Endocrinology and Metabolism

Hyo Jin Lee (Lee HJ)

7 Articles

A Case of an Adrenocortical Carcinoma with Pulmonary Embolism as the Initial Manifestation.: Hyo Jin Lee, Ji Young Kwak, Young Jip Kim, Tae Ho Kim, Jan Dee Lee, Hyun Woo Lee, Hae Jin Kim, Dae Jung Kim, Yoon Sok Chung, Kwan Woo Lee, Seung Jin Han; Endocrinol Metab. 2012;27(1):93-97. Published online March 1, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.1.93

1,961 View
26 Download
1 Crossref

The annual incidence of a first episode of deep vein thrombosis or pulmonary embolism (PE) in the general population is 120 per 100,000. Cancer is associated with an approximately 4- to 7-fold higher risk of thrombosis. Adrenocortical carcinoma (ACC) is a rare type of malignancy, accounting for 0.02% of all cancers reported annually. Approximately 40% of ACCs are nonsecretory. Most patients with nonsecreting tumors have clinical manifestations related to tumor growth (e.g., abdominal or flank pain). Often the adrenal mass is detected by chance via radiographic imaging. As a result, most ACC patients are diagnosed at an advanced stage and have a poor prognosis. Herein, we report a case of a 54-year-old woman who was admitted to our emergency department complaining of dyspnea. She was diagnosed with ACC accompanied by thrombi in the pulmonary artery and inferior vena cava. We performed a left adrenalectomy and administered adjuvant radiotherapy. The patient is currently receiving warfarin and adjuvant mitotane therapy. She was incidentally diagnosed with ACC, with PE as the initial manifestation.

Citations

Citations to this article as recorded by

Iliac vein deep vein thrombosis as an atypical presentation of an adrenocortical carcinoma
Arshpreet Singh Badesha, Taha Khan, Engy Abdellatif
BMJ Case Reports.2022; 15(5): e248708. CrossRef

A Case of Ectopic ACTH Syndrome Associated with Small Cell Lung Cancer Presented with Hypokalemia.: Hong Jun Yang, Hea Jung Sung, Ji Eun Kim, Hyo Jin Lee, Jin Min Park, Chan Kwon Park, Eun Suk Roh, Jae Hyung Cho, Seung Hyun Ko, Ki Ho Song, Yu Bai Ahn; J Korean Endocr Soc. 2007;22(5):359-364. Published online October 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.5.359

1,948 View
26 Download
4 Crossref

Abstract PDF

We report a case of a 73-year-old female patient who was diagnosed with ectopic ACTH syndrome caused by small cell lung cancer. We initially presumed that the patient was in a state of mineralocorticoid excess, because she had hypertension and hypokalemic alkalosis. This was however excluded because her plasma renin activity was not suppressed and her plasma aldosterone/plasma renin activity ratio was below 25. Moreover, her 24 hour urine free cortisol level was elevated and her serum cortisol levels after a low dose dexamethasone suppression test, were not suppressed. Furthermore, her basal plasma ACTH and serum cortisol levels increased and her serum cortisol level after a high dose dexamethasone suppression test was not suppressed. We performed studies to identify the source of ectopic ACTH syndrome and found a 3 cm-sized mass in the patient's right lower lobe of her lung, which was eventually diagnosed as small cell lung cancer following a bronchoscopic biopsy. In conclusion, Cushing's syndrome, and in particular ectopic ACTH syndrome, must be considered in the differential diagnosis of mineralocorticoid-induced hypertension. The excessive cortisol saturates the 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) activity, which in turn, inactivates the conversion of cortisol to cortisone in the renal tubules. Moreover, excessive cortisol causes binding to the mineralocorticoid receptors, causing mineralocorticoid hypertension, characterized by severe hypercortisolism.

Citations

Citations to this article as recorded by

Emergencia hipertensiva como debut de síndrome de Cushing paraneoplásico
E. Rubio González, M. de Valdenebro Recio, M.I. Galán Fernández
Hipertensión y Riesgo Vascular.2024; 41(2): 135. CrossRef
Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review
Yanlong Li, Caiyu Li, Xiangjun Qi, Ling Yu, Lizhu Lin
Frontiers in Endocrinology.2023;[Epub] CrossRef
Ectopic Cushing Syndrome in Adenocarcinoma of the Lung: Case Report and Literature Review
Rana Al-Zakhari, Safa Aljammali, Basma Ataallah, Svetoslav Bardarov, Philip Otterbeck
Cureus.2021;[Epub] CrossRef
A Case of Ectopic Adrenocorticotropic Hormone Syndrome in Small Cell Lung Cancer
Chaiho Jeong, Jinhee Lee, Seongyul Ryu, Hwa Young Lee, Ah Young Shin, Ju Sang Kim, Joong Hyun Ahn, Hye Seon Kang
Tuberculosis and Respiratory Diseases.2015; 78(4): 436. CrossRef

A Case of Antineutrophil Cytoplasmic Antibody (ANCA) Positive, Propylthiouracil-Induced Diffuse Alveolar Hemorrhage in Graves' Disease.: Der Sheng Sun, Dong Kyu Kim, Hyo Jin Lee, Hee Yun Lee, Dae Jun Kim, Eun Sook Kim, Jae Hyoung Cho, Seung Hyun Ko, Wan Ook Kim, Chi Hong Kim, Ki Ho Song, Yu Bae Ahn; J Korean Endocr Soc. 2007;22(3):215-219. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.215

1,796 View
21 Download
1 Crossref

Abstract PDF

Graves' disease is one of the common autoimmune diseases, and it has been controlled by such antithyroid drugs as propylthiouracil (PTU) or methimazole. There are a number of side effects, including agranulocytosis, skin rash, hepatotoxicity, fever, arthralgia and a lupus-like syndrome during treatment. PTU has been recently observed to be associated with the development of antineutrophil cytoplasmic antibody (ANCA) positive vasculitis, and this can cause diffuse alveolar hemorrhage. A 32-year-old woman with Graves' disease had been treated with PTU for 4 years, and she had experienced intermittent hemoptysis for 2 weeks before she visited the hospital. Both myeloperoxidase and proteinase 3 ANCA were positive without other organ systems being involved. She was diagnosed with PTU-induced vasculitis. Cessation of PTU and administration of corticosteroids improved the clinical manifestations.

Citations

Citations to this article as recorded by

A Case of Diffuse Alveolar Hemorrhage with Glomerulonephritis after Propylthiouracil Treatment
Ji Hyun Lee, Min Su Kim, Jae Gon Lee, Dae Sik Kim, Hae Jin Yang, Kyung Woo Kang
Tuberculosis and Respiratory Diseases.2012; 72(1): 93. CrossRef

A Case of Cushing's Disease with Renal Cell Carcinomaand End-stage Renal Disease.: Jang Eun Lee, Ik Jun Choi, Young Jai Park, Hyo Jin Lee, Kyoung Hwan Lee, Seung Hyun Ko, Ki Ho Song, Yu Bai Ahn; J Korean Endocr Soc. 2007;22(1):62-67. Published online February 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.1.62

2,023 View
24 Download

Abstract PDF: Cushing's disease is the most common cause of endogenous Cushing's syndrome caused by the excessive secretion of adrenocorticotropic hormone (ACTH) by pituitary ACTH-secreting tumors. The tumors are usually microadenomas (< 10 mm in diameter). Macroadenomas are rare, and corticotroph hyperplasia and carcinomas are extremely rare. Patients with these tumors exhibit an increase in plasma ACTH and cortisol levels, elevated urinary excretion of cortisol and adrenocortical steroid metabolites, evidence of altered negative feedback of cortisol and disturbances in neuroendocrine regulation. The diagnosis of Cushing's disease can be challenging in patients with renal failure the presence of abnormal plasma cortisol, poor gastrointestinal tract absorption of dexamethasone and altered functioning of the hypophyseal-pituitary-adrenal axis have been reported in end-stage renal disease, and the urinary cortisol increment method is not reliable in these patients. The prevalence of renal cell carcinoma in patients on dialysis is higher than in the general population. We recently treated a patient with Cushing's disease and end-stage renal disease as a result of renal cell carcinoma. The diagnosis was made by laboratory evaluation of plasma and radiological examination. Here we report a case of Cushing's disease with a review of the medical literature.

The Relationship between the BRAF Mutations in Thyroid Papillary Carcinomas and the Prognostic Factors.: So Young Rha, Jun Chul Lee, Ki Hyun Kwon, Hyo Jin Lee, Koon Soon Kim, Young Suk Jo, Bon Jeong Ku, Minho Shong, Young Kun Kim, Heung Kyu Ro; J Korean Endocr Soc. 2005;20(3):224-229. Published online June 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.3.224

1,768 View
18 Download
5 Crossref

Abstract PDF

BACKGROUND
Thyroid cancers account for about 1% of all human malignancies, with papillary thyroid carcinomas being the most common istotype. Several investigators have recently identified the most common BRAF mutation, the T1796A transversion mutation, in 29~69% of papillary thyroid cancers. The BRAF mutation has been demonstrated as a novel prognostic biomarker for the prediction of poor clinicopathological outcomes, such as increased incidence of extrathyroid invasion and distant metastasis of the tumor. In this study, we investigated the prevalence of the BRAF mutation of thyroid tissues obtained by a thyroidectomy, and its correlation with the clinicopathological outcomes. METHODS: We studied 36 thyroid tissues obtained from 24 women and 12 men by thyroidectomies, including 30 papillary carcinomas, 3 follicular carcinomas, 1 medullary carcinoma and 2 nodular hyperplasia. The mutation was sought in all specimens using DNA sequencing. RESULTS: We studied the BRAF exon 15 T1796A in these 36 thyroid tissues. The mean age at surgery was 46.6, ranging from 18 to 72 years, with a median tumor size of 2.79, ranging from 1.5 to 4.5cm. At the time of diagnosis, 27 of the 34 patients presented with some kind of extrathyroidal invasion of the tumor, and 16 had lymph node metastases. 16, 2 and 16 patients were in stages I, II and III, respectively. There was no distant metastasis. A missense mutation was found at T1796A in exon 15 in 21 of the 30 papillary carcinomas(70%). The other thyroid diseases, including the 3 follicular carcinomas, 1 medullary carcinoma and 2 nodular hyperplasia show no exon 15 T1759A transversion mutation. No statistically significant association was found between the BRAF mutations and clinicopathological characteristics of papillary carcinomas. CONCLUSION: The BRAF mutation is a important genetic alteration, with a high prevalence in papillary thyroid carcinomas. However, there was no significant association between the BRAF mutation and any of the clinicopathological factors. Further, large scale studies will be needed to evaluate the correlation between the BRAF mutation and the clinicopathological factors

Citations

Citations to this article as recorded by

Detection of Plasma BRAFV600EMutation Is Associated with Lung Metastasis in Papillary Thyroid Carcinomas
Bo Hyun Kim, In Joo Kim, Byung Joo Lee, Jin Choon Lee, In Suk Kim, Seong-Jang Kim, Won Jin Kim, Yun Kyung Jeon, Sang Soo Kim, Yong Ki Kim
Yonsei Medical Journal.2015; 56(3): 634. CrossRef
Diagnostic Effectiveness of PCR-based Tests DetectingBRAFMutation for Treating Malignant Melanoma: A Systematic Review
Hae-Won Shin, Ryeo-Jin Ko, Min Lee, Hee-Young Bang, Kye-Chul Kwon, Jong-Woo Park, Sun-Hoe Koo
Laboratory Medicine Online.2014; 4(4): 203. CrossRef
BRAFV600E mutation does not serve as a prognostic factor in Korean patients with papillary thyroid carcinoma
Dongbin Ahn, June Sik Park, Jin Ho Sohn, Jae Hyug Kim, Sun-Kyun Park, An Na Seo, Ji Young Park
Auris Nasus Larynx.2012; 39(2): 198. CrossRef
The Frequency ofBRAFMutation in Very Small Papillary Thyroid Carcinomas
Taeeun Kim, Ji-Hyun Roh, Hee-Jung Park, Jee Eun Kwon, So-Young Kang, Yoon-La Choi, Young Lyun Oh
The Korean Journal of Pathology.2010; 44(3): 308. CrossRef
ras Mutation in Korean Papillary Thyroid Carcinomas
Jung Hwa Jung, Keun-Sook Kim, Tae Sik Jung, Young Lyun Oh, Hye Won Jang, Hye Seung Jung, Yong-Ki Min, Myung-Shik Lee, Moon-Kyu Lee, Kwang-Won Kim, Jae Hoon Chung
Journal of Korean Endocrine Society.2007; 22(3): 203. CrossRef

