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A Case of Multiple Cervico-Mediastinal Parathyroid Adenomatosis (다발성 경부종격동 부갑상샘 선종증 1예)

  • Koo, Beom Mo;Beag, Moon Seung;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.1
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    • pp.49-52
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    • 2020
  • The most common cause of primary hyperparathyroidism is a single adenoma accounts for more than 85% and about 1-2% in multiple occurrence. The adenoma arises mainly in the neck and rarely in the mediastinum. The simultaneous occurrence is extremely rare. A 73-year-old man came to our clinic complained about sense of falling forward during last eight months. The brain MRI and vestibular function test showed non-specific findings but total calcium and intact parathyroid hormone levels were markedly elevated. Radiologic studies and sesta-MIBI scan revealed multiple masses in lower paratracheal area and superior mediastinum. We performed mass excision with transcervical approach and all of them were diagnosed as parathyroid adenoma. After surgery, intact PTH and calcium levels returned to the normal range and his symptoms were dramatically improved. We report the unique and rare disease entity with a brief literature review.

Clinical Usefulness of MR FLAIR Image in Mild Head Injuries (경증 두부외상 환자에서 MR FLAIR 영상의 임상적 유용성)

  • Kim, Sei-Yoon;Whang, Kum;Kim, Hun-Joo;Lee, Myoung-Sup
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1182-1186
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    • 2001
  • Objectives : MR fluid-attenuated inversion recovery(FLAIR) image uses paired long inversion time and relaxation time that nulls the signal from CSF. With nulling of the CSF long echo time readout could be used to increase T2-weighting, hence improving the conspicuousness of most tissue lesions without the deleterious effects of CSF artifact seen on T2 weighted sequence. We examed the usefulness of FALIR image in the diagnosis of mild head injury. Methods : A total of 38 patients with mild head injury were examined by FLAIR image. We compared those images with CT scan and T1, T2-weighted images. Careful observation of MR images were done by two well-trained neuroradiologists. Each image was compared for conspicuousness and detectability of traumatic lesions might have shown abnormal signal intensities. The Wilcoxon signed ranks test was used for statistical evaluation. Results : The FLAIR image was significantly more sensitive than those of other images(p<0.001). T2 FFE(Fast Field Echo) image was more useful for detection of small petechial hemorrhages. Conclusion : FLAIR image is considered to be more sensitive than those of conventional MR images in the evaluation of mild head injuries.

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A Study on the Recipe of Byung-Kwa-Ryu (Korean rice cake and cookie) in the Old Cookbooks of Jong-Ga (Head & Noble Family) (종가(宗家)의 고조리서를 통해본 병과류 연구)

  • Kwon, Yong-Seok;Kim, Young;Choe, Jeong-Sook;Lee, Jin-Young
    • Journal of the Korean Society of Food Culture
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    • v.29 no.1
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    • pp.61-83
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    • 2014
  • The aim of this study was to review Byung-Kwa-Ryu recipes in old cookbooks of the head & noble family (Jong-Ga). As for details and classification, we examined the materials and recipes of Byung-Kwa-Ryu. To accomplish this, old cookbooks of the head & noble family ("Soowoonjabbang", "Eumsikdimibang", "Onjubub", and "Jusiksiui") were reviewed. The introduced Byung-Kwa-Ryu recipes numbered 47 total; four from "Soowoonjabbang", 18 from "Eumsikdimibang", nine from "Onjubub", and 16 from "Jusiksiui". We classified the foods (Byung-Kwa_Ryu) into two categories, Tteok-Ryu (Korean rice cake) and Kwa-Jung-Ryu (Korean traditional cookie), on the basis of previous studies. These were further classified into 11 categories: Tteok-Ryu (Jjin-tteok, Salmeun-tteok, Chin-tteok, Jijin-tteok), Kwa-Jung-Ryu (Yumilkwa, Yukwa, Jeongkwa, Dasik, Kwapyun, Dang (Yeot), and others. The most common Byung-Kwa-Ryu type was Jjin-tteok in Tteok-Ryu (14). The next most common Byung-Kwa-Ryu types were Yukwa in Kwa-Jung-Ryu (6) and Yumilkwa in Kwa-Jung-Ryu (5).

Metastatic Papillary Thyroid Carcinoma Masquerading as Type II Branchial Cleft Cyst : A Case Report (제2형 새열 낭종으로 오인된 전이성 갑상선 유두상 암종 1예)

  • Kim, Seung-Woo;Kim, Jung-Min;Kim, Choon-Dong
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.34-36
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    • 2012
  • In case of lateral cervical cystic lesions, the differential diagnoses include branchial cleft cyst(BCC), teratoma, dermoid, hemangioma and lymphangioma etc. But sometimes metastatic cystic lymph nodes may exist in lateral neck. In such circumstance, the primary lesions are known to stem from oropharynx, nasopharynx, salivary and thyroid gland etc. A-66-year-old-male came to our clinic, due to the lateral cervical mass for 5 years. We performed the neck CT, sonography and sono-guided FNAC. He was initially diagnosed with the benign cyst such as BCC. We performed the excisional biopsy on left level II, but the pathologic report was revealed as metastatic papillary thyroid carcinoma(PTC). And then he received the total thyroidectomy with neck dissection. The final diagnosis was cystic metastasis from PTC. We learn a valuable lesson form this case in the following. Even if the simple cervical cyst is presumed with radiology and clinical pattern, more careful considerations on the basis of history and radiologic findings are mandatory.

