미만성 경화 변종 갑상선 유두암의 임상적 고찰
Clinical Characteristics of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives Diffuse sclerosing variant (DSV) is a rare variant of papillary thyroid carcinoma (PTC) and has been adopted as a histologic variant. Due to the limited number of cases and the heterogeneity of the tumor’s clinical behavior, there is no consensus for DSV’s optimal treatment and post-operative follow-up. The purpose of this study is to evaluate the clinical manifestation, recurrence and prognosis of 10 patients with DSV. Subjects and Method We retrospectively reviewed ten consecutive patients in whom DSV was first observed between 2000 and 2012. All patients are presently under active follow-up at Korea Cancer Center Hospital. Patients underwent a total thyroidectomy with central compartment and laterocervical lymph node dissection only when this involvement was documented by pre-surgery ultrasound examination with fine needle aspiration biopsy. Results The mean observation interval was 41.6 months. The ratio of male to female was 1 : 9, and the age of incidence was 34.2±11.4. The average size of mass was measured 2.9±1.9 cm. Upon the diagnosis, eight cases had central and lateral neck lymph nodal metastasis, which was confirmed during the operation. There was no distant metastasis, but one case was confirmed with lung metastasis during the follow-up period. There was no mortality during the follow-up periods in all ten cases. Conclusion DSV of PTC has high risk characteristics of large tumor size, extrathyroidal extension, and multiple lymph nodes metastasis. We may expect comparable outcome with classical PTC by proper surgical treatment and postoperative radioactiveiodine ablation.
Abstract
Background and Objectives Diffuse sclerosing variant (DSV) is a rare variant of papillary thyroid carcinoma (PTC) and has been adopted as a histologic variant. Due to the limited number of cases and the heterogeneity of the tumor’s clinical behavior, there is no consensus for DSV’s optimal treatment and post-operative follow-up. The purpose of this study is to evaluate the clinical manifestation, recurrence and prognosis of 10 patients with DSV. Subjects and Method We retrospectively reviewed ten consecutive patients in whom DSV was first observed between 2000 and 2012. All patients are presently under active follow-up at Korea Cancer Center Hospital. Patients underwent a total thyroidectomy with central compartment and laterocervical lymph node dissection only when this involvement was documented by pre-surgery ultrasound examination with fine needle aspiration biopsy. Results The mean observation interval was 41.6 months. The ratio of male to female was 1 : 9, and the age of incidence was 34.2±11.4. The average size of mass was measured 2.9±1.9 cm. Upon the diagnosis, eight cases had central and lateral neck lymph nodal metastasis, which was confirmed during the operation. There was no distant metastasis, but one case was confirmed with lung metastasis during the follow-up period. There was no mortality during the follow-up periods in all ten cases. Conclusion DSV of PTC has high risk characteristics of large tumor size, extrathyroidal extension, and multiple lymph nodes metastasis. We may expect comparable outcome with classical PTC by proper surgical treatment and postoperative radioactiveiodine ablation.
참고문헌 (16)
- Fukushima M, "Clinicopathologic characteristics and prognosis of diffuse sclerosing variant of papillary thyroid carcinoma in Japan: an 18-year experience at a single institution", World J Surg, 33(5), pp.958~962 (2009)
- LiVolsi VA, "Papillary carcinoma, In Pathology and Genetics of Tumours of the Endocrine Organs. World Health Organization Classification of Tumours", pp.57~66 (2004), IARC Press
- Regalbuto C, "A diffuse sclerosing variant of papillary thyroid carcinoma: clinical and pathologic features and outcomes of 34 consecutive cases", Thyroid, 21(4), pp.383~389 (2011)
- Chow SM, "Diffuse sclerosing variant of papillary thyroid carcinoma--clinical features and outcome", Eur J Surg Oncol, 29(5), pp.446~449 (2003)
- Carcangiu ML, "Diffuse sclerosing variant of papillary thyroid carcinoma. Clinicopathologic study of 15 cases", Am J Surg Pathol, 13(12), pp.1041~1049 (1989)
- Moreno Egea A, "Clinicopathological study of the diffuse sclerosing variety of papillary cancer of the thyroid. Presentation of 4 new cases and review of the literature", Eur J Surg Oncol, 20(1), pp.7~11 (1994)
- Soares J, "Diffuse sclerosing variant of papillary thyroid carcinoma. A clinicopathologic study of 10 cases", Pathol Res Pract, 185(2), pp.200~206 (1989)
- Lam AK, "Diffuse sclerosing variant of papillary carcinoma of the thyroid: a 35-year comparative study at a single institution", Ann Surg Oncol, 13(2), pp.176~181 (2006)
- Kwak JY, "Diffuse sclerosing variant of papillary carcinoma of the thyroid: ultrasound features with histopathological correlation", Clin Radiol, 62(4), pp.382~386 (2007)
- Falvo L, "Prognostic importance of sclerosing variant in papillary thyroid carcinoma", Am Surg, 72(5), pp.438~444 (2006)
- Albareda M, "Clinical forms of presentation and evolution of diffuse sclerosing variant of papillary carcinoma and insular variant of follicular carcinoma of the thyroid", Thyroid, 8(5), pp.385~391 (1998)
- Mizukami Y, "Diffuse sclerosing variant of papillary carcinoma of the thyroid. Report of three cases", Acta Pathol Jpn, 40(9), pp.676~682 (1990)
- Fujimoto Y, "Diffuse sclerosing variant of papillary carcinoma of the thyroid. Clinical importance, surgical treatment, and follow-up study", Cancer, 66, pp.2306~2312 (1990)
- Hay ID, "Papillary thyroid carcinoma", Endocrinol Metab Clin North Am, 19(3), pp.545~576 (1990)
- Hedinger C, "Diffuse sclerosing variant, In Histological typing of thyroid tumours. WHO. 2nd ed", pp.11~ (1988), Spinger- Verlag
- Koo JS, "Diffuse sclerosing variant is a major subtype of papillary thyroid carcinoma in the young", Thyroid, 19(11), pp.1225~1231 (2009)