Biliary Pseudolithiasis in Children: To Avoid Unnecessary Surgical Procedure / 소아외과

Gallbladder stones in children are not common without underlying hemolytic diseases or other risk factors like obesity. Ceftriaxone, a third generation cephalosporin, is known to make biliary precipitations that can be mistaken for biliary stones. We here report two children with biliary pseudolithiasis with different treatment modalities. One child was mistaken for symptomatic gallbladder stones and underwent elective laparoscopic cholecystectomy, while the other child, after thorough history taking on the ceftriaxone medication, was suspected of biliary pseudolithiasis and was treated conservatively. Both children had the history of usage of ceftriaxone in previous hospitals for infectious diseases. The ceftriaxone history of the first child was missed before the surgery. When gallbladder stones are found in children without any underlying diseases, specific history taking of the usage of ceftriaxone seems to be absolutely required. In this case, immediate interruption of the antibiotic could resolve the episode and avoid unnecessary surgical procedure.

Follicular Variant of Papillary Thyroid Carcinoma; Clinicopathologic Features / 대한내분비외과학회지

PURPOSE: The follicular variant of papillary thyroid carcinoma (FVPTC) is the most common subtype of papillary thyroid carcinoma (PTC). However, the clinicopathologic features of patients with FVPTC with those of patients with pure PTC is ill-understood. This study evaluated differences in clinicopathologic features of FVPTC compared with pure PTC. METHODS: All patients with FVPTC or pure PTC diagnosed between January 2006 and August 2008 at our institution were retrospectively reviewed. The two groups were compared in terms of clinocopathological features. RESULTS: Of 417 patients, 370 had PTC, and 47 patients had FVPTC. The meanage was 47.1 years. There was no differencein age and sex ratio between the two groups, and both groups were similar in terms of tumor size, presence of multifocality, thyroid capsular invasion, and extrathyroidal extension. However, FVPTC patients had significantly lower lymph node metastases (P=0.015) and significantly higher tumor encapsulation (P=0.031). Galectin-3 expression was decreased in FVPTC (P=.012). CONCLUSION: The clinicopathologic features of FVPTC are more favorable. The possibility of FVPTC could be considered when thyroid nodules with negative galectin-3 expression have suspicious or malignant fine needle aspiration biopsy.