• Title/Summary/Keyword: Thyroid Neoplasm

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Huge Pulmonary Sclerosing Pneumocytoma with Endobronchial Invasion: A Case Report with a Literature Review

  • Lee, Hyun Soo;Kim, Jina;Moon, Duk Hwan;Park, Chul Hwan;Jeon, Tae Joo;Lee, Sungsoo;Cha, Yoon Jin
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.528-531
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    • 2021
  • Pulmonary sclerosing pneumocytoma (PSP) is a tumor of pneumocytic origin that is classified as a benign neoplasm. To date, aggressive behavior of this tumor has rarely been reported. Here, we describe a case of a 56-year-old woman with a huge, 19-cm PSP that resulted in mediastinal shift and showed microscopic endobronchial invasion and necrosis. The differential diagnosis included malignant mesenchymal tumors, such as solitary fibrous tumor; however, PSP was confirmed based on the characteristic thyroid transcription factor 1 positivity and membranous expression of Ki-67 on immunohistochemical staining of tumor cells.

Clinical Significance of Preoperative Embolization for Non-Hypervascular Metastatic Spine Tumors

  • Yoo, Sung-Lim;Kim, Young-Hoon;Park, Hyung-Youl;Kim, Sang-Il;Ha, Kee-Yong;Min, Hyung-Ki;Seo, Jun-Yeong;Oh, In-Soo;Chang, Dong-Gune;Ahn, Joo-Hyun;Kim, Yong-Woo
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.106-113
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    • 2019
  • Objective : The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss. Methods : A total of 79 patients (36 cases of preoperative embolization and 43 cases of non-embolization) who underwent surgery for metastatic spine lesions were included. Representative hypervascular tumors such as renal cell and thyroid cancers were excluded. Intraoperative and perioperative estimated blood losses (EBL), total number of transfusion and calibrated EBL were recorded in the embolization and non-embolization groups. The differences in EBL were also compared along with the type of surgery. In addition, the incidence of Adamkiewicz artery and complications of embolization were assessed. Results : The average age of 50 males and 29 females was $57.6{\pm}13.5$ years. Lung (30), hepatocellular (14), gastrointestinal (nine) and others (26) were the primary cancers. The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative EBL, perioperative EBL, total transfusion and calibrated EBL between two groups. However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group (1645.5 vs. 892.6 mL, p=0.017 for intraoperative EBL and 6.1 vs. 3.9, p=0.018 for number of transfusion). In addition, the presence of Adamkiewicz artery at the index level was noted in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring. Conclusion : Preoperative embolization for non-hypervascular MSD did not reduce perioperative blood loss. However, the embolization significantly reduced intraoperative bleeding and total transfusion in corpectomy group. Moreover, the procedure provided insights into the anatomy of tumor and spinal cord vasculature.

Cytologic findings of Parathyroid Carcinoma - Report of Two Cases - (부갑상샘 암좀의 세포학적 소견 - 2예 보고 -)

  • Jin, Yun-Hee;Jin, Mi-Sheon;Paik, Seung-Sam;Jang, Se-Jin;Park, Moon-Hyang;Park, Yong-Wook
    • The Korean Journal of Cytopathology
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    • v.14 no.1
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    • pp.1-6
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    • 2003
  • Parathyroid carcinoma is a rare disorder accounting for 0.5% to 5% of parathyroid neoplasia. Diagnosis of parathyroid carcinoma in fine needle aspiration cytology (FNAC) is difficult because ail characteristic features of parathyroid carcinoma can be recognized in parathyroid adenoma or hyperplasia. Cellular atypism cannot be used for the diagnostic criteria of parathyroid carcinoma as malignancies of most other organs. We experienced two cases of cytologic features of parathyroid carcinoma confirmed by histologic examination. The majority of tumor cells formed large cohesive clusters, although individual tumor cells were also present. The tumor cells displayed rather pleomorphic round to oval nuclei, occasional prominent nucleoli, and distinct cytoplasmic margin. Occasionally karyolysis, anuclear cells, and nonepithelial cell clusters were noted. The histologic findings showed a partially lobulated architecture, with admixture of sheets of chief cells, oxyphil cells, and occasional water clear cells. The tumor infiltrated into the thyroid parenchyme and perithyroidal soft tissue. The electron microscopic study of case 1 disclosed typical findings of parathyroid neoplasm; clusters of secretory chief cells with centrally located round to ovoid nuclei, moderately clumped heterochromatins and one or two nucleoli. The tumor cells showed conspicous interdigitation of contiguous ceil membrane and intercellular microvilli.

