• Title/Summary/Keyword: Well differentiated

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Recent Advances in Radioiodine Therapy for Thyroid Cancer (갑상샘암의 방사성요오드 치료의 최신 지견)

  • Bae, Sang-Kyun
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.132-140
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    • 2006
  • Well-differentiated thyroid cancer is the most common endocrine malignancy with an increasing incidence. Most patients with well-differentiated thyroid caner have a favorable prognosis with high survival rate. While surgery and radioiodine therapy is sufficient treatment for the majority of patients with differentiated thyroid cancer, a minority of these patients experiences progressive, life-threatening growth and metastatic spread of the disease. Because there is no prospective controlled study to evaluate the differences of management of thyroid cancer, it is hard to choose the best treatment option. And there are still lots of controversies about the management of this disease, such as surgical extent, proper use of radioiodine for remnant ablation and therapy, use of rhTSH instead of withdrawal of thyroid hormone, long-term follow-up strategy, thyroglobulin as a tumor marker, etc. In this review, recent data related to these conflicting issues and recent advances in diagnosis, radioiodine therapy and long-term monitoring of well-differentiated thyroid cancer are summarized.

Diagnosis of Hepatocellular Carcinoma Using C-11 Choline PET/CT: Comparison with F-18 FDG, Contrast-Enhanced MRI and MDCT

  • Chotipanich, Chanisa;Kunawudhi, Anchisa;Promteangtrong, Chetsadaporn;Tungsuppawattanakit, Puntira;Sricharunrat, Thaniya;Wongsa, Paramest
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3569-3573
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    • 2016
  • Purpose: The aim of this study was to compare C-11 choline and F-18 FDG PET/CT, gadoxetic-enhanced 3-T MRI and contrast-enhanced CT for diagnosis of hepatocellular carcinoma (HCC). Materials and Methods: Twelve chronic hepatitis B patients suspected of having HCC by abdominal ultrasonography received all diagnostic modalities performed within a one-week timeslot. PET/CT results were analyzed visually by two independent nuclear medicine physicians and quantitatively by tumor to background ratio (T/B). Nine patients then had histopathological confirmation. Results: Six patients had well differentiated HCC, while two and one patient(s) were noted with moderately and poorly differentiated HCC, respectively. All were detected by both CT and MRI with an average tumor size of $5.7{\pm}3.8cm$. Five patients had positive C-11 choline and F-18 FDG uptake. Of the remaining four patients, three with well differentiated HCC showed negative F-FDG uptake (one of which showed negative results by both tracers) and one patient with moderately differentiated HCC demonstrated no C-11 choline uptake despite intense F-18 FDG avidity. The overall HCC detection rates with C-11 choline and F-18 FDG were 78% and 67%, respectively, while the sensitivity of F-18 FDG for non-well differentiated HCC was 100%, compared with 83% of C-11 choline. The average T/B of C-11 choline in well-differentiated HCC patients was higher than in moderately and poorly differentiated cases (p=0.5) and vice versa with statistical significance for T/B of F-18 FDG (p = 0.02). Conclusions: Our results suggested better detection rate in C-11 choline for well differentiated HCC than F-18 FDG PET. However, the overall detection rate of PET/CT with both tracers could not compare with contrast-enhanced CT and MRI.

Well-Differentiated Papillary Mesothelial Tumor: An Unusual Radiologic Presentation: A Case Report

  • Moslem Abdelghafar;Krishna Anand;Antonio Paiva-Correia;Elaine Paula Smith;Francoise Galateau Salle;Vijay Joshi
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.220-223
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    • 2023
  • Well-differentiated papillary mesothelial tumor (WDPMT) is an uncommon tumor, formerly named well-differentiated papillary mesothelioma in the 2015 World Health Organization classification. It has a characteristic papillary architecture, bland cytologic features, a tendency toward superficial spread without invasion, and a good prognosis due to its clinically indolent behavior with prolonged survival. Rare cases with superficial invasion are termed WDPMT with invasive foci. WDPMT occurs primarily in the peritoneum of reproductive-age women, but also rarely in the pleura. We report a case of a 60-year-old woman who developed WDPMT with minimal invasion in the pleura with atypical radiological features and a family history of mesothelioma and indirect asbestos exposure.

Assessment of Cellular Proliferation in Oral Verrucous Carcinoma and Well-Differentiated Oral Squamous Cell Carcinoma Using Ki67: A Non-Reliable Factor for Differential Diagnosis?

