• 제목/요약/키워드: 유두상 갑상선암

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갑상선 수술 후 흉쇄유돌근 근골막피판을 이용한 큰 기도 결손부 재건 1예 (Reconstruction of a Large Cricotracheal Defect Using a Sternocleidomastoid Myoperiosteal Flap : A Case of Locally Aggressive Papillary Thyroid Carcinoma with Tracheal Invasion)

  • 김상민;김미라;김용완;백무진;박준욱
    • 대한두경부종양학회지
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    • 제31권1호
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    • pp.18-21
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    • 2015
  • 기관을 침범한 갑상선 악성종양을 제거한 후에 성문하부에 비교적 큰 기관 결손이 발생할 수 있다. 단단문합술은 넓은 부위의 결손부를 재건하는 방법으로 널리 받아들여지고 있지만, 문합부 파열, 반회후두신경마비, 재협착 등의 합병증이 발생할 수 있다. 본 증례는 기도를 침범한 갑상선 유두암종을 제거한 후 윤상연골과 기관연골의 비교적 큰 결손부를 흉쇄유돌근 근골막피판을 사용하여 안전하게 재건한 사례이다. 55세 남자 환자가 기도를 침범한 갑상선 유두상암으로 내원하였으며 기도침범은 윤상연골(둘레의 약 30%)과 4개의 기관연골(둘레의 약 50%)을 해당하는 넓은 부위였다. 수술 전 기관절개술을 시행하여 주위 기관연골의 상태가 좋지 않아 단단문합술 시행 후 문합부 파열 가능성이 있다고 판단하여 흉쇄유돌근 근골막피판을 이용하여 재건하기로 계획하였다. 갑상선 절제술, 경부림프절 절제술, 흉쇄유돌근 근골막피판을 이용한 재건술을 시행하였으며 수술 후 12일째 별다른 문제없이 퇴원하였다. 환자는 수술 후 현재 22개월 간 기도 협착 등의 별다른 합병증 없이 지내고 있다. 흉쇄유돌근 근골막피판은 성문하부나 기관지 전외측벽의 비교적 큰 결손부를 재건하는 데 유용하게 사용될 수 있다.

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림프절 전이가 발견되지 않은(cN0) 유두상 갑상선 암의 중앙 경부 림프절 분석 (The Analysis of Central Cervical Lymph Nodes in Papillary Thyroid Carcinoma with Preoperative No Lymph Node Metastasis)

  • 김윤정;하태권;유성목;김상효
    • 대한두경부종양학회지
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    • 제26권2호
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    • pp.183-186
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    • 2010
  • Purpose : Papillary thyroid carcinoma (PTC) is known for malignant tumor which has a favorable prognosis and long-term survival. Although the prognosis for patients with PTC is generally good, PTC tends to have highly metastatic property. The purpose of this study was to analyze the central compartment lymph node in papillary thyroid cancer with no lymph node metastasis clinically and to assess the significance of prophylactic node dissection. Methods : A retrospective review was carried out in 394 patients with PTC who underwent surgery for the period from January 2004 to December 2006. The positive rate of the lymph node metastasis was analyzed. The relations between the central compartment lymph nodes and the patients' age, gender, tumor size, exrathyroidal extension(ETE), multifocality, and bilaterality were comparatively analyzed in PTC patients with preoperative no lymph node metastasis. Results : The enrolled patients were 40 male and 354 female cases. The 118 cases of them were found to have cervical lymph node metastasis. The mean age was 46 years(range, 15-77years). Tumor size(p=0.000), ETE(p=0.001), multifocality(p=0.014), and bilaterality(p=0.001) were significantly related factors for cervical lymph node metastasis clinically in papillary thyroid cancer. However, age and gender were not significantly related with lymph node metastasis. Conclusion : Although no lymph node metastasis clinically, prophylactic neck node dissection can be performed to avoid risks of local recurrence and reoperation in the light of PTC nature. The pathological status and high positive rate of central compartment lymph node relate to tumor size and extrathyroidal extension. Close surveillance for nodal status is required in follow-up.

