Al-Khatib K, Sieunarine K, Lindsay I, Smith J R
Department of Gynaecology, Chelsea and Westminster Hospital at Imperial College School of Medicine, London, United Kingdom.
Int J Gynecol Cancer. 2006 Jan-Feb;16(1):429-32. doi: 10.1111/j.1525-1438.2006.00484.x.
Hurthle cell carcinoma, a variant of follicular carcinoma of the thyroid, has been regarded as an aggressive type of differentiated thyroid cancer. It is diagnosed histologically and regarded as a carcinoma by the presence of vascular invasion or capsular invasion. In this case report, a patient with a history of thyroid Hurthle cell carcinoma presented with what seemingly appeared to be a pelvic mass of gynecological origin, with a raised risk-of-malignancy index of 567. She underwent a laparotomy which revealed the presence of multiple masses in the form of nodules and lumps attached to her small bowel, sigmoid colon, omentum, and infracolic region, without the involvement of her pelvic organs or para-aortic lymph nodes. At frozen section, the masses were reported to be high-grade metastatic tumor, possibly a melanoma, unlikely to be a female genital tract tumor. These masses were resected along with a 15-cm section of small bowel and analyzed. They were diagnosed to be secondary lesions of Hurthle cell carcinoma of the thyroid. Hurthle cell carcinoma of the thyroid has not been known to be associated with the elevation of CA125 nor has it been known to metastasize to the small bowel and sigmoid colon.
许特尔细胞癌是甲状腺滤泡癌的一种变体,被认为是一种侵袭性的分化型甲状腺癌。它通过组织学诊断,若存在血管侵犯或包膜侵犯则被视为癌。在本病例报告中,一名有甲状腺许特尔细胞癌病史的患者出现了看似起源于妇科的盆腔肿块,恶性风险指数高达567。她接受了剖腹手术,结果发现多个以结节和肿块形式存在的肿物附着于小肠、乙状结肠、大网膜和结肠下区域,盆腔器官和主动脉旁淋巴结未受累。在冰冻切片检查时,这些肿物被报告为高级别转移性肿瘤,可能是黑色素瘤,不太可能是女性生殖道肿瘤。这些肿物连同15厘米长的一段小肠一起被切除并进行分析。它们被诊断为甲状腺许特尔细胞癌的继发性病变。甲状腺许特尔细胞癌此前未知与CA125升高有关,也未知会转移至小肠和乙状结肠。