Cichoń Stanisław, Anielski Ryszard, Konturek Aleksander, Barczyński Marcin, Cichoń Wojciech
3rd Chair of General Surgery, Department of Endocrine Surgery, Jagiellonian University College of Medicine, 37 Prdnicka Street, 31-202 Kraków, Poland.
Langenbecks Arch Surg. 2006 Nov;391(6):581-7. doi: 10.1007/s00423-006-0081-1. Epub 2006 Sep 16.
In spite of its rich vasculature, the thyroid gland is rarely the site of metastatic disease. The incidence of such metastases differs depending on the type of the analyzed material. In clinical papers, the incidence is low and, according to various sources, amounts to 2-3% of all malignant tumors of the thyroid. Most commonly, the primary tumor is located in the breast, bronchi, gastrointestinal system, (the colon, esophagus, or stomach) and kidneys. Usually, metastatic thyroid disease is identified upon autopsy, and only sporadic cases are encountered in clinical material. The authors present their experience in treating metastatic disease involving the thyroid gland based on the analysis of their clinical material consisting of patients operated on in a single center.
Seventeen patients presented with metastatic tumors of the thyroid. The material was further analyzed retrospectively. The group included four men and 13 women, with the male to female ratio of 1:4.25. The age of the patients ranged from 46 to 76 years, with the mean age amounting to 62+/-9.78 years. Eleven patients were diagnosed based on fine needle aspiration biopsy (FNAB).
In 13 patients, the primary lesion was a clear cell carcinoma of the kidney, in one breast cancer, in another one uterine carcinoma. In two patients, no primary focus location was established. All the patients were treated surgically. Twelve patients were consistently followed up after the surgery. Of this group, seven are still alive, including five individuals with metastases of renal carcinomas, but without recurrent disease. Five patients died due to disseminated neoplastic disease. No data are available on three patients. The mean follow-up time after thyroid surgery was 3.9 years. The longest followed-up survival time was 11 years.
The most commonly clinically detected and treated surgically metastatic lesion of the thyroid gland is clear cell cancer of the kidney. In cases of renal cancer metastases to the thyroid gland, a total thyroidectomy seems to be warranted, although it does not affect the survival time.
尽管甲状腺血管丰富，但其很少成为转移性疾病的发生部位。此类转移的发生率因所分析材料的类型而异。在临床文献中，发生率较低，根据不同资料来源，占所有甲状腺恶性肿瘤的2% - 3%。最常见的原发肿瘤位于乳腺、支气管、胃肠道（结肠、食管或胃）和肾脏。转移性甲状腺疾病通常在尸检时发现，在临床资料中仅偶有病例。作者基于对在单一中心接受手术的患者临床资料的分析，介绍了他们治疗累及甲状腺的转移性疾病的经验。
17例患者出现甲状腺转移性肿瘤。对该材料进行了回顾性进一步分析。该组包括4名男性和13名女性，男女比例为1:4.25。患者年龄在46岁至76岁之间，平均年龄为62±9.78岁。11例患者通过细针穿刺活检（FNAB）确诊。
13例患者的原发灶为肾透明细胞癌，1例为乳腺癌，1例为子宫癌。2例患者未确定原发灶位置。所有患者均接受了手术治疗。12例患者术后持续接受随访。在该组中，7例仍然存活，包括5例肾癌转移患者，但无疾病复发。5例患者因肿瘤播散性疾病死亡。3例患者无相关数据。甲状腺手术后的平均随访时间为3.9年。最长随访生存时间为11年。
临床上最常检测到并接受手术治疗的甲状腺转移性病变是肾透明细胞癌。对于肾癌转移至甲状腺的病例，尽管全甲状腺切除术不影响生存时间，但似乎仍有必要进行。
