• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.17
• /
• pp.7271-7275
• /
• 2014

Background: The aim of the present study was to evaluate the presentation, clinical course and outcome between children and young adults with differentiated thyroid cancer (DTC) treated in our hospital. Materials and Methods: The medical records of 145 patients with DTC who underwent surgery followed by radioiodine and thyroid hormone (TSH) suppression were retrospectively reviewed. The follow up was between January 2006 and June 2012. These patients consisted of 38 children (age${\leq}18y$) and 107 young adult patients (age${\leq}30y$). The clinical characteristics and outcome were analyzed and compared, and the progression-free survival (PFS) was evaluated using the Kaplan-Meier method. Results: At initial diagnosis, a greater degree of extra thyroidal extension was found in children than adults patients (p<0.001). However, there was no significant difference between the two groups with regard to the tumor size and the presence of lymph node or distant metastasis (p=0.172, p=0.050 and p=0.068, respectively). The extent of surgery and the cumulative or mean dose of radioiodine were similar in both groups. During the follow up, the overall survival rate was 100% for both groups, and the PFS rate was similar in children and in young adults group (log rank test, ${\chi}^2$=0.126, p=0.723). Conclusions: In comparison to the young adult patients, DTC in children presents with more aggressive behavior, but outcomes are similar between the two groups after the intensive management of surgery followed by radioiodine and TSH suppression therapy.

• Korean Journal of Head & Neck Oncology
• /
• v.14 no.1
• /
• pp.27-34
• /
• 1998

Objectives, Materials & Methods: To prevent deterioration of postoperative voice due to iatrogenic transection of the recurrent laryngeal nerve during the thyroid surgery, intraoperative medialization of the membranous vocal cord by type I thyroplasty together with direct epineurial neurorraphy was done on 2 cases of benign thyroid lesion. To improve the quality of voice together with complete removal of advanced thyroid carcinoma, intraoperative vocal cord medialization on the lesion side together with total thyroidectomy was done by type I thyroplasty in 2 cases and combined procedure by arytenoid adduction and type I thyroplasty in another 2 cases. Results: The resultant voice of the iatrogenic injury cases was relatively tolerable. The voice of the combined procedure was better than that of type I thyroplasty cases for the intraoperative rehabilitation cases. Not only for the preoperative evaluation of the severity of the nerve lesion but also the prognosis will be expected by use of laryngeal EMG in the cases of thyroid cacer with vocal cord palsy. Conclusion: Intraoperative simultaneous rehabilitation for the vocal cord palsy during thyroid surgery is beneficial for the patients.

• Korean Journal of Head & Neck Oncology
• /
• v.14 no.1
• /
• pp.61-69
• /
• 1998

Objectives: The response rate of the radioactive iodine(RI) therapy with low dose was variable. Only a few studies reported the response and complication rate with high dose. The goal of this study was to access the ablation and complication rate after high dose of RI therapy (more than 100mCi) and to evaluate the factors affect the results. Material and Methods: During a period of 12 years, 225 patients received high dose of RI from 100 to 200mCi depending on the RI uptake in the whole body after total thyroidectomy. 100mCi of RI was given to 123 patients for ablation who showed the uptake only in the thyroid bed. 150mCi was given to another 84 patients for ablation who had uptake confined to the neck. The other 21 patients took more than 200mCi of RI because the whole body scan showed distant metastasis. Among these patients, the ablation and the complication rate was investigated. Results: Elevated level of the serum thyroglobulin(Tg) decreased less than 5ng/ml after RI therapy in all patients except two in the first group. The second group showed reduction of the serum Tg in 93%. Eighteen of the 21 patients in the third group are still alive after RI therapy. There were no fatal complications after high dose RI therapy and most of the complications were minimal and transient. The complication rate was not related with the dose of RI, age, sex, DNA flowcytometry, serum thyroglobulin level and the extent of node dissection. Conclusion: We concluded that RI therapy with high dose was very effective for thyroid ablation after operation and it also showed excellent results with minimal complications for treatment of metastatic lesions.

