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안동빈,손진호,박지영 대한갑상선학회 2013 International Journal of Thyroidology Vol.6 No.1
As the prevalence of thyroid carcinoma is rapidly increasing, coexisting subtypes of thyroid carcinomas are often found. However, concurrent papillary and medullary carcinomas in the thyroid gland are extremely rare. We report the case of a 50-year-old man with co-occurrence of multiple papillary and medullary thyroid carcinomas; the latter were undetected at initial diagnosis. Sixty-three months after the initial operation performed because of papillary carcinoma diagnosis, a metastatic lymph node was detected in the left level IV region, which was revealed as medullary carcinoma. The histopathologic results from initial surgery were reviewed, and we found multiple coexisting medullary carcinomas that were not identified initially. The incidence of concurrent papillary and medullary thyroid carcinomas will continue to increase as rates of diagnosis of and surgery for thyroid carcinoma increase. Therefore, surgeons and pathologists should be aware of the possible coexistence of subtypes of thyroid carcinomas to avoid missing concurrent lesions.
갑상선 수질암과 갑상선 유두암의 충돌종양: 5예 증례보고
정호철,김제룡,안병현,이진선,장일성,김진만1,Ho Chul Jeong,Je Ryong Kim,Byong Hyon Ahn,Jin Sun Lee,Eil Sung Chang,Jin Man Kim1 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.1
Medullary thyroid carcinoma and papillary thyroid carcinoma are different subtypes of thyroid carcinoma. The concomitant occurrence of medullary thyroid carcinoma and papil-lary thyroid carcinoma as a collision tumor is rare. We describe five cases of medullary and papillary thyroid carcinoma as a collision tumor. Four women and one man underwent thyroidectomy for treatment of thyroid cancer. Collision tumor was then detected by histopathologic finding. Genetic testing, point mutation of the BRAF gene or mutation of the RET gene was performed in three cases. However, only one case had point mutation of the BRAF gene. Exact diagnosis of this uncommon event is important because the strategies for treatment of papillary thyroid carcinoma and medullary thyroid carcinoma are different.
증례 : 그레이브스씨병(Graves` disease) 환자에서 수질암(medullary thyroid carcinoma)이 동반된 1예
공지현 ( Jee Hyun Kong ),김철식 ( Chul Sik Kim ),조민호 ( Min Ho Jo ),안철우 ( Chul Woo Ahn ),김경래 ( Kyung Rae Kim ),장항석 ( Hang Seok Jang ),홍순원 ( Soon Won Hong ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
본 저자들은 54세 여자 환자가 그레이브스씨병으로 치료받던 중 발견된 갑상선 결절을 주소로 내원하여, 수질암으로 전갑상선절제술 및 중앙경부림프절 절제술을 시행받은 증례를 경험하였기에 문헌보고와 함께 보고하는 바이다. It is believed that Graves` disease is associated with an increased prevalence of thyroid carcinoma, but the reported incidence is variable, ranging between 0% and 9.8% generally of differentiated thyroid carcinoma type. The majority of thyroid carcinomas in patients with Graves` disease are papillary, followed in frequency by follicular carcinoma. Medullary thyroid carcinoma in combination with Graves` disease appears to be very rare. To our knowledge, only 11 cases have been described in which medullary thyroid carcinoma associated Graves` disease and all of them, at foreign countries. So we experienced medullary thyroid carcinoma associated Graves` disease, we report this case with review of literature. (Korean J Med 69:S851-S855, 2005)
갑상선 수질암 조직에서 RET 원암유전자의 돌연변이 양상
조남훈(Nam Hoon Cho),박정수(Cheong Soo Park),송현정(Hyeun Jung Song),정웅윤(Woong Youn Chung) 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.1
Background: The molecular pathogenesis of hereditary medullary thyroid carcinoma is well known to be associated with germ-line mutation in the RET proto-oncogene and sporadic medullary thyroid carcinoma has been shown to carry somatic RET mutation especially in exon 13 and 16. The aim of this study is to evaluate the genetic background in the pathogenesis of the sporadic medullary thyroid carcinoma which shows extremely high incidence in Korea. Materials and Methods: Direct DNA sequencing for RET exon 13 and 16, as well as immunohistochemistrical assay for a monoclonal RET antibody were performed from 20 cases of archival tissues of medullary thyroid carcinoma. Results: Monoclonal RET antibody with C-terminal epitope showed comparatively stronger expression in tumor cells than in normal tissues and immunoreactive area in the tumor was 66.0±40.1. Direct sequencing of RET exon 13 revealed 4 cases of mis-sense mutations in Codon 778, Codon 767, and both in Codon 768 and 778. One case showed a silent mutation (ACG-ACT) in RET exon 16 (Codon 926). Conclusions: The strong RET immunoreactivity of medullary thyroid carcinoma may suggest that there could be a genetic alteration in oncoprotein level. RET proto-oncogene mutation may be involved in the evolutional process of medullary thyroid carcinoma in the aspect of molecular basis.
