Papillary thyroid carcinoma with honeycomb-like multiple small cysts: characteristic features on ultrasonography.

Background: Thyroid nodules with cystic content or mixed sponge-like aspect on ultrasonography and a concordant cytology are strongly predictive of benignity.

Objectives: We present 8 patients with honeycomb-like papillary thyroid carcinoma with multiple small cysts on ultrasonography.

Methods: The patients were 6 women and 2 men aged between 30 and 57 years.

Attenuation of postmenopausal bone loss in patients with transient hypoparathyroidism after total thyroidectomy.

Background: Increased bone mineral density (BMD) has been reported in patients with postsurgical permanent hypoparathyroidism. Hypoparathyroidism may attenuate the high-turnover bone loss in postmenopausal women. We reported previously that patients who had transient hypoparathyroidism postoperatively were at subclinical hypoparathyroid (hP) status even 5 years after surgery.

Prognostic significance of changes in serum thyroglobulin antibody levels of pre- and post-total thyroidectomy in thyroglobulin antibody-positive papillary thyroid carcinoma patients.

Although postoperative serum thyroglobulin (Tg) is a prognostic indicator for papillary thyroid carcinoma (PTC), it is unreliable when Tg antibody (TgAb) is positive. We evaluated the prognostic significance of changes in serum TgAb levels of pre- and post-total thyroidectomy in TgAb-positive PTC patients. We reviewed our medical charts of 225 TgAb-positive PTC patients in whom TgAb levels were measured before and 1-2 years after total thyroidectomy, performed between April 2002 and March 2007.

Distant metastasis at diagnosis and large tumor size are significant prognostic factors of widely invasive follicular thyroid carcinoma.

In contrast to minimally invasive follicular thyroid carcinoma (FTC), widely invasive FTC is aggressive and is associated with a dire prognosis. However, prognostic factors of widely invasive FTC have not been intensively investigated. In this study, we investigated this issue in a series of 79 widely invasive FTC patients.

Prognostic factors of minimally invasive follicular thyroid carcinoma: extensive vascular invasion significantly affects patient prognosis.

Follicular thyroid carcinoma (FTC) is divided into two categories: minimally and widely invasive FTC. Generally, the prognosis of minimally invasive FTC is excellent, but patients showing certain characteristics have a dire prognosis. In this study, we investigated the prognostic factors of minimally invasive FTC using a series of 292 patients.

Incidence and predictors of right paraesophageal lymph node metastasis of N0 papillary thyroid carcinoma located in the right lobe.

Papillary thyroid carcinoma (PTC) frequently metastasizes to the regional lymph nodes and, thus, guidelines edited by Japan Association of Endocrine Surgeons/Japanese Society of Thyroid Surgery routinely recommend central node dissection even for patients with no clinically detectable node metastasis (N0). However, in the central compartment, metastasis to the right paraesophageal node has not been intensively investigated. We investigated the incidence and predictors of right paraesophageal node metastasis based on pre- and intraoperative findings in 922 patients with N0 PTC in the right lobe.

Evaluation of cytologically benign solitary thyroid nodules by ultrasonography: a retrospective analysis of 1877 cases.

Objective: The purpose of this study is to evaluate the role of ultrasonography (US) in the management of thyroid nodules when the cytology is benign tumor on fine needle aspiration biopsy (FNAB).

Methods: Between 2006 and 2011, we investigated 13,972 patients who had solitary thyroid nodule with cytological findings of benign. Surgery was performed according to our criteria for surgical indication.

Tumor size is the strongest predictor of microscopic lymph node metastasis and lymph node recurrence of N0 papillary thyroid carcinoma.

It is well-known that papillary thyroid carcinoma (PTC) frequently metastasizes to the regional (central and lateral) lymph nodes, even though it is diagnosed as node-negative on preoperative imaging studies. In this study, we investigated predictors of microscopic node metastasis and lymph node recurrence of PTC without node metastasis detected preoperatively (N0). Of the clinicopathological features that can be evaluated pre- and intraoperatively, tumor size (> 2 cm) was the strongest predictor of microscopic central and lateral node metastasis on multivariate logistic analysis.

