Melanoma metastásico a la glándula tiroides: reporte de dos casos / Metastatic thyroid melanoma: report of two cases

Las metástasis por melanoma a la glándula tiroides son raras, su presentación representa para elpaciente un pésimo pronóstico, dado que indica enfermedad diseminada terminal. El proceso de diagnóstico no difiere al usual para toda masa tiroidea y su tratamiento final depende del estado del paciente y de lo avanzado de la enfermedad. En el presente artículo presentamos dos casos de melanomametastásico a la tiroides.

Metastatic melanoma to the thyroid gland are rare, their presence on a patient represents bad prognosisas it indicates disseminated terminal disease. The diagnostic process is similar to all thyroid masses and its final treatment depends on the patient´s status and how disseminated the disease is. In the present article we describe two cases of metastatic thyroid melanoma.

Revisión histórica de la tiroiditis / Historial review of thyroiditis

La inflamación de la glándula tiroides, tiroiditis, puede presentarse por tres causas principales: autoinmune, infecciosa y secundaria a fármacos. Entre las tiroiditis de base autoinmune destacan: tiroiditis de Hashimoto, descubierta en el año 1912 por el japonés Dr. Hakaru Hashimoto, reportándola como "struma lymplhomatosa" en su artículo "Notes of lymphomatous in the thyroid gland"; tiroiditis Silente o indolora, reportada en el año 1977 por Nobuyuki Amino et al en su artículo "Transient post-partum hypothyroidism: fourteen cases with autoimmune thyroiditis" luego del estudio de 14 casos de tiroiditis post-parto; tiroiditis de Riedel, enfermedad descubierta en 1883 por Bernhard Riedel, publicado en 1896 una descripción de dos casos usando el nombre de "eisenharte struma", posteriormente estudiada por investigadores como Woolner et al (1957) y por Schwaegerle et al (1988). Entre las tiroiditis de base infecciosa se han descrito dos tipos: tiroiditis aguda o supurada infecciosa originada por bacterias, hongos, o parásitos, siendo predominante en individuos con cierto grado de inmunosupresión; tiroiditis de Quervain, descubierta por Fritz de Quervain, quien en 1902 presenta ante el Congreso de la Sociedad Alemana de Cirugía su trabajo titulado "Ueber acute, nicht eiterige thyreoiditis" (tiroiditis subaguda no supurativa), y es para 1904 que pública su trabajo "Die akute nicht eiterige thyreoiditis und die betelingung der schilddrüse an akuten intoxikationen und infektionen überhaupt", que luego llevaría el nombre del investigador. Por último se encuentran las tiroiditis secundarias a fármacos como amiodarona y litio, cuyos componentes han sido responsables de la inflamación de la glándula tiroidea.

Inflammation of the thyroid gland, also called thyroiditis, can occur by three main causes autoimmune, infectious and secondary to drugs. Thyroiditis of autoimmune origin include: Hashimoto's thyroiditis, discovered in 1912 by japanese Dr. Hakaru Hashimoto who reported it as "struma lymphomatosa" in his article "Notes of lymphomatous in the thyroid gland"; Silent or painless thyroiditis, reported in 1977 by Nobuyuki Amino et al in their article "Transient postpartum hypothyroidism: fourteen cases with autoimmune thyroiditis" after studying 14 cases of postpartum thyroiditis; Riedel thyroiditis, a disease discovered in 1883 by Bernhard Riedel, who published in 1896 a description of two cases using the name "eisenhart struma" to describe this new form, later developed by researchers Woolner et al (1957) and Schwagerle et al (1988). Among the infectious thyroiditis there have been desribed two types: acute or suppurative thyroiditis caused by infectious bacteria, fungi, parasites, being individuals with a degree of immunosuppression the main risk group; De Quervain's thyroiditis, disecovered by Fritz de Quervain, who in the Congress of the German Society of Surgery of 1902 presented his work entitled "ueber acute, nicht eiterige tryreoiditis" (non suppurative subacute thyroiditis), and by 1904 published his work entitled "Die akute nicht eiterige thyreoiditis und die beteilingung der schilddrüse an akuten intoxikationen und infektionen überhaupt", named later after him. Finally thyroiditis secondary to drugs such as amiodarone and lithium, whose components are responsible for inflammation of the thyroid gland.

