No abstract available.

No abstract available.

No abstract available.

19 cases of non-pineal intracranial germ cell tumors were reviewed retrospectively with both radiologic andclinical featurses. The results were as follows: 1. The age distribution was 8 to 32 year old (16 year old of meanage) and the sex distribution shows male predominence(15:4). 2. The histopathologic diagnosis included 11 cases ofgeminoma, 2 cases of mixed germ cell tumor, 1 case of embryonal cell carcinoma and 5 cases of unknown. 3. Thelocation of tumors was the suprasellar region in 8 cases, the left basal ganglia and thalamus in 5 cases, and theright frontal lobe in 1 case. Among 11 cases of geminoma, 6 cases involve the suprasellar region and 3 cases theleft basal ganglia and thalamus. 4. In clinical features, there were visual disturbance, diabetes insipidus,increased ICP signs, motor weakness, hormonal disorders, and personal changes in order. 5. In tumor marker studyof 6 cases of geminoma, 5 cases show increase in HCG, titie, but all 6 cases were normal in AFP titer. 6. In brainCT, most of all revealed well-defined homogeneous high density with or without small central low density andhomogenous enhancement at solid portion,and there was calcification in only case with mixed germ cell tumor.
Age Distribution ; Basal Ganglia ; Brain ; Diagnosis ; Frontal Lobe ; Germ Cells ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; Retrospective Studies ; Sex Distribution ; Thalamus

No abstract available.

PURPOSE: Parathyroid cysts are rare clinical entities of the neck and superior mediastinum. These cysts often present a difficult diagnostic challenge. They often present as a solitary thyroid nodule and may be difficult to differentiate clinically. The objectives of this study were to review our 27 cases of parathyroid cyst and to suggest the method of diagnostic approach and treatment for parathyroid cyst. METHODS: A retrospective study was performed for a 24-year period (1981~2004), on 27 patients operated of parathyroid cyst. RESULTS: Most of these patients (22/27) complained asymptomatic anterior neck mass at presentation. Preoperative radiologic examinations included ultrasonography (70.4%), computed tomography (25.9%), and (99m)Tc thyroid scan (22.2%). Hypercalcemia was detected in 3 cases with high serum calcium (11.3 mg/dl) and intact PTH (158.1 pg/mL). Fine Needle Aspiration (FNA) was performed in nineteen cases. It revealed crystal clear aspirate in non-functioning cysts and hemorrhagic in functioning cysts. In the analysis of the aspirate, mean N-terminal PTH (n=10) and intact PTH (n=9) were 22.5 pg/mL (9.3~45.0) and 686.5 pg/mL (138.0~1500.0), respectively. Mean size of the cysts was 4.0 cm (1.0~9.2) and the left inferior parathyroid glands were most commonly involved (63.0%). All parathyroid cysts were surgically removed. CONCLUSION: Parathyroid cysts need to be differentiated from other cystic lesions in the neck and superior mediastinum. Aspiration of crystal clear fluid is highly suggestive of a parathyroid cyst. The aspirate should be analyzed for PTH levels as these are always elevated in parathyroid cysts, regardless of the function. Nonfunctioning cysts may be treated with aspiration alone or sclerosing agents. Surgical excision is indicated for functioning cysts and recurrent case of nonfunctioning cysts.
Biopsy, Fine-Needle ; Calcium ; Humans ; Hypercalcemia ; Mediastinum ; Methods ; Neck ; Parathyroid Glands ; Parathyroid Hormone ; Retrospective Studies ; Sclerosing Solutions ; Thyroid Gland ; Thyroid Nodule ; Ultrasonography

PURPOSE: A post-thyroidectomy hematoma is a rare complication, affecting 0.1~2.5% of patients undergoing a thyroidectomy, but this complication deserves special attention because it is potentially life threatening and unpredictable. This study was performed to evaluate the prevalence and clinical features of post-thyroidectomy hematomas as well as their implications on the early discharge after a thyroidectomy. METHODS: In a retrospective review of 5, 465 patients that underwent a thyroidectomy between Jan 1994 and Dec 2003, 21 (0.38%) with post-thyroidectomy hematomas were identified. The clinical features and outcomes of these 21 patients were evaluated. RESULTS: The 21 patients were composed of 3 men and 18 women, with a mean age of 47.9+/-19.4 years, ranging from 23~80. The mean time to recognition of the hematoma was 7.0+/-15.3 hours, ranging from 0~72. Sixteen hematomas (76.2%) presented within 6 hours postoperatively, 4 (19.0%) between 6 and 24 hours, and 1 (4.8%) after more than 24 hours. Except for two patients with minimal hematomas, the other 19 underwent re-exploration under general anesthesia after evacuation of the hematoma at bedside. The bleeding source was the lacerated strap muscles in 16 patients (76.2%), venous in 3, arterial in 1 and thyroid lobe stump in 1. Mean hospital stay was 5.2+/-2.0 days, ranging from 2~9. There were no mortality or complications after reoperation, and patients required a blood transfusion or tracheostomy. There were no significant differences in the clinical features between Graves' disease and non-Graves' disease, as well as between benign and malignant groups. CONCLUSION: Early detection and prompt surgical intervention are critical to a successful outcome in patients with post- thyroidectomy hematomas. Because most of the patients in our series with post-thyroidectomy hematomas presented within 24 hours postoperatively, early discharge, with careful monitoring for the first 24 hours after a thyroidectomy, can be recommended. However the relatively long interval between the initial operation and the development of the hematoma should be considered when recommending early discharge after a thyroidectomy.
Anesthesia, General ; Blood Transfusion ; Female ; Graves Disease ; Hematoma* ; Hemorrhage ; Humans ; Length of Stay ; Male ; Mortality ; Muscles ; Prevalence ; Reoperation ; Retrospective Studies ; Thyroid Gland ; Thyroidectomy ; Tracheostomy