Improvement of lymph node recurrence rate, but not distant recurrence and carcinoma death rates, in patients with papillary thyroid carcinoma after disease-free survival for 5 years.

In this study, we investigated the difference in lymph node-recurrence free survival (LN-RFS), distant recurrence-free survival (DRFS), and cause-specific survival (CSS) between patients with papillary thyroid carcinoma (PTC) in the entire group (Group I) and those with lymph node- and distant-recurrence-free survival (DFS) for 5 years after initial surgery (Group II). The LN-RFS of patients with all risk classifications in Group II was significantly better than that of those in Group I. The LN-RFS of intermediate-risk patients in Group II did not differ from that of low-risk patients in Group I, but LN-RFS of high-risk patients in Group II was significantly poorer than intermediate- and low-risk patients in Group I.

The ima approach for the quick identification of the right recurrent laryngeal nerve in thyroid cancer surgery.

Background: The right recurrent laryngeal nerve (RLN) is more difficult to identify than the left RLN. The superior, lateral and inferior approaches are currently used to identify the RLN. This report presents a new technique, called the ima approach (the most inferior approach) for the quick identification of the right RLN.

TSH-suppressive doses of levothyroxine are required to achieve preoperative native serum triiodothyronine levels in patients who have undergone total thyroidectomy.

Objective: Thyroidal production of triiodothyronine (T(3)) is absent in patients who have undergone total thyroidectomy. Therefore, relative T(3) deficiency may occur during postoperative levothyroxine (L-T(4)) therapy. The objective of this study was to evaluate how the individual serum T(3) level changes between preoperative native thyroid function and postoperative L-T(4) therapy.

Clinical trial of weekly paclitaxel chemotherapy for papillary thyroid carcinoma with squamous cell carcinoma component.

Papillary thyroid carcinoma (PC) can occasionally include a squamous cell carcinoma (SCC) component. In this study, we evaluated the effect of weekly paclitaxel chemotherapy in 3 patients with PC including an SCC component. None of these patients had lesions of anaplastic carcinoma on pathological examination.

Prognostic value of poorly differentiated carcinoma in Japanese Society of Thyroid Surgery in a series of papillary thyroid carcinoma patients: comparison with risk classification system in Kuma Hospital.

Papillary thyroid carcinoma (PTC) often has poorly differentiated components, and it is discriminated from others and classified as an independent entity in the General Rules for the Description of Thyroid Cancer by Japanese Society of Thyroid Surgery (JSTS). In this study, we compared the prognostic significance between this type of poorly differentiated carcinoma (PDC-JSTS) and our risk classification system based on pre- and intraoperative findings in a series of PTC patients. The 10-year lymph node- and distant organ recurrence-free survival (LN-DFS and DRFS) and cause-specific survival (CSS) of high-risk patients were much poorer than in PDC-JSTS patients.

Prognosis and prognostic factors of papillary thyroid carcinoma in patients under 20 years.

Age is an important prognostic factor of papillary thyroid carcinoma (PTC). In this study, we investigated the prognosis and prognostic factors of PTC in patients younger than 20 years. We enrolled 110 patients who underwent initial surgery at Kuma Hospital between 1987 and 2008.

Investigation of the prognosis of patients with papillary thyroid carcinoma by tumor size.

In papillary thyroid carcinoma (PTC), extrathyroid extension (Ex) and clinical lymph node metastasis (N) significantly affect the prognosis. We investigated the prognosis of patients with PTC 1 cm or less (1,220 patients), 1.1-2 cm (2,101 patients), 2.

Laryngeal approach to the recurrent laryngeal nerve involved by thyroid cancer at the ligament of Berry.

Background: Thyroid cancer often involves the RLN at the ligament of Berry, which makes preservation of the nerve difficult. If the portion of RLN is resected, finding the peripheral RLN for reconstruction is difficult. Here we describe a laryngeal approach performed before dissecting the RLN to overcome these problems.

Validity of 6(th) edition of UICC TNM classification system for medullary thyroid carcinoma: a proposal for intraoperative evaluation of T category.

