OBJECTIVE: To research the value of frozen section examination for intraoperation diagnosis of thyroid nodule and determination of extent of thyroidectomy. METHOD: A retrospective evaluation of a group of 1 057 patients with thyroid nodular disease was analyzed. The group was divided into frozen section examination group (FS group) and non-frozen section examination group (NFS group). RESULT: There were 750 cases in FS group. The diagnosis made by frozen section examination was carcinoma in 117; benign lesion in 626. Diagnosis was deferred in 7 patients. The final pathology diagnosis was carcinoma in 127; benign lesion in 623. The sensitivity, specificity, accuracy and disaccord rate of frozen section examination were 95. 9%, 100. 0%, and 98. 4%, and 1. 6%, respectively. There were 307 cases in NFS group, and the final pathology diagnosis was carcinoma in 30; benign lesion in 277. The disaccord rate with clinical diagnosis was 9. 77%. The binomial distribution analysis indicate that the difference of disaccord rate between the FS group and the NFS group was remarkable ( P <0. 01). CONCLUSION Frozen section examination has value in diagnosing the thyroid nodular, and is capable of determination of the extent of thyroidectomy.
Adolescent ; Adult ; Aged ; Female ; Frozen Sections ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; pathology ; Thyroid Nodule ; diagnosis ; pathology ; surgery ; Thyroidectomy ; Young Adult

OBJECTIVE: To seek for the ultrasound (US) findings of partially cystic thyroid nodules that are associated with malignancy. MATERIALS AND METHODS: We reviewed the US characteristics of 22 surgically confirmed partially cystic papillary carcinomas, and compared them with those of 80 benign partially cystic nodules. The review cases were selected in a random order from a total of 1029 partially cystic nodules that were diagnosed with an US-guided fine needle aspiration biopsy over a period of 8 years (June 2003 to October 2010) at our institution. RESULTS: In partially cystic thyroid nodules, a taller-than-wide shape (100%, p < 0.001) and spiculated or microlobulated margin (58.3%, p = 0.003) were significantly associated with malignancy. In terms of internal solid portion of the nodule, eccentric configuration (68.0%, p < 0.001), non-smooth margin (81.3%, p < 0.001), hypoechogenecity (30.0%, p < 0.042), and microcalcification (89.5%, p < 0.001) were more frequently demonstrated in malignant nodules than benign ones. CONCLUSION: In partially cystic thyroid nodules, understanding the characteristics of US findings is important to make a precise diagnosis of malignant nodules.
Adolescent ; Adult ; Aged ; Biopsy, Fine-Needle ; Carcinoma, Papillary/pathology/surgery/*ultrasonography ; Case-Control Studies ; Chi-Square Distribution ; Cysts/pathology/surgery/*ultrasonography ; Female ; Humans ; Male ; Middle Aged ; Statistics, Nonparametric ; Thyroid Neoplasms/pathology/surgery/*ultrasonography ; Thyroid Nodule/pathology/surgery/*ultrasonography

Metastasis to the primary thyroid carcinoma is extremely rare. We report here a case of colonic adenocarcinoma metastasis to medullary thyroid carcinoma in a 53-yr old man with a history of colon cancer. He showed a nodular lesion, suggesting malignancy in the thyroid gland, in a follow-up examination after colon cancer surgery. Fine needle aspiration biopsy (FNAB) of the thyroid gland showed tumor cell clusters, which was suspected to be medullary thyroid carcinoma (MTC). The patient underwent a total thyroidectomy. Using several specific immunohistochemical stains, the patient was diagnosed with colonic adenocarcinoma metastasis to MTC. To the best of our knowledge, the present patient is the first case of colonic adenocarcinoma metastasizing to MTC. Although tumor-tumor metastasis to primary thyroid carcinoma is very rare, we still should consider metastasis to the thyroid gland, when a patient with a history of other malignancy presents with a new thyroid finding.
Adenocarcinoma/pathology/surgery ; Biopsy, Fine-Needle ; Carcinoma, Medullary/diagnosis/radiography/*secondary ; Colonic Neoplasms/*pathology/surgery ; Humans ; Male ; Middle Aged ; Neoplasms, Second Primary/*diagnosis ; Thyroid Gland/pathology ; Thyroid Neoplasms/diagnosis/radiography/*secondary ; Thyroid Nodule/diagnosis

