effect of allergen-removed Rhus Verniciflua Stokes (A-RVS).

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3307-3312
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• 2015

The papillary patterned lesion of thyroid may be challenging with many diagnostic pitfalls. Tumor stroma plays an important part in the determination of the tumor phenotype. CD34 is thought to be involved in the modulation of cell adhesion and signal transduction as CD34(+) fibrocytes are potent antigen-presenting cells. Smooth muscle actin (SMA) positivity could be diagnostic for fibroblast activation during tumorigenesis. We aimed to examine the expression of CD34 and alphaSMA in the stroma of papillary thyroid hyperplasia, papillary thyroid carcinoma and papillary tumors of uncertain malignant potential in order to elucidate their possible differential distribution and roles. A total number of 54 cases with papillary thyroid lesions were studied by routine H&E staining, CD34 and ASMA immunostaining. ASMA was not expressed in benign papillary hyperplastic lesions while it was expressed in papillary carcinoma, indicating that tumors have modulated stroma. Although the stroma was not well developed in papillary lesions with equivocal features of uncertain potentiality, CD34 was notable in such cases with higher incidence in malignant cases. So ASMA as well as CD34 could predict neoplastic behavior, pointing to the importance of the stromal role. Differences between groups suggest that the presence of CD34 + stromal cells is an early event in carcinogensis and is associated with neoplasia, however ASMA+ cells are more likely to be associated with malignant behavior and metastatic potential adding additional tools to the light microscopic picture helping in diagnosis of problematic cases with H&E.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.855-860
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• 2014

Background: The purpose of this study was to assess the relationship between different sonographic features of papillary thyroid carcinoma (PTC) on high-frequency ultrasound and cervical lymph node metastasis (CLNM). Materials and Methods: We enrolled 548 patients who underwent initial surgery for PTC between May 2011 and December 2012 in our hospital at diagnosis. The sonographic features of 513 PTC nodules in 513 eligible patients, who had single PTC nodules in their thyroid glands, were retrospectively investigated. All patients with a suspect malignant nodule (d<0.5cm) among multiple nodules were initially diagnosed by fine-needle aspiration biopsy (FNAB) to ascertain if the suspect nodule was PTC. The final diagnosis of all the thyroid nodules and existence of CLNM were based on postoperative pathology. Patients were divided into two groups: a positive group with CLNM (224 nodules) and a negative group without CLNM (289 nodules). The following factors were investigated: gender, age, echogenicity, echotexture, size, shape, location, margin, contour, calcification morphology, distance between the nodule and pre- or post-border of the thyroid capsule, vascularity and the differences between the two groups. Results: Correlation analysis showed that shorter distances between the nodule and pre- or postborder of thyroid capsule resulted in greater risk of CLNM (Spearman correlation coefficient=-0.22, p<0.0001). The significant factors in multivariate analysis were age<45yrs, larger size (d>1cm), "wider than tall" shape, extrathyroid extension and mixed flow (internal and peripheral) (p<0.05, OR=0.406, 2.093, 0.461, 1.610, 1.322). Conclusions: Significant sonographic features of PTC nodules in preoperative high-frequency ultrasound are crucial for predicting CLNM.