유두상(乳頭像) 갑상선암(甲狀腺癌)에서 VEGF, HIF-$1{\alpha}$, E-cadherin, p53의 발현(發現)과 병기(病期)의 관련성(關聯性) 연구(硏究) (Relationship between the Expression of VEGF, HIF-$1{\alpha}$, E-cadherin, p53 and Stage in Papillary Thyroid Carcinoma)

  • 김종삼;나백주;이무식;김철웅;정계림
    • 한국산학기술학회:학술대회논문집
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    • 한국산학기술학회 2009년도 춘계학술발표논문집
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    • pp.335-338
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    • 2009
  • 본 연구에서는 HIF-$1{\alpha}$의 과발현은 VEGF의 발현과 유의한 상관 관계가 있음을 보여 주었다. 그리고, HIF-$1{\alpha}$의 과발현과 E-cadherin의 발현 사이에도 연관성은 있었지만 통계적인 유의성은 없었다. 종양의 병기와 VEGF, HIF-$1{\alpha}$, E-cadherin, p53의 상관성을 살펴본 결과 E-cadherin에서만 유의성이 관찰되었다. 갑상샘 유두암종에서 HIF-$1{\alpha}$의 발현이 종양의 증식과 관련된 단백, 특히 맥관형성과 관련된 단백인 VEGF의 발현, p53의 축적 및 E-cadherin의 발현소실과의 관계, 그리고 병리학적 표지자와의 관련성을 조사하고, 갑상샘 유두암종 환자의 수술후 예후와의 관계를 알고자 하였다.

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갑상선 편측형성부전에 동반된 유두 갑상선암 1예 (Thyroid Hemiagenesis Associated with Papillary Thyroid Carcinoma : Report of a Case and Review of the Literature)

  • 이용상;윤지섭;정종주;남기현;정웅윤;박정수
    • 대한두경부종양학회지
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    • 제23권2호
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    • pp.161-164
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    • 2007
  • Thyroid hemiagenesis is a rare anomaly, which is the result of failure of embryologic development of a lobe of thyroid gland. It is more frequently found in the left lobe and in female patients. We, herein, report an extremely rare case of thyroid hemiagenesis associated with papillary thyroid carcinoma. A 69-year-old female presented with an incidentally discovered thyroid nodule in the right thyroid during a routine medical check-up. Ultrasonography(US) and computed tomography(CT) disclosed $0.7{\times}0.5cm\;and\;2.8{\times}2.2cm$ sized nodules in the right thyroid. The left thyroid, however, was not seen in the imaging studies of US and CT. Fine-needle aspiration of the small and large nodules showed papillary thyroid carcinoma and adenomatous hyperplasia, respectively. The patient underwent a right total thyroidectomy with central compartment node dissection. The operative findings and histologic examination confirmed the absence of the left thyroid associated with papillary thyroid carcinoma and ademonatous hyperplasia of the right thyroid.

유두상 갑상선암의 피부전이 1예 (A Case of Skin Metastasis from Papillary Thyroid Carcinoma)

  • 임치영;이잔디;남기현;권지은;장항석;정웅윤;박정수
    • 대한두경부종양학회지
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    • 제21권2호
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    • pp.174-177
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    • 2005
  • Skin metastasis from papillary thyroid carcinoma is extremely rare. Due to similar histopathologic features, it is difficult to differentiate skin metastatic papillary thyroid carcinoma and some primary skin neoplasms without a clinical history. However, most of metastatic skin lesions showed a strong reactivity to the antithyroglobulin antibodies unlike primary skin neoplasms. Metastatic skin lesions must be completely removed and radiotherapy can be added. Investigators reported that prognosis of skin metastases from thyroid carcinoma is dismal and the average survival after it's diagnosis was only 19 months because distant metastases were often discovered at diagnosis of skin metastasis or during follow-up period. We report a case of skin metastasis from tall cell variant of papillary thyroid carcinoma. In our case, the anti thyroglobulin antibodies measured from cystic fluid from a skin lesion was more than 2000 IU/ml. Skin metastasis was diagnosed at 20 months after primary surgery for thyroid cancer and brain metastasis at 12 months after diagnosis of skin metastasis. Although skin metastasis is an ominous prognostic indicator in patients with thyroid carcinoma, a radical treatment for skin lesions and early diagnosis of distant metastasis could provide a chance to the patients to improve their survival.

