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甲状腺癌胸骨转移的外科治疗:两例报告

Surgical treatment of sternal metastases from thyroid carcinoma: report of two cases.

作者信息

Mishra A, Mishra S K, Agarwal A, Agarwal G, Agarwal S K

机构信息

Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

出版信息

Surg Today. 2001;31(9):799-802. doi: 10.1007/s005950170050.

Abstract

Radioiodine therapy is currently the treatment of choice for metastasizing differentiated thyroid cancer (DTC); however, skeletal metastases are resistant to this form of therapy. The surgical removal of distant metastases from DTC offers the best chance for prolonged survival and improved quality of life. Furthermore, the surgical removal of a resectable skeletal metastasis can be a valuable complement to radioiodine therapy. This report describes two cases of sternal metastases from thyroid carcinoma that were managed successfully by surgery involving partial excision of the sternum followed by reconstruction of the chest wall with Marlex mesh. Both patients recovered uneventfully. Sternal resection with Marlex mesh reconstruction of the chest wall defect proved a simple and effective method for managing sternal metastasis. Thus, the surgical resection of distant bony metastases in patients with DTC is recommended as it can be curative, provide symptomatic palliation, or allow for more effective radioiodine treatment.

摘要

放射性碘治疗目前是转移性分化型甲状腺癌(DTC)的首选治疗方法;然而,骨转移对此种治疗方式具有抗性。手术切除DTC的远处转移灶为延长生存期和改善生活质量提供了最佳机会。此外,手术切除可切除的骨转移灶对于放射性碘治疗而言可能是一种有价值的补充。本报告描述了两例甲状腺癌胸骨转移患者,通过包括胸骨部分切除并随后用Marlex网片重建胸壁的手术成功进行了治疗。两名患者均顺利康复。用Marlex网片重建胸壁缺损的胸骨切除术被证明是处理胸骨转移的一种简单有效的方法。因此,建议对DTC患者进行远处骨转移灶的手术切除,因为它可以治愈疾病、提供症状缓解或使放射性碘治疗更有效。

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