• Title/Summary/Keyword: Thyroid Neoplasm

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Safety of Thyroidectomy in Thyroid Cancer Patients Older than 75 Years (고령 갑상선암 환자의 갑상선 절제술의 안정성)

  • Yang, Seung Yoon;Kim, Seok-Mo;Kim, Soo Young;Kim, Bup-Woo;Lee, Yong Sang;Park, Cheong Soo;Chang, Hang-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.5-8
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    • 2016
  • Background and Objectives: The aim of this study was to evaluate the safety and the feasibility of thyroidectomy for aged (${\geq}75$ years old) thyroid cancer by reviewing postoperative morbidity and pathologic characteristics. Materials & Methods: The clinical records of patients submitted to thyroid operation between 2014 and 2015 with histopathological diagnosis of thyroid cancer were analyzed. Clinical variables included age, gender, preoperative symptom, final pathology, length of stay, comorbidities, American Society of Anesthesiologists score, postoperative complications, and mortality. Results: There were 30 patients aged more than 75 years old, and only one patient passed over with postoperative pneumonia. There were 8 male and 22 female patients. Half of the patients presented with symptoms such as palpable mass (33.3%), voice change (6.7%) and dyspnea (6.7%). The pathologic diagnosis was thyroid cancer in all cases. The median postoperative hospitalization time was 4 days. There was one perioperative mortality case observed in this study. Conclusion: Thyroid surgery in patients 75 years or older can be performed except extensive surgical resection. Aggressive histology and extent of surgery may be an important factor of perioperative mortality and morbidity.

Perigastric Lymph Node Metastasis from Papillary Thyroid Carcinoma in a Patient with Early Gastric Cancer: The First Case Report

  • Jeong, Gui-Ae;Kim, Hyung-Chul;Kim, Hee-Kyung;Cho, Gyu-Seok
    • Journal of Gastric Cancer
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    • v.14 no.3
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    • pp.215-219
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    • 2014
  • Distant metastasis from papillary thyroid carcinoma (PTC), particularly from papillary thyroid microcarcinoma, is rare. We present a case of perigastric lymph node metastasis from PTC in a patient with early gastric cancer and breast cancer. During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer. Therefore, laparoscopic distal gastrectomy with lymph node dissection and left thyroidectomy were performed. On the basis of the pathologic findings of the surgical specimens, the patient was diagnosed to have papillary thyroid microcarcinoma with perigastric lymph node metastasis and early gastric cancer with mucosal invasion. Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made. When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

Macrofollicular Variant of Papillary Thyroid Carcinoma with Extensive Hemorrhage -Report of A Case- (출혈을 동반한 대여포성 유두상 갑상선 암종 -1예 보고-)

  • Kim, Hae-Ryoung;Lee, Kwang-Gil;Kim, Eun-Kyung;Park, Cheong-Soo;Chung, Woung-Youn;Yang, Woo-Ick;Hong, Soon-Wong
    • The Korean Journal of Cytopathology
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    • v.15 no.1
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    • pp.60-64
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    • 2004
  • The macrofollicular variant of papillary thyroid carcinoma (MVPC) is characterized by macrofollicles occupying more than half of the tumor and demonstrating nuclear features of classic papillary carcinoma. It is difficult to recognize on fine needle aspiration (FNA) cytology due to the paucity of aspirated neoplastic cell clusters, especially when the tumor is associated with extensive areas of hemorrhage. Case: A 34-year-old female presented with a well-demarcated nodule in the thyroid gland, diagnosed as a benign nodule on ultrasonography and computed tomography. FNA cytology smear revealed a few small aggregates of follicular cells with morphological features suspicious for papillary carcinoma, set in a background of hemorrhage, inflammatory cells, and hemosiderin-laden macrophages. Intraoperative frozen section revealed macrofollicular nests filled with hemorrhage and composed of follicular cells demonstrating nuclear clearing and grooves. Conclusion: MVPC is a rare but distinctive variant of papillary carcinoma, which is easily mistaken for adenomatous goiter or benign macrofollicular neoplasm on radiologic findings. The cytopathologist should alert oneself on encountering benign radiologic findings and any smear composed of scant numbers of follicular cells with nuclear features suspicious for papillary carcinoma despite the bland-looking background of hemorrhage and hemosiderin-laden macrophages, and recommend intraoperative frozen sections for a definite diagnosis.

Ethanol Ablation of the Thyroid Nodules: 2018 Consensus Statement by the Korean Society of Thyroid Radiology

  • Soo Yeon Hahn;Jung Hee Shin;Dong Gyu Na;Eun Joo Ha;Hye Shin Ahn;Hyun Kyung Lim;Jeong Hyun Lee;Jeong Seon Park;Ji-hoon Kim;Jin Yong Sung;Joon Hyung Lee;Jung Hwan Baek;Jung Hyun Yoon;Jung Suk Sim;Kwang Hwi Lee;Seon Mi Baek;So Lyung Jung;Yeo Koon Kim;Yoon Jung Choi
    • Korean Journal of Radiology
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    • v.20 no.4
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    • pp.609-620
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    • 2019
  • Minimally invasive treatment of symptomatic thyroid nodules is now commonplace. Ethanol ablation (EA) of thyroid cystic nodules has been performed since the 1990s, but there is no global consensus or guideline. Although various limitations of EA have been described, recommendations for practical application are necessary. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology initiated the present consensus statement and here we provide recommendations for the role of EA in the management of symptomatic thyroid nodules. These recommendations are based on evidence to date from the literature and expert opinion.