A case of Werner Syndrome Complicated by Bone Metastasis of Rhabdomyosarcoma (횡문근육종의 골전이가 동반된 워너증후군 1례)

  • Song, Joon-Hwan;Sun, Dong-Shin;Kim, Ho;Lee, Yoon-Hee;Hong, Yong-Hee;Lee, Dong-Hwan
    • Journal of Genetic Medicine
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    • v.6 no.1
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    • pp.91-94
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    • 2009
  • Werner syndrome (WRN), or adult progeria, is a very rare, autosomal recessive disorder characterized by the appearance of accelerated aging, including cataracts, gray hair, skin atrophy, and atherosclerosis. This syndrome is caused by mutations in the WRN gene and had a high risk of a spectrum of rare neoplasms including: i) non-epithelial malignant or pre-malignant tumors/conditions, osteosarcomas and soft tissue sarcomas, malignant melanomas, myeloid leukemia and myelodysplastic syndrome; ii) an epithelial neoplasm, thyroid carcinoma, and iii) meningiomas. Recently, authors experienced a case of Werner syndrome complicated by bone metastasis of rhabdomyosarcoma in a 20-year old Korean man. The patient revealed a painful mass on his right knee and progeroid features, short stature, scalp alopecia, abnormal dentition, craniofacial disproportion, hypothyroidsm, cataracts and osteoporosis. The onset of symptoms of Werner syndrome generally precedes any later symptoms of associated conditions, such as malignant tumor. Therefore, early recognition of Werner syndrome is important to assist identification of malignant tumors at an early stage in this patient group.

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Visualization of the Gastric Calcification due to Cancer on Tc-99m DPD and Abdominal CT Images (Tc-99m DPD 골스캔과 복부 CT 영상에서 보이는 위암의 석회화)

  • Jeong, Young-Jin;Kang, Do-Young
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.5
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    • pp.344-346
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    • 2004
  • A 69-year-old woman was presented with progressed dysphagia, gastric soreness and weight loss during 2 months. She was performed abdomen x-ray, EGDS and abdomen CT. Abdomen x-ray demonstrated punctuate calcification on LUQ. EGDS showed an ulceroinfiltrative mass with bleeding on cardia to antrum of stomach. And CT showed diffuse gastric wall thickness with multiple calcifications. Biopsy of the stomach and esophagus during EGDS examination revealed an adenocarcinoma, with signet ring cell type, infiltrating the wall of the stomach and the distal esophagus. Then acne scan was performed a few days later. It revealed intense uptake in LUQ, corresponding to the calcium containing neoplasm seen on the abdomen x-ray, EGDS and abdomen CT. And there was no evidence of any metastatic lesion and thyroid uptake on the bone scan. There are many reports about accumulation of the tracer in extraosseous lesion, but only a few literatures were reported about gastric calcification in stomach cancer. More over, no reports showed CT images. We are performed many diagnostic examinations and found well correlation between them. The reason of gastric calcification is considered with calcium deposition within extracellular space due to hemorrhage or necrosis. Other possibility offered to explain gastric calcification have been increased blood flow and/or increased neovascularity with capillary leaks of tracer, and specific enzymatic (phosphatases) receptor binding of tracer. So, it was happened ion exchange between intracellular calcium and phosphate groups of tracer.

