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1.  On-site ultrasound-guided localization for impalpable nodal recurrences in papillary thyroid carcinoma patients 
The cervical lymph nodes are the most common sites of locoregional recurrence in patients with papillary thyroid carcinoma (PTC). Accurate tumor localization is important for the successful removal of impalpable recurrences in the cervical lymph nodes. We evaluated the benefits of ultrasound-guided localization (UGL) performed by a single surgeon on site.
Of 53 PTC patients who underwent reoperation for impalpable nodal recurrences, 32 (group 1) were assessed only using preoperative imaging, while 21 (group 2) were additionally evaluated by on-site UGL performed by the operating surgeon. Postoperative outcomes were compared between the two groups.
Operation times were significantly shorter (P < 0.001) and the mean size of the resected lymph nodes were smaller (P = 0.013) for group 2 patients. More lymph nodes were identified and resected in group 1 (3.56 vs. 3.19), but the rate of positive lymph nodes was significantly higher in group 2 (P < 0.001). There were no differences between the two groups in terms of resection success rate, complication rate, and postoperative hospital stay. During a mean follow-up period of 27.6 months, 52 patients (98.1%) showed no evidence of recurrence on routine ultrasound, and serum thyroglobulin concentrations remained < 1 ng/mL in 49 patients (92.5%).
On-site UGL performed by the operating surgeon is useful for accurate resection of impalpable nodal recurrences in PTC patients.
PMCID: PMC3764360  PMID: 24020018
On-site ultrasound; Localization; Impalpable nodal recurrences; Papillary thyroid carcinoma
2.  A case of Riedel's thyroiditis 
Riedel's thyroiditis is an extremely rare disease that is difficult to diagnose correctly using preoperative diagnostic tools because it can mimic malignant neoplasm or the fibrous variant of Hashimoto thyroiditis during preoperative physical, radiologic, and pathologic examination. We describe here a rare case of Riedel's thyroiditis in an elderly patient and its radiologic characteristics.
PMCID: PMC3341482  PMID: 22563540
Riedel's thyroiditis; Ultrasonography; X-ray computed tomography; Magnetic resonance imaging; Positron-emission tomography
3.  Primary thyroid mucosa-associated lymphoid tissue lymphoma; a clinicopathological study of seven cases 
Primary thyroid mucosa-associated lymphoid tissue (MALT) lymphoma is a very rare subgroup of thyroid lymphoma, accounting for about 6 to 28% of all primary thyroid lymphomas. The purpose of this study was to evaluate its clinicopathological features and treatment outcomes.
We identified seven patients with thyroid MALT lymphoma who were treated between January 1997 and December 2007, and reviewed their clinicopathological features and follow-up outcomes.
There were five female and two male patients, and their mean age was 73 years. All patients presented with palpable neck mass. Two patients had hoarseness and dyspnea. All patients had a history of Hashimoto's thyroiditis with a mean of 175 months. Malignant lymphoma was suspected in only three patients using core needle biopsy. Four patients underwent thyroidectomy in the absence of preoperative pathologic confirmation, and histologic diagnosis was obtained after surgery. As initial treatment, complete surgical resection was performed in five patients, radiotherapy in one, and a combination of chemotherapy and radiotherapy in one. Six patients were alive for the mean follow-up period of 66 months and one patient died of unrelated causes. There were neither recurrences nor disease-specific mortalities.
When primary thyroid MALT lymphoma occurs in the thyroid or is confined to the neck, it responds well to local treatment such as surgical resection and external beam radiation therapy.
PMCID: PMC3243853  PMID: 22200037
Primary thyroid MALT lymphoma; Hashimoto's thyroiditis; Diffuse large B-cell lymphoma
4.  Difficult evaluation of thyroid cancer due to cervical paraffin injection 
Journal of the Korean Surgical Society  2011;81(Suppl 1):S17-S20.
Paraffinoma is a well known complication of previous paraffin injection into the subcutaneous layer that presents as various conditions including firm mass formation, edema, induration, ulceration, and skin necrosis. Paraffinoma can mimic neoplasm on physical examination and imaging studies and may complicate ultrasonographic diagnoses due to typical posterior shadowing and high echogenicity. When paraffinomas involve around the thyroid gland, the diagnosis of thyroid tumors is very difficult. We present a case of thyroid cancer, the evaluation of which was complicated by the presence of cervical paraffinoma.
PMCID: PMC3267058  PMID: 22319731
Thyroid neoplasms; Paraffinoma; Ultrasonography
5.  Coexistence of parathyroid adenoma and papillary thyroid carcinoma 
Although several reports have been published regarding the coexistence of hyperparathyroidism and papillary thyroid carcinomas, concurrence of parathyroid adenoma and papillary thyroid carcinoma is extremely rare. The aim of this study was to describe experiences with concurrent parathyroid adenoma and papillary thyroid carcinoma.
Seven patients with concurrent parathyroid adenoma and papillary thyroid carcinoma were identified between January 2006 and December 2007, and their medical records were reviewed retrospectively.
Of the seven patients identified, three were male and four were female; their mean age was 53.6 years. None of the patients presented with symptomatic hyperparathyroidism preoperatively. On laboratory findings, four patients had mild to moderate hypercalcemia, but serum parathyroid hormone concentrations were high in all patients. Preoperative imaging showed suspicious features of diseased parathyroid glands in four patients; two upon ultrasonography and computed tomography together and two upon ultrasonography only. The coexistence of parathyroid adenoma did not affect the extent of thyroid surgery. Laboratory values after surgery returned to within normal ranges in all patients.
It is important not only to analyze serum calcium levels but also to carefully interpret imaging studies in order to identify asymptomatic hyperparathyroidism when performing thyroid cancer surgery.
PMCID: PMC3228999  PMID: 22148123
Parathyroid neoplasms; Papillary thyroid cancer

Results 1-5 (5)