Purpose: The aim of this study was to investigate the clinical features and outcome of thyroid carcinoma in elderly patients, and to identify factors that influenced survival. METHODS: Among 3, 267 patients with thyroid carcinoma who were treated in the Department of Surgery at Yonsei University College of Medicine from March 1986 to March 2004, 53 patients were identified who were age 75 years or older at the time of diagnosis. The mean age was 78 years (range, 75~90 years) and the mean follow-up was 37.6 months (range, 10~96 months). RESULTS: There were 41 female and 12 male patients. Forty eight tumors were well-differentiated carcinoma, 5 tumors were undifferentiated or anaplastic carcinoma. Twenty eight patients were in stage T4. Palpable lateral neck node and distant metastases were evident at presentation in 24 and 7 patients, respectively. Forty two patients were completely resected, and 11 patients were unresectable and underwent biopsy only. Of the 42 patients who were completely resected, 30 and 12 patients underwent total and less than total thyroidectomy, repectively. External radiotherapy was administered to 6 patients. The overall survival rate and disease specific survival rate were 49.8% and 51.0% at 5 years, respectively. Multivariate analysis showed that distant metastases and external radiotherapy were independent prognostic factors for survival. Conclusion: Thyroid carcinoma in patients aged 75 years or older appears to behave more aggressively. Therefore, an optimal therapeutic approach is recommended and should not be withheld on the basis of chronological age. If indicated, aggressive surgery should be necessary to improve survival.
Aged ; Biopsy ; Carcinoma ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Multivariate Analysis ; Neck ; Neoplasm Metastasis ; Radiotherapy ; Survival Rate ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: The optimal timing of a surgery for well-differentiated thyroid carcinoma detected during pregnancy remains controversial. This study was performed to determine the optimal timing of surgery for a well-differentiated thyroid carcinoma detected during pregnancy. METHODS: Betwwen July 1991 and June 2004, 20 cases diagnosed with a well-differentiated thyroid carcinoma during pregnancy were retrospectively analyzed. All 20 patients had undergone surgery. The patients were divided into three groups according to the timing of their surgery. Group I (n=9) had a thyroidectomy after delivery, group II (n=6) had a thyroidectomy during the second trimester, and group III (n=5) had a thyroidectomy after an abortion. Group III was excluded from the study as our particularly interest was in determining the optimal timing of surgery during pregnancy. RESULTS: No significant differences were noted between groups I and II with regard to age, tumor size, TNM stage and the timing of diagnosis. There were no TNM stage changes in group I, although a slight increase in tumor size during pregnancy was noted. There were no significant differences in the surgical outcomes between groups I and II with regard to types of operation, operation times, perioperative complications, length of hospital stays and treatment outcomes. CONCLUSION: The treatment of a well-differentiated thyroid carcinoma detected during pregnancy can be delayed until after delivery in most patients.
Diagnosis ; Female ; Humans ; Length of Stay ; Pregnancy Trimester, Second ; Pregnancy* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

OBJECTIVE: The purpose of this study was to review the incidence, types, chemotherapy regimens, operation methods, pregnancy rate and propiosis of the ov#arian malignancy under the age of twenty years old. METHODS: Retrospective reviews of the medical recordings for 22 patients with ovarian malignancy under the age of twenty years old in the Department of Obstetrics and Gynecology, Hanyang University from 1986 to 1997 were done. RESULTS: Gerin cell tumor accounts for the majority of cases (77%), whereas 5 patients(23%) belong to the common epithelial poup which were all mucinous type. Our experiences with 22 cases are as followings: 5 mucinous cystadenocarcinoma, 8 immature teratoma, 4 endodermal sinus tumor, 3 dysgernma and 2 mixed germ cell tumor. The incidence of this group was 8.2% (22/266) in all ovarian malignancy. Fourteen of them are stage I, each one is, stage II and IV, and six patients are stage III. The average age was 14.9 years old in germ cell tumor and 18.4 yems old in mucinous cystadenoearcinoma. Malignant ovarian cancer under the age of twenty can be treated with conservative surgery, followed by adjuvant chemotherapy. Commonly used chemotherapeutic regimens were VAC(Vincristine, Actinomycin-D; Cyclophosphamide), VBP(Vinblastine, Bleomycin, Cisplatin) and BEP(Bleomycin, Etoposide, Cisplatin). Second look operations were done in 11 patienth and histologic positive findings were detected in 4 of them. The length of follow-up ranged ftom 3 months to 137 months and median value was 44 rnonths. CONCLUSIONS: It is concluded that for young women who wish to preserve child-bearing capacity, regardless of the stage of the tumor, fertility preserving surgery with complete surgical staging, if necessary followed by combination chemotherapy is an appropriate treatment.
Bleomycin ; Chemotherapy, Adjuvant ; Cystadenocarcinoma, Mucinous ; Drug Therapy ; Drug Therapy, Combination ; Endodermal Sinus Tumor ; Etoposide ; Female ; Fertility ; Follow-Up Studies ; Gynecology ; Humans ; Incidence ; Medical Records ; Mucins ; Neoplasms, Germ Cell and Embryonal ; Obstetrics ; Ovarian Neoplasms ; Pregnancy Rate ; Retrospective Studies ; Teratoma