PURPOSE: Anaplastic thyroid cancer (ATC) is rare and has a poor prognosis. The aim of this study was to analyze the clinicopathologic characteristics of patients diagnosed with ATC expected to undergo curative thyroidectomy, with the goal of finding differences between patients surviving > or =6 months and <6 months. METHODS: From 1981 to 2010, 24 patients underwent thyroidectomy due to ATC. Among those patients, 12 suspected of distant metastasis preoperatively were excluded. The remaining 12 patients were analyzed by retrospective review of electronic medical records. RESULTS: Median age was 55 years, and the male to female ratio was 1:5. All patients presented with neck mass at initial diagnosis. Five patients lived <6 months and seven patients lived > or =6 months after operation. In patients surviving > or =6 months, all lesions were <5 cm and all patients underwent total thyroidectomy. In patients surviving <6 months, two of the four lesions were >5 cm, and two of the five patients underwent less than total thyroidectomy (P = 0.287 and 0.152, respectively). All patients with lesion size <5 cm underwent total thyroidectomy and showed a shorter median operation time (P = 0.182 and 0.033, respectively). CONCLUSION: ATC showed female predominance. Patients initially presented with neck mass, and median age was 55 years. In patients with ATC who are expected to undergo curative thyroidectomy, surgery should actively be considered as primary therapy for patient survival when the size is <5 cm.
Electronics ; Electrons ; Female ; Humans ; Male ; Neck ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: Cervical lymphadenectomy is frequently performed in papillary thyroid carcinoma (PTC) patients with lateral node metastasis to improve regional control, but the cervical levels that require dissection remain controversial. We conducted this study to investigate the necessity of the routine dissection of level V in papillary thyroid microcarcinoma (PTMC). METHODS: To identify the relation between PTMC and level V metastases, we analyzed 90 patients who underwent lateral neck dissection (ND). Twenty-five patients underwent lateral ND when metastasis was detected during follow-up, whereas the other 65 patients underwent total thyroidectomy with central and lateral ND at initial surgery. RESULTS: There were 18 PTMC patients and 72 patients with a PTC of >1 cm. Metastasis at level III or IV was detected in 80.0% and 78.9%, respectively, whereas metastasis at level V was only detected in 12.2%, and metastasis at level II occurred in 30%. In PTMC patients, metastatic rates at levels II, III, IV, and V were 11.1%, 61.1%, 61.1%, and 5.6%, respectively, and in patients with a PTC of >1 cm, metastatic rates at levels II, III, IV, and V were 34.7%, 84.7%, 83.3% and 13.9%, respectively. PTMC was not found to be significantly associated with level V metastasis (P=0.452). CONCLUSION: The level V metastatic rate in PTMC was no different from that of PTC>1 cm statistically. However, the metastatic rate was only 5.6% in PTMC. Therefore, we recommend that care be taken when deciding whether to perform level V dissection when dissecting the lateral cervical nodes in PTMC.
Follow-Up Studies ; Humans ; Lymph Node Excision* ; Lymph Nodes* ; Neck Dissection ; Neoplasm Metastasis ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: To analyze the incidence and patterns of calcification of papillary thyroid microcarcinoma (PTMC) on neck ultrasonography (NUS) and assess the clinical implications of calcification, especially for neck node metastasis. METHODS: The clinical data of 379 patients with PTMC who underwent thyroidectomy between January and December 2011 were retrospectively analyzed. PTMC lesions were classified into four subgroups according to their calcification patterns on preoperative NUS: microcalcification, macrocalcification, rim calcification, and noncalcification. The clinicopathologic characteristics were compared between the patients with and without calcification, and among the four subgroups. RESULTS: Calcifications were detected on NUS in 203 patients (53.5%) and central neck node metastasis was observed in 119 patients (31.3%). Calcification was associated with larger tumor size (0.68 cm vs. 0.54 cm), higher rate of lymph node metastasis (38.6% vs. 23.2%) and higher lymph node ratio (0.11 vs. 0.06) compared to noncalcification (All P < 0.05). In addition, the extent of calcification correlated with lesion size (0.67 cm vs. 0.69 cm vs. 0.85 cm). Further, the likelihood of lymph node metastasis also correlated with the extent of calcification in the order of non-, micro- and macrocalcification (23.3%, 36.8%, and 44.1%, respectively). The calcification rate was higher in patients with lymph node metastasis than those without it (65.5% vs.47.7%) (All P < 0.05). CONCLUSION: PTMC patients positive for calcification on NUS had a higher rate of lymph node metastasis, and a higher lymph node ratio compared to noncalcification patients. Calcification patterns should be assessed carefully in patients with PTMC by preoperative NUS.
Humans ; Incidence ; Lymph Nodes ; Neck* ; Neoplasm Metastasis ; Retrospective Studies ; Thyroid Gland* ; Thyroidectomy ; Ultrasonography*

