Miccoli Paolo, Minuto Michele N, Galleri David, Puccini Marco, Berti Piero
Dipartimento di Chirurgia, Università degli Studi di Pisa, Italy.
Thyroid. 2004 Feb;14(2):121-3. doi: 10.1089/105072504322880355.
The occurrence of carcinoma of the thyroglossal duct remnant (TDRCa) is reported to be less than 1%. We retrospectively analyzed 18 cases (14 females, 4 males; mean age, 38.17 years) of TDRCa who underwent surgery in our department, to evaluate the correct workup for diagnosis and treatment. Nine patients underwent a total thyroidectomy and a Sistrunk procedure (SP) whereas 8 underwent a completion total thyroidectomy after a postoperative diagnosis of TDRCa. One patient was diagnosed with TDRCa several years after total thyroidectomy for goiter. Postoperatively all patients were given radioiodide and levothyroxine therapy. Mean follow-up was 85 months. No patient died of tumor-related disease. Thyroglossal duct neoplasms were represented by papillary carcinoma in 16 cases; thyroid histology demonstrated papillary carcinoma in 6 cases (33.3%). Three patients demonstrated single regional node metastasis and only one of them demonstrated the presence of malignant thyroid disease. When clinical diagnosis of thyroglossal duct cyst is made, the workup should be completed by ultrasound (US) scan and fine-needle aspiration cytology (FNAC) in order to plan the correct surgery for a possible TDRCa. Total thyroidectomy should always be considered with SP to permit the correct treatment and follow-up in those patients. Long-term survival of patients with cTDRCa is excellent.
据报道，甲状舌管残余癌（TDRCa）的发生率低于1%。我们回顾性分析了在我科接受手术的18例TDRCa患者（14例女性，4例男性；平均年龄38.17岁），以评估诊断和治疗的正确检查方法。9例患者接受了全甲状腺切除术和Sistrunk手术（SP），而8例在术后诊断为TDRCa后接受了全甲状腺切除术。1例患者在因甲状腺肿接受全甲状腺切除术后数年被诊断为TDRCa。术后所有患者均接受放射性碘和左甲状腺素治疗。平均随访85个月。无患者死于肿瘤相关疾病。甲状舌管肿瘤中16例为乳头状癌；甲状腺组织学检查显示6例为乳头状癌（33.3%）。3例患者出现单个区域淋巴结转移，其中仅1例显示存在甲状腺恶性疾病。当临床诊断为甲状舌管囊肿时，应通过超声（US）扫描和细针穿刺细胞学检查（FNAC）来完善检查，以便为可能的TDRCa制定正确的手术方案。对于这些患者，应始终考虑行全甲状腺切除术加SP，以进行正确的治疗和随访。cTDRCa患者的长期生存率良好。
