• Title/Summary/Keyword: Thyroid scan

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A Case of Patella Metastasis of Papillary Thyroid Carcinoma (갑상선 유두암의 슬개골 전이)

  • Han, Eun-Ji;Choi, Woo-Hee;Chung, Yong-An;Sohn, Hyung-Sun;Kang, Chang-Suk
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.79-82
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    • 2009
  • A 73-year-old man presented with a chief complaint of progressive left knee pain for two months. He had a history of total thyroidectomy and central lymph node dissection due to papillary thyroid carcinoma three months ago. MRI images revealed a solid mass in the left patella. A solid mass demonstrated low signal on T1 weighed image, and high signal on T2 weighed image. And whole body bone scan showed focal photon defect in same lesion of left patella. The histologic result of left knee lesion was adenocarcinoma, consistent with metastatic papillary thyroid carcinoma. Although patellar metastasis of papillary thyroid carcinoma is very rare, when knee pain and radiologic abnormality are noted, differential diagnosis of metastasis is necessary.

A Case of a Huge Lateral Neck Mass as the Initial Presentation of Thyroid Carcinoma (거대한 단발성 측경부 종물로 나타난 전이성 갑상선암 1례)

  • Sohn Jin-Ho;Park Jae-Yul;Kim Kwang-Hoon;Sung Nak-Kwan
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.89-91
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    • 1999
  • We experienced a case of the papillary thyroid carcinoma seen as a huge solid lateral neck mass. The mass grew very slowly over the period of 30years up to 10cm in diameter while relatively well sparing the surrounding tissues. Physical examinations, CT scan, and fine needle aspiration cytology did not reveal any strong suggestions for evidence of malignancy. But it was pathologically diagnosed as metastatic thyroid carcinoma by excisional biopsy. We emphasize that for a large solitary neck mass which persists for several decades, head and neck surgeons should always keep in mind the possibility of metastasis from the malignancy of thyroid gland.

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A Case of Giant Papillary Thyroid Carcinoma Resection with Massive Intraoperative Bleeding (술 중 대량 출혈을 동반한 거대 갑상선유두상암종 절제술 1례)

  • Kim, Seok Hyun;Jung, Jae Hwan;Sung, Eui Suk;Lee, Jin Choon
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.85-89
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    • 2017
  • A 62-year-old female patient had goiter for twenty years. She visited out-patient clinic with a hoarse voice and intermittent breathing difficulties. About protruding 15cm sized mass located the anterior neck and right vocal cord paralysis was observed. Preoperative CT scan was strongly suspected of thyroid gland cancer and cervical lymph node metastasis. Therefore, fine needle aspiration test was performed and surgical treatment was planned with the histopathologic results (papillary thyroid carcinoma). Surgery was performed with total thyroidectomy, bilateral cervical lymph node dissection, and right selective nodal lymph node dissection (level II-V). During operation right thyroid seemed to be adherent to surrounding tissue and the blood vessels were extremely engorged. There was hypotensive crisis because of intraoperative excessive bleeding. However it was managed by repetitive transfusion. The operation was completed without abnormalities. She underwent 4 times of bleeding control operation due to postoperative bleeding. After complications were improved, we are currently undergoing out-patient follow up without morbidity.

A case of Thyroid Hematoma Managed by Conservative Treatment (갑상선 혈종의 보존적 치료 1예)

  • Jung, Young-Do;Kim, Deok Su;Son, Ho Jin;Kim, Jeong Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.45-47
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    • 2018
  • Thyroid hematoma secondary to a blunt trauma is a rare problem. Despite the rarity, it can be a life-threatening condition with tracheal compression. Both surgical exploration and conservative management have been suggested for thyroid hematoma. However, there is still controversy on the optimal treatment. A 67-year old man who progressed severe dyspnea and neck swelling was transferred to the emergency department with a blunt anterior neck trauma after traffic accident. Contrast enhanced neck computed tomography scan showed huge hematoma within the right thyroid gland and slight tracheal deviation without prominent airway obstruction. One day later, anterior neck swelling was aggravated and the patient was intubated to prevent airway obstruction. After 3 days, hematoma resolution was revealed and extubation was done. We report this case with a review of literature.

Lung Metastasis of Thyroid Papillary Carcinoma which was Temporarily Treated for Milliary Tuberculosis (파종성 폐결핵으로 오인된 갑상선 유두상암종의 폐전이)

  • Na, Hong-Shik;Lee, Je-Hyuck;Paeng, Jae-Pil;Jung, Kwang-Yoon;Choi, Jong-Ouck
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.16-20
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    • 2000
  • The patient a 24-year-old male, was shown to have milliary shadows on chest radiographs from the age of 20. He was temporarily treated for pulmonary tuberculosis without success. He had left thyroid mass and lymph node metastases in neck CT scan which was taken after admission but fine needle aspiration result in scanty cellularity. He underwent total thyroidectomy with left modified radical neck dissection and right selective neck dissection under the impression of differentiated thyroid cancer with bilateral neck metastases. Then he underwent 131I ablation treatment and postoperative whole body 131I scintigraphy revealed diffuse intensive uptake in the bilateral lung fields, demonstrating that the pulmonary lesions were metastases of the thyroid cancer.

