• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.222-225
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• 1999

Background and Objectives: Medullary thyroid carcinoma(MTC) is a rare tumor derived from the parafollicular C cells of the thyroid gland accounting for 5-10% of all thyroid malignancies. In Korea, there has been a few case report of medullary thyroid carcinoma(MTC) but their clinical analysis were not exactly studied. So, we made clinical study of 10 patients diagnosed as medullary thyroid carcinoma. Materials and Methods: We reviewed clinical data of 10 patients who were diagnosed as medullary thyroid carcinoma(MTC) from April 1973 to August 1998 at National Medical Center. Results: The incidence of MTC was 2.3% of all thyroid cancer and their mean age were 44.2 years old. Preoperative thyroid scan showed cold nodule in all patients and thyroid function test(TFT) was within normal range. Of the 10 patents, only 4 patients had diagnosis of MTC in preoperative fine needle aspiration biopsy. All the patients underwent total thyroidectomy with central neck dissection. Two patients with cervical lymph node metastasis underwent total thyroidectomy, central neck dissection and modified neck dissection. Two patients (20%) showed recurrence at the site of neck, lung, mediastinum, bone and liver. Conclusion: Most MTC is sporadic form and have peak incidence in the fifth decade and female preponderance. Preoperative fine needle aspiration biopsy is considered to be a clinically useful diagnostic method, but its accuracy is not considered as much high as others. Total thyroidectomy with central neck dissection may be an useful surgical modality in treating medullary thyroid carcinoma.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.594-599
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• 1995

Although papillary carcinoma of the thyroid generally follows an indolent course characterized by slow growth and the absence of distant metastases, several available reports suggest that metastasis to bone and/or lung parenchyma may occur infrequently. But pleural metastases are known to be very rare, so there have been only two case reports about the pleural metastases of papillary thyroid carcinoma in the literatures. Even the case of occult papillary thyroid carcinoma presenting as a metastatic pleural effusion has been never been reported. Recently we experienced a case with the chief complaint of dyspnea due to massive pleural effusion, the cytologic examination of which revealed the papillary carcinoma with psamomma bodies. The examination of the thyroid revealed no definite primary tumor. The total thyroidectomy was done with the plan of post-operative radioactive iodine treatment and the pathologic result confirmed the occult papillary microcarcinoma as expected. With the present case report, the extension of the clinical spectrum. of metastatic papillary carcinoma of the thyroid is expected.

• Korean Journal of Clinical Laboratory Science
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• v.39 no.3
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• pp.241-248
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• 2007

To clarify the growth mechanisms of thyroid tumors, we investigated apoptotic cells in 88 thyroid tumors, consisting of 24 adenomas, 58 papillary thyroid carcinomas, and 6 undifferentiated carcinoma, using terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate digoxigenin-nick end labeling (TUNEL). The cell proliferating marker was also evaluated immunohistochemically using the monoclonal antibody to Ki-67 antigen (MIB-1) in the same tumors. The apoptosis was expressed as a percentage of the TUNEL-positive cells in the tumor cells, and a proliferating marker, being the percentage of Ki-67 positive cells, was counted up each tumor. The statistical analysis were used analysis of variance (ANOVA) and student's t-test that were analyze the differences in the rate of each histological types of the thyroid tumors. The overall level of apoptosis was extremely low in all histological types of the thyroid tumors analyzed, the mean apoptosis being $0.31{\pm}0.40$ in adenoma, $0.55{\pm}0.48 $in papillary thyroid carcinoma, and $4.60{\pm}3.27$ in undifferentiated carcinoma. The Ki-67 protein in the thyroid tumor subtypes was significantly lower in adenoma and papillary carcinoma, at $2.45{\pm}2.99$ and $6.27{\pm}4.42$, respectively, than that in undifferentiated carcinoma at $26.47{\pm}23.88$ (p<0.0001). There was no correlation between clinicopathological factors and apoptosis or Ki-67 in papillary thyroid carcinoma. In conclusion, our findings suggest that apoptosis occurs infrequently in thyroid tumor, and that cell proliferating maker Ki-67 markedly differs according to the thyroid tumor subtypes. Moreover, the ratio between proliferating cells and apoptotic cells may reflect thyroid tumor progression.

