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A Case of Papillary Thyroid Carcinoma Coexistent with Thyroid Sarcoidosis.

Nan Hee CHO ; In Wook SONG ; Sun Young KWON ; Ho Chan CHO

Journal of Korean Thyroid Association.2015;8(1):121-124. doi:10.11106/cet.2015.8.1.121

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. The involvement of thyroid gland with sarcoidosis is uncommon. Moreover, sarcoidosis with thyroid cancer are rarely reported in the world. We encountered papillary thyroid carcinoma (PTC) coexistent with pulmonary sarcoidosis. A 35-year-old female with a medical history of pulmonary sarcoidosis visited the endocrinology department for evaluation of the thyroid nodule. Thyroid ultrasonography showed multiple markedly hypoechoic nodules in the left thyroid lobe. Then ultrasonogram-guided fine needle aspiration of left thyroid nodule was positive for papillary carcinoma. She underwent total thyroidectomy with left complete cervical lymph node dissection. The histopathology was confirmed PTC combined with non-caseating granulomatous inflammation suggesting sarcoidosis on thyroid mass and lymph node. We report here a case of PTC coexistent with thyroid involvement of pulmonary sarcoidosis.
Adult ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Endocrinology ; Female ; Humans ; Inflammation ; Lung ; Lymph Node Excision ; Lymph Nodes ; Lymphatic System ; Sarcoidosis* ; Sarcoidosis, Pulmonary ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

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A Case of Rhabdomyosarcoma Presenting a Rapidly Growing Thyroid Mass Showing Cytological Features Mimic Anaplastic Thyroid Carcinoma.

Young Ju JIN ; Hyung Gu KIM ; Seong Keun KWON

Journal of Korean Thyroid Association.2015;8(1):117-120. doi:10.11106/cet.2015.8.1.117

This is a case of a 30-year-old man who was referred to our hospital for evaluation of a rapidly growing tumor in the left thyroid gland. It was palpated 2 weeks ago. But it was growing fast. A 4x3 cm mass was palpated in the left thyroid gland. Our impression was anaplastic thyroid carcinoma. Computed tomography finding indicated a thyroid malignant tumor and cytology result suggested spindle cell neoplasm. A lower anterior neck mass was resected and final histopathological result turns out to be a rhabdomyosarcoma (RMS). Although cervical RMS is very rare in adults, it has to be included for the differential diagnosis for the rapidly growing mass at thyroid gland.
Adult ; Diagnosis, Differential ; Humans ; Neck ; Rhabdomyosarcoma* ; Thyroid Gland* ; Thyroid Neoplasms*

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Metastatic Lung Nodule of Thyroid Papillary Carcinoma, Mimicking Primary Lung Cancer.

Min Ji JEON ; Ji Hye YIM ; Eui Young KIM ; Won Gu KIM ; Tae Yong KIM ; Won Bae KIM ; Young Kee SHONG

Journal of Korean Thyroid Association.2011;4(1):69-71.

No abstract available.
Carcinoma, Papillary ; Lung ; Lung Neoplasms ; Multiple Pulmonary Nodules ; Thyroid Gland

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A Case of Cystic Lymph Node Metastasis from Thyroid Papillary Microcarcinoma.

Inn Chul NAM ; Dong Hee LEE ; Beom Cho JUN ; Kwang Jae CHO

Journal of Korean Thyroid Association.2011;4(1):63-68.

Papillary carcinoma is the most common type of thyroid cancer, usually presenting as a thyroid mass. Presentation in cervical nodes alone, with no clinical suspicion of thyroid tumor, also occurs. Lymph node metastasis from papillary carcinoma of the thyroid may undergo cystic transformation. This occurrence is seldom encountered in clinical practice and in cases of microcarcinomas the diagnosis may be difficult, resulting in a delay of the correct diagnosis and of therapy for the primary tumor. We present a rare case of solitary cystic lymph node metastasis of papillary microcarcinoma of the thyroid.
Bone Cysts ; Carcinoma, Papillary ; Lymph Nodes ; Neoplasm Metastasis ; Thyroid Gland ; Thyroid Neoplasms

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Subacute Thyroiditis with Coexisting Papillary Carcinoma.