PURPOSE: To examine the feasibility of endoscopic thyroidectomy (ET) via an axillo-breast approach without gas insufflation for large thyroid tumors and micropapillary carcinomas. MATERIALS AND METHODS: The patients in the benign group were separated into groups 1 (n=95, <4 cm in tumor diameter) and 2 (n=37, > or =4 cm in tumor diameter). Also, 57 patients in the micropapillary carcinoma group underwent an endoscopic hemithyroidectomy (HT) (group 3) and were compared with 60 patients who received conventional open HT (group 4). Postoperative functional outcome, local complications, surgical outcomes, and pathological outcomes were compared between the groups. RESULTS: In the benign group, there was no significant difference in mean operating time, hospital stay, or overall perioperative complications between the two groups. In the micropapillary carcinoma group, mean operating time and hospital stay in group 3 were significantly longer than in group 4 (p=0.015 and p< or =0.001). The overall perioperative complications did not differ significantly between the groups. The postoperative cosmetic result was better in groups 1-3 (endo group) than in group 4 (open group). CONCLUSION: ET via a gasless axillo-breast approach seems to be a safe procedure even for benign thyroid lesions > or =4 cm and micropapillary carcinomas. Although it has the advantage of better cosmetic results over open thyroidectomy, there is room for improvement in terms of lessening its invasiveness and shortening the operative time.
Adult ; Carcinoma, Papillary/pathology/*surgery ; Endoscopy/adverse effects/methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Nodule/pathology/*surgery ; Thyroidectomy/adverse effects/*methods ; Treatment Outcome

Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for the optimal use of radiofrequency ablation for thyroid nodules. These recommendations are based on a comprehensive analysis of the current literature, the results of multicenter studies, and expert consensus.
Biopsy, Fine-Needle ; Catheter Ablation/*methods ; Consensus ; Humans ; Informed Consent ; Neoplasm Recurrence, Local/parasitology/surgery ; Patient Safety ; Radio Waves ; Republic of Korea ; Thyroid Neoplasms/pathology/*surgery ; Thyroid Nodule/pathology/*surgery ; Ultrasonography, Interventional

OBJECTIVETo evaluate the method, safety and short-term efficacy of ultrasound-guided percutaneous laser ablation (PLA) for benign solid thyroid nodule (BSTN).

METHODSThe treatment group consisting of 12 patients with single BSTN were treated with ultrasound-guided PLA. After treatment, the size and blood flow signals in conventional ultrasonography, the ablation extent of lesions in contrast-enhanced ultrasonography (CEUS), and the related complications and thyroid function were assessed in comparison with the the baseline. A control group including 12 untreated patients with single BSTN was followed-up in the same manner as in the treatment group.

RESULTSIn the treatment group, all the 12 patients completed the treatment successfully. During the follow-up, the volume of the nodules was reduced gradually (P<0.05), and blood flow signals in the nodules disappeared. Eleven nodules were non-enhanced in CEUS immediately after the treatment, and the complete ablation rate was 91.7%. During the operation, 3 patients complained of intolerable pain, which was ameliorated or totally relieved after appropriate treatment. The thyroid function showed no significant changes after the treatment (P>0.05). The control group followed up for 6 months showed no significant changes in the nodule volume or thyroid function in comparison with the baseline (P>0.05).

CONCLUSIONUltrasound-guided PLA is a safe and effective minimally invasive treatment of BSTN without obvious adverse effect on thyroid function.

Adult ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; adverse effects ; methods ; Male ; Middle Aged ; Neck Pain ; etiology ; Pilot Projects ; Thyroid Gland ; diagnostic imaging ; pathology ; surgery ; Thyroid Nodule ; diagnostic imaging ; pathology ; surgery ; Treatment Outcome ; Ultrasonography, Doppler, Color ; Ultrasonography, Interventional

Biopsy, Fine-Needle ; Carcinoma ; diagnosis ; pathology ; surgery ; Carcinoma, Medullary ; diagnosis ; pathology ; surgery ; Carcinoma, Papillary ; diagnosis ; pathology ; surgery ; Carcinoma, Papillary, Follicular ; diagnosis ; pathology ; surgery ; Diagnosis, Differential ; Goiter, Nodular ; diagnosis ; pathology ; therapy ; Hashimoto Disease ; diagnosis ; pathology ; therapy ; Humans ; Lymphoma ; diagnosis ; pathology ; surgery ; Thyroid Nodule ; pathology ; surgery ; Thyroidectomy

Carcinoma, Mucoepidermoid ; complications ; metabolism ; pathology ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Eosinophilia ; complications ; metabolism ; pathology ; Epithelial Cells ; pathology ; Female ; Hashimoto Disease ; metabolism ; pathology ; surgery ; Humans ; Keratin-19 ; metabolism ; Membrane Proteins ; metabolism ; Middle Aged ; Thyroid Gland ; metabolism ; pathology ; surgery ; Thyroid Nodule ; metabolism ; pathology ; surgery ; Transcription Factors ; beta Catenin ; metabolism