Risk factors associated with high thyroglobulin level following radioactive iodine ablation, measured 12 months after treatment for papillary thyroid carcinoma

PURPOSE: The measurement of serum thyroglobulin (Tg) of papillary thyroid carcinoma patients, 12 months after total thyroidectomy and radioactive iodine (RAI) ablation following thyroxine hormone withdrawal (T4-off Tg) or recombinant human thyroid-stimulating hormone stimulation (rhTSH-Tg), is standard method for monitoring disease status. The aim of this study was to find predictive factors for detectable T4-off Tg during follow-up. METHODS: A retrospective review was conducted of 329 patients who underwent total thyroidectomy and RAI ablation between October 2008 and August 2012. Subjects were assigned to high (>1 ng/mL, n = 53) and low (≤1 ng/mL, n = 276) groups, based on T4-off Tg measured 12 months postoperatively. Demographic and clinicopathological characteristics at diagnosis and follow-up were compared between the 2 groups. RESULTS: The low and high T4-off Tg groups differed with respect to tumor size, preoperative Tg, ablative Tg, cervical lymph node metastasis, thyroglobulinemia out of proportion to results of diagnostic whole body scan, and American Thyroid Association 3-level stratification and restratification. Multivariate analysis confirmed that ablative Tg > 1.0 ng/mL (odds ratio [OR], 10.801; P = 0.001), more than 5 cervical lymph node metastasis (OR, 6.491; P = 0.003), and thyroglobulinemia out of proportion (OR, 9.221; P = 0.000) were risk factors. CONCLUSION: Ablative Tg >1.0 ng/mL, more than 5 cervical lymph node metastasis, and thyroglobulinemia out of proportion were independent factors for T4-off Tg >1 ng/mL 12 months postoperative. In low-risk patients without these risk factors, the possible omission of Tg measurements could be considered during follow-up.

Predictors for the Transition from Ductal Carcinoma In Situ to Invasive Breast Cancer in Korean Patients

PURPOSE: To identify predictive factors of upstaging from diagnosed ductal carcinoma in situ (DCIS) to invasive cancer after surgical excision. METHODS: One hundred seventy-four patients diagnosed with DCIS based on biopsies between January 2009 and December 2014 were evaluated. Patients' clinicopathological variables were assessed to identify predictive factors of invasive carcinoma from final pathology. RESULTS: One hundred seventy-four cases of DCIS were included. Of these, 42 were upstaged to invasive carcinoma on the final excision. Preoperative features such as age 40 years or younger at diagnosis, presence of a palpable mass, ultrasonography (USG)-guided core needle biopsy, tumor size ≥20 mm on USG, high grade DCIS, cribriform DCIS, comedo necrosis, presence of intraluminal calcification, estrogen receptor negativity, progesterone receptor negativity and triple-negative subtype were significantly associated with the risk of invasive carcinoma. Multivariate analysis showed that a tumor size ≥20 mm on USG and triple negative subtype were independently associated with upstaging. CONCLUSION: Tumor size ≥20 mm on USG and triple-negative subtype were independently associated with the upstaging of DCIS to invasive cancer.

Laparoscopic Resection of an Asymptomatic Intra-Abdominal Lymphangioma / 대한내시경복강경외과학회지

An intra-abdominal cystic lymphangioma is a benign neoplasm that rarely occurs within the abdominal cavity. Intra-abdominal cystic lymphangioma is treated by a resection performed through a radical procedure. We report a case of a 37-year-old woman who had an asymptomatic mesenteric cyst that was discovered incidentally during a routine physical check-up. Treatment was completed without complications using a laparoscope.

Laparoscopic vs Transumbilical Single-Port Laparoscopic Appendectomy; Results of Prospective Randomized Trial

PURPOSE: Conventional three-port laparoscopic appendectomy (LA) is more commonly performed than transumbilical single port laparoscopic appendectomy (TUSPLA). In this report, we performed a prospective randomized study comparing the outcomes of LA and TUSPLA. METHODS: Between April 14, 2009 and June 10, 2009, 40 patients who required laparoscopic appendectomies were randomly selected to receive either a TUSPLA or a LA. None of these patients had perforation or abscess. Twenty of the patients received a LA and the other 20 received a TUSPLA. The clinical outcomes and visual analog pain scores (VAS) were compared between the groups. RESULTS: The TUSPLA procedures were performed successfully in every indicated patient. Clinical outcomes were similar in both study groups. The TUSPLA group showed a significantly higher VAS score 24 hours postoperatively than the LA group. CONCLUSION: Compared with LA, TUSPLA was technically feasible and safe in patients with non-complicated appendicitis. However, the patients in the TUSPLA group reported more postoperative pain than those in the LA group.