• Korean Journal of Head & Neck Oncology
• /
• v.23 no.2
• /
• pp.161-164
• /
• 2007

Thyroid hemiagenesis is a rare anomaly, which is the result of failure of embryologic development of a lobe of thyroid gland. It is more frequently found in the left lobe and in female patients. We, herein, report an extremely rare case of thyroid hemiagenesis associated with papillary thyroid carcinoma. A 69-year-old female presented with an incidentally discovered thyroid nodule in the right thyroid during a routine medical check-up. Ultrasonography(US) and computed tomography(CT) disclosed $0.7{\times}0.5cm\;and\;2.8{\times}2.2cm$ sized nodules in the right thyroid. The left thyroid, however, was not seen in the imaging studies of US and CT. Fine-needle aspiration of the small and large nodules showed papillary thyroid carcinoma and adenomatous hyperplasia, respectively. The patient underwent a right total thyroidectomy with central compartment node dissection. The operative findings and histologic examination confirmed the absence of the left thyroid associated with papillary thyroid carcinoma and ademonatous hyperplasia of the right thyroid.

• The Journal of Internal Korean Medicine
• /
• v.29 no.3
• /
• pp.827-834
• /
• 2008

Papillary thyroid carcinoma is the most common type of thyroid malignancy. It has better prognosis and rarer incidence of distant metastasis than other types of thyroid malignancy. However, once distant metastasis happens, its result will be bad. They mostly spread to the lungs and bones. and rarely to the brain. We report a patient with a papillary thyroid carcinoma metastasis to the lymph nodes. the ribs. the brain, and the lungs. The patient underwent total thyroidectomy, radioiodine ablation, rib partial resection, and lung wedge resection. However, upon progress of metastasis. the patient insisted on being treated with traditional Korean medical treatment using allergen-removed Rhus Verniciflua Stokes (A-RVS) instead of the conventional treatment including chemotherapy. The size of the tumor partly decreased, and the patient showed no side effects. This case report brings forth the importance of a thorough study in papillary thyroid carcinomas and their metastasis from the traditional Korean medical point of view, along with the long-term effect of allergen-removed Rhus Verniciflua Stokes (A-RVS).

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.4
• /
• pp.2321-2323
• /
• 2016

Background: Inflammatory hematological parameters like the neutrophil/lymphocyte (N/L) ratio have been investigated in many cancer types and significant relationships found with prognosis, for example. The aim of this present study was to investigate the impact of hematological parameters notably on N/L ratio and mean platelet volume (MPV) in papillary thyroid cancer cases. Materials and Methods: A total of 79 patients who underwent a thyroidectomy operation in Findikli, Goiter Research and Treatment Center during 2011-2015 period were enrolled in the study, 41 with papillary thyroid cancer and 38 with benign goiter confirmed by pathological examination. We collected clinical and laboratory data for the patients from hospital records retrospectively. Blood samples taken at admission were assessed for parameters compared between the groups. Results: No significant differences between papillary thyroid cancer and benign goiter groups were apparent in terms of age, the N/L ratio, MPV, white blood cell count (WBC), red blood cell count (RBC), hemoglobin, hematocrit, platelet, neutrophil, lymphocyte, red blood cell distribution width (RDW) and platelet crit (PCT) levels (p>0.05). Only the level of platelet distribution width (PDW) significantly differed, being lower in the papillary cancer group (p<0.05). Conclusions: No significant relationship between papillary thyroid cancer and inflammatory hematological parameters including in particular the N/L ratio and MPV. The relevance of the PDW values remains unclear.

• The Korean Journal of Cytopathology
• /
• v.5 no.1
• /
• pp.46-51
• /
• 1994

Fine needle aspiration cytologic features of a case of insular carcinoma of the thyroid in a 23-year-old woman who presented a palpable neck mass is described. The aspirate showed cellular smear arranged in trabeculae, solid or loose clusters, and microfillicles in necrotic background. The tumor cells had uniform, small round, hyperchromatic nuclei. The chromatin was finely granular, and nuclear membrane was smooth. Nucleoli were not discernible. Nuclear pleomorphism was minimal. The cytoplasm was usually scanty, pale, poorly outlined, and almostly amphophilic. Sometimes paranuclear cytoplasmic vacuoles were noted. final diagnosis was confirmed by total thyroidectomy as insular carcinoma.