On ultrasonography, medullary thyroid carcinoma (MTC) shows hypoechogenicity, an irregular margin, a predominantly solid composition, and microcalcifications, similar to those observed in papillary thyroid carcinoma (PTC). MTC presenting as a cystic lesion is rare, and endoscopic thyroidectomy can be performed for benign thyroid masses and early stage PTC, however it is inappropriate for MTC regardless of cystic change. The authors report a case of cystic MTC found after endoscopic thyroid lobectomy and provide a review of the literature on this topic.
Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography

Right intrathoracic stomach associated with organoaxial torsion is a rare form of congenital hiatal hernia. We report the radiologic findings in two cases of complete or partial right intrathoracic stomach secondary to congenital hiatal hernia. The barium meal test demonstrated the presence of complete or partial right intrathoracic stomach and non-obstructive organoaxial torsion with the greater curvature lying against the right chest wall. The esophagogastric junction was located above the diaphragm. CT revealed a cystic mass in the right posterior mediastinum. This cystic lesion should be differentiated from other congenital mediastinal cysts.
Barium ; Deception ; Diaphragm ; Esophagogastric Junction ; Hernia, Hiatal* ; Meals ; Mediastinal Cyst ; Mediastinum ; Stomach* ; Thoracic Wall

Rhabdomyosarcoma is the most common soft tissue sarcoma occurring in children, though retroperitoneal rhabdomyosarcoma is rare. We experienced a case of embryonal rhabdomyosarcoma of the retroperitoneum in a 43-month-old child, and describe the CT , MRI and pathologic findings.
Child* ; Child, Preschool ; Humans ; Magnetic Resonance Imaging ; Myosarcoma ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal* ; Sarcoma

BACKGROUND: Although sun-caps are widely used to shun hazardous solar ultraviolet (UV) radiation in Korea, little is known about their protective efficacy. OBJECTIVE: We tried to measure and compare sun-cap protection from UV radiation. METHODS: Seventeen commercially available sun-caps (products 1~17) were evaluated against UV-protection by spectrophotometerically measuring absorption and transmission spectra, percent protection of solar UVB and UVA photometerically, and solar UV-spectra spectroradiometerically. RESULTS: The absorption and transmission spectra of 17 different sun-caps were different, and they were not related to either price or their stated UV-guarantee. Percent protection showed some correlation, particularly with that of UVB. Protection against solar UV-spectra was similar to that of the absorption ond transmission spectra. CONCLUSION: Protection of sun-caps were highly varied, and this was not related to their price or stated UV- guarantee. Among three evaluation methods, absorption and transmission spectra seemed to be more objective. Further studies would be necessary to provide proper information and guidelines to dermatologists and consumers on the UV- protection of sun-caps.
Absorption ; Korea