  • Zargaran, Massoumeh;Eshghyar, Nosratollah;Baghaei, Fahimeh;Moghimbeigi, Abbas
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5811-5815
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    • 2012
  • Background: Non-invasive oral verrucous carcinoma (OVC) and invasive well-differentiated oral squamous cell carcinoma (OSCC) have similar histopathologic findings but different biological behavior. These two malignancies must be correctly differentiated by pathologists. The aim of this study was to determine immunohistochemical (IHC) expression of Ki67 in OVC and well-differentiated OSCC. Methods: Expression of Ki67 was evaluated by IHC in 15 cases of epithelial hyperplasia with no dysplasia (A group), 15 cases of OVC (B group), 12 cases of microinvasive OSCC(C group) and 15 cases of well-differentiated OSCC (D group). Results: There was a significant difference in Ki67 expression based on pattern distribution of immunostaining positive cells, with quantitative and semi-quantitative analyses, among the four groups ; also, between A group and each of the other three groups (P=0.0001). But there was no significant difference between B and C, C and D, and B and D groups (P>0.05). Conclusions: The three evaluation methods of Ki67 expression showed Ki67 (Mib-1) is not a good immunohistochemical marker to assess invasion status and differentiate OVC from well-differentiated OSCC; also, it cannot be used as a diagnostic tool to distinguish between variants of OSCC with similar grade.

Coexistent Parathyroid Adenoma and Well Differentiated Thyroid Careinoma (분화성 갑상선암과 공존한 부갑상선 선종)

  • Lee Joon-Ho;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.241-246
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    • 1997
  • It has become evident in recent years that parathyroid adenoma and well differentiated thyroid cancer occur together more than would be expected by chance alone. However, the association between them is not well understood. We have experienced 4 cases of coexistent parathyroid adenoma and well-differentiated thyroid cancer during the past 16 years. None of them had a familial incidence or a history of radiation exposure. Three cases showed symptomatic hypercalcemia(including renal stones, bone pain, joint pain) and in two of them(patient 1 and patient 2), thyroid abnormalities were detected preoperatively by neck ultrasonography or neck CT for evaluation of parathyroid lesions. However, in patient 3, a parathyoid humor was identified and removed incidentally during the course of thyroidectomy. In 3 cases, surgeries for thyroid carcinoma and parathyroid adenoma were performed during the same exploration of the neck, but in patient 4, thyroidectomy preceded parathyroidectomy; The interval between thyroidectomy and subsequent parathyroidectomy was 11 yeras. The thyroid tumors in 3 cases were papillary carcinoma, the sizes of which ranged from 1.0 cm to 1.5 cm in greatest diameter. The remaining case(patient 4) was minimal invasive follicular carcinoma. Total or near-total thyroidectomy with various types of cervical lymphnode dissection and bilateral neck exploration for the parathyroid lesion was performed in 3 cases with papillary carcinoma. Ipsilateral lobectomy and contralateral partial thyroidectomy with consequent unilateral neck exploration for the parathyroid tumor was performed in the case of follicular cancer. In our experience, parathyroid adenoma and well-differentiated thyroid carcinomas can be coexistent and we felt that the attention to the hypercalcemic patients would be needed for detection of this rare condition.

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Brain Metastases from Well-Differentiated Thyroid Carcinoma (뇌 전이 분화 갑상선암)

  • Lee Jan-Dee;Yoon Jong-Ho;Chang Hang-Seok;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.1
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    • pp.7-12
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    • 2004
  • Background and Objectives: Brain metastasis from well-differentiated thyroid carcinoma is uncommon, and the treatment remains controversial. In this study, we analyzed cases of brain metastasis from well differentiated thyroid carcinoma to determine optimal treatment. Material and Methods: From March 1986 to May 2003, we experienced 13 cases of brain metastases from well-differentiated thyroid carcinomas. There were 6 men and 7 women with a mean age of 62.3 years. The time interval detecting the brain metastasis, treatment methods, outcomes, and the prognostic factors were analyzed. Results: In 11 patients, brain metastasis was found at a mean of 96 months after thyroid surgery (range, 1-204months). In 1 patient, brain metastasis was found simultaneously with the thyroid cancer. In the remaining one, brain metastasis was presented as the first sign. Treatment included gamma knife therapy in 2, external radiation therapy (ExRT) in 2, resection and ExRT in 2, gamma knife therapy and ExRT in 2 and intracranial holmium injection in 1. Three patients received no treatment. The mean survival was 20.5months (1-119 months). Only 2 patients with early detection remained alive after treatment (23months and 119months). The age, sex, primary tumor size, combined organs of distant metastasis and treatment methods did not affect the prognosis. There were noticeable symptomatic improvements in patients who received any kind of treatment for brain metastasis. Conclusion: Early detection and treatment of brain metastasis appears to bring symptomatic relief and improve survival. Therefore, early screening for brain metastasis is recommended for patients with symptoms. However, further study is needed to determine the optimal method of treatment.