Theodor Kocher (1841-1917) Nobel Prize Centenary 2009 / Theodor Kocher (1841-1917) Centenário de Prêmio Nobel 2009

One hundred years ago, in 1909, Theodor Kocher was awarded the Nobel Prize in Physiology and Medicine for his work on the physiology, pathology, and surgery of the thyroid gland. In the late 19th century, the resection of the thyroid was feared because of its high mortality rate. Kocher's innovative techniques resulted in safe outcomes. His observations that radical resection of the thyroid results in "cachexia strumipriva" contributed to the recognition that the thyroid is essential for normal growth, development and metabolism. He made many other seminal contributions to the field of surgery and medicine, and his expertise was internationally recognized. Kocher served as the chairman of surgery at the University of Bern in Switzerland, his alma mater, until his death in 1917.

Há 100 anos, em 1909, Theodor Kocher foi agraciado com o Prêmio Nobel de Fisiologia e Medicina pelo seu trabalho na fisiologia, na patologia e na cirurgia da glândula tireoide. No final do século XIX, a ressecção da tireoide era temida pelo alto índice de mortalidade. As técnicas inovadoras de Kocher resultaram como procedimento seguro. Suas observações de que a ressecção radical da tireoide resulta em cachexia strumipriva contribuiu no reconhecimento de que a tireoide é essencial no crescimento normal, no desenvolvimento e no metabolismo. Ele realizou muitas outras contribuições seminais no campo da cirurgia e da medicina, e seu conhecimento foi reconhecido internacionalmente. Kocher foi chefe da cirurgia da Universidade de Berna na Suíça, sua alma mater, até sua morte em 1917.

Historical Perspectives of the Treatment of Thyroid Disease / 의사학

Although several findings of historical writings have been made, the exact role of the thyroid was not known in the ancient times. From the middle of the nineteenth century, the anatomy and the physiological role of the thyroid were gradually elucidated, and diagnostic and therapeutic modalities were developed. It has been 100 years since Theodor Kocher was awarded the Nobel Prize for his work in pathophysiology and surgery of the thyroid. Fifty years have passed since radioactive iodine was first used for the diagnosis and the treatment of hyperthyroidism in Korea. Today, thyroid cancer is one of the most prevalent malignancy in Korean women. However, the detailed history of the thyroid disease has not been introduced in Korea. The aim of this paper is to describe the historical perspectives of the thyroid disease, especially focusing on the development of the treatment. The common thyroid disease ere named after their discoverers, such as Graves and Hashimoto. It is meaningful to understand the historical background of the thyroid gland, because the important concepts in the area of endocrinology such as hormone replacement therapy, feedback mechanisms, and the use of isotopes were first established based on the research of the thyroid.

Emil Theodore Kocher: Cirujano, Maestro y Nobel / Emil Theodore Kocher: Surgeon, Master and Nobel

Emil Theodore Kocher nació en Suiza el 25 de agosto de 1841. inició su vida escolar a los 4 años hasta graduarse Summa Cum Laude en 1865 de la prestigiosa facultad de medicina de la Universidad de Berna. Visitó distinguidos profesores como Billroth, Lister, Pasteur y Nelaton para luego establecerse en Berna en 1866. En 1875, asumió la jefatura de cirugía de dicha Universidad permaneciendo en el cargo durante 45 años. Kocher contribuyó extensamente a la cirugía general, cirugía gastrointestinal, cirugía endocrina, urología, ginecología, neurocirugía, traumatología y a la cirugía en los frentes de guerra, que fueron registradas en su texto de Cirugía Operatoria, editado por primera vez en 1892. Mediante su técnica, Kocher redujo la mortalidad de la cirugía tiroidea electiva de manera considerable, disminuyó la morbilidad de la misma y describió el hipotiroidismo posquirúrgico. Fue el primer presidente de la Sociedad Internacional de Cirugía y fue galardonado con el premio Nobel en 1909 por su contribución al estudio de la fisiología, cirugía y patología de la glándula tiroides. Kocher no fue sólo un cirujano magistral, sino también un excelente maestro. Persona cortés, respetuosa, devota y arraigado nacionalista; fue jefe de una familia tranquila, armoniosa y feliz por 48 años. Falleció el 25 de julio de 1917, no sin antes dejarnos una fama digna de respeto y admiración en todos aquellos lugares donde la cirugía se practica diariamente

Tireóide, näo: tiróide, sim / Tireóide, no: tiróide, yes

O autor mostra, mediante revisão histórica, que em português, como nas demais línguas, há de dizer-se "tiróide" e não "tireóide"