Hyalinizing Trabecular Tumor (HTT) of Thyroid: Two Case Report / 대한내분비외과학회지

Hyalinizing trabecular tumor (HTT), a type of thyroid lesion, was first reported by Carney in 1987 and has since been reported continuously. Due to its histological non-specificity, HTT can be misdiagnosed as papillary thyroid cancer or medullary thyroid cancer. For this reason, over treatment might occur; for example, total thyroidectomy and lymphadenectomy. Diagnosis and treatment is a challenge because there is still controversy regarding HTT characters. We report on two cases. One patient was a 48-year-old female and the other was a 46-year-old female. Both patients complained of a thyroid mass and were diagnosed as HTT.

Body size and thyroid nodules in healthy Korean population / 대한외과학회지

PURPOSE: Excess weight and obesity have been associated with numerous diseases including thyroid cancer, but the relationship has been weak. The objective of this study was to evaluate the relationship of body sizes on thyroid nodules in healthy Korean population. METHODS: A total of 7,763 persons who underwent a health examination in our health examination center were included in this study. The epidemiologic factors, body size and thyroid ultrasound results were reviewed. We investigated the effects of body size on the presence of thyroid nodules and malignancy. RESULTS: The incidence of thyroid nodules was 20.6%. In the group who were found to have thyroid nodules, mean height, weight and body surface area (BSA) were significantly smaller compared to the others. Especially, in the women, smaller height (less than 160 cm) and overweight (> or = 60 kg) were identified as independent risk factors for the presence of thyroid nodules. The patients with body mass index (BMI) subgroups of normal or overweight had a tendency to have thyroid nodules more frequently. The detection rate of thyroid cancer was 0.47%. The patients with thyroid cancer tended to be smaller in height and BSA than the others. CONCLUSION: A higher frequency of thyroid nodules was associated with women and, older age. In women, there were significant correlations in height, weight and BMI subgroups to the presence of thyroid nodules.

The indices of body size and aggressiveness of papillary thyroid carcinoma / 대한외과학회지

PURPOSE: The incidence of papillary thyroid carcinoma (PTC) is increasing worldwide. Positive associations between indices of body size and thyroid cancer have been reported. However, the relationships to cancer severities and/or behaviors are uncertain. METHODS: We performed a retrospective analysis of the data of patients who underwent total thyroidectomy due to PTC. The epidemiologic factor and pathologic report after operation were determined based on chart review. The relationships between indices of body size and these parameters were assessed. RESULTS: Positive association between body mass index and T stage was found, but it was not statically significant. In neck lymph node metastasis, the group with metastasis had a tendency for larger mean height and weight, but significant difference was found only in height. However, in the multivariate analysis, the age and size of nodules were only identified as independent risk factors of neck lymph node metastasis (P = 0.000 and 0.019). CONCLUSION: There was no independent association between indices of body size and stages of PTC in patients who underwent total thyroidectomy.

The Predictable Factors of Hypothyroidism Following to Thyroid Lobectomy / 대한내분비외과학회지

PURPOSE: Thyroid lobectomy is one of the common operative procedures in patients with benign thyroid nodules. The procedure is relatively feasible, but some patients who receive lobectomies have the complications, such as nerve injury, hypocalcemia, and hypothyroidism. We examined the frequency of hypothyroidism and predictable factor following thyroid lobectomy due to benign thyroid nodules. METHODS: Retrospective analysis was carried out on 212 patients who underwent thyroid lobectomy to benign nodules from January 2005 to May 2010. The risk factors, including sex, age at diagnosis, thyroid function test results, existence of thyroiditis, thyroid volume, and results of the preand post-operation thyroid ultrasounds, were analyzed between euthyroidism and hypothyroidism groups. RESULTS: The rate of hypothyroidism was 17%. In the univariate analysis, age, multiplicity of nodules, thyroiditis, preoperative levels of Tg and TSH, and thyroid volume were significantly predictable factors of hypothyroidism. In the multivariate analysis, the significant factors associated with hypothyroidism were being over 40 years old, having a preoperative TSH of more than 2 mlU/L, and having a small thyroid volume. CONCLUSION: Hypothyroidism following lobectomy is not disasterous complication. We should discuss the possibility of postoperative hypothyroidism carefully with patients before operation, especially when we plan to perform lobectomy on the patients who are over 40, have high TSH levels before surgery, or have a small thyroid volume.

The Risk Factors of Reflux Complication after Gastrectomy for Proximal Gastric Cancer

PURPOSE: The aim of this study was to investigate the risk factors of reflux associated complications (reflux symptoms, reflux esophagitis, and esophageal stricture) after gastrectomy for proximal gastric cancer. METHODS: 150 patients with proximal gastric cancer were included from January 2005 to December 2008. Their medical and surgical records were retrospectively analyzed concerning clinical and pathologic characteristics, operation methods, morbidity, reflux associated complications and nutritional states. RESULTS: Tumor sizes and operation methods were statistically significant in univariate analysis of risk factors for reflux associated complications (P0.05). However, reflux complications were significantly more common in proximal gastrectomy groups (72.4%) than in total gastrectomy groups (29.5%). Severe reflux esophagitis (LA classification C or D) was found in only proximal gastrectomy groups. CONCLUSION: Total gastrectomy is favorable for proximal early gastric cancer in terms of reduced esophageal reflux complications.

The Characteristics and Strategy of Treatment for Non-diagnostic Thyroid Fine-needle Aspiration Cytology / 대한내분비외과학회지

PURPOSE: The management of non-diagnostic fine needle aspiration biopsy of thyroid nodules has been a dilemma. The purposes of this study were to analyze the characteristics and the results of follow up of non-diagnostic aspirates and to evaluate the management strategy. METHODS: A retrospective review was conducted on the patients who underwent fine-needle aspiration of thyroid nodules that were found on a health examination. The patients' records were assessed for the demographics, the ultrasound findings and the pathologic findings. RESULTS: The initial non-diagnostic rate was 35%. The nodule size (≤10 mm) and cystic nodule were related to a high rate of non-diagnostic results. The common causes of non-diagnostic results by pathologic description were reducedcellularity (59.3%) and blood (28.2%). Among the 62 initially non-diagnosed patients, 2 patients were confirmed to have malignancy and 32 patients (51.6%) were lost from follow-up. Reaspiration was performed in 18 patients and 6 patients still resulted non-diagnostic aspirates. CONCLUSION: Nodule size and cystic nodule were associated with a high rate of non-diagnostic results. Non-diagnostic results of thyroid nodules may be associated with a relatively high frequency of follow up loss, and non-diagnostic results may be associated with a probability of malignancy. So, non-diagnostic results should not be considered just benign, and clinicians should recommend a repeat exam for such patients.