• Korean Journal of Head & Neck Oncology
• /
• v.13 no.1
• /
• pp.74-80
• /
• 1997

We have experienced 5 cases of unusual well differentiated thyroid carcinoma with insular component during the past 5 years. 4 cases were presented with cervical masses but I case (patient 2.) was initiallty with lung and brain metastasis. The tumors from 4 cases showed invasive growths but that of 1 cases(patient 1.) showed intrathyroidal. Total thyroidectomy and cervical lymphnode dissection(CCND or RND) was performed in 4 cases but only RND was performed in spite of mediastinal metastasis of the tumor in patient 5 under the patient's choice. During the follow-up period, we also performed radical nephrectomy and metastatectomy for the kidney and iliac bone metastasis respectively, in patint 2. Microcsopically, the tumors showed the insular growth patterns, focally(less than 50%) in 3 cases and predominantly(more than 75%) in 2 cases. And the insular componentas were combined with papillary carcinoma in 2 cases and follicular carcinoma in 3 cases. Cervical lymphnode metastases were confirmed in 4 cases. Patient 2 died of disease with metastases to lung, brain, bone and kidney, 52 months after initial therapy. Patient 1, 3 and 4 are alive and have no recurrence and distant metastasis. Patient 5 is also alive with the mediastinal metastasis. In our experience, the well differentiated thyroid carcinomas with insular component showed characteristic histologic features, aggressive behavior in initial presentation and unfavorable prognosis regardless of the percentage of the insular component.

• Journal of Yeungnam Medical Science
• /
• v.31 no.2
• /
• pp.103-108
• /
• 2014

Thyroglossal duct cyst (TGDC) carcinoma generally shows a favorable prognosis. If metastasis is present latently, it may not threaten the patient's life immediately. It has been shown, however, that larger than 1 cm papillary carcinoma (PC), level VI metastasis to the lymph node (LN), which is the nearest to the thyroid, independently predicts a worse prognosis. In the case presented herein, a 61-year-old female patient was diagnosed with an about 3 cm PC in the TGDC, particularly the columnar variant subtype, one of the aggressive variants. She had occult papillary thyroid microcarcinoma, but no LN metastasis. Even though she underwent the Sistrunk procedure and total thyroidectomy with central compartment neck dissection followed by high-dose radioactive iodine remnant ablation, however, the cancer cells spread to level IV neck LN, and finally to the lung. Therefore, when a patient is diagnosed with an aggressive histologic variant of PC in the TGDC, even without LN metastasis, the invasive surgical approach and close postoperative surveillance are necessary, with consideration of the risk of disease progression. Therefore, if it is possible to stratify the risk for patients, higher-risk patients can be offered a more invasive therapeutic approach.

• Journal of Medicine and Life Science
• /
• v.19 no.3
• /
• pp.95-102
• /
• 2022

This retrospective study aimed to investigate whether there was a difference in the success rate of removal of residual thyroid tissue in patients with the same cutoff serum thyroglobulin (Tg) value-measured 2 weeks after thyroid hormone withdrawal (THW)-for different radioactive iodine (RAI) activities. We identified 132 patients with papillary thyroid cancer who were treated with total thyroidectomy and RAI therapy to evaluate the efficacy of three radioactivities of I-131: 1,110, 3,700, and 5,550 MBq. Serum Tg testing was performed 1 week before RAI treatment and 2 weeks after THW (pre-Tg); the cutoff pre-Tg level was below 10 ng/mL. Stimulated Tg levels were measured on the day of I-131 administration (off-Tg). After 6 months of treatment, we compared the groups for complete ablation, defined as no uptake on a diagnostic I-131 scan, stimulated Tg level of <1.0 ng/mL, and Tg antibody level of <100 ng/mL. Ninety-five patients (72.0%) achieved complete ablation, with 57.1% (8/14), 78.2% (68/87), and 61.3% (19/31) in the 1,110 MBq, 3,700 MBq, and 5,550 MBq groups, respectively. There was no significant difference in the complete ablation rates between the three groups. In the multivariate analysis, the off-Tg level was a significant predictor of complete ablation. RAI therapy with low radioactivity (1,110 MBq) seemed sufficient for ablation in patients with papillary thyroid cancer with a pre-Tg level below 10 ng/mL. The off-Tg level is a promising and useful predictor of complete ablation after initial RAI therapy.