• Korean Journal of Head & Neck Oncology
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• v.8 no.2
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• pp.72-81
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• 1992

Thyroid cancer, the most common cancer of endocrine neoplasms, has tremendous variation in tumor biologic behavior. There is no consensus about treatment mode to prevent recurrences despite of recent advance in understanding characteristics of thyroid cancer. So, we have made a clinical analysis and follow-up study of recurred 27 cases among 189 cases treated under the diagnosis of thyroid carcinoma in the department of surgery, Chonnam University Hospital from February, 1982 to February, 1992 to clarify our experience about the characteristics of recurred thyroid cancer. The results were as follow: According to the pathological classification of recurred thyroid cancer, recurrence rate was 11.6% in papillary carcinoma, 15.6% in follicular carcinoma, 37.5% in medullary carcinoma, 66.7% in undifferentiated carcinoma, respectively, and the mean recurrence rate of thyroid cancer was 14.3%. The recurrence rate according to age was 28.6% in 8th decade and 17.9% in 4th decade. The recurrence rate according to sex was not singificant(15.6% in male: 14% in female). The mean period to relapse was 4 years 6 months in papillary carcinoma, 2 years 5 months in follicular carcinoma, 2 years 1 months in medullary carcinoma, 2 years 6 months in undifferentiated carcinoma. The recurrence rate according to previous operating methods, such as performing lymph node dissection or not, mode of thyridectomy, type of lymph node dissection was statisfically non-specific. Common recurrent sites of papillary and follicular carcinoma was cervical lymph node and remained thyroid tissue. Medullary and undifferentiated carcinoma was noted in multiregional or systemic involvement Reoperation was performed with complete resection of recurred or metastatic mass, such as radical neck dissection or mass extirpation from involved organs as possible. The postoperative complications were 2 cases of horseness, and 1 case with hematoma, transient hypocalcemia, wound infection, and pulmonary insufficency, respectively. 5-year survival rate was 85.5% in papillary carcinoma, 66.7% in follicular carcinoma. 50% in medullary carcinoma, and 50% in undifferentiated carcinoma. We concluded that recurrence in thyroid cancer give a reconsideration to previous conservative therapy and more extensive surgical procedures for thyroid cancer including lymphatic dissection are recommanded to prevent recurrences in selected cases if possible.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.268-273
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• 1996

Cystic lesions of the neck are frequently encountered on clinical basis. The usual differential diagnosis includes branchial cleft, cystic hygroma, dermoid cyst, tuberculous lymphadenitis, benign detached goiterous thyroid cyst, and Cavitation epidermoid carcinoma. Most of cysts are benign and malignant cysts are rare. The most common form of cystic malignancy in the lateral neck is cystic degeneration of epidermoid carcinoma metastatic to cervical lymph nodes. Cystic neoplasia may result from malingnant changes occurring within the wall of a previously benign cyst Complete head and neck examination on the primary focus is important Especially, when palpation of thyroid is negative, thyroid carcinoma is easily overlooked. Recently, we experienced papillary carcinoma of the thyroid seen as lateral neck cyst. So we report this case with review of literatures.

• The Korean Journal of Cytopathology
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• v.8 no.1
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• pp.57-61
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• 1997

A primary squamous cell carcinoma of the thyroid is extremely rare disease. We evaluated this disease by fine needle aspiration cytology in a 43 year-old female. On physical examination, the thyroid was moderately enlarged and palpated with hard consistency. The cytologic aspirate revealed nests of squamous cells, malignant squame and thyroid follicular cells in the necrotic background. We diagnosed this tumor as squamous cell carcinoma with cytologic evidence. Surgically resected thyroid revealed well differentiated squamous cell carcinoma. Immunohistochemical staining for antithyroglobulin proved that this tumor was primary in origin and clinical study confirmed this lesion to be of primary thyroid origin rather than metastasis or direct invasion from contiguous structures.