고진우,김도형,김미경,김현옥,최영식 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2
저자들은 태생학적 기원, 면역조직화학적, 분자생물학적으로 완전히 별개의 암종인 갑상선 수질암종과 유두암종이 동시에 동일한 갑상선에 발생하는 매우 드문 사례를 경험하였고 이러한 현상이 우연한 동시 발생인지, 공통의 줄기세포 기원인지 혹은 공통의 암 유발인자에 의한 것인지는 여전히 논쟁의 여지를 남겨두고 있다. It is generally believed that the origins of medullary and papillary carcinoma of thyroid are embryologically different. So mixed medullary-papillary thyroid carcinomas are rare. The two separate tumors of the present case may be coincidental double primaries. It can be assumed that at least some of the mixed papillary and parafollicular cell carcinomas are results of collision of carcinomas derived from two embryogenetically different cell types. Recently, we experienced a case of mixed medullary-papillary thyroid carcinomas. A 50-year-old woman was found to have mixed medullary thyroid carcinoma and papillary thyroid carcinoma on the same lobe with lymph node metastases. We report a this case with literature review
김상현(Sang Hyun Kim),노호상(Ho Sang No),문준환(Jun Hwan Moon),김정수(Jung Su Kim),황동조(Dong Jo Hwang),서정민(Jeong Min Seo) 대한두경부종양학회 1999 대한두경부 종양학회지 Vol.15 No.2
Background and Objectives: Medullary thyroid carcinoma(MTC) is a rare tumor derived from the parafollicular C cells of the thyroid gland accounting for 5-10% of all thyroid malignancies. In Korea, there has been a few case report of medullary thyroid carcinoma(MTC) but their clinical analysis were not exactly studied. So, we made clinical study of 10 patients diagnosed as medullary thyroid carcinoma. Materials and Methods: We reviewed clinical data of 10 patients who were diagnosed as medullary thyroid carcinoma(MTC) from April 1973 to August 1998 at National Medical Center. Results: The incidence of MTC was 2.3% of all thyroid cancer and their mean age were 44.2 years old. Preoperative thyroid scan showed cold nodule in all patients and thyroid function test(TFT) was within normal range. Of the 10 patents, only 4 patients had diagnosis of MTC in preoperative fine needle aspiration biopsy. All the patients underwent total thyroidectomy with central neck dissection. Two patients with cervical lymph node metastasis underwent total thyroidectomy, central neck dissection and modified neck dissection. Two patients (20%) showed recurrence at the site of neck, lung, mediastinum, bone and liver. Conclusion: Most MTC is sporadic form and have peak incidence in the fifth decade and female preponderance. Preoperative fine needle aspiration biopsy is considered to be a clinically useful diagnostic method, but its accuracy is not considered as much high as others. Total thyroidectomy with central neck dissection may be an useful surgical modality in treating medullary thyroid carcinoma.
Hyoung Yeob Kim,Noh Hyuck Park 대한영상의학회 2023 대한영상의학회지 Vol.84 No.5
Medullary thyroid carcinoma (MTC) is a rare malignancy that originates from the parafollicular cells of the thyroid gland. Hashimoto’s thyroiditis (HT) is an autoimmune thyroid disease and is the most common cause of hypothyroidism. Previous studies have frequently discussed the association among HT, papillary thyroid carcinoma, and thyroid lymphoma. However, there have been few reports on the ultrasonographic findings of concomitant HT and MTC. In the present case, a heterogeneous hypoechoic background parenchymal echogenicity, with intraglandular echogenic strands, and increased vascularity were observed. A concurrent, ill-defined, parallel-oriented, heterogeneous hypoechoic mass with central microcalcifications was located at the left thyroid gland, consistent with reported US findings of medullary thyroid carcinoma except for an ill-defined margin in our case.
( Wook Yi ),( Bo Hyun Kim ),( Byung Joo Lee ),( Kyungbin Kim ) 대한갑상선학회 2021 International Journal of Thyroidology Vol.14 No.1
Branchial cleft cysts are the most common lateral neck mass, and usually have well-delineated cystic structures under ultrasonography. Ultrasonography and fine needle aspiration cytology is very helpful during preoperative diagnosis. However, these cysts may occur in unusual locations and have a sonographic morphology similar to malignant thyroid neoplasm. A 61-year-old woman presented with thyroid nodules, and ultrasonography revealed a 0.8-cm, hypoechoic, solid nodule with microcalcifications in the right lobe of thyroid in the lower portion. Postoperative histopathological examination revealed the 0.8-cm hypoechoic nodule to be a branchial cleft cyst. In addition, concurrent medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) were found. Herein, we present a rare case of branchial cleft cyst mimicking malignant thyroid neoplasm concurrent with medullary and PTC.