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이잔디,남기현,정웅윤,소의영,박정수 대한의학회 2008 Journal of Korean medical science Vol.23 No.5
The clinical behaviors and treatment outcomes of thyroid carcinomas in patients with Graves’ disease is a matter of controversy. This study aimed to identify the clinicopathologic features, treatment outcome, and the indicators for predicting recurrence, and to suggest the optimal extent of surgery in these patients. We retrospectively analyzed data of 58 patients who underwent surgical treatment for differentiated thyroid cancer and concurrent Graves’ disease. The follow-up period ranged from 23 to 260 months (mean±standard devuation, 116.8±54.0). In our series, the mean age was 40.8±12.7 yr (range, 15-70), with a male-to-female ratio of 1: 6.25. The mean tumor size was 13±9 mm (range, 3-62). The surgical methods included 19 cases of total thyroidectomy, 38 cases of subtotal thyroidectomy, and 1 case of completion total thyroidectomy. Locoregional recurrence occurred in four patients (6.9%). The 10-yr overall survival and disease-free survival of patients were 95.8% and 91.1%, respectively. Age over 45 yr (p=0.031), tumor size over 10 mm (p=0.049), multiplicity (p=0.007), extracapsular invasion (p=0.021), and clinical cancer (p=0.035) were significantly more prevalent in patients with locoregional recurrence than in those without recurrence. We recommend that Graves’ disease patients should undergo regular ultrasonography screening for early detection of thyroid carcinoma. We also suggest that the choice of extent of surgery should depend on the diagnostic timing (clinical or incidental) and factors for predicting recurrence.
이잔디,남기현,임치영,장항석,정웅윤,박정수,Jandee Lee,M.D.,Kee-Hyun Nam,M.D.,Chi-Young Lim,M.D.,Hang-Seok Chang,M.D.,Woung Youn Chung,M.D. and Cheong Soo Park,M.D. 대한갑상선-내분비외과학회 2005 The Koreran journal of Endocrine Surgery Vol.5 No.2
Forgotten mediastinal goiter is an extremely rare disease. It is most often the consequence of the incomplete removal of a 'plunging' goiter, but it can sometimes be attributed to a concomitant, unrecongnized primary mediastinal goiter which is not connected to the thyroid. A primary mediastinal goiter(autonomous intrathoracic goiter) essentially caused by an abnormal embryonic development of the thyroid gland and a thyroid gland formation located in the thorax or the mediastinum. The differential diagnosis with ordinary recurrence was based on the absence of parenchymatous or vascular connections with the cervical thyroid gland. It is fed by local intrathoracic vessels and observed in the absence of previous thyroidectomy. Nevertheless, for primary mediastinal goiter, sternum-splitting incision will be required in most cases as troublesome mediastinal bleeding may occur which is difficult to control from a cervical collar incision. In this study we report a case of forgotten mediastinal goiter and review the various diagnostic and therapeutic problems posed by the condition. A number of possible solutions that can be implemented for this diasease are identified. (Korean J Endocrine Surg 2005;5:114-117)
이잔디,정선향,이화영,박선미,정미선,조영석 대한내분비학회 2023 Endocrinology and metabolism Vol.38 No.6
Background: Radiation exposure is a well-known risk factor for papillary thyroid cancer (PTC). South Korea has 24 nuclear reactors in operation; however, no molecular biological analysis has been performed on patients with PTC living near nuclear power plants. Methods: We retrospectively included patients with PTC (n=512) divided into three groups according to their place of residence at the time of operation: inland areas (n=300), coastal areas far from nuclear power plants (n=134), and nuclear power plant areas (n=78). After propensity score matching (1:1:1) by age, sex, and surgical procedure, the frequency of representative driver mutations and gene expression profiles were compared (n=50 per group). Epithelial-mesenchymal transition (EMT), BRAF, thyroid differentiation, and radiation scores were calculated and compared. Results: No significant difference was observed in clinicopathological characteristics, including radiation exposure history and the frequency of incidentally discovered thyroid cancer, among the three groups. BRAFV600E mutation was most frequently detected in the groups, with no difference among the three groups. Furthermore, gene expression profiles showed no statistically significant difference. EMT and BRAF scores were higher in our cohort than in cohorts from Chernobyl tissue bank and The Cancer Genome Atlas Thyroid Cancer; however, there was no difference according to the place of residence. Radiation scores were highest in the Chernobyl tissue bank but exhibited no difference according to the place of residence. Conclusion: Differences in clinicopathological characteristics, frequency of representative driver mutations, and gene expression profiles were not observed according to patients’ region of residence in South Korea.
가족성 대장 용종증과 동반된 유두상 갑상선암의 소공질-상실양 변이(Cribriform-morular Variant) 2예
이잔디,이시훈<SUP>1<,SUP>,임치영,남기현,장항석,정웅윤,박정수,Jandee Lee,Sihoon Lee,<SUP>1<,SUP>,Chi-Young Lim,Kee-Hyun Nam,Hang-Seok Chang,Woung Youn Chung and Cheong Soo Park 대한갑상선-내분비외과학회 2005 The Koreran journal of Endocrine Surgery Vol.5 No.2
Cribriform-morular variant (CMV) is a rare histologic subtype of papillary thyroid carcinoma (PTC). Patients with familial adenomatous polyposis (FAP) could be associated with several comorbid diseases including thyroid cancer. Most thyroid cancers in them are PTCs, but infrequently CMV types can occur. The FAP concomitant CMV-PTCs are found predominantly in young women and reveals lower recurrence rate. Moreover, this variant shows circumscribed morphology and rarely metastasizes to node. Because the incidence of thyroid carcinoma is higher than that in general population, comprehensive evaluation of thyroid gland should be performed for the patients with FAP. Because thyroid cancer could be first manifestation of FAP, colonic screening should be considered in CMV-PTC patient. We report two cases of CMV-PTCs concurrent with FAP. (Korean J Endocrine Surg 2005;5:109-113)
이잔디,남기현,임치영,장항석,홍순원<SUP>1<.SUP>,박정수,Jandee Lee,M.D.,Kee-Hyun Nam,M.D.,Chi-Young Lim,M.D.,Hang-Seok Chang,M.D.,Soon Won Hong,M.D.<SUP>1<.SUP> and Cheong Soo Park,M.D. 대한갑상선-내분비외과학회 2005 The Koreran journal of Endocrine Surgery Vol.5 No.1
Differentiated thyroid carcinoma rarely shows gross angioinvasion with intraluminal tumor thrombus. Although there was no definite result of long-term survival, a vascular invasion or thrombus indicates poor prognosis. Total thyroidectomy with en block resection of involved vessels is known as the best surgical approach, and followed by postoperative radioiodine therapy. However, the effect of adjuvant external irradiation therapy remains in debate. We report a case of differentiated thyroid carcinoma with internal jugular vein tumor thrombus treated successfully by a complete surgical resection and postoperative radioiodine therapy. (Korean J Endocrine Surg 2005;5:32-35)