Histologic Degree of Invasion and Prognosis in Follicular Thyroid Carcinoma / 대한내분비외과학회지

PURPOSE: Follicular thyroid carcinoma (FTC) is the second most common malignancy of the thyroid after papillary thyroid carcinoma, constituting about 10% of all thyroid malignancies. The objective of the current investigation was to determine whether there was a direct relationship between the histologic degree of invasion, tumor recurrence, and patient survival. METHODS: We retrospectively reviewed the records of 55 patients with a histologic diagnosis of pure follicular carcinoma of the thyroid who were treated from 1990 to 2003 at the Presbyterian Medical Center in Jeonju, Korea. Their mean follow-up period was 8.4 years (range, 1~15 years). The following criteria were used to histologically define malignant follicular neoplasms: 1) minimally invasive, tumor invasion through the entire thickness of the tumor capsule; 2) moderately invasive, tumor with angioinvasion (with or without capsular invasion); and 3) widely invasive, broad area or areas of transcapsular invasion of thyroid and extrathyroid tissue. RESULTS: Among 33 patients with capsular invasion only, 2 patients (6%) developed recurrent disease. Of the 16 patients who had angioinvasion with or without capsular invasion, 4 patients (25%) developed recurrent disease. Among 6 patients who had widely invasive FTC, 5 patients (83%) developed recurrent disease, and 2 of those 6 patients (33%) with widely invasive FTC died of the disease. Patients who had widely invasive FTC had greater recurrence rates than patients who had a capsular or angioinvasion (P<0.001). The overall death rate for patients with widely invasive FTC was 33%. CONCLUSION: This study shows that patients with widely invasive FTC had greater recurrence rates and poorer survival than patients who had capsular or angioinvasion; this difference was statistically significant. The authors conclude that patients who had widely invasive FTC need close follow-up and active treatment.

Male Polythelia

Supernumerary nipples or polythelia are developmental abnormalities located along the embryonic mammary lines. It occurs sporadically but familial aggregation was been reported. Polythelia has been reported in association with congenital malformations, in particular with renal anomalies. We report a case of polythelia.

Tuberculosis of the Thyroid Gland - Report of Two Cases and Review of the Literatures / 대한내분비외과학회지

PURPOSE: Tuberculosis of the thyroid gland is very rare and some cases were reported in Korea since 1968. We experienced a case of tuberculous thyroiditis and found a old case in our medical center. This report is about the two case and the review of all cases reported about tuberculosis of the thyroid gland in Korea. METHODS: We present the case of a 55-year-old woman with thyroid tuberculosis who has been treated with antituberculous medication because of tuberculous meningitis during 6 months. We performed thyroid isthmectomy and she is now taking the antituberculous drugs. We found a case of 40- year-old woman who underwent extended thyroid lobectomy, Lt. in 1985 at our medical center. We reviewed the 18 literatures with 29 cases of tuberculosis of the thyroid gland reported in Korea and analyzed total 31 cases (reported 29 cases and our 2 cases). RESULTS: 28 patients were women and only 2 patients were over 60 years old. 26 patients had complained the neck mass. Duration of symptoms were below 6 months in 18 cases. There were associated symptoms like as weight loss, easy fatigue or generalized weakness, dysphagia, palpitation, fever, chills and/or anorexia. Only 9 patients had underlying tuberculosis - 2 meningitis, 2 pneumonia, 3 lymphadenopathy and 2 pneumonia combined with meningitis. But 3 patients were newly diagnosed as old or active pulmonary tuberculosis at the time of diagnosis of thyroid tuberculosis. Thyroid function was normal in 9 cases and abnormal in 5 cases. 3 cases were diagnosed nonoperatively and 15 patients of surgically treated 28 cases were underwent lobectomy. AFB stain was positive in only 13 cases and 2 cases were positive of culture with negative AFB stain. All of cases were diagnosed by pathology as granulomatous tuberculosis with caseous necrosis. CONCLUSION: Either surgical resection plus antituberculous medications or only medications are effective and recurrences were not reported after any initial treatments. So preoperative evaluation is very important and will guide the patient and the surgeon to the most effective management.

Operative Indications for Hashimoto's Thyroiditis in Consideration of the Risk of Concurrent Thyroid Carcinoma / 대한내분비외과학회지

PURPOSE: This study was performed to further refine the indications for operative treatment of patients with Hashimoto's thyroiditis, and also to present the better histopathologic diagnosis method for Hashimoto's thyroiditis. METHODS: The authors evaluated retrospectively 130 patients with surgically proven Hashimoto's thyroiditis at presbyterian medical center in Chonju and Yonsei hospital in Masan from Jan. 1995 to Feb. 2002. RESULTS: The sensitivity of gun biopsy for the diagnosis of Hashimoto's thyroiditis was significantly higher than the one of fine needle aspiration (83.3% vs 46..2%, P<0.001). There were 26 cases (13.8%) of coexistent carcinoma of 130 patients. The incidence of carcinoma in men (6 in 9, 66.6%) was significantly higher than in women (20 in 121, 16.5%, P<0.05). The incidence of carcinoma in antithyroglobulin antibody negative group (8 in 10, 80%) was significantly higher than in antibody positive guoup (16 in 111, 14.4%, P<0.001). There was no significant difference in the incidence of carcinoma between positive and negative lymphadenopathy groups (22.6% vs 20.0%, P=0.681). As for ultrasonographic findings, patients with irregular-marginated dominant nodule or calcification had significantly higher incidence of carcinoma than those without so findings had (P<0.001). As for the distribution patterns of lymphocytes infiltration, the incidence of carcinoma in nodular or localized pattern groups is significantly higher than in diffuse group (24.5% vs 8.3%, P<0.05). CONCLUSION: For histopathologic diagnosis of Hashimoto's thyroiditis, gun biopsy is more sensitive than fine needle aspiration. And the incidence of concurrent carcinoma in patients with Hashimoto's thyroiditis is increased under the circumstances as follows: men, negative antithyroglobulin antibody results on serologic test, ultrasonographic findings such as irregular-marginated dominant nodule, increased vascularity or calcification, and nodular or localized patterns of lymphocytes infiltration on histopathologic examination.

A Clinical Analysis of Thyroid Nodules of Below 1 cm in Size

BACKGROUND: Thyroid nodules are among the most common endocrine diseases requiring surgical treatment. To determine the appropriate treatment methods for thyroid nodules, we conducted this study by analyzed the clinical characteristics of thyroid nodules, the surgical procedure, and postoperative complications. METHODS: We experienced 39 cases of thyroid nodules below 1 cm in size and treated them by surgical intervention at the Department of Surgery, Masan St. Mary's Hospital, from April 1994 to June 1996. We examined the age and the sex distributions, the clinical manifestations, the locations of the thyroid nodules, the pathologic findings, the ultrasonographic findings, the aspiration biopsy cytology findings, the surgical procedures, and the postoperative complications. RESULTS: 1) The mean age of the patients was 45 years, and the sex ratio of males to females was 1:18.5. 2) The nodules were located in the right lobe (24 cases), the left lobe (10 cases), both lobes (3 cases), isthmus (2 cases). 3) When 39 cases were examined by ultrasonography, the malignant nodules were found in 1 of 14 cases of anechoic nodules and 10 of 25 cases of isoechoic nodules. 4) Aspiration biopsy cytology was performed in 21 cases, and the false negativity was 25%, the false positivity was 25%, and the accuracy rate was 75%. 5) The histopathologic classification of the benign nodules were follicular adenomas, 13 cases; adenomatous goiters, 12 cases; Hashimoto's thyroiditis, 1 case; Hurthle cell adenoma, 1 case; and simple cyst, 1 case. The malignant diseases were papillary carcinoma, 10 cases; and follicular carcinoma, 1 case. 6) Most cases of benign nodules were treated with a lobectomy (72.4%). Malignant nodules were treated with an extended lobectomy and anterior compartment node dissection. 7) The major postoperative complication was transient hypocalcemia. CONCLUSIONS: When voice change or hoarseness is observed and a thyroid nodule is suspected on ultrasonography, aspiration biopsy cytology is considered to be required to exactly distinguish benign nodules from malignant nodules. Further, in case of malignant nodules, it can be concluded that a more active and careful operation may be required to minimize the complications, to decrease the recurrence rate, and to increase the survival rate.

Surgical treatment of pancreatic pseudocyst(s)

No abstract available.

Surgical treatment of adenocarcinoma of the cardia and proximal third of the stomach / 대한암학회지

No abstract available.

Traumatic duodenal wounds

No abstract available.