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A Case of Paratracheal Air Cyst Mimicking an Upper Esophageal Diverticulum.

Jee Hee YOON ; Soo Jeong KIM ; Hee Kyung KIM ; Ho Cheol KANG

International Journal of Thyroidology.2016;9(1):51-54. doi:10.11106/ijt.2016.9.1.51

Paratracheal air cyst (PTAC) is a small air collection in the right paratracheal area and mainly diagnosed by computed tomography (CT). Increased with ultrasonographic (US) screening of the thyroid, PTAC can be detected incidentally. However, the US findings of PTAC have not been well described. Herein, we report our experience with a rare instance of a PTAC. A 64-year-old female was referred to our hospital for fine-needle aspiration (FNA) cytology of a thyroid nodule. The lesion was identified as an ovoid, hypoechoic lesion with internal hyperechoic foci, abutting on the inferior pole of the right thyroid lobe. The margin was smooth without hypoechoic rim, which is typical in upper esophageal diverticula. US-guided FNA suggested a benign bronchial epithelial lining cyst. If a hypoechoic neck mass containing air without a thick hypoechoic rim is observed, especially at the right side of the trachea, the possibility of PTAC should be considered.
Biopsy, Fine-Needle ; Diverticulum, Esophageal* ; Female ; Humans ; Mass Screening ; Middle Aged ; Neck ; Thyroid Gland ; Thyroid Nodule ; Trachea ; Ultrasonography

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Papillary Thyroid Carcinoma Presented as a Hot Nodule with Hyperthyroidism.

Sung Hye KONG ; Seo Young LEE ; Ye Seul YANG ; Jae Hoon MOON

International Journal of Thyroidology.2016;9(1):47-50. doi:10.11106/ijt.2016.9.1.47

We report a case of a 74-year-old woman who was incidentally found to have a single thyroid nodule. Laboratory evaluation showed undetectable serum thyroid stimulating hormone and elevated free thyroxine levels. (99m)Tc thyroid scan showed a hyperfunctioning autonomous nodule in a right lobe of the thyroid. Thyroid ultrasonography showed a 2.2 cm sized nonhomogeneous spiculated nodule with microcalcification, and which was identical with the hyperfunctioning nodule confirmed in thyroid scan by (99m)Tc single photon emission computed tomography/computed tomography. Fine needle aspiration was done, and cytology reported as suspicious of malignancy. The patient underwent total thyroidectomy with central neck dissection, and pathology was consistent with papillary thyroid carcinoma. This case report demonstrates that diagnosis of a hyperfunctioning autonomous thyroid nodule does not preclude the possibility of thyroid cancer. Clinicians should consider further evaluation such as ultrasonography and fine needle aspiration in patients with hyperfunctioning autonomous nodules.
Aged ; Biopsy, Fine-Needle ; Diagnosis ; Female ; Humans ; Hyperthyroidism* ; Neck Dissection ; Pathology ; Radionuclide Imaging ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Thyrotropin ; Thyroxine ; Ultrasonography

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Thyroid Hemiagenesis Associated with Papillary Thyroid Carcinoma.

Inhye PARK ; Jun Ho CHOI ; Jung Han KIM ; Jee Soo KIM

International Journal of Thyroidology.2016;9(1):43-46. doi:10.11106/ijt.2016.9.1.43

Thyroid hemiagenesis is a rare congenital anomaly that is caused by a developmental defect of a thyroid. Previous reports indicate that thyroid cancer associated with hemiagenesis is extremely rare. A 47-year-old woman presented with single nodule in the right thyroid gland that was incidentally detected during a routine medical checkup. Ultrasonography showed a 1.5×1.2 cm sized ill-defined irregular hypoehoic nodule in the right thyroid and the isthmus was present. However, the left thyroid was not seen and thyroid was disconnected at left paraisthmic area. Fine-needle aspiration cytology confirmed that the right thyroid nodule was papillary thyroid carcinoma. Total thyroidectomy with bilateral central compartment node dissection was performed. Permanent pathologic finding was 1.3×1 cm sized classical type papillary thyroid carcinoma with nodular hyperplasia. There was extensive lymphatic invasion and 3 metastatic lymph nodes out of 4 in central compartment. In conclusion, although thyroid hemiagenesis associated with thyroid carcinoma is extremely rare, treatment strategy is not different with patients with normal anatomy. And the possibility of developing a thyroid carcinoma should be considered in patients with hemiagenesis. Furthermore, it requires awareness of anatomical difference around the thyroid gland during operation.
Biopsy, Fine-Needle ; Female ; Humans ; Hyperplasia ; Lymph Nodes ; Middle Aged ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

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Hyponatremia after Radioactive Iodine Treatment in Thyroid Cancer Patients.