PURPOSE: The current study examined the validity and outcomes of three lobectomy methods for papillary thyroid carcinoma (PTC), open surgery, minimally invasive videoassisted thyroidectomy (MIVAT), and endoscopic surgery. METHODS: Between January 2006 and June 2011, 360 patients underwent lobectomy for treatment of PTC. Clinical data were collected and analyzed retrospectively. Open lobectomy, MIVAT, and endoscopic lobectomy were performed in 170 (47.2%, Group A), 81 (22.5%, Group B), and 109 patients (30.3%, Group C), respectively. Median tumor size was 0.5 cm. RESULTS: No significant differences in tumor size, lymphovascular invasion, extrathyroidal extension, and metastatic lymph node number were observed among the groups. However, the mean number of retrieved central lymph nodes was higher in the open surgery group than in the other groups (8.9, 4.9, and 5.8 in Groups A, B, and C, respectively P<0.05). Postoperative bleeding occurred in one patient each in Group A. Temporary hypoparathyroidism developed in ten, three, and three patients in Groups A, B, and C, respectively. Recurrence occurred in five cases (1.4%), however, no significant difference in short-term recurrence (median duration of follow up: 1,109 days) was observed among the three groups. CONCLUSION: The number of retrieved central lymph nodes was higher in the open surgery group. However, no differences in the incidence of complications or short-term recurrence were observed among the groups, indicating that either one of these methods can be recommended as limited surgery for PTC.
Follow-Up Studies ; Hemorrhage ; Humans ; Hypoparathyroidism ; Incidence ; Lymph Nodes ; Recurrence ; Retrospective Studies ; Surgical Procedures, Minimally Invasive ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: Several reports have examined the predictors of temporary hypoparathyroidism after total thyroidectomy; however, few have assessed the clinical predictors of early recovery from the condition. Here, we compared the clinical factors of early and late recovery groups of patients with temporary hypoparathyroidism. METHODS: The electronic medical records of 248 patients who underwent total thyroidectomy from January 2012 to July 2013 and had parathyroid hormone (PTH) levels <10 pg/mL on the first postoperative day were examined retrospectively. The early recovery group showed recovery from PTH at two weeks postoperatively and the late recovery group showed recovery from PTH at one month postoperatively. RESULTS: The early recovery group included a lower proportion of males (8.6% vs. 23.7%, P<0.01) and a higher proportion of patients with more than three parathyroid glands saved (83.8% vs. 76.8%, P<0.04). There were no significant differences in the other variables examined. CONCLUSION: The early recovery group of patients with temporary hypoparathyroidism included a lower proportion of males and a higher proportion of patients with more than three parathyroid glands saved intraoperatively. These findings can be used as clinical indicators when discharge medication is prescribed.
Electronic Health Records ; Humans ; Hypoparathyroidism* ; Male ; Parathyroid Glands ; Parathyroid Hormone ; Retrospective Studies ; Thyroidectomy*

PURPOSE: Neck ultrasonography (NUS) is one of the most commonly used methods for evaluating thyroid nodules and preoperative higher TSH levels are known to be associated with differentiated thyroid cancers. This study was conducted to assess whether serum TSH levels and neck ultrasonography are of value in predicting malignancy in patients with atypia of undetermined significance/follicular lesions of undetermined significance (AUS). METHODS: A total of 62 patients (7 men, 55 women; mean age 48.4±11.9 years) who had indeterminate cytologic results indicating AUS underwent thyroidectomy. Preoperative clinical data including serum TSH and the findings of NUS were analyzed retrospectively between malignant and non-malignant groups. RESULTS: The final pathologic results of malignancy were reported in 53 of 62 (85.5%) patients with AUS. There was no significant difference in the mean value of preoperative serum TSH between malignant and non-malignant groups (1.5±1.3 vs. 1.9±1.2, P=NS). In NUS, the patients diagnosed with malignancy in histology showed a higher proportion of calcification, taller-than-wide shape, hypoechoic texture and irregular margin (58.5% vs. 22.2%, P=0.044; 34% vs. 0%, P=0.038; 98.1% vs. 44.4%, P<0.01; 47.2% vs. 0%, P=0.008). CONCLUSION: Serum TSH was not related to malignancy in thyroid nodules showing AUS. However, ultrasonographic features including calcifications, taller-than-wide shape, hypoechoic pattern and irregular margin could be used to predict malignancy. Ultrasonography should be the first useful methods when making decisions regarding management of thyroid nodules showing indeterminate cytologic results as AUS.
Female ; Humans ; Male ; Neck* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography*