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J Korean Cancer Assoc > Volume 26(2); 1994 > Article
Journal of the Korean Cancer Association 1994;26(2): 249-262.
갑상선 결절의 임상적 분석
오승근, 문병인, 유환영
A Clinical Analysis of the Thyroid Nodules
Seung Keun Oh, Byung In Moon, Hwan Young Yoo
One thousand and fifty five patients with thyroid nodules who underwent thyroidectomy at the department of surgery, Seoul National University Hospital between August, 1983 and July, 1993 were clinically analyzed and the follow-up study was performed for the patients. Of the thyroid nodules, the benign was 63.7% and the malignant was 36.4%. The malignancy ratio was increasing in tendency according to the diagnostic improvement and strict application of the surgical indications. Of the benign nodules, 83.9% was the adenomatous goiter, 13.3% was the follicular adenoma, and 1.9% was the Hashimoto's disease. Of the malignant nodules, 83.6% was the papillary carcinoma, 12.0% was the follicular carcinoma, 1.3/ was the medullary carcinoma, and 2.9 was the anaplastic carcinoma. The thyroid nodules were commonly observed between the thirties and fifties of age. The malignancy ratio, however, was significantly high under the tenth and over the fifties of age. The male to female ratio was 1 to 8.3 in the benign and 1 to 5.6 in the malignant. The malig- nant ratio was higher in males. The nodules were common in the right lobe and bilateral lesions were more common in the benign nodules. The possibility of malignancy was higher in the solitary rather than multiple, and in the solid rather than cystic lesions. The nodules fell mostly between 1.6 cm and 3.0 cm in size. The malignancy ratio, however, was significantly higher in the nodules under 1.5 cm in size and over 6.1 cm as welL The possibility of coexisitence of malignant disease was 7.5/ in the benign nodules. There were lymphnode metastases in 59.5% of the papillary, 2.2% of the follicular, 80% of the medullary, and 100/ of the anaplastic carcinomas. The distant metastatic sites commonly observed were the lung in the papillary and anaplastic, and the spine in the follicular carcinomas. The operation frequently performed was total lobectomy with or without isthmectomy for the benign, and subtotal thyroidectomy for the malignant nodules. The recurrence was not related to the extent of thyoidectomy itself but the status of metastasis and the operation on the neck nodes as well. The rate of complications was higher in the cases with malignant nodules than in the benign cases.
Key words: Thyroid nodule, Thyroid carcinoma
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