The Adequacy of Ultrasound-Guided Fine Needle Aspiration in Thyroid Nodules.: Hyo Jin Lee, So Young Rha, Ki Hyun Kwon, Jun Chul Lee, Koon Soon Kim, Young Suk Jo, Bon Jeong Ku, Minho Shong, Young Kun Kim, Heung Kyu Ro; J Korean Endocr Soc. 2005;20(2):154-159. Published online April 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.2.154

1,759 View
18 Download
1 Crossref

Abstract PDF

BACKGROUND
Fine needle aspiration(FNA) is an accurate and safe method for the diagnosis of thyroid nodules. One of the limitations of FNA is the variable rate of unsatisfactory specimens, especially in small sized, deep seated or complex cystic nodules. To overcome this problem, ultrasound-guided FNA(US-FNA) has been widely used. In this study, the adequacy of cytologic specimens by US-FNA was compared with that of conventional palpation-guided FNA(P-FNA). METHODS: The medical records of all patients who were engaged in FNA due to thyroid nodules at Chungnam National University Hospital from January 2003 to July 2004 were retrospectively examined. The US-FNA and P-FNA were performed in 114 and 185 patients, respectively. RESULTS: Comparison of the adequacy of the two techniques in providing sufficient material for the cytologic diagnosis showed that specimens in 24(13.0%) and 6(5.3%) patients collected by P-FNA and US-FNA, respectively, were unsatisfactory(P=0.031). A total of 23 patients underwent thyroid surgery due to strong suspicion of malignancy at cytologic finding and/or on clinical judgement. Seventeen patients belonged to the P-FNA group and 6 patients to the US-FNA group. In the P-FNA group, a histologic diagnosis revealed two false-negative cytologic findings, but no false-negative findings were found in the US-FNA group. CONCLUSION: Compared with P-FNA, US-FNA may reduce the possibility of unsatisfactory cytologic specimens and the rate of false-negative diagnosis, and may improve the diagnostic accuracy in investigating thyroid nodules

Citations

Citations to this article as recorded by

Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-up and Analysis of Fine Needle Aspiration Cytology
Jae Hoon Chung
Journal of Korean Endocrine Society.2008; 23(6): 391. CrossRef

A Case of Atypical McCune-Albright Syndrome Associated with Hyperthyroidism and Hypersecretion of Growth Hormone.: Moon Bin You, Ki Hoon Kang, Byung Soo Lee, Eun Ha Chae, Myung Chan Kim, Jae Il Jung, Sun Hee Park, Hyo Jin Lee, Seok Tae Jung; J Korean Endocr Soc. 2003;18(4):426-432. Published online August 1, 2003

973 View
19 Download

Abstract PDF: McCune-Albright syndrome is characterized by polyostotic fibrous dysplasia, Caf -au-lait pigmentation and precocious puberty or other endocrinopathy. It can be caused by substitution of His, Cys or Gly for Arg 201st amino acid of the Gs protein subunit. The case of a 32-year-old woman, with atypical McCune-Albright syndrome, is reported. She had no skin lesion or precocity puberty. The polyostotic fibrous dysplasia was examined by a simple radiological image and whole body scan. She developed hyperthyroidism, with a multinodular toxic goiter. No thyroid related autoantibodies were detected. The cause of hyperthyroidism was thought to be a non- autoimmune thyroid hyperfunction. The level of growth hormone was not suppressed by oral glucose load. After a bromocriptine suppression test, the level of growth hormone decreased. There was no mass in the pituitary gland on a sellar MRI. A case of atypical McCune-Albright syndrome, including hyperthyroidism and hypersecretion of growth hormone, is reported.

Author index