RESUMO
PURPOSE: Prolonged immunosuppression after kidney transplantation (KT) is known to increase the risk of various cancers; however, few studies on posttransplant thyroid carcinoma (TC) have been reported in the literature. We investigated the incidence of posttransplant malignancies (PTMs) and the clinicopathological features of postransplant TC. METHODS: We conducted a retrospective study of 1,622 patients who underwent KT from Mar. 1969 to Dec. 2008. Overall incidence and the standardized incidence ratio (SIR) of posttransplant TC according to the 2007 annual report of the Korea Cancer Center Registry were calculated. RESULTS: During the mean follow-up period of 109 months, 137 (8.4%) recipients were identified as having PTM, including five males and seven females with papillary TC. (0.74%) SIR of the TC was 12.4 in males and 0.5 in females. During the mean follow-up period of 69.1 months, three (25.0%) patients with TC developed loco-regional recurrence. CONCLUSION: Overall incidence of TC was higher compared to the general Korean population (0.74% vs 0.04%) without differences in gender distribution (P=0.086) and higher tendency of locoregional recurrence in clinical carcinoma (P=0.0512). Therefore, to ensure early detection and favorable outcome of posttransplant TC, frequent surveillance using ultrasonography and prophylactic central neck dissection should be considered.
Assuntos
Feminino , Humanos , Masculino , Aloenxertos , Seguimentos , Terapia de Imunossupressão , Incidência , Transplante de Rim , Coreia (Geográfico) , Esvaziamento Cervical , Recidiva , Estudos Retrospectivos , Neoplasias da Glândula Tireoide , UltrassonografiaRESUMO
PURPOSE: Despite the overall excellent prognosis for patients with papillary thyroid microcarcinoma (PTMC), these tumors are also associated with a 5% relatively high lymph node (LN) recurrence rate and the optimal surgical extent of papillary thyroid microcarcinoma has been controversial. Cervical LN metastases (LNMs) are found in about 40~65% of patients with PTMC. The aim of this study is to identify the factors affecting lymph node metastases (LNMs) in patients with PTMC. METHODS: We performed a retrospective study of 335 patients with PTMC who underwent total thyroidectomy or lobectomy with elective central lymph node dissection (CLND) at Kangnam St. Mary's Hospital between Jan. 2006 and Dec. 2008. We investigated the association of LNMs and clinicopathologic factors such as sex, age, multiplicity, extrathyroidal extension, and tumor size. RESULTS: LNMs were present in 88 patients (26.3%). Univariate analysis showed that less than 45 years of age, male, multiplicity, a tumor size of greater than 5 mm, thyroid capsular invasion and extrathyroidal extension were predictive factors for LNMs (P5 mm), male, age (<45) and extrathyroidal extension were determined as the predictive factors for LNMs, which occurred in about one fourth of the patients with PTMC. Therefore, elective CLND should be considered in patients with PTMC who have these factors through a thorough investigation before surgery.
Assuntos
Humanos , Masculino , Carcinoma Papilar , Excisão de Linfonodo , Linfonodos , Metástase Neoplásica , Prognóstico , Recidiva , Estudos Retrospectivos , Fatores de Risco , Glândula Tireoide , Neoplasias da Glândula Tireoide , TireoidectomiaRESUMO
PURPOSE: For the accurate diagnosis of non-palpable breast lesions with microcalcification, a localization and biopsy procedure should be performed by using mammography. Recently, a stereotactic vacuum-assisted biopsy has been reported as a convenient and accurate method for a procedure. This study was performed to determine whether the upright add-on type stereotactic biopsy was suitable for the diagnosis of microcalcified breast lesions in Korean women. METHODS: Between April 2002 and March 2003, an upright add-on type stereotactic vacuum-assisted biopsy was performed in 21 cases with microcalcification; that had been categorized from 2 to 5 according to the BI-RADS (Breast Imaging Reporting and Data System). The microcalcified lesions in biopsy specimens were confirmed with tissue mammogram and a pathological review performed. RESULTS: The pathological findings revealed fibrocystic changes in 15 cases, intraductal papilloma in 1 and ductal carcinoma in situ (DCIS) in 5. There were no malignancy among the BI-RADS category 2 & 3 cases, but DCIS was found in 2 (25%) out of 8 BI-RADS category 4 cases, and in all 3 (100%) of BI-RADS category 5 cases. The malignancy detection rate among the cases with microcalcification with a BI-RADS category above 4 was 45.4% (5/11). CONCLUSION: An upright add-on type stereotactic vacuum assisted biopsy is an accurate, safe and very convenient tool for the diagnosis of breast lesions with microcalcification.