Wong G K C, Boet R, Poon W S, Ng H K
Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Med J. 2002 Apr;8(2):149-51.
We report an unusual case of skull metastasis secondary to thyroid carcinoma in an adolescent girl. The 18-year-old presented with an occipital scalp swelling of 5 years' duration. She reported having thyroid surgery in mainland China 10 years previously. Radiological investigations on presentation demonstrated a lytic hypervascular skull lesion. Preoperative angiography and embolisation was followed by surgical excision. Pathological examination showed the lesion to be a thyroid carcinoma with a predominantly follicular pattern and a completion hemithyroidectomy was subsequently performed. Computed tomography of the thorax showed small micronodules in both lung fields compatible with metastases. The patient was given whole body iodine-131 internal radiation treatment and subsequently commenced thyroid-stimulating hormone-suppressive treatment with thyroxine. The management of thyroid carcinoma and subsequent skull metastasis in children and adolescents is reviewed and controversial points are highlighted.
我们报告了一例青春期女孩继发于甲状腺癌的颅骨转移罕见病例。该18岁女孩枕部头皮肿胀已有5年。她报告10年前在中国内地接受过甲状腺手术。就诊时的影像学检查显示颅骨有溶骨性高血运病变。术前进行了血管造影和栓塞，随后手术切除。病理检查显示病变为甲状腺癌，主要为滤泡型，随后进行了甲状腺次全切除术。胸部计算机断层扫描显示双肺野有小结节，符合转移表现。患者接受了全身碘-131内照射治疗，随后开始用甲状腺素进行促甲状腺激素抑制治疗。本文对儿童和青少年甲状腺癌及随后颅骨转移的治疗进行了综述，并强调了有争议的要点。