Pil Soo SUNG ; Min Hee KIM ; Dong Jun LIM ; Yoon Hee CHOI ; Moo Il KANG ; Bong Yun CHA ; Ja Seong BAE

Journal of Korean Thyroid Association.2011;4(1):58-62.

Subacute thyroiditis with coexisting papillary carcinoma is very rare. Here, we report a case of 36-year-old Korean female with both thyroid diseases. She presented with acute onset of anterior neck pain and swelling for 2 weeks. Physical examination, laboratory and image findings suggested subacute thyroiditis. Ultrasonographic examination found a 0.8 cm-sized marked hypoechoic nodule surrounded by multiple irregular hypoechoic lesions and central lymph node metastasis was suspected. Subsequent fine needle aspiration cytology for this nodule showed papillary carcinoma. Two months of oral prednisolone therapy relieved clinical symptoms and normalized her thyroid function. Total thyroidectomy was performed along with central neck dissection and the nodule was confirmed to be papillary carcinoma with one metastatic lymph node among ten dissected nodes, otherwise unremarkable. The other portion of the thyroid showed the typical pathologic features of subacute thyroiditis. Thyroid ultrasonography as an ancillary diagnostic tool in subacute thyroiditis may have clinical implications of finding out hidden malignancy, although the association between two diseases is unclear.
Adult ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Humans ; Lymph Nodes ; Neck Dissection ; Neck Pain ; Neoplasm Metastasis ; Physical Examination ; Prednisolone ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Thyroidectomy ; Thyroiditis, Subacute

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A Case of Agranulocytosis and Soft Tissue Abscess after Increasing Methimazole Dose in a Patient with Graves Disease under Long-term Mainternance Therapy.

Se Yoon PARK ; Sung Wan CHUN ; Yeo Joo KIM ; Sang Jin KIM

Journal of Korean Thyroid Association.2011;4(1):54-57.

Antithyroid drugs (ATD) has been widely used to treat Graves' disease. However agranulocytosis, a serious fatal complication of ATD treatment, occurs in about 0.5 percent. The symptoms may mimic viral infections (fever, sore throat), and the potentially life-threatening pyogenic infections can go unrecognized initially. The median duration of drug exposure before the onset of acute agranulocytosis is within 30 days in most cases. We report a case of agranulocytosis with secondary soft tissue infection and abscess occuring after increasing the dose of methimazole in a woman who had taken methimazole for more than 10 years. We administered broad-spectrum antibiotics and aspirated the soft tissue abscess. A review of the medical literature regarding agranulocytosis in the setting of ATDs is presented.
Abscess ; Agranulocytosis ; Anti-Bacterial Agents ; Antithyroid Agents ; Female ; Graves Disease ; Humans ; Hydrazines ; Methimazole ; Soft Tissue Infections

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Tumor Size Is Still a Useful Prognostic Factor for the Therapeutic Plan of Papillary Thyroid Carcinoma.

Tae Sik JUNG ; Hee Kyung KIM ; Hyun Won SHIN ; Jung Hwa JUNG ; Hye Won JANG ; Sun Wook KIM ; Man Ki CHUNG ; Jung Han KIM ; Jee Soo KIM ; Young Ik SON ; Jae Hoon CHUNG

Journal of Korean Thyroid Association.2011;4(1):47-53.

