Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

BACKGROUND AND OBJECTIVES: Although anaplastic thyroid carcinoma (ATC) accounts for less than 2% of all thyroid malignancies, it contributes to 14-50% of deaths related to thyroid tumors. However, there is no definite treatment. The aim of the study is to review our experience of ATC at our own university clinic to look for clues for the management of ATC. SUBJECTS AND METHOD: The medical record of 15 patients with ATC treated in our clinic between 1997 and 2010 were retrospectively reviewed. RESULTS: Five (33.3%) patients underwent no curative treatment but biopsy or tracheostomy. Complete surgical resection was possible in only one patient. Six patients underwent debulking surgery with or without adjuvant treatment. One and two patients were treated with radiation therapy alone and concurrent chemoradiation therapy (CCRT), respectively. Despite various treatment regimens, there are surviving patients at the time of present evaluation. The mean survival was 253.1 days and median survival was 128 days. Only two patients had survived longer than a year. Each patient had been treated with complete surgical resection and CCRT with doxorubicin, respectively. In univariate analysis, there was no association between survival duration and various clinico-pathological parameters. However, old age (> or =65), history of pre-existing thyroid nodule, and radiation therapy was significantly associated with survival duration in multivariate analysis. CONCLUSION: Most ATC was unresponsive to ongoing treatment modalities in our clinic. However, we experienced that a certain treatment was effective in some patients. For the goal of forming a generally effective treatment regimen for ATC, we suggest a prospective multicenter study to be performed on the basis of present study.
Biopsy ; Doxorubicin ; Humans ; Medical Records ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Tracheostomy

Here, we describe two cases of cervical bronchogenic cysts mimicking thyroid cancer on ultrasound (US), introducing some sources of diagnostic error with the aim of improving the understanding of cervical bronchogenic cysts. In these cases, US demonstrated ill-defined nonhomogeneous hypoechoic nodules at the inferior pole of the thyroid gland, exhibiting several echogenic foci that mimicked microcalcification of papillary thyroid carcinoma. Although cervical bronchogenic cysts can be presented as highly suspicious thyroid nodules on US, recognition of this disease entity and comprehensive understanding of its presentation can allow an appropriate diagnostic process without unnecessary diagnostic surgery.

In the last few decades, the standard surgical treatment for primary hyperparathyroidism (PHPT) has shifted from bilateral neck exploration to focused/minimally invasive parathyroidectomy (FMIP). This shift was accelerated by the introduction of intraoperative parathyroid hormone (IOPTH) monitoring, which can provide intraoperative information regarding the localization and complete excision of the pathological parathyroid gland during FMIP. Since the first clinical application of the IOPTH assay in 1991, IOPTH monitoring has substantially improved to date to increase its performance and availability. In addition, the clinical applications of IOPTH changed with the needs of actual clinical practice, although the fundamental concept and technique remained unchanged. In this review, we discuss the role of IOPTH monitoring in the surgical management of PHPT based on the results of contemporary studies and summarized the major issues regarding IOPTH.

As the prevalence of thyroid carcinoma is rapidly increasing, coexisting subtypes of thyroid carcinomas are often found. However, concurrent papillary and medullary carcinomas in the thyroid gland are extremely rare. We report the case of a 50-year-old man with co-occurrence of multiple papillary and medullary thyroid carcinomas; the latter were undetected at initial diagnosis. Sixty-three months after the initial operation performed because of papillary carcinoma diagnosis, a metastatic lymph node was detected in the left level IV region, which was revealed as medullary carcinoma. The histopathologic results from initial surgery were reviewed, and we found multiple coexisting medullary carcinomas that were not identified initially. The incidence of concurrent papillary and medullary thyroid carcinomas will continue to increase as rates of diagnosis of and surgery for thyroid carcinoma increase. Therefore, surgeons and pathologists should be aware of the possible coexistence of subtypes of thyroid carcinomas to avoid missing concurrent lesions.
Carcinoma, Medullary ; Carcinoma, Papillary ; Incidence ; Lymph Nodes ; Prevalence ; Thyroid Gland ; Thyroid Neoplasms

Sialolipoma, a rare tumor of the salivary gland, is a recently described variant of salivary gland lipoma. Oncocytic sialolipoma was first described by Pusiol et al. in 2009. We report the case of an oncocytic sialolipoma of the submandibular gland in a 43-year-old female. Excision of the tumor was performed with preservation of the submandibular gland. The tumor had a thin, fibrous capsule and consisted of abundant adipose tissue, an oncocytic nodule, and scattered normal glandular structures surrounded by adipose tissue. Four cases of sialolipoma of the submandibular gland, including the present case, were reviewed. All 4 tumors were developed on the right submandibular glands, with a composition of adipose tissue as high as that of sialolipoma of the parotid gland; in contrast to previous reports, three cases were in females. As newly described tumor type, care should be taken to distinguish oncocytic sialolipoma from other salivary gland neoplasms such as simple lipoma, pleomorphic adenoma, or oncocytoma.
Adenoma ; Adenoma, Oxyphilic ; Adipose Tissue ; Adult ; Female ; Humans ; Lipoma ; Parotid Gland ; Salivary Gland Neoplasms ; Salivary Glands ; Submandibular Gland*