Medullary thyroid carcinoma (MTC) accounts for 1.4% of all thyroid malignancies in Japan. Here, we studied the validity of a staging system evaluated preoperatively (Stage), intraoperatively (intra-Stage), and pathologically (pStage) based on the 6(th) and 7(th) UICC TNM classifications.

Relationship between prognosis of papillary thyroid carcinoma patient and age: a retrospective single-institution study.

Age is an important prognostic factor in papillary thyroid carcinoma (PTC). In this study, we investigated the difference in prognosis of 7 subsets of PTC patients without distant metastasis at presentation or a history of radiation exposure (20 years or younger, 21-30 years, 31-40 years, 41-50 years, 51-60 years, 61-70 years, and older than 70 years). The lymph node recurrence rate was high in patients 20 years or younger and those older than 60 years.

Lymph node recurrence in patients with N1b papillary thyroid carcinoma who underwent unilateral therapeutic modified radical neck dissection.

Background: Therapeutic modified radical neck dissection (MND) is a mandatory surgical procedure for patients with papillary thyroid carcinoma (PTC) having clinical lateral node metastasis (N1b). However, N1b PTC is still likely to recur in regional lymph nodes after surgery. We investigated the clinicopathological features predicting recurrence in nodes in previously dissected compartments (ipsilateral lateral compartment or central compartment) and nodes in the contralateral lateral compartment for N1b patients who underwent unilateral therapeutic MND.

Prognosis and prognostic factors of patients with papillary thyroid carcinoma requiring resection of recurrent laryngeal nerve due to carcinoma extension.

The recurrent laryngeal nerve (RN) is one of the most common organs to which papillary thyroid carcinoma (PTC) extends. However, the prognosis and prognostic factors for patients with PTC extending to the RN remain unclear. In this study, we investigated this issue in 298 patients who underwent initial and locally curative surgery for PTC requiring RN resection due to carcinoma extension.

Prognosis of low-risk papillary thyroid carcinoma patients: its relationship with the size of primary tumors.

It is well-known that papillary thyroid carcinoma (PTC) has a generally indolent character and shows a favorable prognosis unless it has no high-risk features such as clinical lymph node metastasis, distant metastasis, and significant extrathyroid extension. In this study, we investigated the prognosis of 3,965 patients with PTC without these features. We classified these patients into 3 groups: T-1, tumor ≤ 2 cm (n = 2,591); T-2, tumor 2.

Significance of prophylactic modified radical neck dissection for patients with low-risk papillary thyroid carcinoma measuring 1.1-3.0 cm: first report of a trial at Kuma Hospital.

Purpose: Papillary thyroid carcinoma (PTC) frequently metastasizes to and recurs in regional lymph nodes. Of the two compartments, the central compartment can be dissected through the same wound as the thyroidectomy, and the central node dissection (CND) is routinely performed in most Japanese surgical departments. However, the indications for prophylactic lateral compartment dissection (modified radical neck dissection [MND]) for low-risk PTC remain unclear.

Prognostic factors of papillary thyroid carcinoma vary according to sex and patient age.

Background: We previously showed that preoperative and intraoperative evaluations of papillary thyroid carcinoma (PTC) are important for predicting a patient's prognosis, and we identified several prognostic factors. In this study, we investigated differences in the significance of these factors according to patient age and sex.

Methods: A total of 5768 PTC patients (608 men, 5160 women) without distant metastasis at diagnosis who underwent initial surgery between 1987 and 2004 in Kuma Hospital were enrolled in this study.

Biological behavior of papillary carcinoma of the thyroid including squamous cell carcinoma components and prognosis of patients who underwent locally curative surgery.

Thyroid carcinoma showing squamous differentiation throughout the entire lesion is diagnosed as squamous cell carcinoma of the thyroid (SCCT) in the WHO classification. This entity is a rare disease and shows a dire prognosis; however, squamous differentiation is more frequently detected in only a portion of papillary thyroid carcinoma. In this paper, we present our experience of 10 patients (8 primary lesions and 2 with recurrence in the lymph nodes) with papillary thyroid carcinoma having an SCC component (PTC-SCC).