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Korean Journal of Endocrine Surgery.2005;5(1):43-45. doi:10.16956/kjes.2005.5.1.43
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Korean Journal of Endocrine Surgery
2002 (v1, n1) to Present ISSN: 1671-8925
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Parathyroid Cyst: Description of Two Cases and Review of the Literature.
Korean Journal of Endocrine Surgery.2005;5(1):40-42. doi:10.16956/kjes.2005.5.1.40
Parathyroid cysts are uncommon causes of neck or mediastinal masses. They have been mistaken for cystic thyroid nodules, brachial cleft cysts, or thyroglossal duct cysts. Two types of parathyroid cysts have been recognized; the non- functioning forms, which are more frequent and the functioning paratyroid cysts, which are rarer and cause hyperparathyroidism. Parathyroid cysts are usually located in the inferior parathyroid gland, which are most commonly involved with a left-sides predominance. Although their location in mediastinum has also been described. Parathyroid cysts may present as a diagnostic problem. It is sometimes difficult that parathyroid lesions are distinguished from thyroid ones with current imaging techniques. Diagnosis is based on the histopathological appearance of the cyst and PTH level in the cystic fluid. Percutaneous needle aspiration of parathyroid cysts reveals crystal clear fluid. Elevated PTH levels in the cystic fluid confirms the diagnosis. The presence of parathyroid tissue within the cyst wall is diagnostic. Nonfunctioning cyst may be treated with aspiration alone, surgical excision is indicated for functioning cyst. We present the case of two patients with a parathyroid cyst.
Diagnosis ; Humans ; Hyperparathyroidism ; Mediastinum ; Neck ; Needles ; Parathyroid Glands ; Thyroglossal Cyst ; Thyroid Gland ; Thyroid Nodule
Diagnosis ; Humans ; Hyperparathyroidism ; Mediastinum ; Neck ; Needles ; Parathyroid Glands ; Thyroglossal Cyst ; Thyroid Gland ; Thyroid Nodule
Fibromatosis of the Neck: a Case Report and Review of the Literatures.
Korean Journal of Endocrine Surgery.2005;5(1):36-39. doi:10.16956/kjes.2005.5.1.36
The fibromatosis (desmoid tumor) is histologically benign fibrous neoplasm arising from the musculoaponeurotic structures through out the body, but that shows locally aggressive growth. Common anatomic sites includes the limbs, trunk and mesentery. Fibromatoses arising in the neck have been reported rarely. If the tumors are occurred in the neck, complete resection is often difficult, because of its locally infiltrative nature. Therefore radiotherapy, chemotherapy and hormonal therapy are occasionally needed to reduce local recurrence. We report herein a case of fibromatosis arising in the left supraclavicular region with infiltration to surrounding tissues, which was successfully treated by complete surgical excision and postoperative adjuvant radiotherapy.
Drug Therapy ; Extremities ; Fibroma* ; Mesentery ; Neck* ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence
Drug Therapy ; Extremities ; Fibroma* ; Mesentery ; Neck* ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence
A Case of Differentiated Thyroid Carcinoma with Internal Jugular Vein Tumor Thrombus.
Korean Journal of Endocrine Surgery.2005;5(1):32-35. doi:10.16956/kjes.2005.5.1.32
Differentiated thyroid carcinoma rarely shows gross angioinvasion with intraluminal tumor thrombus. Although there was no definite result of long-term survival, a vascular invasion or thrombus indicates poor prognosis. Total thyroidectomy with en block resection of involved vessels is known as the best surgical approach, and followed by postoperative radioiodine therapy. However, the effect of adjuvant external irradiation therapy remains in debate. We report a case of differentiated thyroid carcinoma with internal jugular vein tumor thrombus treated successfully by a complete surgical resection and postoperative radioiodine therapy.
Jugular Veins* ; Prognosis ; Thrombosis* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy
Jugular Veins* ; Prognosis ; Thrombosis* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy
Medullary Thyroid Cancer Misunderstanding as Recurrent Rectal Cancer due to High Serum CEA Levels.