• The Korean Journal of Cytopathology
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• v.2 no.2
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• pp.127-133
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• 1991

Mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland is a very rare malignant tumor characterized by rapidly progressive clinical course and radioresistance. A 63-year-old woman had mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland diagnosed by fine needle aspiration cytology (FNA), and the diagnosis was confirmed by histological examination. She had complained of a fixed, egg-sized mass of the anterior neck with hoarseness for 1 year. The findings of FNA consisted of sheets and clusters of polygonal epithelial cells with hyperchromatic, pleomorphic nuclei and eosinophilic, abundant, laminated cytoplasm. These findings were consistent with squamous cell carcinoma. Also, fool of papillary carcinoma were noted, and the cells exhibited nuclear groovings and intranuclear cytoplasmic inclusions. Total thyroidectomy specimen showed a diffusely infiltrating tumor in the left thyroid which was composed of mixed papillary carcinoma and well-differentiated squamous cell carcinoma. In junction between two components, squamous metaplasia of papillary carcinoma was noted.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7425-7432
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• 2014

Aim: To investigate the expression of protein kinase $CK2{\alpha}$ ($CK2{\alpha}$) in human thyroid disease and its relationship with thyroid cancer metastasis. Materials and Methods: Using immunohistochemistry we measured the expression of $CK2{\alpha}$ in 76 benign and malignant human thyroid cancer tissues, including 10 pairs of papillary carcinoma tissues with or without lymph node cancerous metastasis and similarly 10 pairs of lymph nodes. Results: The expression of $CK2{\alpha}$ was found to be higher in thyroid carcinoma cases (papillary carcinoma, follicular carcinoma, anaplastic carcinoma and medullary carcinoma) than in ones such as chronic lymphocytic thyroiditis, nodular goiter and adenoma. These findings were also confirmed by RT-PCR and Western blotting. More strikingly, elevated expression of $CK2{\alpha}$ in thyroid papillary carcinoma tissues was not only significantly associated with lymph node cancerous metastasis and clinical stage of thyroid cancers; but also correlated with epithelial-mesenchymal transition (EMT) and high tenascin C (TNC) expression. In addition, EMT and high TNC expression in thyroid carcinoma tissues was significantly associated with lymph node cancerous metastasis. Conclusions: Elevated expression of nuclear $CK2{\alpha}$ is a poor prognosis indicator in lymph node cancerous metastasis of human thyroid cancers.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.5
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• pp.294-298
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• 2019

Treatment of metastatic carcinoma of the oral cavity can be a challenge due to its rarity. The current case report details metastatic carcinoma of the mandible originating from follicular thyroid carcinoma, which is the second most prevalent tumor of the thyroid. As the mandibular lesion developed, the primary thyroid lesion of thyroid. Here, we report a case of metastatic carcinoma of the mandible in a 67-year-old female that was treated with partial mandibulectomy and fibular free flap.

• Advances in pediatric surgery
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• v.6 no.2
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• pp.95-99
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• 2000

Thyroid carcinoma is relatively rare in children. Eight cases of thyroid carcinoma were among 18 patients operated upon for thyroid tumors at Pediatric Surgery, Asan Medical Center in 11 years' period between 1989 and 2000. Five patients were boys and three were girls. The age distribution ranged from 10 to 14 years with a median age of 11.6 years. We studied clinical presentations, diagnostic workup, pathology, treatment, and follow-up (recurrence, mortality, and survival). All patients presented with anterior neck mass but one with multiple cervical lymph nodes enlargement. Familial history of thyroid cancer was seen in one case. All patients had a cold nodule by 1-131 thyroid scan. Fine needle aspiration (FNA) biopsy was performed in all patients. The right lobe was involved in four patients and the left lobe in two. Two had both lobes involvement. Pathologically, six cases were papillary carcinoma, one was follicular carcinoma, and one insular carcinoma. Four patients underwent unilateral lobectomy and isthmectomy. Total thyroidectomy was performed in three patients. The insular carcinoma case was preoperatively diagnosed as follicular neoplasm by FNA. After confirmation of the pathology by initial right thyroid lobectomy, total thyroidectomy was subsequently done. Cervical lymph node metastases were presented in three cases (37.5%), and lung metastasis in two cases (25%). Three patients received postoperative I-131 ablation. After a median follow-up of 53 months, all patients were alive without evidence of recurrence. In conclusion, thyroid carcinoma in children is frequently associated with lymph nodes involvement and distant metastasis, however, the prognosis is relatively good.