Oh Chan KWON ; Hoon Hee LEE ; Kyung Hwan OH ; Tae Yong KIM

International Journal of Thyroidology.2016;9(1):39-42. doi:10.11106/ijt.2016.9.1.39

Radioactive iodine treatment (RAIT) after surgery reduces local recurrence and cancer related death. Cases of hyponatremia after preparation for RAIT have rarely been reported. We report 4 cases of hyponatremia which developed after RAIT. The cause of hyponatremia seemed to be related with over ingestion of free water which is recommended during RAIT. These cases highlighted the importance of weight adjusted water ingestion during RAIT.
Eating ; Humans ; Hyponatremia* ; Iodine Radioisotopes ; Iodine* ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Water ; Water Intoxication

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Surgical Technique for the Functional Preservation of the Inferior Parathyroid Glands.

Young Min PARK ; Seok Hwan LEE ; Byung Joo LEE

International Journal of Thyroidology.2016;9(1):35-38. doi:10.11106/ijt.2016.9.1.35

BACKGROUND AND OBJECTIVES: The inferior parathyroid glands receive their blood supply from the inferior thyroid artery. The anatomic relationship of this artery and the recurrent laryngeal nerve can assume three different patterns. To maintain the vascular supply of the inferior parathyroid glands during central neck dissection, we considered the anatomic relationship of these structures in our surgical approach. MATERIALS AND METHODS: Fibrofatty tissue in the central neck compartment was removed by dissection proceeding along the recurrent laryngeal nerve. During the dissection, care was taken not to injure the vascular supply of the inferior parathyroid gland. RESULTS: For an inferior parathyroid gland that receives its blood supply from the posterolateral vascular pedicle, preservation is achieved by performing the dissection along the recurrence laryngeal nerve on the gland's medial side. In patients in whom the inferior thyroid artery travels deep to the right recurrent laryngeal nerve, such that the right parathyroid gland receives its blood supply from the posteromedial vascular pedicle, central neck dissection should be performed carefully along the lateral side of the gland to preserve the pedicle. CONCLUSION: Preservation of inferior parathyroid gland function requires a detailed understanding of the anatomic relationship between the inferior thyroid artery and recurrent laryngeal nerve. The direction of the dissection along the nerve should be adjusted according to its anatomic relationship to the inferior thyroid artery.
Arteries ; Humans ; Hypoparathyroidism ; Laryngeal Nerves ; Neck ; Neck Dissection ; Parathyroid Glands* ; Recurrence ; Recurrent Laryngeal Nerve ; Thyroid Gland

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Clinicopathological Implications of the BRAF(V600E) Mutation in PTC with Concurrent Hashimoto Thyroiditis.

Suyeon PARK ; Won Gu KIM ; Mijin KIM ; Hyemi KWON ; Yun Mi CHOI ; Min Ji JEON ; Tae Yong KIM ; Young Kee SHONG ; Won Bae KIM

International Journal of Thyroidology.2016;9(1):29-34. doi:10.11106/ijt.2016.9.1.29

BACKGROUND AND OBJECTIVES: The relationship between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) is still controversial. Some studies suggested that molecular basis of the association between HT and PTC. BRAF(V600E) mutation is the most common genetic alteration founded in PTC. This study was to determine a role of BRAF(V600E) mutation in PTC with concurrent HT and their association with other clinicopathological factors. MATERIALS AND METHODS: We enrolled 452 patients who underwent thyroid surgery between 2009 and 2012 for classical PTC. The status of BRAF(V600E) mutation was evaluated by direct sequencing. HT was defined as presence of lymphocytic thyroiditis in pathology or positive serum anti-thyroid peroxidase antibody. RESULTS: Total 139 patients (30%) with PTC had coexistence HT. HT was significantly associated female (p=0.006), and younger age (p=0.045). BRAF(V600E) mutation was confirmed in 264 patients (58%). The frequency of BRAF(V600E) mutation was significantly lower in PTC with coexistence HT (48.2%) compared by PTC without HT (62.9%, p=0.004). However, there was no significant difference in clinicopathological feature of PTC according to the presence of HT in patients with BRAF(V600E) mutated PTC. BRAF(V600E) mutation was less frequent in PTC with coexistence HT. CONCLUSION: These findings suggested that HT and BRAF(V600E) mutation might be independent factors in development and progression of PTC.
Female ; Hashimoto Disease* ; Humans ; Pathology ; Peroxidase ; Thyroid Gland ; Thyroid Neoplasms ; Thyroiditis, Autoimmune

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A Case of Ectopic Lateral Cervical Thymic Cyst Mimicking as a Second Branchial Cleft Cyst.