Methylene Blue Dye-Induced Skin Necrosis in Immediate Breast Reconstruction: Evaluation and Management

  • Lee, Ji Hwan;Chang, Choong Hyun;Park, Chan Heun;Kim, June-Kyu
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.258-263
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    • 2014
  • Background For early breast cancer patients, skin-sparing mastectomy or nipple-sparing mastectomy with sentinel lymph node biopsy has become the mainstream treatment for immediate breast reconstruction in possible cases. However, a few cases of skin necrosis caused by methylene blue dye (MBD) used for sentinel lymph node localization have been reported. Methods Immediate breast reconstruction using a silicone implant was performed on 35 breasts of 34 patients after mastectomy. For sentinel lymph node localization, 1% MBD (3 mL) was injected into the subareolar area. The operation site was inspected in the postoperative evaluation. Results Six cases of immediate breast reconstruction using implants were complicated by methylene blue dye. One case of local infection was improved by conservative treatment. In two cases, partial necrosis and wound dehiscence of the incision areas were observed; thus, debridement and closure were performed. Of the three cases of wide skin necrosis, two cases underwent removal of the dead tissue and implants, followed by primary closure. In the other case, the breast implant was salvaged using latissimus dorsi musculocutaneous flap reconstruction. Conclusions The complications were caused by MBD toxicity, which aggravated blood disturbance and skin tension after implant insertion. When planning immediate breast reconstruction using silicone implants, complications of MBD should be discussed in detail prior to surgery, and appropriate management in the event of complications is required.

Clinical Presentation of Paraganglioma in Orthopaedics - Report of Two Cases - (정형외과 영역에서의 부신경절종의 임상 양상 - 2례 보고 -)

  • Lee, Sang-Lim;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo;Kim, Hyung-Ho;Kim, June-Hyuk
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.94-99
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    • 2005
  • Paraganglioma is a neoplasm consisting of sympathetic neuroendocrine cells, which arise from neural ectoderm of extra-adrenal paraganglia. It often occurs in thyroid, carotid body, mediastinum, lung, duodenum, the retroperitoneal area and periaortic area. Malignant paraganglioma is defined not by the histological diagnosis, but by spread to regional lymph nodes or distant metastasis. Rare bone metastasis mostly occurs in the base of skull or spine, and even it rarely metastasizes to pelvis or femur. We would like to report two cases of paraganglioma; one in the subcutaneous fat layer that was mistaken for a vascular tumor, and the other in the retroperitoneal space with early bone metastasis.

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Clinical Manifestation and Treatment Results of the Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Arising in the Head and Neck Region (두경부의 점막연관 림프조직에서 발생한 림프절외 변연부 B세포 림프종의 임상 양상 및 치료 결과에 대한 고찰)

  • Rah, Yoon-Chan;Han, Kyu-Hee;An, Soo-Youn;Kwon, Tack-Kyun;Sung, Myung-Whun;Kim, Kwang-Hyun;Hah, J.-Hun
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.128-131
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    • 2009
  • Objectives : Mucosa-associated lymphoid tissue(MALT) lymphoma of the head and neck region is relatively rare, but it has variable clinical and biological characteristics. Although there were few studies on this topic, there is still controversy regarding the best treatment. The authors retrospectively investigated the clinical courses and treatment results in 10 patients presenting with MALT-lymphoma in head and neck region except ocular adnexa. Material and Methods : Ten patients with a histologically verified diagnosis of the extranodal marginal zone B cell lymphoma arising in thyroid glands(3), larynx(3), oral cavity(2), oropharynx(1), salivary glands(1) were analyzed. Results : Four patients were allocated to stage IE and another six patients to stage IIE according to the Ann Arbor staging system. Treatment consisted of local therapy(surgical resection and/or radiotherapy) in four patients and systemic chemotherapy with/without local therapy in six patients. Complete remission and partial remission were achieved in seven patients(70%) and two patients(20%), respectively. No recurrence or mortality was observed with a mean follow-up of 40.5 months. Conclusion : Patients with MALT-lymphomas of the head and neck region were potentially treated by local modality in localized disease state. However systemic chemotherapy was also effective even in localized disease state and was well tolerated by patients. And strict staging and close long-term monitoring were recommended considering its indolent progression.

