• 대한두경부종양학회지
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• 제17권1호
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• pp.56-58
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• 2001

Anaplastic thyroid carcinoma, which is one of the most aggressive tumors of the thyroid, has been seldomly reposted to have altered thyroid function. There have been few reports of patients with anaplastic thyroid cancer presenting in a hyperthyroid state. In the literatures, the mechanism of hyperthyroidism in anaplastic thyroid cancer is supposed that the rapid invasive growth of cancer seems to cause destruction of thyroid tissue and develops a hyperthyroid state, which is thought to be anlalogous to that of subacute thyroiditis and several types of metastatic cancer of the thyroid: rapid tissue necrosis with resultant release of thyroid hormone. Recently, we experienced a case of anaplastic thyroid cancer presenting with rapid growing mass and hyperthyroidism in a 67-year-old woman and report it with the review of the literatures.

• Journal of Chest Surgery
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• 제42권4호
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• pp.537-539
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• 2009

47세 여자 환자가 이전부터 있던 흉골상 절흔부에 종괴를 제거하기 위해 내원하였다. 흉부 CT에서 종괴는 상전종격동에 위치하고 있었다. 경부 절개 후에 종괴를 제거하였고 병리학적 검사상 종괴는 결절성 과형성(nodular hyperplasia)을 함유한 이소성 갑상선 조직으로 진단되었다. 저자들은 드문 종격동 이소성 값상선 조직을 치험하였기에 보고하는 바이다.

• 대한두경부종양학회지
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• 제15권1호
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• pp.66-69
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• 1999

Background and Objectives: It is critical to distinguish benign from malignant thyroid nodule and to select a patient for surgery. Even though the U/S study dose not make great contribution to diagnose a malignant thyroid nodule, it is widely used in the evaluation of anatomic feature of thyroid. The authors tried to estimate the efficacy of the U/S study in preoperative diagnosis of malignant thyroid nodule. Materials and Method: At the department of General Surgery of Ajou University, 75 patients who were operated after diagnosis with thyroid nodule by U/S study between July 1996 to June 1997 were retrospectively analyzed. By comparing the U/S impression that implies malignant thyroid nodule to FNAC and post-operative pathologic results ware as follows. Results: 1) Absence of cystic change, presence of internal hypoechogenicity, lobulation, calcification, thick and irregular halo, and nodule more than 4cm in diameter on U/S were considered significant statistically for the diagnosis of malignancy(Chi-square test, p<0.05) 2) Presence of internal hypoechogenicity or thick and irregular halo has the validity in Logistic regression analysis. 3) FNAC was done in 65 case. 19 case were malignant, 11 case were suspicious and 46 patients were benign (sensitivity 52.6%, specificity 87%). 4) The findings of U/S which are hypoechogenic and thick and irregular halo show 82% sensitivity and 97% specificity. In combination with the findings of FNAC that imply benign or suspicious lesions, the sensitivity was 100% and the specificity was 97%. Conclusion: This study suggest that the hypoechogenicity and thick and irregular halo on U/S are important information for the diagnosis of thyroid malignancy which were considered benign or suspicious after FNAC.

• Advances in pediatric surgery
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• 제6권2호
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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.

• International journal of thyroidology
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• 제11권2호
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• pp.99-108
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• 2018

Most thyroid cancers are well-differentiated cancers and have a very good prognosis. About 10% of thyroid cancer, however, invades the surrounding tissues, causing local recurrence and distant metastasis, and eventually affecting survival rate. In locally advanced thyroid cancers, the invasion of trachea, larynx and esophagus, can be occurred by primary tumor and may also result in lymph nodes metastasis. Surgical resection is still mainstay for the treatment of locally advanced thyroid cancer. The main purpose of the surgical resection is to eliminate the cancer completely, therefore, it can cause many complications such as dysfunction of the larynx, trachea and esophagus. It can have a serious effect on the quality of life, therefore there is still controversy on the extent of the surgery. The authors compare and analyze the opinions which were already discussed in the literatures published so far. These will help to select the surgical method.

• 대한두경부종양학회지
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• 제31권2호
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• pp.6-10
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• 2015

Background and Objective : Papillary thyroid microcarcinoma(PTMC) is known as slow growing cancer with good prognosis. However, extrathyroidal extension may increase the risk of cervical lymph node metastasis and local invasion to surrounding structures. The aim of this study was to assess the characteristic features of the tumor invading the posterior thyroid capsule. Material and Methods : We made a retrospective review of 123 PTMC patients with thyroid capsule invasion, pathologically staged as T3 or T4. 74 patients (60.2%) had invasion to posterior thyroid capsule (group A) while 49 patients (39.8%) had invasion to-anterior thyroid capsule or anterior wall of trachea (group B). We assessed the clinicopathologic factors of the patients according to the location of capsular invasion of PTMC. Results : There was no difference regarding age, gender, T and N classification and incidence of lymph node metastasis between two groups. Local invasion rate to recurrent laryngeal nerve was 6.8% in patients with posterior thyroid capsule invasion, while the incidence was zero in those with capsular invasion to other locations Conclusion : Increased risk of local invasion to the recurrent laryngeal nerve should be considered in patients with PTMC presenting invasion of the posterior capsule.

