Sugimoto Seiichiro, Doihara Hiroyoshi, Ogasawara Yutaka, Aoe Motoi, Sano Shunji, Shimizu Nobuyoshi
Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Acta Med Okayama. 2006 Apr;60(2):135-40. doi: 10.18926/AMO/30734.
A 61-year-old man, who was diagnosed with superior vena cava syndrome by papillary thyroid carcinoma, was referred to our hospital. A bulky thyroid tumor with tracheal invasion extended from the left neck to the right atrium without distant metastases. The risk of sudden death due to airway occlusion, tumor embolism or obstruction of the tricuspid valve led us to elect surgery. Extended resection of thyroid cancer was performed with cardiopulmonary bypass. Peritoneal dissemination was found via laparotomy. A histological diagnosis of anaplastic carcinoma arising from transformation of papillary carcinoma was made. After the operation, bilateral ureteral occlusion by peritoneal dissemination and multiple lung metastases were detected. The patient died with acute renal failure on postoperative day 12. Intraatrial extension of thyroid cancer is rare, and only 12 cases have been reported in the literature. We present a case of thyroid cancer with intraatrial extension.
一名61岁男性因甲状腺乳头状癌导致上腔静脉综合征,转诊至我院。一个巨大的甲状腺肿瘤侵犯气管,从左颈部延伸至右心房,无远处转移。由于气道阻塞、肿瘤栓塞或三尖瓣梗阻导致猝死的风险促使我们选择手术。在体外循环下进行了甲状腺癌扩大切除术。通过剖腹手术发现腹膜播散。病理组织学诊断为乳头状癌转变而来的未分化癌。术后,检测到腹膜播散导致双侧输尿管梗阻和多发肺转移。患者于术后第12天死于急性肾衰竭。甲状腺癌心房内延伸罕见,文献中仅报道过12例。我们报告一例甲状腺癌心房内延伸的病例。