A Case of Occult Papillary Carcinoma of Thyroid, Invaded Trachea and Esophagus / 결핵

Occult papillary adenocarcinoma of the thyroid is known to be indolent, slow metastatic, and has a good prognosis. Occult thyroid carcinoma presenting as a blood-borne metastasis without obvious cervical lymph node involvement is extremely rare. A 65-year-old male patient was visited for hoarseness, dysphagia, and shortness of breath. Bronchoscopy with biopsy revealed a papillary carcinoma of thyroid by immunohistochemical staining. Head & neck CT revealed that involving both the upper esophagus and the posterior tracheal wall, extending into the mediastinum along the upper thoracic spine at T1-T2. We have experienced a rare case of occult papillary carcinoma which invaded the trachea, esophagus and fascia of thoracic spine. Treatment was initiated with radioactive iodine and external bean therapy.

Quantitative Correlation between the Biochemical Markers and The Extent of Metastatic Bone Tumors / 대한암학회지

PURPOSE: We investigated the usefulness of urinary pyridinoline (uPyr) and deoxypyridinoline (uDpyr) and serum osteocalcin as markers of bone metastasis, particularly focussing on quantitative correlation between the degree of bone metastasis and the level of biochemical markers. MATERIALS AND METHODS: By using ELISA method we measured the levels of uPyr, uDpyr, and osteocalcin in 100 cancer patients of whom 58 patients had bone metastasis, 42 had no bone metastasis, and 44 control subjects. RESULTS: There was a significant difference in uPyr level between the patients with bone metastasis and the patients without bone metastasis or control group (mean+/-SD, 70.26+/-43.11 vs 38.93+/-21.48 or 25.13+/-8.81 nM/mM Creatinine, p<0.05). And uDpyr level showed more significant elevation in the patients with bone metastasis than in the patients without bone metastasis and in control group (12.63+/-7.51 vs 6.44+/-3.58 and 4.23+/-1.70 nM/mM Creatinine p<0.05). Osteocalcin level showed no significant difference among groups. We could demonstrate a significant quantitative correlation between the extent of bone metastasis and the amount of uPyr (r=0.7482, p<0.001) or uDpyr (r=0.5992, p<0.001). CONCLUSION: uPyr and uDpyr were significantly increased in metastatic bone tumors and quantitatively correlated well with the extent of bone metastasis. Therefore we can use these two markers as an evidence of bone metastasis. Further studies are recommended to decide the usefulness of these markers in the early detection of bone metastasis and in the assessment of response to antiresorptive treatments.

A Study on Clinical Progress of the Metastatic Adenocarcinoma of Pleura / 결핵

BACKGROUND: We had undergone this study to investigate clinical progress of this disease and to decide the role of aggressive diagnostic approaches, the efficacy of treatments and prognoses. METHODS: A retrospective study was done on 113 patients who had been diagnosed to metastatic adenocarcinoma of pleura by pleural fluid cytology (106 cases) or pleural needle biopsy(22 cases), at Presbyterian Medical Center, from Jan. 1990 to Dec. 1994. RESULTS: 1) The patients were composed of 59 males(52.2%) and 54 females(47.8%), and the mean age distribution was 57.4 +/- 12.1 years. 2) The site of origin was lung cancer 46.9%(53/l 13), stomach cancer 20.4%(23/113), breast cancer 11.5%(13/113), and unknown primary site 6.2%(7/113 cases), as a whole. In male, lung cancer was 55.9%(33/59), stomach cancer was 28.8%(17/59), and in female, lung cancer was 37% (20/54), breast cancer was 24.1% (13/54) of cases. 3) The cardinal symptoms were dyspnea(69%), cough(61%), chest pain(50%), weight loss(50%), anorexia(49%), sputum(43%), malaise(30%). 4) The pleural fluid findings were exudative in 94.4%(102/108), serosanguinous or bloody in 36~53%, unilateral involvement in 74.3%(84/l 13) of cases, and lymphocyte predominance (71 +/- 27%) in differential count of WBC. 5) CEA levels in pleural fluid or plasma were over 10ng/ml in 60.6% (40/66), and ADA levels in pleural fluid were under 40U/L in 95% (57/60) of cases. 6) The patients were managed by various methods, but the efficacy of treatment was uncertain. 7) The mean survival time was 12.7 +/- 13.5 weeks. CONCLUSION: It seems to be no effective treatment methods yet and the prognosis was very poor in this disease, so the objectives of diagnostic approaches and treatment methods should be directed to early diagnosis, treatment and prevention of curable disease. And we must make our best endeavors to lengthen the survival time and improve the quality of patients' life.