Korean Journal of Endocrine Surgery.2005;5(1):29-31. doi:10.16956/kjes.2005.5.1.29
The medullary carcinoma of the thyroid gland is relatively rare tumor, accounting about 1.2~10% of the all thyroid malignancies, which arises from the parafollicular C-cells in thyroid gland. Operation is the only means to cure the patients. Serial concentrations of serum CEA and calcitonin seem to play an important role in the diagnosis and clinical management and also in the therapeutic monitoring of patients with medullary thyroid cancer. In this case, patient with high serum CEA levels after the resection of rectal cancer underwent abdomen CT scan, colonofibroscopy, FDG-PET scan and chest X-ray, but this imaging methods couldn't detect recurrent evidence of rectal cancer. Neck ultrasonography was performed after 8 years from operation, and fine needle aspiration biopsy was performed for thyroid nodule. As diagnosed to suspicious medullary carcinoma, patient underwent total thyroidectomy and central compartment neck dissection. Patient diagnosed as medullary thyroid cancer without lymph node metastasis and capsular invasion pathologically. As well as this case, in patients with high serum CEA levels after definitive surgical resection of gastrointestinal cancer, if imaging study or FDG-PET scan detect no evidence of recurrence, evaluation of thyroid such as neck ultrasonography and serum calcitonin should be performed.
Abdomen ; Biopsy ; Biopsy, Fine-Needle ; Calcitonin ; Carcinoma, Medullary ; Diagnosis ; Gastrointestinal Neoplasms ; Humans ; Lymph Nodes ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Thorax ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Tomography, X-Ray Computed ; Ultrasonography
Abdomen ; Biopsy ; Biopsy, Fine-Needle ; Calcitonin ; Carcinoma, Medullary ; Diagnosis ; Gastrointestinal Neoplasms ; Humans ; Lymph Nodes ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Thorax ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Tomography, X-Ray Computed ; Ultrasonography
Korean Journal of Endocrine Surgery.2005;5(1):24-28. doi:10.16956/kjes.2005.5.1.24
Hyperparathyroidism is a common finding in patients with chronic renal failure. Among the hyperparathyroidism, tertiary hyperparathyroidism, which is secreting parathyroid hormone autonomously in spite of hypercalcemia. Sometimes it requires surgical intervention due to not only symptomatic hypercalcemia, but also longstanding asymptomatic hypercalcemia. Hungry bone syndrome was known to be developed due to extensive re-mineralization of skeleton after parathyroidectomy. It is characteristic of persistent hypocalcemia, hypophosphatemia and often with tetany. The patient's condition improved without complication after the calcium chloride and calcium carbonate administration. We report a case of hungry bone syndrome developed after parathyroidectomy in patient with tertiary hyperparathyroidism and chronic renal failure.
Calcium Carbonate ; Calcium Chloride ; Humans ; Hypercalcemia ; Hyperparathyroidism* ; Hypocalcemia ; Hypophosphatemia ; Kidney Failure, Chronic ; Parathyroid Hormone ; Parathyroidectomy* ; Renal Dialysis* ; Skeleton ; Tetany
Calcium Carbonate ; Calcium Chloride ; Humans ; Hypercalcemia ; Hyperparathyroidism* ; Hypocalcemia ; Hypophosphatemia ; Kidney Failure, Chronic ; Parathyroid Hormone ; Parathyroidectomy* ; Renal Dialysis* ; Skeleton ; Tetany
Korean Journal of Endocrine Surgery.2005;5(1):18-23. doi:10.16956/kjes.2005.5.1.18
PURPOSE: Angiogeneisis is essential process for tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is major regulator of angiogenesis. Recently, the incidence of papillary thyroid microcarcinoma (PTMC) increased because of development in diagnostic modality. Several recent reports have documented relationship of VEGF and papillary thyroid cancer. The aims of this study were to determine whether angiogenetic phenotype was changed or not changed and to evaluate the relationship between clinicopathologic features and VEGF, vascular endothelial growth factor receptor-1 (VEGFR-1), hypoxic induced factor-1alpha (HIF-1α) mRNA expression in PTMC. METHODS: VEGF, VEGFR-1, HIF-1α mRNA expression was examined by RT-PCR in 14 patients who had undergone thyroidectomy due to PTMC. The thyroid tumor tissue and adjacent normal thyroid tissue were collected in operation and preserved at -70℃ in RNA later solution. We evaluate the expression of VEGF, VEGFR-1, HIF-1α mRNA by RTPCR. The expression of mRNA was quantititated by densitometer and analyzed the relationship between clinicopathologic features and mRNA expression. RESULTS: Compared to normal tissues, in PTMC we observed higher expression of HIF-1α mRNA (P=0.024) and lower expression of VEGF mRNA (P=0.002). There was no difference in expression of VEGFR-1.The patients with nodal metastasis had higher expression of the VEGF mRNA in tumor tissues than those without nodal metastasis but not significantly. The VEGF mRNA of tumor tissues in patients with thyroid capsule invasion or not were expressed similarly. The lower expression of VEGF mRNA were observed more frequently in younger patients (<40). CONCLUSION: The expression of VEGF mRNA was lower in tumor tissue in spite of higher expression of HIF-1α mRNA. These results suggest that the reason for good prognosis and no progression to clinical cancer in PTMC was related to the unchanged angiogenic phenotype.
