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issn:2093-0.88
1.  On-site ultrasound-guided localization for impalpable nodal recurrences in papillary thyroid carcinoma patients 
Purpose
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.
Methods
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.
Results
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%).
Conclusion
On-site UGL performed by the operating surgeon is useful for accurate resection of impalpable nodal recurrences in PTC patients.
doi:10.4174/jkss.2013.85.3.104
PMCID: PMC3764360  PMID: 24020018
On-site ultrasound; Localization; Impalpable nodal recurrences; Papillary thyroid carcinoma
2.  Surgical completeness of total thyroidectomy using harmonic scalpel: comparison with conventional total thyroidectomy in papillary thyroid carcinoma patients 
Purpose
The aim of this study was to compare the surgical completeness and outcome of total thyroidectomy in two patient groups: One treated by harmonic scalpel (HS) and one by conventional total thyroidectomy (CT).
Methods
Between March 2006 and December 2007, 104 patients had total thyroidectomy by HS and 108 patients underwent CT. We analyzed clinicopathological characteristics and stimulated serum thyroid-stimulating hormone (TSH), thyroglobulin (Tg), and anti-Tg antibodies at the time of ablation for both groups.
Results
Compared with the CT group, the HS group had shorter operating time and hospital stays and reduced postoperative drainage. At postsurgical ablation, mean serum TSH was 80.47 ± 21.77 mU/L in the HS group and 69.74 ± 21.17 mU/L in the CT group, with significant between-group differences (P < 0.001). Mean serum Tg levels after TSH stimulation were 1.57 ± 3.17 and 3.95 ± 10.14 ng/mL in the HS and CT groups, respectively, with significant between-group differences (P = 0.028).
Conclusion
Total thyroidectomy with an HS is a relatively safe and effective technique for use in patients with PTC. The HS provides surgical completeness and has a beneficial effect on successful ablation.
doi:10.4174/jkss.2012.83.5.267
PMCID: PMC3491228  PMID: 23166885
Harmonic scalpel; Papillary thyroid cancer; Thyroidectomy; Completeness; Ablation
3.  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.
doi:10.4174/jkss.2012.82.5.317
PMCID: PMC3341482  PMID: 22563540
Riedel's thyroiditis; Ultrasonography; X-ray computed tomography; Magnetic resonance imaging; Positron-emission tomography
4.  Primary thyroid mucosa-associated lymphoid tissue lymphoma; a clinicopathological study of seven cases 
Purpose
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.
Methods
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.
Results
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.
Conclusion
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.
doi:10.4174/jkss.2011.81.6.374
PMCID: PMC3243853  PMID: 22200037
Primary thyroid MALT lymphoma; Hashimoto's thyroiditis; Diffuse large B-cell lymphoma
5.  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.
doi:10.4174/jkss.2011.81.Suppl1.S17
PMCID: PMC3267058  PMID: 22319731
Thyroid neoplasms; Paraffinoma; Ultrasonography
6.  Coexistence of parathyroid adenoma and papillary thyroid carcinoma 
Purpose
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.
Methods
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.
Results
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.
Conclusion
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.
doi:10.4174/jkss.2011.81.5.316
PMCID: PMC3228999  PMID: 22148123
Parathyroid neoplasms; Papillary thyroid cancer

Results 1-6 (6)