Ghfir I, Ccedil Aoui M, Ben Raïs N
Service de médecine nucléaire, Hôpital Ibn Sina, CHU de Rabat, Morocco.
Presse Med. 2005 Sep 24;34(16 Pt 1):1145-6. doi: 10.1016/s0755-4982(05)84140-5.
Cutaneous metastasis of thyroid cancer is rare. When it occurs, it usually affects the scalp and neck. We report here a case where follicular thyroid carcinoma metastasized to unusual skin locations.
An 82-year-old woman was followed after a total thyroidectomy for follicular thyroid carcinoma. Assessment after 2 years showed the presence of a small cervical residue, pulmonary metastases, and a high thyroglobulin level. Two sets of internal radiation therapy with iodine 131 (100 mCi each) followed. Response to treatment was poor, and cutaneous and subcutaneous nodules appeared on the abdomen, back, and front left thigh. Biopsy of these lesions showed that they were malignant, and testing with anti-thyroglobulin antibodies confirmed the diagnosis of cutaneous metastasis of follicular thyroid carcinoma.
Although the rare cutaneous metastases of follicular thyroid carcinoma usually occur on the scalp, firm nodular cutaneous lesions that are painless and resist standard treatment in patients with a history of thyroid cancer should suggest the possibility of metastasis.
甲状腺癌的皮肤转移很少见。一旦发生,通常累及头皮和颈部。我们在此报告一例滤泡状甲状腺癌转移至不寻常皮肤部位的病例。
一名82岁女性在接受滤泡状甲状腺癌全甲状腺切除术后接受随访。2年后的评估显示存在颈部小残留、肺转移以及高甲状腺球蛋白水平。随后进行了两组碘131内放射治疗(每组100毫居里)。治疗反应不佳,腹部、背部和左大腿前部出现皮肤和皮下结节。对这些病变进行活检显示为恶性,抗甲状腺球蛋白抗体检测确诊为滤泡状甲状腺癌皮肤转移。
尽管滤泡状甲状腺癌罕见的皮肤转移通常发生在头皮,但对于有甲状腺癌病史的患者,出现无痛性、质地坚硬的结节状皮肤病变且对标准治疗无反应时,应考虑转移的可能性。