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A Case of Recurrent Papillary Thyroid Carcinoma with Adrenal Metastasis (재발 유두 갑상선암의 부신전이 1예)

  • Kim, Chang-Woo;Yun, Ji-Sup;Lee, Yong-Sang;Nam, Kee-Hyun;Chung, Woong-Youn;Hong, Soon-Won;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.50-53
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    • 2007
  • Adrenal metastasis from papillary thyroid carcinoma is extremely rare. We present herein a patient with adrenal metastases from recurrent papillary carcinoma of the thyroid. A 54 year-old woman had received a total thyroidectomy and postoperative radioactive iodine therapy for locally advanced papillary thyroid carcinoma. One year after initial surgery, distant metastases to multiple organs including right cervical lymph nodes, left upper lung, left 2nd and 3rd ribs, 2nd thoracic vertebra and left adrenal gland were found by 18-FDG-PET-CT whole body scan. She underwent right modified neck dissection, partial resection of left 2nd and 3rd ribs, posterior arch of 2nd thoracic vertebra, left upper lobectomy of lung, and left adrenalectomy. On histologic examination, metastases to the left adrenal gland and cervical lymph nodes were papillary thyroid carcinomas, while other metastatic sites turned out to be anaplastic thyroid carcinomas. Despite aggressive surgery and postoperative adjuvant therapy, her general clinical conditions were getting worse day by day due to regrowing of the anaplastic thyroid carcinomas. To our knowledge, this is the first case reported in Korea.

Long-Term Trend Analysis in Nuclear Medicine Examinations (핵의학 영상 검사의 중장기 추세 분석 - 서울 소재 일개 상급 종합병원을 중심으로 -)

  • Jung, Woo-Young;Shim, Dong-Oh;Choi, Jae-Min
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.15-28
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    • 2019
  • Purpose Nuclear medicine was initially introduced in Korea in 1969 and widely applied to treat hyperthyroidism with $^{131}I$. Also, gamma camera was adopted in 1969 in the first place and its application has been growing continually in many ways. We analyzed long-term trend in nuclear medicine examinations for the last 2 decades. The purpose of this paper is to make predictions and to set both plans and directions on the development of nuclear medicine. Materials and Methods We analyzed the performance of nuclear medicine examinations and therapies performed in Asan Medical Center from 1998 to 2017. Results Results from the last 20 years regarding Bone scan, Renal scan, MUGA scan and $^{18}F$-FPCIT, Bone Mineral Density were on a increase. And Myocardium perfusion SPECT, Thyroid scan, Lung scan were on a decrease while $^{18}F-FDG$ PET maintained on a steady course. Until 2010 there was a positive performance with the therapy but after the excessive medical care in thyroid examination performance is at status quo. Key events such as a medical strike(2000), Middle-East Respiratory Syndrome (2015) influenced the overall performance of the therapy. Conclusion In order to promote a long-term growth in nuclear medicine examination and therapy, it is inevitable to respond to the changes in current medical environment. Furthermore, it is strongly suggested to put efforts to maintain and develop new examinations and clinical indicators.

Comparative Analysis of Preoperative Diagnotic Findings with Histologic Results in Thyroid Nodule (갑상선 결절의 술전진단과 술후 조직학적 결과의 비교분석)

  • Park Jin-Young;Cho Hyun-Jin;Lim Sung-Chul
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.52-57
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    • 2000
  • Purpose: The purpose of the study was to evaluate the sensitivity, specificity and accuracy between the FNAC and intraopevative frozen biopsy based upon the Final histologic diagnosis. Method: Authors studied 232 cases of thyroid nodule operated at Department of Surgery, College of Medicine, Chosun University, from January 1992 to December 1998. The medical records of these patients were studied retrospectively. The cytology of FNAC and the frozen section was compared to the final histologic diagnosis. 232 cases were analysed in regard to correlation of FNAC diagnosis and Intraoperative frozen section with final pathology, preoperative thyroid scan, thyroid function test, ultrasonography, final histopathology of the specimens, and surgical operation methods. 174 cases who underwent FNAC for diagnosis before operation, and Intraoperative frozen-section biopsy were classified according to whether the clinical diagnosis was benign, suspicious or malignant and evaluated the specificity sensitivity and accuracy. Result: Comparing with final histopathology, FNAC as a diagnostic test for thyroid nodules demonstrated an accuracy of 81.3%, a sensitivity of 87.5%, a specificity 86.5% with a false positivity of 2.9%, false negativity of 4.3%, respectively. and Intra-operative frozen section demonstrated an accuracy of 86.8%, a sensitivity of 87.5%, a specificity 92.1%. In the benign lesion, there was no difference in accuracy between FNAC(95.6%) and frozen section(95.1%) but, in the suspicious malignant lesion, frozen section(46.2%) was superior to FNAC(32.0%), and in the malignant disease, FNAC(97.1%) was superior to frozen section(92.3%). Conclusion: Intraoperative frozen section biopsy is useful in patients undergoing surgery for a thyroid nodule with a 'suspicious' malignant lesion and could reduce inadequate extensive excision without missing malignancy and second operation and help to determine the resection margin. It adds no information in patients with a diagnosis of malignancy following FNAC assessment and is of limited use in those in whom a benign lesion is diagnosed.

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