Lung Metastasis of Thyroid Papillary Carcinoma which was Temporarily Treated for Milliary Tuberculosis (파종성 폐결핵으로 오인된 갑상선 유두상암종의 폐전이)

  • Na, Hong-Shik;Lee, Je-Hyuck;Paeng, Jae-Pil;Jung, Kwang-Yoon;Choi, Jong-Ouck
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.16-20
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    • 2000
  • The patient a 24-year-old male, was shown to have milliary shadows on chest radiographs from the age of 20. He was temporarily treated for pulmonary tuberculosis without success. He had left thyroid mass and lymph node metastases in neck CT scan which was taken after admission but fine needle aspiration result in scanty cellularity. He underwent total thyroidectomy with left modified radical neck dissection and right selective neck dissection under the impression of differentiated thyroid cancer with bilateral neck metastases. Then he underwent 131I ablation treatment and postoperative whole body 131I scintigraphy revealed diffuse intensive uptake in the bilateral lung fields, demonstrating that the pulmonary lesions were metastases of the thyroid cancer.

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A Case of Creation of Mediastinal Tracheostoma with Unilateral Manubrial Resection as Salvage Operation (구제수술에서 일측 복장뼈자루 절제를 통한 전종격동 기관절개술의 1례)

  • Jeon, Seok Won;Kim, Chang Hoi;Lee, Hae Young;Kim, Sung Won
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.29-33
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    • 2016
  • A 65-year-old male visited hospital in the state of tracheostomal recurrence 1 year after total pharyngolaryngectomy. Extensive recurrence around stoma or paratracheal, superior mediastinal area is challenging in treatment, especially in securing airway. We performed mediastinal tracheotomy through resection of unilateral manubrium, some part of sternal side of clavicle and $1^{st}$ rib as the salvage operation for recurrent laryngeal cancer. This procedure could be risky, thus very careful patient selection is required because of a tortuous postoperative course. We would like to present the case that anterior mediastinal tracheostomy could be needed as appropriate palliative means of airway construction in the patients with recurrent laryngeal cancer with lower neck extension with literature review.

A Case of Columnar Cell Variant of Papillary Thyroid Carcinoma (갑상선 유두암 원주세포변형 1예)

  • Choe, Si Hong;Lee, Donghoo;Jung, Soo Jin;Kim, Do Hun
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.281-285
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    • 2018
  • Columnar cell variant of papillary thyroid carcinoma (CCV-PTC) is a rare variant representing 0.15-0.2% of all PTCs. The CCV is aggressive, due to its rapid growth, high local recurrence rate, and frequent lung, brain and bone metastasis. Aggressive surgical and medical management are recommended for these neoplasias. The authors experienced a case of CCV-PTC in a 45-year-old man. We performed total thyroidectomy with neck dissection. The patient received radiation and radioactive iodine therapy. There were no recurrences or complications in the following 24 months after the operation. The patient will closely undergo continuous follow up. We present the clinical characteristics, pathology, treatment, and prognosis of the tumor with a review of the literature.

A Case of Solitary Metastatic Deposit in the Orbital Rim from Follicular Thyroid Cancer (단일성 안와 골병변으로 확인된 갑상선 여포암의 원격 전이 1예)

  • Jeon, Gyeong Hwa;Oh, Hyeon Seok;Choi, In Ho;Byeon, Hyung Kwon
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.105-109
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    • 2021
  • Follicular thyroid carcinoma (FTC) is the second most common thyroid cancer, following papillary carcinoma. Metastasis to the orbital rim from FTC is very rare. We recently experienced a case of FTC with metastasis to the orbital rim in a 74-year-old woman, who initially presented with a huge thyroid mass and an asymptomatic solitary orbital rim lesion. The solitary orbital rim lesion was suspected to be a separate disease entity such as lymphoma from the preoperative imaging, but bone metastasis from FTC was finally confirmed after orbital rim resection and total thyroidectomy. During follow-up, the patient presented multiple bone metastasis, so the solitary orbital rim lesion was considered a clinical sign of systemic metastasis from FTC. Therefore, we present this unique case with a review of the literature.

Cochlear Implant Failure in the Pediatric Population

  • Ozer, Fulya;Yavuz, Haluk;Yilmaz, Ismail;Ozluoglu, Levent N.
    • Journal of Audiology & Otology
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    • v.25 no.4
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    • pp.217-223
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    • 2021
  • Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation. Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer. Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results. Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.

Cochlear Implant Failure in the Pediatric Population

  • Ozer, Fulya;Yavuz, Haluk;Yilmaz, Ismail;Ozluoglu, Levent N.
    • Korean Journal of Audiology
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    • v.25 no.4
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    • pp.217-223
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    • 2021
  • Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation. Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer. Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results. Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.