부산대학교 도서관

INTRODUCTION The incidence of thyroid cancer has increased in recent years. Medullary thyroid carcinoma (MTC) accounts for approximately 1-10% of all thyroid malignancies and 0.41.4% of all thyroid nodules. It [...]
Objective: The aim of this study was to analyze the clinical, imaging, pathological and postoperative surveillance data of patients with medullary thyroid carcinoma (MTC). Method: We included 11 patients who underwent surgery. The surgical type was documented. Clinical characteristics and imaging findings as well as preoperative and postoperative calcitonin and carcinoembryonic antigen (CEA) levels and preoperative thyroid stimulating hormone (TSH) levels were retrospectively reviewed. The demographic characteristics of the patients were also noted. Results: The mean age of the patients was 53.7 [+ or -] 12.8 years, and the mean nodule size was 27 [+ or -] 18 (range, 9-70) mm. The mean preoperative TSH level was 1.1 [+ or -] 1.0 mIU/L, and the median calcitonin and CEA levels were 898 (range, 10.9-1747) pg/mL and 98.1 (range, 44-196) ng/mL, respectively. Total thyroidectomy and central/lateral lymph node dissection were performed in all patients. According to preoperative fine-needle aspiration biopsy results, two (18.2%) patients were classified as Bethesda 2 and one (9.1%) as Bethesda 4 and eight (72.7%) patients had MTC. Of the patients, seven (63.6%) were in the early stage and four (36.4%) were in the localized advance stage. One patient had ret proto-oncogene-positive hereditary MTC and 10 had sporadic MTC. During the follow-up, one (9.1%) patient died because of lung metastasis. Conclusion: For the preoperative diagnosis of MTC, clinical characteristics, imaging findings, cytology test results, and genetic test results as well as serum calcitonin and CEA levels should be comprehensively evaluated. As a clinical approach, obtaining preoperative calcitonin and CEA levels for patients with thyroid nodules scheduled for thyroidectomy is advisable. Keywords: Medullary thyroid carcinoma, calcitonin, carcinoembryonic antigen, thyroidectomy Amac: Bu calismanin amaci, meduller tiroid karsinomlu (MTK) hastalarinin klinik, goruntuleme, patolojik ve postoperatif gozetim bulgulari verilerini belgelemek ve analiz etmektir. Yontem: On bir hasta dahil edildi. Tum hastalar ameliyat edildi ve cerrahi tipi belgelendi. Bu hastalarin klinik ozellikleri ve goruntuleme ozellikleri, ameliyat oncesi ve sonrasi kalsitonin ve karsinoembriyojenik antijen (CEA) duzeyleri ve ameliyat oncesi tiroid uyarici hormon (TSH) duzeyleri geriye donuk olarak gozden gecirildi. Hastalarin demografik ozellikleri listelendi. Bulgular: Ortalama yas 53,7 [+ or -] 12,8, ortalama nodul boyutu 27 [+ or -] 18 mm olarak belirlendi. Ortalama preoperatif TSH degeri 1,1 [+ or -] 1,0 mIU / L, ortanca kalsitonin ve CEA degerleri sirasiyla 898 (10,9-1747) pq/mL ve 98,1 (44-196) ng/mL idi. Tum hastalara total tiroidektomi + santral/lateral lenf nodu diseksiyonu uygulandi. Preoperatif ince igne aspirasyon biyopsisi (IIAB) sonuclarina gore iki (%18,2) hasta Bethesda 2, bir (%9,1) Bethesda 4 ve 8 (%72,7) hasta MTK olarak rapor edildi. Hastalardan 7'si (%63,6) erken evrede, 4'u (%36,4) lokalize ileri evrede idi. Bir hasta RET onkogen pozitif kalitsal MTC olarak degerlendirildi ve 10 hasta sporadik MTK olarak degerlendirildi. Takip sirasinda 1 (%9,1) hasta akciger metastazi nedeniyle kaybedildi. Sonuc: MTK'nin preoperatif tanisi icin klinik ve goruntuleme bulgulari, sitoloji ve serum kalsitonin ve CEA seviyeleri, genetik testler kapsamli bir sekilde degerlendirilmelidir. Klinik bir yaklasim olarak, tiroidektomi planlanan tiroid nodulu olan hastalarda ameliyat oncesi kalsitonin ve CEA olcumu alinmalidir. Anahtar kelimeler: Meduller tiroid karsinomu, kalsitonin, karsinom biyometrik antijen, tiroidektomi