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정을삼(Eul Sam Chung),박성길(Sung Gil Park),오성수(Sung Soo Oh),윤경석(Kyung Seok Yoon) 대한두경부종양학회 1998 대한두경부 종양학회지 Vol.14 No.2
Objectives: Papillary microcarcinoma of the thyroid was evaluated as to the effectiveness of diagnostic modalities, lymphatic spread pattern, and therapeutic decision according to tumor size. Material and Methods: We retrospectively analyzed a clinicopathologic findings of 72 papillary microcarcinoma patients who were treated at the over 11 years between 1985 and 1995. The authors divided papillary microcarcinoma of the thyroid into two subgroups according to tumor size: 0?5mm and 5<0?10mm. An analysis including age and gender distribution, diagnostic tools(thyroid sonogram, thyroid scan, thyroid function test, fine needle aspiration cytology, frozen section), pathological examination of lymphnode, and surgical procedures was carried out in each subgroups. Results: The carcinoma of smaller than 5mm were found in 32 patients, and of 6 -10mm were in 40 patients. The average age of patients was 45years and all of them were female. Cold nodules on thyroid scan were noticed in 53 patientss and normal findings were in 15 patients. Suspicious malignant lesions(fine calcification, solid mass, irregular margin) on thyroid sonography were detected in 23 patients and the sonography was more useful in detecting 0?5mm small sized lesions than other diagnostic methods. FNAC were performed in 17 patients, and 7 patients were diagnosed as having thyroid papillary cancer. But diagnotic rate in 0?5mm small sized lesions was very low(one of eights).Frozen section were performed in all patients, among these 15 patients were diagnosed as being benign diseases and false negative rates were higher in 0?5mm small sized lesions than in 5<0?10mm sized lesions(p-value<0?10mm sized lesions. Postoperative management were performed with TSH suppression therapy(T4, synthroid) in all patients and RI therapy in 29 patients. Conclusion: On the basis of our study, improved preoperative diagnostic tools for papillary microcarcinoma of the thyroid was helpful in the choice of surgical treatment. As a result of techninological progress(ultrasonography, FNAC), the pencentage of the discovery of papillary microcarcinoma has been increased. The thyroid ultrasonography was useful in detecting small sized lesions(0?5mm), but FNAC may not be beneficial in detecting small sized lesions(0?5mm). In the surgical procedure, thyroid lobectomy alone should be avoided because of the high rate of bilaterality and multifocality.
박윤규(Yoon Kyu Park),박성길(Sung Gil Park),이삼열(Samu el Lee),오성수(Sung Soo Oh),이혜경(Hye Kyung Lee) 대한두경부종양학회 1991 대한두경부 종양학회지 Vol.7 No.2
This is a clinical, retrospective review of 66 cases of the Adenoid cystic carcinoma who were treated at the Department of Surgery, Presbyterian Medical Center, Chonju during the past 20 years from January, 1971 to December, 1990. The results were obtained as follows; 1) The most common malignant tumor in the minor salivary gland was adenoid cystic carcinoma and it's incidence was 57.6% (38 cases). 2) The most common site of adenoid cystic carcinoma in the major salivary gland was parotid gland with the incidence of 22.7% (15 cases). 3) The peak age of patients with adenoid cystic carcinoma was 5th decade(30.3%) and others' peak age except adenoid cystic carcinoma was 6th decade(35.9%). 4) The duration of symptoms of adenoid cystic carcinoma patient was less than one year in the minor salivary gland, comprising 21 cases(55.3 %) and more than one year in 18 cases(64.9 %) of the major salivary gland carcinoma. 5) According to histologic grades of 66 cases of adenoid cystic carcinoma, Grade I was 15 cases and Grade II 19 cases, Grade III 5 cases. Other 27 cases were undetermined. 6) The incidence of cervical lymphnode metastasis of 39 cases of adenoid cystic carcinoma classified into histologic grades was 0% in Grade I, 10.5% in Grade II and 20% in Grade III. 7) The incidence of nerve invasion confirmed histologically was 20% in Grade I, 63.2% in Grade II and 100% in Grade III. It was significant(p<0.01). 8) The local recurrence rate was 26.7% in Grade I, 47.4% in Grade II and 60% in Grade III. The lung was the commonest site for distant metastasis comprising 14 cases among 19 cases in which distant spread occurred. 9) 5 year determinate disease-free survival rate according to the histologic grade was 57.1% in Grade I, 27.33 in Grade II and 25.03 in Grade III. 10) The determinate 5-year survial rate of adenoid cystic carcinoma was 71.4% in the only curative surgery group, 70.6% in the combined treatment group of surgery and postoperative irradiation, 66.7% in the combined treatment group of surgeη with postoperative irradiation and chemotherapy, and 33.3% in the non-curative treatment group. 11) The average size of tumor was 3.6cm in Grade I, 4.8cm in Grade II and 4.5cm in Grade III.