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Cystic Medullary Thyroid Carcinoma: A Case of Undergoing Endoscopic Thyroid Lobectomy
Dong Hae Chung,Jae Yeon Seok,Yoo Seung Chung1,Eun Mee Oh1,Jung Won Ryu1,Young Don Lee1 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.1
On ultrasonography, medullary thyroid carcinoma (MTC) shows hypoechogenicity, an irregular margin, a predominantly solid composition, and microcalcifications, similar to those observed in papillary thyroid carcinoma (PTC). MTC presenting as a cystic lesion is rare, and endoscopic thyroidectomy can be performed for benign thyroid masses and early stage PTC, however it is inappropriate for MTC regardless of cystic change. The authors report a case of cystic MTC found after endoscopic thyroid lobectomy and provide a review of the literature on this topic.
원발성 알도스테론증으로 부신 절제술 받은 환자의 수술 후 결과에 대한 분석
류재민,정승필,이정희,김지영,최민영,이세경,길원호,최준호,이정언,김지수,남석진,양정현<SUP>1<.SUP>,김정한,Jai-Min Ryu,M.D.,Seung-Pil Jung,M.D.,Jeong-Hee Lee,M.D.,Ji-Yeong Kim,M.D.,Min-Yeong Choi,M.D.,Se-Kyung Lee,M.D.,Won-Ho Kil,M.D.,Jun-Ho C 대한갑상선-내분비외과학회 2011 The Koreran journal of Endocrine Surgery Vol.11 No.4
Purpose: Primary aldosteronism (PA) is characterized by hypertension (HTN), hypokalemia, suppressed plasma renin activity, and inappropriate aldosterone secretion. The purpose of this study was to analyze postoperative results on blood pressure (BP), and to determine the factors associated with resolution of HTN after adrenalectomy for PA. Methods: One hundred eight patients (66 females and 42 males) with a mean age of 46 years underwent adrenalectomy for PA between January 1, 1996 and September 30, 2009. Their clinical characteristics and biochemical parameters were reviewed retrospectively. Results: All patients had HTN preoperatively and 20 patients (18.1%) had uncontrolled HTN. Hypokalemia was evident in 89.1% of patients, cardiovascular events in 4.5% and cerebrovascular events in 8.2%. There was a significant decrease in both systolic BP and diastolic BP postoperatively, as compared with that before operation. Median systolic BP decreased from 150 mmHg to 125 mmHg at the last follow-up (P<0.01), and median diastolic BP decreased from 93.5 mmHg to 81.5 mmHg (P<0.01). Sixty two (57.4%) patients were cured of HTN and did not require any hypertensive agent, and 38 (35.1%) patients had an improvement in BP control, whereas 9 (8.3%) patients had no change in BP. Univariate analysis showed that duration of HTN and more than two HTN treatment agents were independent factors predicting sustained hypertension after surgery. Conclusion: The duration of HTN and the severity of HTN are factors influencing persistence of HTN after operation for a PA. (Korean J Endocrine Surg 2011;11:276-282)
갑상선 미세유두암에서 갑상선 주변 조직 침윤(Minimal Extrathyroid Extension)의 임상적 의의
이재복,김훈엽,우상욱,류우상,이정아,손길수,배정원,이유미<SUP>1<.SUP>,Jae Bok Lee,Hoon Yub Kim,Sang-Wook Woo,Woo Sang Ryu,Jung Ah Lee,Gil Soo Son,Jung-Won Bae,and Yu Mi Lee,Ph.D.<SUP>1<.SUP> 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.4
Purpose: The prognosis of papillary thyroid carcinoma is determined by such risk factors as old age, male gender, a large tumor size and extrathyroid extension. The aim of this study was to investigate the value of extrathyroid extension for the recurrence of papillary microcarcinoma and its association with the risk factors for papillary thyroid carcinoma. Methods: We retrospectively studied 167 patients with papillary microcarcinoma and who underwent thyroidectomy from Feb. 2003 to Dec. 2008. Papillary microcarcinoma (PTMC) was defined as a tumor smaller than 1 cm and an extrathyroid extension was identified by the pathological findings. Age, gender, extrathyroid extensions, the operative methods, lymph node metastasis and the MACIS score were analyzed by the appropriate statistical methods. Results: Patients with PTMC showed a lower MACIS score, fewer lymph node metastasis and less extrathyroid extension, as compared to the patients with papillary thyroid carcinoma. Total thyroidectomy and selective lymph node dissection were less frequently done in the patients suffering with PTMC. Analysis of the risk factors showed that PTMC had a close relationship with lymph node metastasis, the extent of surgery and multifocal cancer. The disease free survival rate of the patients with PTMC was statistically related with lymph node metastasis, but not with an extrathyroid extension (P=0.001). Conclusion: The patients with PTMC showed less lymph node metastasis and extrathyroid extension as compared to the patients with PTC. Lymph node metastasis of PTMC is an independent factor for disease free survival, but minimal extrathyroid extension is not related with recurrence. PTMC with lymph node metastasis should be regarded as an aggressive large tumor and lymph node dissection should be done. (Korean J Endocrine Surg 2008;8:243-249)