Kouso Hidenori, Ikegami Toru, Ezaki Takahiro, Ishida Teruyoshi, Aimitsu Shiomi, Fujihara Megumu, Mori Masaki
Department of Surgery, Hiroshima Red Cross and Atomic Bomb Survivors Hospital, Hiroshima, 730-8619, Japan.
Surg Today. 2005;35(6):480-2. doi: 10.1007/s00595-004-2949-4.
Follicular thyroid carcinoma is a differentiated cancer originating from the follicular cells in the thyroid gland. A 73-year-old woman, who had undergone curative resection of thyroid carcinoma 32 years earlier, was referred to our hospital after ultrasonography showed a solid mass in the liver. Laboratory data revealed positive hepatitis B core antibody, but all other values were normal. Computed tomography showed a round tumor, about 1.5 cm in diameter, which was enhanced early and washed out later, in segment 5 of the liver. She underwent laparotomy and partial resection of the liver. Microscopic examination showed follicular cells with minimal atypia growing in a thyroid follicular pattern with colloids, whereby a diagnosis of metastatic liver cancer from thyroid follicular carcinoma was made. This is a rare case of solitary liver metastasis appearing 32 years after eradication of primary follicular carcinoma. Although the reason for the delayed presentation of the metastatic lesion remains unclear, this case shows that patients with differentiated thyroid cancer should be followed up for their entire life.
滤泡状甲状腺癌是一种起源于甲状腺滤泡细胞的分化型癌症。一名73岁女性,32年前曾接受甲状腺癌根治性切除术,超声检查发现肝脏有实性肿块后转诊至我院。实验室检查数据显示乙肝核心抗体阳性,但其他所有指标均正常。计算机断层扫描显示肝脏第5段有一个直径约1.5厘米的圆形肿瘤,早期强化,后期廓清。她接受了剖腹手术和肝脏部分切除术。显微镜检查显示滤泡细胞有轻微异型性,呈甲状腺滤泡样生长并伴有胶体,据此诊断为甲状腺滤泡癌肝转移。这是一例原发性滤泡癌根除32年后出现孤立性肝转移的罕见病例。尽管转移灶延迟出现的原因尚不清楚,但该病例表明分化型甲状腺癌患者应终身随访。