Sevinc A, Buyukberber S, Sari R, Baysal T, Mizrak B
Department of Internal Medicine, School of Medicine, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey.
Jpn J Clin Oncol. 2000 Jan;30(1):27-9. doi: 10.1093/jjco/hyd007.
Follicular thyroid cancer rarely manifests itself as a distant metastatic lesion. We report a case of an otherwise asymptomatic 58-year-old woman with follicular thyroid cancer who initially presented with a soft tissue mass on the right scapular region. An incisional biopsy specimen of soft tissue metastasis showed thyroid follicular neoplasm. Upon this diagnosis, the thyroid gland was re-evaluated by ultrasound, which demonstrated a solitary, hypoechoic nodule in the right lobe. Ultrasonography guided fine-needle aspiration biopsy of the thyroid nodule confirmed follicular neoplasm and the diagnosis of metastatic follicular thyroid cancer was established. The patient refused any type of treatment and left hospital against medical advice. 2.5 years later the patient was admitted to the hospital with giant, sarcoma-like multiple soft tissue masses. On this admission, the serum thyroglobulin level was extremely elevated (3500 ng/ml) and she only accepted to receive chemotherapy. Epirubicin and cyclophosphamide were administered. She received three courses of chemotherapy and is alive with a stable disease after 3 months of follow-up. This case of follicular thyroid cancer is reported because of its uncommon initial presentation with soft tissue metastasis which spread to multiple areas as giant soft tissue masses during follow-up.
滤泡状甲状腺癌很少表现为远处转移病灶。我们报告一例58岁无症状女性滤泡状甲状腺癌病例，该患者最初表现为右肩胛区软组织肿块。软组织转移灶的切开活检标本显示为甲状腺滤泡性肿瘤。基于此诊断，通过超声对甲状腺进行重新评估，结果显示右叶有一个孤立的低回声结节。超声引导下对甲状腺结节进行细针穿刺活检证实为滤泡性肿瘤，从而确立了转移性滤泡状甲状腺癌的诊断。患者拒绝任何形式的治疗并自行离院。2.5年后，患者因巨大的、肉瘤样的多发软组织肿块入院。此次入院时，血清甲状腺球蛋白水平极度升高（3500 ng/ml），她仅同意接受化疗。给予表柔比星和环磷酰胺治疗。她接受了三个疗程的化疗，随访3个月后病情稳定存活。报告该例滤泡状甲状腺癌是因其罕见的初始表现为软组织转移，且在随访期间转移至多个部位形成巨大软组织肿块。