Hyun Gi GIM ; Mee Sook ROH ; Jong Chul HONG ; Heon Soo PARK

International Journal of Thyroidology.2017;10(2):123-126. doi:10.11106/ijt.2017.10.2.123

Cervical thymic cysts are rare lesions of neck mass often misdiagnosed clinically as branchial cleft cyst and are mostly diagnosed, pathologically after surgery. The authors applied surgical resection to a 34-year-old man with right upper neck mass, which was misdiagnosed preoperatively as a second branchial cleft cyst. The pathological tissue examination result showed that the patient was diagnosed with a cervical thymic cyst. The thymic cyst of the lateral neck has not been reported from adult in Korean. Herein, we present the case with review of the related literature.
Adult ; Branchial Region* ; Branchioma* ; Humans ; Mediastinal Cyst* ; Neck ; Thymus Gland

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Cervical Bronchogenic Cyst Mimicking Thyroid Cyst.

Sung Hoon KANG ; Sung Min JIN ; Hee Kyung KIM ; Tae Mi YOON

International Journal of Thyroidology.2017;10(2):118-122. doi:10.11106/ijt.2017.10.2.118

Bronchogenic cysts are rare congenital malformations that result from an abnormal development of the ventral foregut budding of the tracheobronchial tree at the time of organogenesis. They are usually located in the mediastinum and intrapulmonary regions. Localization in the cervical area is unusual, and specially, bronchogenic cysts presenting as thyroid and perithyroid cyst are quite rare. We report a case of bronchogenic cyst mimicking a thyroid colloid cyst. We tried percutaneous ethanol injection at 3 times for treatment of this thyroid cyst, but we failed, because of intractable cough. After cyst excision with thyroid lobectomy, we diagnosed the lesion to bronchogenic cyst. Bronchogenic cyst should be considered in the differential diagnosis of perithyroid cyst, which especially the lesion is intolerable cyst to enthanol injection.
Bronchogenic Cyst* ; Colloid Cysts ; Cough ; Diagnosis, Differential ; Ethanol ; Mediastinum ; Organogenesis ; Sclerotherapy ; Thyroid Gland* ; Trees

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A Case of Pseudoaneurysm of the Superior Thyroid Artery after Core Needle Biopsy.

Mi Sun CHUN ; So Jeong LEE ; Han Su KIM ; Soo Yeon JUNG

International Journal of Thyroidology.2017;10(2):114-117. doi:10.11106/ijt.2017.10.2.114

A pseudoaneurysm is a collection of blood that locates between the two outer layers of an artery, the muscularis propria and the adventitia. It is resulted from disruption of a portion of the arterial wall. A pseudoaneurysm can be caused by trauma, blood vessel intervention, intravenous drug use, vasculitis, infectious aneurysm, and postoperative anastomotic leakage. The pseudoaneurysm of superior thyroid artery after core needle biopsy is rare. We report a case of pseudoaneurysm caused by thyroid core needle biopsy and treated by surgical treatment.
Adventitia ; Anastomotic Leak ; Aneurysm ; Aneurysm, False* ; Arteries* ; Biopsy, Large-Core Needle* ; Blood Vessels ; Thyroid Gland* ; Vasculitis

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Primary Sclerosing Mucoepidermoid Carcinoma with Eosinophilia of the Thyroid: Description of a Case and Review of the Literature.

Song I YANG ; Kwang Kuk PARK ; Ji Young YOO

International Journal of Thyroidology.2017;10(2):107-113. doi:10.11106/ijt.2017.10.2.107

Primary sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) of the thyroid gland is a very rare disease. We present the clinical and histopathologic findings of a 37-year-old woman recently diagnosed with SMECE of the thyroid gland. The patient, clinically euthyroid, who presented with a neck swelling since last 2 years along. Fine needle aspiration cytology suggested thyroid papillary carcinoma. Total thyroidectomy, central neck dissection and right selective neck dissection were performed. Although SMECE is considered to be a relatively slow growing and non-aggressive tumor, occasional metastasis does occur. We report an additional case of SMECE, with metastasis to regional lymph nodes. Physicians should be aware of extended operation, including total thyroidectomy and/or neck node dissection for metastatic lesion of the neck node. More standardized treatment is likely to evolve in the future.
Adult ; Biopsy, Fine-Needle ; Carcinoma, Mucoepidermoid* ; Carcinoma, Papillary ; Eosinophilia* ; Female ; Humans ; Lymph Nodes ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Rare Diseases ; Thyroid Gland* ; Thyroidectomy

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