BACKGROUND AND OBJECTIVES: Papillary thyroid microcarcinoma (PTMC) was regarded as early-stage carcinoma, but its aggressiveness has been frequently reported. We performed this study to compare the clinicopathologic characteristics of PTMC with those of papillary thyroid carcinoma (PTC) >1 cm. We evaluated the association of clinicopathologic parameters of PTMC with tumor size divided by each millimeter. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 1,139 patients with PTMC and 1,296 patients with PTC >1 cm who underwent thyroidectomy from 1995 to 2004 at Samsung Medical Center. The aggressive variants of PTC were excluded in the subjects. RESULTS: Multifocality, extrathyroidal invasion (ETI), lymph node invasion (LNI), and distant metastasis (DM) were significantly less frequent in PTMC than PTC >1 cm (p<0.001). Recurrence and disease-specific mortality rates for PTMC were also significantly lower than those of PTC >1 cm (recurrence 2.9% vs. 8.1%, p<0.001; mortality 0.5% vs. 1.5%, p<0.05). Tumor size was correlated with the rates of multifocality, ETI, LNI, and DM in all PTC (p<0.01). All patients with DM had the tumor size 0.6 cm in diameter or more. Among PTMC, the rates of LNI, multifocality, and N1b significantly increased when tumor size exceeded 0.3 cm, 0.4 cm, and 0.6 cm, respectively (p<0.05). CONCLUSION: Recurrence and mortality rates of PTMC were extremely low, although local invasion was detected on the level of subcentimeter. Tumor size was well correlated with the aggressiveness of PTC. We suggest that tumor size is still a useful prognostic factor for the therapeutic plan of PTC.
Carcinoma ; Carcinoma, Papillary ; Factor IX ; Humans ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

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Effect of Thyroid Hormone to the Expression of ATP-binding Cassette Transporter ABCG5.

Hwa Young AHN ; Jin Mi JANG ; Kwan Jae LEE ; Soon Hui KIM ; Kyung Won KIM ; Do Joon PARK ; Hak Chul JANG ; Young Joo PARK

Journal of Korean Thyroid Association.2011;4(1):39-46.

BACKGROUND AND OBJECTIVES: Excretion of bile acid and free cholesterol of bile was important to maintain cholesterol homeostasis. ATP-binding cassette transporter G5 (ABCG5) and G8 (ABCG8) promoted biliary cholesterol excretion. In previous study, hepatic secretion of cholesterol and ABCG5/G8 expression are strongly stimulated in hypophysectomized rats during treatment with thyroid hormone. In this study, we aimed to evaluate the effect of thyroid hormone to expression of ABCG5 and G8 in mouse liver. MATERIALS AND METHODS: We administered thyroid hormone (T3) to C57BL/6 mice and then RNA and protein was isolated from liver. We isolated primary hepatocyte and administered T3 to evaluate in vitro effect. HepG2 cells were cotransfected with either a control plasmid or expression plasmids for human thyroid hormone receptor (hTR)beta/human retinoid X receptor (hRXR)alpha or human liver X receptor (hLXR)alpha in combination with reporter plasmids TK-LXRE3-LUC with or without T3. RESULTS: Serum total cholesterol was decreased after 5 days of T3 treatment. Expression of ABCG5/8 mRNA and ABCG5 protein was increased after T3 treatment. In primary hepatocytes, T3 also increased ABCG5/8 mRNA expression. LXRalpha mRNA was not increased by T3. However, when we cotransfected liver X receptor response element (LXRE) construct and TRbeta/RXRalpha with T3, the activity of LXRE containing construct was markedly increased. CONCLUSION: We confirmed that thyroid hormone increased expression of ABCG5/8. This result suggested that thyroid hormone played an important role in decreasing serum cholesterol through bile excretion.
Animals ; Bile ; Cholesterol ; Hep G2 Cells ; Hepatocytes ; Homeostasis ; Humans ; Liver ; Mice ; Orphan Nuclear Receptors ; Plasmids ; Rats ; Receptors, Thyroid Hormone ; Response Elements ; Retinoid X Receptors ; RNA ; RNA, Messenger ; Thyroid Gland ; Thyroid Hormones

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Model Development of Papillary Thyroid Carcinoma by BRAFV600E Transgenic Mice.

