Ers Vincent, Galant Christine, Malaise Jacques, Rahier Jacques, Daumerie Chantal
Department of Endocrinology, Université Catholique de Louvain, Cliniques Universitaires St. Luc, Brussels, Belgium.
Wien Klin Wochenschr. 2006 Mar;118(3-4):124-7. doi: 10.1007/s00508-006-0533-1.
Papillary thyroid cancer usually metastasizes to regional lymph nodes and to distant sites such as lungs and bones. We report a case of axillary lymph node metastasis as a result of recurrence of papillary carcinoma in a 62-year-old woman with papillary thyroid cancer extending locally beyond the thyroid capsule. Six years after initial surgical treatment, a lymph node metastasis in the left axillary region was diagnosed with positron tomography. To our knowledge, only one previous case of confirmed axillary metastasis of thyroid cancer has ever been reported. These two cases provide some evidence that thyroid carcinoma may exceptionally spread to axillary lymph nodes. Hypotheses that may account for such unusual localization include hematogenous dissemination or retrograde dissemination to regional lymphatic channels. Thus, when recurrence of thyroid carcinoma is considered, careful clinical examination of the axilla is recommended. Furthermore, thyroid carcinoma must be considered in the differential diagnosis of an axillary mass, especially when breast cancer is ruled out.
甲状腺乳头状癌通常转移至区域淋巴结以及肺和骨等远处部位。我们报告一例62岁患有甲状腺乳头状癌且局部侵犯超出甲状腺包膜的女性患者，因乳头状癌复发导致腋窝淋巴结转移。初次手术治疗6年后，通过正电子断层扫描诊断出左腋窝区域有淋巴结转移。据我们所知，此前仅报道过一例经证实的甲状腺癌腋窝转移病例。这两例病例提供了一些证据，表明甲状腺癌可能会罕见地转移至腋窝淋巴结。可能解释这种异常定位的假说是血行播散或逆行播散至区域淋巴管。因此，当考虑甲状腺癌复发时，建议仔细对腋窝进行临床检查。此外，在腋窝肿块的鉴别诊断中必须考虑甲状腺癌，尤其是在排除乳腺癌的情况下。