Evaluation of Post-Neoadjuvant Chemotherapy Pathologic Complete Response and Residual Tumor Size of Breast Cancer: Analysis on Accuracy of MRI and Affecting Factors (신보강화학요법 후 유방암의 병리학적 완전 관해 예측 및 잔류 암 평가: 유방자기공명영상의 정확도 및 영향인자 분석)

  • Hyun Soo Ahn;Yeong Yi An;Ye Won Jeon;Young Jin Suh;Hyun-Joo Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.654-669
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    • 2021
  • Purpose To evaluate the accuracy of MRI in predicting the pathological complete response (pCR) and the residual tumor size of breast cancer after neoadjucant chemotherapy (NAC), and to determine the factors affecting the accuarcy. Materials and Methods Eighty-eight breast cancer patients who underwent surgery after NAC at our center between 2010 and 2017 were included in this study. pCR was defined as the absence of invasive cancer on pathological evaluation. The maximum diameter of the residual tumor on post-NAC MRI was compared with the tumor size of the surgical specimen measured pathologically. Statistical analysis was performed to elucidate the factors affecting pCR and the residual tumor size-discrepancy between the MRI and the pathological measurements. Results The pCR rate was 10%. The diagnostic accuracy of MRI and the area under the curve for predicting pCR were 90.91% and 0.8017, respectively. The residual tumor sizes obtained using MRI and pathological measurements showed a strong correlation (r = 0.9, p < 0.001), especially in patients with a single mass lesion (p = 0.047). The size discrepancy between MRI and the pathological measurements was significantly greater in patients with the luminal type (p = 0.023) and multifocal tumors/non-mass enhancement on pre-NAC MRI (p = 0.047). Conclusion MRI is an accurate tool for evaluating pCR and residual tumor size in breast cancer patients who receive NAC. Tumor subtype and initial MRI features affect the accuracy of MRI.

The Prevalence of Cancer in Kangwha County (강화지역 암의 유병률)

  • Yi, Sang-Wook;Lee, Kang-Hee;Kim, Suk-Il;Kang, Hyung-Gon;Jee, Sun-Ha;Ohrr, Hee-Choul
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.333-342
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    • 1999
  • Objectives: Most descriptive studies of cancer have focused either or cancer incidence or mortality. Cancer prevalence has rarely been estimated. Cancer prevalence data can be used as a measure of the economic and social burden of cancer and are also useful for health care planning. This study attempts to estimate cancer prevalence in Kangwha county. Methods: This investigation is based on data of Kangwha cancer registry. The data include all cases of cancer diagnosed from 1983 through 1992. We define 'prevalent cases' as cancer patients who is alive as of January 1, 1993. For each five-year age group, the number of 'known prevalent cases' is added to the number of 'estimated prevalent cases'. Prevalence is calculated by dividing these sums by the populations of Kangwha County on December 31, 1992(derived from Kangwha Statistics Annual). Results: Crude prevalence of cancel among males and females are 536.7 and 601.1 per 100,000 respectively. Gastric cancer is the most common malignant neoplasm(213.2 per 100,000, crude prevalence) among males. It is followed by lung cancer(45.1 per 100,000), liver cancer(32.8 per 100,000), rectal cancer(25.4 per 100,000) and colon cancer(25.4 per 100,000). Cervical cancer is the most common cancer(201.9 per 100,000, crude prevalence) and is fellowed by gastric cancer(91.5 per 100,000), thyroid cancer(64.8 per 100,000), breast cancer(57.2 per 100,000) and rectal cancer(32.7 per 100,000) among females. Conclusions: We tried to estimate cancer prevalence based on the Kangwha cancer registry for the first time in Korea. The estimation of cancer prevalence based on a population-based cancer registry will be more correct and useful as the data accumulate. We will make another estimation in the near future.

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