Humans ; Incidence ; Neoplasm Metastasis ; Phenotype ; Prognosis ; RNA ; RNA, Messenger* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Vascular Endothelial Growth Factor A* ; Vascular Endothelial Growth Factor Receptor-1*
Humans ; Incidence ; Neoplasm Metastasis ; Phenotype ; Prognosis ; RNA ; RNA, Messenger* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Vascular Endothelial Growth Factor A* ; Vascular Endothelial Growth Factor Receptor-1*
Current Status of Endoscopic Thyroidectomy in Korea.
Korean Journal of Endocrine Surgery.2005;5(1):12-17. doi:10.16956/kjes.2005.5.1.12
PURPOSE: The endoscopic surgery has been widely used and developed in operations of the thyroid and parathyroid gland because of the cosmetic advantage and the development of laparoscopic instrument. Since the first endoscopic thyroid surgery in late 1990's, many endoscopic operations for thyroid tumors have been performed in Korea. The authors analyzed the current status of endoscopic thyroid surgery performed in Korea. METHODS: We have collected and analyzed the data of endoscopic thyroid operations using survey. RESULTS: The surgeons working in 16 hospitals answered the questions in survey. The total endoscopic thyroid operations were performed over 1,200 cases until the end of 2004. In the pathologic diagnosis, nodular hyperplasia was most frequent in 64.5%. The axillary approach was most frequently applied in 9 hospitals (56.2%). Most of endoscopic thyroid operations were performed in 2~3 hours. The operation time was decreased according to the experience. The endoscopic surgery for malignant tumors were also performed in 11 hospitals, The hospital stay was usually 3~4 days. The most common complications in endoscopic thyroid surgery were temporary recurrent laryngeal nerve paralysis and anteior chest wall discomfort or paresthesia. The most common reason for conversion to conventional surgery was the intraoperative diagnosis as for a malignancy. CONCLUSION: Endoscopic thyroid surgery has been perfomed in many hospitals not only special thyroid clinic in Korea. The operation cases are increasing rapidly in these days. According to the development of technique and instrument, the endoscopic surgery are applied to various neck disease involving malignancy. The safety and efficacy of endoscopic surgery for malignancy should be further evaluated with accumulation of experience of endoscopic operation and long term follow-up of thyroid cancer patients.
Diagnosis ; Follow-Up Studies ; Humans ; Hyperplasia ; Korea* ; Length of Stay ; Neck ; Paralysis ; Parathyroid Glands ; Paresthesia ; Recurrent Laryngeal Nerve ; Surgeons ; Thoracic Wall ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy*
Diagnosis ; Follow-Up Studies ; Humans ; Hyperplasia ; Korea* ; Length of Stay ; Neck ; Paralysis ; Parathyroid Glands ; Paresthesia ; Recurrent Laryngeal Nerve ; Surgeons ; Thoracic Wall ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy*
Korean Journal of Endocrine Surgery.2005;5(1):7-11. doi:10.16956/kjes.2005.5.1.7
PURPOSE: In papillary thyroid carcinoma, lymph node metastasis at presentation does not seem to affect survival adversely, but does increase the risk of loco-regional tumor recurrence. The benefits of prophylactic central neck node dissection (PCND) have not been clearly demonstrated so far and should be weighed against the potential risks of the procedure. The aims of this study are as follows; to determine the frequency and the pattern of the lymph node metastasis and the risk factors influencing the metastasis to level VI lymph nodes, and to determine the necessity of the contralateral central lymph node dissection. METHODS: A retrospective analysis had been carefully performed over 68 patients with papillary carcinomas undergoing total thyroidectomy with PCND during the period from July 1, 2000 to August 31, 2002. In addition to the analyses of the incidence and the pattern of central lymph node metastasis, we statistically analyzed the correlation between lymph node metastases and the risk factors such as tumor size, age, lymphatic tumor emboli, vascular tumor emboli, perithyroidal soft tissue invasion, and multifocality, etc. RESULTS: The mean age was 46 years (22~76) and the tumor size ranged from 0.2 to 9 cm (mean 2.2 cm). The micropapillary carcinoma was detected by pathological findings in 10 patients (14.7%). The lymphatic tumor emboli and vascular tumor emboli occurred in 8 patients (11.8%) and 2 patients (2.9%) respectively. Thirty eight patients (55.9%) showed perithyroidal tissue invasion. The mean number of harvested lymph nodes in level VI was 13.7 (6~32). Among 68 patients, lymph node metastasis occurred in 49 patients (72.1%) and the mean number of metastatic lymph node was 5.4. Among the patients with metastasis, the rate of metastasis among the harvest nodes amounted to 39.0%. Metastasis to Delphian nodes was detected in 2 patients (2.9%). In addition, 15 patients (22.1%) showed metastatic contralateral central nodes. Patients less than 40 years old tend to have more metastatic lymph nodes (P=0.012). Futhermore, the patients with tumor larger than 2 cm increased incidence of lymph node metastasis (P=0.036). CONCLUSION: After the prophylactic central neck nodes dissection in case of papillary carcinoma patients, metastatic lymph nodes were found in 72.1%. In conclusion, we would like to recommend prophylactic central neck node dissection to papillary carcinoma patients in order not only to prevent local recurrence but to avoid the difficulties of reoperation, especially for those with high risk for nodal involvement (less than 40 years old or more than 2 cm of tumor size). Because of the relatively high incidence of contralateral central lymph nodes metastasis, we suggest the importance of dissection of contralateral central lymph nodes along with unilateral central.