A Case of Well-Differentiated Thymic Carcinoma with Extensive Cystic Degeneration (광범위한 낭성 변화를 보인 고분화성 흉선암종 1예)

  • Kim, Kyung-Wook;Kim, Hyung-Jung;Ahn, Chul-Min;Lee, Doo-Yun;Kim, Sang-Jin;Yang, Woo-Ik
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.718-722
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    • 1999
  • Thymoma is the most common tumor in the compartment of anterior mediastinum. The malignant thymoma is classified into invasive thymoma(category I) and thymic carcinoma(category II). Recently, well-differentiated thymic carcinoma is a proposed category 1.5 used to describe a subset of thymic epithelial tumors, allowing for the existence of intermediate form based on the clinical features and the histological characteristics. Thymic cyst is a congenital or a acquired disorder. Congenital thymic cyst may develop due to failure of the thymopharyngeal duct to obliterate and acquired thymic cyst develops from inflammation(multilocular thymic cyst), or neoplasm(cystic thymoma). Cystic degeneration in thymoma is a relatively frequent but focal event. In rare cases, the process proceeds to the extent that most or all of the lesion becomes cystic. Until now, well-differentiated thymic carcinoma with extensive cystic degeneration has not been reported in our country. We experienced a case of 14 year-old female patient showing extensive cystic degeneration in well-differentiated thymic carcinoma. And so we report it with review of the articles related.

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Robotic Lateral Compartment Selective Neck Dissection in Well-Differentiated Thyroid Carcinoma (갑상선 분화암에서 로봇을 이용한 측경부 림프절 절제술)

  • Tae, Kyung
    • Korean Journal of Bronchoesophagology
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    • v.17 no.2
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    • pp.83-88
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    • 2011
  • Robotic thyroidectomy has been developed to minimize neck scarring, and several authors have described its feasibility and safety, and have reported surgical outcomes comparable with conventional open thyroidectomy. The da Vinci surgical system robot provides a three-dimensional $10-12{\times}$magnified view of the surgical area. It also provides hand-tremor filtration, fine motion scaling, and precise and multi-articulated hand-like motions. Recently, robotic technology has also been applied to lateral compartment neck dissection in thyroid cancer. We have developed a new novel selective neck dissection procedure by a gasless unilateral axillo-breast (GUAB) approach with a da Vinci Surgical System for well-differentiated thyroid carcinoma to avoid a long visible neck scar. Based on our early experience, robotic selective neck dissection by GUAB approach is a safe, feasible and cosmetically excellent procedure. It can be an alternative to conventional open surgery in the highly selected patients with well-differentiated thyroid carcinoma. The oncologic safety of robotic selective neck dissection should be verified with long-term follow-up data.

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A Case of Well-Differentiated Liposarcoma on the Anterior and Posterior Neck (전, 후경부에 동시 발생한 호분화성 지방육종 1예)

  • Sah, Dae Jin;Kim, Yoon Jung;Baek, Hun Hee;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.1
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    • pp.31-34
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    • 2014
  • Liposarcoma is a malignant tumor originated from adipose tissue, accounting for 20% of all soft tissue sarcomas. A 69-year-old man with anterior and posterior neck mass visited to our department and we performed an excisional biopsy in level I. Histopathological examination revealed liposarcoma, so we performed wide excision in anterior and posterior neck, and adjuvant radiotherapy. We report a unique case of well-differentiated liposarcoma on anterior and posterior neck with literature review. To our best knowledge, such case has not been reported earlier in Korea previously.

Correlations between Expression of Tumor-Related Proteins and COX-2 in Gastric Cancer (위암에서 종양관련 단백질들과 COX-2 발현의 상관성)

  • Yu, Suk;Noh, Jeong-Hwan;Kim, Jong-Yull
    • Korean Journal of Clinical Laboratory Science
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    • v.39 no.3
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    • pp.231-240
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    • 2007
  • It has been reported the higher incidence rate of gastric cancer in our country. Helicobacter pylori (H. pylori), that exhibited a higher infection rate among Korean people, has been known as a cofactor to cause cancer. Therefore, the aim of this study was to identify correlations among overexpressions of COX-2 (Cyclooxygenase-2) gene, p53 mutation and cell proliferation index related to H. pylori. Taking 28 cases of gastric cancer with H. pylori detection, immunohistochemical staining for COX-2, p53 and Ki-67 were performed. In the H. pylori positive group, the well differentiated type and diffuse type of gastric cancer were distributed in larger area and the expression rate of COX-2 was revealed high. The H. pylori negative group showed higher p53 expression than that of the positive group. However, the statistical correlation between H. pylori and histopathological factors was not observed. The significantly higher expression of COX-2 had were observed in both well differentiated type and the intestinal type of gastric cancer. Although there were no statistical significances, this showed a higher inclination of manifest in the early gastric cancer. p53 exhibited a higher tendency of expression in the well differentiated, moderately differentiated and the intestinal type of gastric cancers including the early gastric cancer. Ki-67 was expressed in a significantly higher fashion along with the increase of age. In addition, it was significantly expressed in well differentiated type and intestinal type of gastric cancer. Therefore, these results suggest that H. pylori, COX-2, p53, and Ki-67 influences on the new occurrence of gastric cancer and its development procedures. In the future, the more researches would be required to focus on a larger category relative to gene expressions in gastric cancer.

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