• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.3
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• pp.141-151
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• 2018

Objectives: This paper aims to report the effects of Korean medical treatment on three patients who underwent thyroid lobectomy for thyroid cancer. Methods: Three patients were hospitalized at hospital to treat pain and general weakness after thyroid lobectomy. The patients took Korean medical treatment including herbal medicine and acupuncture. Numerical Rating Scale (NRS) of symptoms was measured every morning. Results: After the treatment, the pain and general weakness following surgery decreased, and general conditions improved. Conclusions: This cases show that Korean medical treatment is effective for a patients who underwent thyroid lobectomy for thyroid cancer.

• Korean Journal of Head & Neck Oncology
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• v.22 no.2
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• pp.137-141
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• 2006

Purpose : It has been generally accepted that lobectomy is a standard surgical procedure in treatment of benign thyroid nodules. However lobectomy may cause postoperative hypothyroidism. Most of surgeons believe that nodulectomy has its limitation in treatment of thyroid nodules due to recurrence of nodules and presence of cancer. The current study attempts to determine whether nodulectomy is justified in aspects of preservation of thyroid function, risk of recurrence and complications. Methods: Data was collected retrospectively on 74 patients undergoing thyroidectomy(single nodulectomy, n=43;bilateral nodulectomies, n=9;lobectomy with nodulectomy, n=22) for benign thyroid nodules from 1999 to 2004. All patients were evaluated for complication, postoperative thyroid function, and recurrence of benign nodule and cancer were followed by regular ultrasonographic examination for 2-6 years. Results : The pathologic results of 74 patients were nodular hyperplasia(55 patients), Hashimoto's thyroiditis(8 patients), follicular adenoma(7 patients) and papillary carcinoma(4 patients). Average operation time was 30 minutes from skin incision to specimen out. In postoperative follow-up of 70 patients, six cases(8.5%) became mild hypothyroid, and ultrasonographically detected micronodule was also six cases(8.5%). There were no other complications. Conclusion : Thyroid nodulectomy appears to have advantages of relatively few complication and simple procedure with no access to laryngeal nerves. Therefore, it may be one of treatment options in selected cases of benign thyroid nodules.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.41-45
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• 2007

A 60 years old female patient presented with $8{\times}6\;cm$ sized painless oval mass in the left parietal region. She had left lobectomy of thyroid gland 10 years ago. Cranial CT, MRI, FGD PET-CT showed a solid mass which invaded left parietal bone. After embolization, craniectomy with tumor excision was performed. Histological examination revealed metastatic follicular cancer originated thyroid gland, with vascular and dura invasion. Postoperatively, neck CT showed right thyroid multiple nodules and right level III multiple lymph node enlargement. Thyroid function test was normal, but level of thyroglobulin was high (72ng/ml). So she had right lobectomy of thyroid gland with lymph node dissection under a diagnosis of follicular carcinoma. But histological examination revealed adenomatous hyperplasia and not lymph node metastasis. After operation, she received radioiodine therapy of 150mCi and then the level of thyroglobulin normalized (8.4ng/ml). The patient is under follow-up since she had operation 4 months ago.

• 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.

• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.25-31
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• 2021

Background/Objectives: Although thyroid lobectomy recently is considered as sufficient for low-risk papillary thyroid carcinoma (PTC), completion thyroidectomy is required due to the insufficiency of the preoperative evaluation. The aim of this study was to investigate recurrence rate and disease free survival depending on the gross extrathyroidal extension (gETE) or the number of metastatic lymph node identified in patients with PTC. Materials & Methods: We assessed 3373 patients with PTC who underwent lobectomy at Seoul St. Mary's Hospital (Seoul, Korea) between January 2009 and December 2014. Clinicopathological characteristics and long-term surgical outcomes were retrospectively analyzed through complete chart reviews. The mean follow-up duration was 97.1 ± 21.4 months. Results: The rate of recurrence was higher in gETE group (1.8% vs. 6.0%, p=0.004), leading to decreased disease free survival in Kaplan-Meier analysis (log-rank p<0.001). N1 group (n=1389) was analyzed into two groups whether the number of positive nodes is more than 5 or less. For the group of the more metastatic nodes, the recurrence rate higher compared to the other group (3.0% vs. 9.3%, p<0.001). DFS was longer in the group that had lesser metastatic nodes (log-rank p<0.001). However, in terms of N1 group over 1cm (n=492), No statistical difference was observed according to the number of positive lymph nodes (4.5% vs. 9.1%, p=0.092) Conclusion: When it comes to node positive PTC, Despite the number of positive lymph nodes was over 5, follow-up with no further surgery can be an option.