Carcinoma, Papillary* ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes* ; Neck* ; Neoplasm Metastasis* ; Recurrence ; Reoperation ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy
Carcinoma, Papillary* ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes* ; Neck* ; Neoplasm Metastasis* ; Recurrence ; Reoperation ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy
The Characteristics of Multiple Endocrine Neoplasia in Korean.
Korean Journal of Endocrine Surgery.2005;5(1):1-6. doi:10.16956/kjes.2005.5.1.1
PURPOSE: Multiple Endocrine Neoplasm (MEN) is a rare, complex and familial disease. There are MEN syndromes are inherited in an autosomal dominant fashion with high penetrance. The variations in the RET gene play an important role in the MEN syndromes. Recent advances in diagnosis, treatment and genetic study of patients with MEN in Korean are reviewed. METHODS: There were 79 cases and 20 families with MEN syndromes in Korea which based on my experiences and 27 published papers. According to subtypes, there were classified and analyzed. RESULTS: Mean age was 37.9±11.5 years old. Sex ratio was 1:2.6. There were 7 families and 23 cases with MEN type I in Korean. The clinical characteristics of MEN I in Korean are mostly not different from the previous reports except older age (mean=43.2 old-year) at diagnosis. The frequency of the MEN I germ-line mutation in Korean MEN I (80%) families was similar to those reported previously. There were 13 families and 52 cases with MEN type II A in Korean. Three-quarters (9/12) of the Korean patients with MEN IIa had RET mutations on codon 634 of exon 11 (4 patients, C634; 4 patients, C634Y; 1 patient, C634W), but a quarter (3/12) had mutations on codon 618 of exon 10 (2 patients, C618R; 1 patient, C618S). A small medullary carcinoma in a patient of MEN type II A family was detected by genetic mutation screening in SMC. MEN IIb was reported only 4 cases. A case showed a codon 918 mutation (M918T) at exon 16 of RET proto-oncogene. CONCLUSION: Multiple endocrine neoplasia is rare hereditary cancer syndromes expressing a variety of tumors. With understanding of the molecular and clinical pathology of MEN syndromes, genetic screening is now feasible, and treatments have become more individualized based on genetic information of Korean.
Carcinoma, Medullary ; Codon ; Diagnosis ; Exons ; Genetic Testing ; Germ-Line Mutation ; Humans ; Korea ; Male ; Mass Screening ; Multiple Endocrine Neoplasia Type 1 ; Multiple Endocrine Neoplasia Type 2a ; Multiple Endocrine Neoplasia Type 2b ; Multiple Endocrine Neoplasia* ; Neoplastic Syndromes, Hereditary ; Pathology, Clinical ; Penetrance ; Proto-Oncogenes ; Sex Ratio
Carcinoma, Medullary ; Codon ; Diagnosis ; Exons ; Genetic Testing ; Germ-Line Mutation ; Humans ; Korea ; Male ; Mass Screening ; Multiple Endocrine Neoplasia Type 1 ; Multiple Endocrine Neoplasia Type 2a ; Multiple Endocrine Neoplasia Type 2b ; Multiple Endocrine Neoplasia* ; Neoplastic Syndromes, Hereditary ; Pathology, Clinical ; Penetrance ; Proto-Oncogenes ; Sex Ratio
Country
Republic of Korea
Publisher
Korean Association of Thyroid and Endocrine Surgeons
ElectronicLinks
http://koreamed.org/JournalVolume.php?id=219Editor-in-chief
정 웅 윤
Abbreviation
Korean J Endocr Surg
Vernacular Journal Title
대한내분비외과학회지
ISSN
1598-1703
EISSN
2287-6782
Year Approved
2014
Current Indexing Status
Currently Indexed
Start Year
2001
Description
Current Title
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