• 대한두경부종양학회지
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• 제21권2호
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• pp.174-177
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• 2005

Skin metastasis from papillary thyroid carcinoma is extremely rare. Due to similar histopathologic features, it is difficult to differentiate skin metastatic papillary thyroid carcinoma and some primary skin neoplasms without a clinical history. However, most of metastatic skin lesions showed a strong reactivity to the antithyroglobulin antibodies unlike primary skin neoplasms. Metastatic skin lesions must be completely removed and radiotherapy can be added. Investigators reported that prognosis of skin metastases from thyroid carcinoma is dismal and the average survival after it's diagnosis was only 19 months because distant metastases were often discovered at diagnosis of skin metastasis or during follow-up period. We report a case of skin metastasis from tall cell variant of papillary thyroid carcinoma. In our case, the anti thyroglobulin antibodies measured from cystic fluid from a skin lesion was more than 2000 IU/ml. Skin metastasis was diagnosed at 20 months after primary surgery for thyroid cancer and brain metastasis at 12 months after diagnosis of skin metastasis. Although skin metastasis is an ominous prognostic indicator in patients with thyroid carcinoma, a radical treatment for skin lesions and early diagnosis of distant metastasis could provide a chance to the patients to improve their survival.

• 대한두경부종양학회지
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• 제8권2호
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• pp.82-90
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• 1992

A pathologic review was made of 1547 cases of thyroid nodule during the 20 years from 1970 to 1989 at the department of Head and Neck surgery of Presbyterian Medical Center in Chonju. 1547 cases were analysed in regard to cancer incidence of thyroid nodule, correlation of preoperative diagnosis with pathology and of frozen section diagnosis with final pathology, surgical procedures employed in managing thyroid itself, location of metastatic nodes, further definite procedure in cnacer cases, effectiveness of prophylactic neck dissection with lymph node pathology. The results are summarized as follows: 1) The cancer incidence of thyroid nodule was 21.7%. 2) The incidence of thyroid cnacer in total neoplasms increased from 1.6% to 2.9%. 3) The thyroid cancer was prevalent in female(5.9:1) and in fifth, fourth and sixth decade of life. 4) The incidence of solitary cold nodule in thyroid cancer was 72.7% (210/289). S) The incidence of thyroid cancer in solitary cold nodule was 28.7% (210/782). 6) The false negative of frozen section (1240 cases) was 19.8%. 7) Histologically, well differentiated carcinoma comprises about 94% of all cases and papillary carcinoma was 78.5% of all cases 8) The most frequent lymphatic metastasis was pre- & paratrachel nodes(63.3%), followed by Level III(50%) and Level II(47.7%). 9) 47.7% among 130 cases of papillary adenocarcinoma and 12.5% among 16 cases of follicular adenocarcinoma, each group treated with prophylactic neck dissection, were confirmed to be occult cervical node metastasis.

• 대한두경부종양학회지
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• 제14권1호
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• pp.88-93
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• 1998

In order to review the clinicopathologic characteristics of the thyroid cancer associated with benign thyroid disease, we evaluated 47 patients treated between January, 1993 and September, 1997 at the Chonnam National University Hospital. In those period, we had operated a total of 690 thyroidectomy of which 320 were diagnosed as thyroid cancer. Forty three(91.4%)occurred in women and four(8.5%)occurred in men. The mean age at operation was 46.7years(range, 15 to 76 years). Forty three of the 47 cancers(91.4%) were papillary carcinomas while 4(8.5%)were follicular. Twenty four of the 47 patients (51%) were occult thyroid carcinomas measured less than 1 cm in diameter. The concurrent benign disease were nodular goiter(n=17), Hashimoto's thyroiditis(n=16), follicular adenoma(n=10), Graves' disease(n=2) and diffuse hyperplasia(n=2). Thirty one patients were diagnosed by preoperative FNAC and they underwent total thyroidectomy. Three were diagnosed by frozen section examination at the time of operation. Among them, one underwent total thyroidectomy and two underwent subtotal thyroidectomy. Eight cases revealed lymph node metastases and 2 cases extended to surrounding muscles. In conclusion, concurrent thyroid cancers and benign thyroid disease are not uncommon and a regular ultrasonic follow-up with selective aspiration cytologic examination is recommaned to enhance their diagnostic accuracy.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.377-380
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• 2016

Background: Epidemiological data on thyroid cancer and associated risk factors are scarce in our setting. The present study was therefore designed to gather data which could be helpful in providing insights to thyroid physicians and surgeons for better management of affected patients. Purpose: To determine the frequency of carcinoma thyroid among patients presenting with goiter and its association with TSH, Tg/ATg and other demographic factors. Materials and Methods: A total of 73 adult patients of either gender with solitary solid cold nodules and/or multi-ndoular goiter (MNG) with predominant solid cold nodules were enrolled. All surgically resected samples were sent for histopathology. The frequency of thyroid cancer and its subtypes was noted and tested for association with gender, age (< or ${\geq}40years$), recent increase in swelling size, TSH, Tg and ATg. Results: Thyroid cancer was diagnosed in 26% (n=19) of the patients, 14 (73.7%) being diagnosed with papillary thyroid cancer and 5 (26.3%) with follicular thyroid cancer. No other subtypes were noted. Presence of thyroid cancer was significantly associated with recent increase in swelling size and higher TSH Values mean TSH values (P<0.05). No significant association was found with gender, age, Tg and ATg values (P>0.05). Conclusions: Overall percentage of thyroid cancer in our study sample was found to be 26%, with a predominance of papillary over follicular lesions. Rates were significantly higher in patients who had history of recent increase in swelling size and higher and higher pre-surgery TSH values.