저분화성 갑상선 암종에 대한 임상 병리학적 연구
Clinicopathologic Features of Poorly Differentiated (Insular) Carcinoma of Thyroid
이태원, 오승근, 최국진, 윤여규, 노동영, 정기욱, 장명철, 유성호,
소속 상세정보
이태원 ( Lee Tae-Won )
서울대학교 의과대학 외과학교실
오승근 ( Oh Seung-Keun )
서울대학교 의과대학 외과학교실
최국진 ( Choi Kook-Jin )
서울대학교 의과대학 외과학교실
윤여규 ( Youn Yeo-Kyu )
서울대학교 의과대학 외과학교실
노동영 ( Roh Dong-Young )
서울대학교 의과대학 외과학교실
정기욱 ( Chung Ki-Wook )
서울대학교 의과대학 외과학교실
장명철 ( Chang Myung-Chul )
서울대학교 의과대학 외과학교실
유성호 ( Yoo Seong-Ho )
서울대학교 의과대학 병리학교실
KMID : 0371320030640020121
Abstract
Purpose: Well-differentiated carcinomas of the thyroid run an excellent clinical course. However 10∼20% of thyroid carcinomas showed poor clinical outcomes. Insular carcinomas are an uncommon thyroglobulin-producing neoplasm, which show intermediate prognosis between well-differentiated carcinomas and undifferentiated anaplastic carcinomas, and their clinicopathologic features are poorly understood. Therefore, we aimed to investigate the clinicopathologic features and the prognosis of insular thyroid carcinomas.
Methods: We reviewed 10 patients who underwent an operation due to an insular thyroid carcinoma at Seoul National University Hospital between January 1990 and December 2001. Their clinicopathologic features and follow-up findings were retrospectively reviewed and compared.
Results: Four male and six female patients are reviewed, with a mean age of 54.8±6.4187, ranging from 37 to 69 years. Pathologically, eight of the tumors consisted of pure insular carcinoma and the others showed a papillary carcinoma as the major component and a minor insular component. The mean tumor size was 4.53 ㎝ (4.53±1.4288 ㎝). An extrathyroidal extension was present in 7 cases and a vascular invasion in 6. Distant metastasis and local relapse of the regional lymph node were seen in 9 patients. Comparing the survivor and expired groups, all the male patients were in the expired group, and the mean tumor size was larger in the expired group (5.46 ㎝ vs. 3.6 ㎝). But these differences were not statistically significant.
Conclusion: Our study revealed that insular carcinomas have distinctive clinicopathologic features, and recognition of this histologic variant is important and significant for management of these unique tumors.
키워드
갑상선 암종;섬모양 암종;저분화성 갑상선 암종
Thyroid carcinoma;Insular carcinoma;Poorly differentiated carcinoma
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