Jung Uee LEE ; Kyong Hye JOUNG ; Young Suk JO ; Minho SHONG

Journal of Korean Thyroid Association.2011;4(1):30-38.

BACKGROUND AND OBJECTIVES: The BRAFV600E mutation has been regarded as the leading cause of papillary thyroid cancer (PTC). However, the multi-step carcinogenic process induced by BRAFV600E has been remained to be elucidated in thyroid gland. In this study, to investigate staged development of papillary thyroid carcinoma, we observed the histo-pathological findings of thyroid gland from BRAFV600E transgenic mice with a period of 60 weeks. MATERIALS AND METHODS: We histologically inspected 3, 9, 20, 27, 39, 44, 48 and 60 week old BRAFV600E transgenic mice derived from FVB/N background mice with a bovine thyroglobulin promoter which are providing thyroid specific BRAFV600E expression. RESULTS: Thyroid glands from 3 and 9 week old BRAFV600E transgenic mice were enlarged and showed abnormal histologic feature such as distorted follicular architectures. The 20 and 27 week old BRAFV600E transgenic mice showed irregularly enlarged thyroid gland sprouting out above the carotid arteries. Thyroid gland derived from 39 week old mice showed reduced formation of intact follicular structure and increased solid area. Thyroid glands were entirely replaced by firm tumor mass composed of poorly differentiated cell at 44 weeks. Interestingly, we could observe tracheal invasion, surrounding muscle invasion in thyroid gland from 48 week old mice and detect lung metastasis in 60 week old mice. CONCLUSION: Thyroid specific expression of BRAFV600E induced staged development of thyroid cancer. This finding may support that BRAFV600E have a role in entire carcinogenic process such as tumor initiation, development and progression.
Animals ; Carcinoma ; Carotid Arteries ; Lung ; Mice ; Mice, Transgenic ; Muscles ; Neoplasm Metastasis ; Proto-Oncogene Proteins B-raf ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms

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Preoperative Staging of Well-Differentiated Thyroid Cancer: Is CT Needed?.

Dong Gyu NA

Journal of Korean Thyroid Association.2011;4(1):22-29.

Ultrasound (US) is the essential primary imaging modality for preoperative staging of differentiated thyroid cancer. Although contrast-enhanced neck CT has been routinely used for the evaluation of general head and neck malignancy, routine use of contrast-enhanced CT is not recommended for the differentiated thyroid cancer by most international thyroid societies, and they recommend very conservative selective use of CT only for locally advanced thyroid cancers. This recommendation seems based on the fact that iodinated contrast media may interfere with radio-iodine treatment and the added value of CT has been little investigated. Although the safety issue of CT contrast media is still controversial, the effect of CT contrast media on radio-iodine treatment seems not clinically significant if there is more than 2 month interval between intravascular administration of iodinated contrast media and radio-iodine treatment. Although CT has been widely used for preoperative evaluation of differentiated thyroid cancers in Korea, the added value of CT for detection of metastatic nodes has been little investigated. Compared with US, CT has advantages of less operator dependency and capability of scanning the whole neck. This suggests that CT may have complementary roles for detection of possible missing diagnosis of metastatic nodes by US and for detection of metastatic nodes at retropharyngeal area and low central neck (level 7 and low level 6 in some cases) which are not accessible by US. Because CT features of metastatic lymph nodes are different from those of US, combination of US and CT may have a potential to increase the diagnostic sensitivity for detection of metastatic cervical nodes. Recent studies suggest that CT may have a helpful complementary role for the evaluation of cervical metastatic nodes in differentiated thyroid carcinoma. However, added diagnostic value of CT and indication for CT use should be further investigated in the preoperative staging of differentiated thyroid carcinomas.
Contrast Media ; Dependency (Psychology) ; Head ; Korea ; Lymph Nodes ; Neck ; Thyroid Gland ; Thyroid Neoplasms

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