Barczyński M, Jamski J, Cichoń S, Barczyński M, Sułowicz W
III Katedra i Klinika Chirurgii Ogólnej Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 2000;57(3):157-9.
The most common metastatic tumour of the thyroid gland which is clinically revealed is renal clear cell carcinoma (RCCC). Our clinical experience in cases of RCCC metastases into thyroid gland is reviewed in terms of the history of the disease, obligatory diagnostic procedures, surgical management and outcome prognosis. We believe that all the patients with even a remote RCCC history require systematic follow-up including thyroid gland as metachronic metastatic disease can occur many years after primary surgery. Clinical diagnosis and ultrasound of the thyroid gland is essential in selection for surgical treatment. Confirmation of malignancy in FNA (fine needle aspiration) in often difficult regarding concomitant multinodular goitre. Enlargement of a single thyroid nodule except L-thyroxin therapy for 3-6 months is a sufficient indication for surgical treatment, not depending on FNA result, particularly when a suspected nodule becomes bigger than 30 mm in diameter.
临床上最常见的甲状腺转移瘤是肾透明细胞癌(RCCC)。我们从疾病史、必要的诊断程序、手术治疗和预后等方面回顾了RCCC转移至甲状腺的临床经验。我们认为,即使是有远期RCCC病史的所有患者都需要进行系统随访,因为异时性转移疾病可能在初次手术后多年发生。甲状腺的临床诊断和超声检查对于选择手术治疗至关重要。对于合并多结节性甲状腺肿的患者,在细针穿刺抽吸活检(FNA)中确认恶性往往很困难。除了进行3至6个月的左旋甲状腺素治疗外,单个甲状腺结节增大是手术治疗的充分指征,不取决于FNA结果,特别是当疑似结节直径大于30mm时。