• 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.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.54-60
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• 1998

Objectives: We'd like to give help in diagnosis and treatment of children's thyoid tumor through our clinical experiences and reference consideration. Materials and Methods: The authors report their experiences with 33 cases of thyroid tumor in patients younger than 16 years of age who were treated at Presbyterian Medical Center from 1979 to 1995. Results: 1) Girls were more predominant than boys by a ratio of 5.6:1. The peak incidence was in the 15 years old of age. 2) The final diagnosis in the 33 patients were thyroid carcinoma in 12 cases, nodular goiter in 6 cases, adenoma in 6 cases, Graves disease in 4 cases, Hasimoto's disease in 4 cases and cyst in 1 case. 3) All of 12 patients with thyroid cancer had nodular tumor. 4) In 5 of 6 patients with palpable cervical lymphadenopathy, the final diagnosis was thyroid carcinoma. 5) Delayed diagnosis arose in 6 of 12 thyroid carcinomas which were treated for long periods as benign disease. 6) The surgical procedures were total thyroidectomy in 3 cases, subtotal thyroidectomy in 13 cases and thyroid lobectomy in 17 cases. 7) 11 of 12 patients with thyroid carcinoma had subtotal or total thyroidectomy with lymphnode dissection and only one had lobectomy. 8) The overall rate of postoperative complication was 3%(1 of 33 patient). 9) Postoperative $^{131}I$ therapy was done in 7 case because of recurrence and distant metastasis in six and severe local invasion in one. 10) In thyroid cancer, the metastatic rate of lymph node at initial surgery was 81%(9/11) and rate of recurrence was 50%(6/12). 11) Patients with thyroid carcinoma were followed up for a mean of 12 years but only one died as a result of thyroid carcinoma 3.5 years later. Conclusion: The authors suggest that thyroid tumors in childhood should receive the benifit of joint management by endocrine pediatrician and experianced surgeons with an agreed protocol of diagnosis and management. We, also, recommend aggressive surgical and $^{131}I$ treatment as the most effective regimen for children with thyroid carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.21 no.1
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• pp.10-14
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• 2005

Objectives: Various techniques of endoscopic thyroidectomy have been developed in thyroid resection since 1998 in the aspect of excellent cosmetic viewpoint. Of them, we evaluated our experiences and advantages of gasless axillary approach technique for resection of dominant thyroid nodules. Material and Methods: Twenty-nine cases of thyroid nodules were operated by the technique of gasless axillary approach during one year from December 2003 to December 2004. Twenty four patients underwent total lobectomy and five patients were partial lobectomy. Results: The operation time of first case took 300 minutes, however it became gradually shortened with case experiences down to 100-120 minutes. Pathologically, nodular hyperplasia was twenty cases, follicular adenoma five cases, papillary carcinoma three patients, and Hashimoto's thyroiditis one patient. There was no case of conversion to open thyroidectomy. Three cases of postoperative hoarseness were recovered spontaneously in 3 months. Hospital stay was four days for most patients. The cosmetic result was excellent without visible scar in anterior neck and chest. Conclusion: Endoscopic thyroidectomy via gasless axillary approach shows excellent result in cosmetic view point with hidden incision scar at axilla, and shorter hospitalization. However a question of longer operation time for dissection of the long plane over pectoral muscle is still remained.

• Korean Journal of Head & Neck Oncology
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• v.34 no.1
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• pp.33-36
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• 2018

Hyalinizing trabecular tumor (HTT) of the thyroid gland is a rare neoplasm and only less than 100 cases have been reported so far. It is characterized by hyalinizing stroma with trabecular growth pattern and has an indolent clinical course. Because of its histologic features, it is frequently misdiagnosed as papillary or medullary carcinoma in fine needle aspiration cytologic findings. The tumor is benign or low malignant potential and thyroid lobectomy is recommended for adequate treatment. We recently experienced a case of thyroidal HTT in a 57-year-old man, who presented with a right thyroid nodule that was suspicious of papillary carcinoma in aspiration cytology. We report the unique and rare disease entity with brief literature review.

• Korean Journal of Head & Neck Oncology
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• v.36 no.2
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• pp.1-7
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• 2020

Background/Objectives: Pediatric & Adolescent thyroid cancer is a steadily increasing malignancy. We aimed to report our experience at a single tertiary institution and to evaluate the risk factors for recurrence in pediatric & adolescent patients with differentiated thyroid carcinoma (DTC). Materials & Methods: The data of 42 pediatric & adolescent patients (aged ≤19 years) with DTC who underwent thyroidectomy at Seoul St. Mary's Hospital (Seoul, Korea) between December 1997 and February 2019 were retrospectively reviewed. Clinicopathologic features and surgical outcomes were retrospectively analyzed through complete chart reviews. Results: The mean age was 16.6 years. A total of 6 (14.3%) patients experienced recurrence after initial treatment. The recurrence rate was significantly different between total thyroidectomy (TT) and lobectomy groups (23.1% vs. 0%, p=0.038). However, no statistically significant differences were found in the recurrence rate according to lymph node ratio (LNR) of 0.4 (10.7% vs 21.4%; P=0.383). Multivariate analysis confirmed age (hazard ratio [HR], 0.443; P=0.008) and bilaterality (HR, 11.477; P=0.022) as significant risk factors for DFS. Conclusion: Pediatric & Adolescent thyroid cancer is a rare malignancy and TT is recommended as the treatment of choice. However, lobectomy may be considered for Pediatric & Adolescent patients with age >16 years, tumor size <1 cm, and no bilateral disease.