A Case of Squamous Cell Carcinoma of the Thyroid Gland (갑상선 편평 세포암 1예)

  • Roh Jin-Woo;Lee Sang-Choon;Lee Soo-Jung;Kwun Koing-Bo;Nam Hae-Joo
    • Korean Journal of Head & Neck Oncology
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    • v.6 no.2
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    • pp.91-96
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    • 1990
  • Squamous cell carcinoma of the thyroid gland is an extremely rare primary neoplasm, comprising only 1.1% of all primary thyroid cancers. The cancer is characterized by rapidly progressive clinical course in spite of its differentiated morphologic feature. Histogenetic origin of the cancer has also been debated. In most cases, a squamous epithelium is believed to be a result of metaplasia of a follicullar epithelium, although in rare exceptions, it can originate from a remnant of the thyroglossal duct or ultimobrachial body. Squamous cell carcinoma of the thyroid can occur in a pure form or mixed with adenocarcinoma; the latter may be designated as adenoacanthoma. Because this lesion typically runs a fulminant course, radical surgical resection at the earliest opportunity offers the best hope for cure. The lesions are usually radioresistant, and chemotherapy has not been shown to alter the course of this disease. We experienced a case of squamous carcinoma of the thyroid. This report summarize our experience and review of the literatures.

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Fine Needle Aspiration Cytology of Insular Carcinoma of the Thyroid - Report of A Case with Intact Insulae - (갑상샘 섬암종의 세침흡인 세포학적 소견 - 온전한 섬모양 구조를 가진 1예 보고 -)

  • Choi, Kyung-Un;Kim, Jee-Yeon;Lee, Jin-Sook;Lee, Chang-Hun
    • The Korean Journal of Cytopathology
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    • v.14 no.1
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    • pp.17-21
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    • 2003
  • Insular carcinoma of the thyroid(ICT) is an uncommon thyroglobulin-producing neoplasm, intermediate between well differentiated and anaplastic carcinoma. Only a few publications have addressed the fine needle aspiration cytologic(FNAC) findings from ICT. We experienced a case histologically diagnosed as ICT and with preoperative FNAC in a 52 - year - old woman. The FNAC displayed scanty colloid and abundant monomorphic follicular cells presented singly, in small loose aggregates, and in cohesive trabecular or acinar clusters. Intact insulae of tumor cells were also identified. Necrosis and mitosis were rare. Tumor cells showed round and monomorphic nuclei, finely granular chromatin, and inconspicuous nucleoli. When insular structure is identified in thyroid FNAC specimen, ICT should be included in the differential diagnosis. Herein we discuss and review the cytologic criteria for separation of ICT from other thyroid neoplasms.

Successful Treatment of Tracheal Invasion Caused by Thyroid Cancer Using Endotracheal Tube Balloon Inflation under Flexible Bronchoscopic Guidance

  • Han, Yang-Hee;Jung, Bock-Hyun;Kwon, Jun Sung;Lim, Jaemin
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.215-218
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    • 2014
  • Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

A Case of Advanced Thyroid Insular Carcinoma with Invasion of the Sternum (흉골침습을 동반한 진행성 갑상선 섬암종(Insular Carcinoma) 1예)

  • Koh Yoon-Woo;Lee Seung-Won;Lee Jong-Dae;Kim Hyo-Jin;Kim Hee-Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.178-182
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    • 2005
  • Insular carcinoma(poorly differentiated thyroid cancer) is defined as a aggressive, follicular-derived thyroid carcinoma with behavior intermediate between follicular/papillary and anaplastic carcinomas. It was described by Carcangiu in 1984, but its prognosis, classification and the origin is not yet clear. And preoperative fine needle aspiration cytology of insular carcinoma has not been satisfactory. We experienced a case of advanced thyroid insular carcinoma with invasion of the sternum. So we intend to present the case with a review of the related literatures.

High-grade mucoepidermoid carcinoma in the thyroid gland with poor prognosis

  • Shin, Hyeong Chan
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.169-174
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    • 2021
  • Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid-Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and paired box gene 8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

A Case of Inoperable Advanced Papillary Thyroid Carcinoma Maintaining Long-term Stable Disease State after Palliative Aim Radiation Therapy Alone (수술이 불가능하여 고식적 목적의 외부방사선 단독치료 후 장기 안정병변 상태를 유지하고 있는 진행된 갑상선 유두암 1예)

  • Tae Hyun Kim;Hong Gyun Wu
    • Korean Journal of Head & Neck Oncology
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    • v.40 no.1
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    • pp.7-13
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    • 2024
  • The current standard of treatment for differentiated thyroid cancer is surgical resection followed by radioactive iodine therapy according to the recurrence risk. However, external beam radiotherapy may be recommended in limited cases where surgical resection is impossible or residual gross lesion remains or the aforementioned standard therapy is deemed insufficient in achieving local control. We report a case of 59 year old patient who presented with advanced papillary thyroid carcinoma of right neck but was unable to receive surgical resection due to underlying Eisenmenger syndrome. He received radiation therapy of 67.5 Gy in 30 fractions with palliative aim with no further treatment and has been maintaining long-term stable disease state for 38 months. Herein, we report a rare case of palliative aim radiation therapy alone for advanced papillary thyroid carcinoma with literature review.