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Title   남성의 외과적 갑상선 질환에 대한 임상적 고찰 ( Clinical Analysis of the Surgical Thyroid Disease in Male )
Publicationinfo   1991 Jan; 023(02): 387-402.
Key_word   Male thyroid nodule
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Abstract   During the 10 years period from January 1980 to December 1989, 1959 patients had undergone surgical treatment for thyroid disease in the department of surgery, Korea Cancer Center Hospital. Among the 1959 cases, male patients were 151 cases, but, we could analyze 120 cases. The results of the clinical analyses were obtained; 1) Overall male to female ratio was 1:12.0 in all surgically removed thyroid disease. Female was more frequently affected by both benign and malignant thyroid disease than male with the ratio of 17.2:1 and 10.2:1 respectively. 2) Among the 120 male cases of thyroid disease, thyroid cancers were 37 cases (30.8%) and benign lesions were 83 cases (69.2%), Whereas in the female cases, thyroid cancers were 21.0% and benign lesions were 79.0%. 3) Thyroid disease were prevalent in 4th decade (31.7%). Thyroid cancer was prevalent in 3rd to 5th decade of life (75.7% of the malignant cases) and benign thyroid disease was prevalent in 4th to 6th decade of life (78.3%). The youngest was S years old in benign lesions and 10 years old in thyroid cancers. 4) Most common clinical manifestation was palable mass on anterior neck (10096). Other symptoms were easy fatigability, dyspnea, dysphagia, headache and palpitation in order of frequency. 5) The durations of symptoms and signs prior to admission were less than one year in 62.6% of benign and in 48.6% of malignancy. 6) Thyroid function test (TFT) prior to operation revealed euthyroidism in 97.5%, hypofunction in 0.8% and hyperfunction in 1.7%. 7) The thyroid scanning revealed cold area in 83.3%, normal distribution in 92% and warm to hot area in 7.5%. 8) The locations revealed the right lobe in 46.7%, the left lobe in 40%, the isthmus in 4.2% and the both lobes in 9.1. 9) The Jesion of benign thyroid diseases were single nodule in 81.9%, multiple nodules in 18.1%, whereas in thyroid cancer, 73% and 27%, respectively. 10) The preoperative fine needle aspiration cytology was performed in 33 cases from 1986 to 1989, diagnostic accuracy rate was 72.7%. 11) Modes of operation in benign lesions were lobectomy (45.8%) and lobectomy with isthmectomy (49.4%). In the cases of malignancy, lobectomy with isthmectomy (21.6%), subtatal thyroidectomy (48. 6%), total thyraidectomy (24.3%) were performed. When the cervical LN metastasis in cancer was confirmed, modified radical neck dissection (43.2%) was added to subtotal or total thyroidectomy (43. 2%) was added to subtotal or total thyrnidectomy. 12) In pathologic classification, benign lesions revealed adenomatous goiter in 79.5%, adenoma in 19.3%, Hashimoto's disease in 1.2%, while malignant disease revealed papillary cancer in 86.5% follicular cancer in 5.4%. We experienced one case of primary malignant lymphoma, one case of insular cancer (poorly differentiated follicular cancer), and one case of primary squamous cell carcinoma. 13) The major postoperative complications were developed in 10 cases (8.3%). 14) In thyraglobulin test (19 cases in benign and 28 cases in malignancy), preoperative high value of thyroglobulin was completely normalized in one month after operation, but 4 recurrent cases of these thyroid cancer revealed reincreased value of thyroglobulin during follaw-up period within 2 years. 15) The ten-year survival rate revealed 86.5%
저 자   강성만(Sung Man Kang),백남선(Nam Sun Paik),김용규(Yong Kyu Kim)