경부 악성 림프종과 동반된 유두상 갑상선암 (Synchronous Presentation of Papillary Thyroid Cancer and Malignant Lymphoma)

  • 장항석;정웅윤;박정수
    • 대한두경부종양학회지
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    • 제14권2호
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    • pp.253-259
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    • 1998
  • The increasing risk of subsequent malignancy after treatment of malignant lymphoma is well known, which is mainly due to longer survival of these patients. Radiotherapy at an early stage of Hodgkin's disease or non-Hodgkin's lymphoma is accepted to be associated with future occurrence of secondary thyroid cancer. Nevertheless, the synchronous presentation of these malignancies is extremely rare. Well differentiated thyroid cancer, a slow-growing tumor that responds to therapy with surgery and radioactive iodine, is associated with prolonged survival. therefore, it is important to make this diagnosis in patients who show evidence of malignant lymphoma. Furthermore, appropriate treatment must be considered for thyroid cancer to improve the prognosis of these patients. We herein reported 4 cases of synchronous thyroid cancer and malignant lymphoma in patients who had not previously recieved radiotherapy or chemotherapy.

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유두상 갑상선암 환자의 갑상선절제술 후 합병증에 대한 임상경과 보고 3례 (A Clinical Study on 3 Cases of Complications after Total Thyroidectomy and Neck Dissection in the Papillary Thyroid Carcinoma)

  • 박은영;권형근;공복철;김동철
    • 대한한방부인과학회지
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    • 제26권3호
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    • pp.103-113
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    • 2013
  • Objectives: Thyroid cancer is the most common cancer for female in Korea. This study aims to report the effects of Korean medicine on complications after total thyroidectomy and neck dissection in the papillary thyroid carcinoma. Methods: The 3 patients with papillary thyroid carcinoma were treated by Korean medicine such as acupuncture, moxibustion and pharmacopuncture therapy. We evaluated the results of treatments by change of symptoms. Results: After treatments such as acupuncture, moxibustion and pharmacopuncture therapy except herb medicine, the symptoms of complications after total thyroidectomy and neck dissection were improved. Conclusions: This study shows that Korean medicine has effects on complications after total thyroidectomy and neck dissection in the papillary thyroid carcinoma.

중증 근무력증과 동반된 유두상 갑상선암 2예 (Thyroid Carcinoma Coexisting with Myasthenia Gravis : Report of 2 Cases)

  • 임치영;이잔디;남기현;장항석;김혜령;박정수
    • 대한두경부종양학회지
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    • 제21권1호
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    • pp.32-34
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    • 2005
  • Myasthenia gravis with thymoma is associated with an increased risk of second malignancy, but concurrence of myasthenia gravis and thyroid carcinoma is rarely seen. In the treatment, it is emphasized to operate in two stage to avoid myasthenic crisis after surgery. In general, a thyroid cancer surgery is performed after controlling yasthenia gravis by means of thymectomy or medical treatment with steroids and anticholine esterase. We experienced two cases of thyroid carcinoma coexisting with myasthenia gravis, which is thought to be true first report in Korea.

재발 유두 갑상선암의 부신전이 1예 (A Case of Recurrent Papillary Thyroid Carcinoma with Adrenal Metastasis)

  • 김창우;윤지섭;이용상;남기현;정웅윤;홍순원;박정수
    • 대한두경부종양학회지
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    • 제23권1호
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    • pp.50-53
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    • 2007
  • Adrenal metastasis from papillary thyroid carcinoma is extremely rare. We present herein a patient with adrenal metastases from recurrent papillary carcinoma of the thyroid. A 54 year-old woman had received a total thyroidectomy and postoperative radioactive iodine therapy for locally advanced papillary thyroid carcinoma. One year after initial surgery, distant metastases to multiple organs including right cervical lymph nodes, left upper lung, left 2nd and 3rd ribs, 2nd thoracic vertebra and left adrenal gland were found by 18-FDG-PET-CT whole body scan. She underwent right modified neck dissection, partial resection of left 2nd and 3rd ribs, posterior arch of 2nd thoracic vertebra, left upper lobectomy of lung, and left adrenalectomy. On histologic examination, metastases to the left adrenal gland and cervical lymph nodes were papillary thyroid carcinomas, while other metastatic sites turned out to be anaplastic thyroid carcinomas. Despite aggressive surgery and postoperative adjuvant therapy, her general clinical conditions were getting worse day by day due to regrowing of the anaplastic thyroid carcinomas. To our knowledge, this is the first case reported in Korea.