Aïssaoui R, Turki Z, Achiche A, Balti M H, Ben Slama C, Zbiba M
Service Hôpital de jour, Hôpital des Forces de Sécurité Intérieure, La Marsa, Tunis, Tunisia.
Ann Endocrinol (Paris). 2006 Sep;67(4):364-7. doi: 10.1016/s0003-4266(06)72614-2.
Adrenal metastases of the papillary thyroid carcinoma (PTC) are very rare. We report one case. A 63-year-old woman had undergone 15 years earlier left lobo-ishmectomy for a papillary thyroid cancer (PTC) and 7 years earlier right adrenalectomy for a tumor. Histologic examination showed a benign cortical tumor. In 1999, when the patient was admitted for worsening of glycemic control, a recurrence of the adrenal mass was detected. According to the hormone evaluation it was a non-functional tumor. Adrenalectomy was performed in June 2002 because the patient had initially declined surgery. Histologic examination and thyroglobulin immunochemistry identified metastatic PTC. Re-reading the histology slide of the first adrenalectomy agreed with the diagnosis. Thyroidectomy was completed in March 2003. Although iodine-131 therapy and thyroxine treatment were given, bone metastases were detected in August 2004. PTC usually spreads to the cervical and mediastinal lymph nodes. Distant spread may occur to bone or lung, but exceptionally to the adrenal gland. The adrenal localization is often associated with lung or bone metastasis. In our patient, the adrenal metastasis remained isolated for many years. It has been reported that survival rate decreases considerably after appearance of a distant metastasis. Although given delayed radical treatment, our patient remained alive 13 years after.
甲状腺乳头状癌（PTC）的肾上腺转移非常罕见。我们报告一例。一名63岁女性15年前因甲状腺乳头状癌（PTC）接受了左叶甲状腺切除术，7年前因肿瘤接受了右肾上腺切除术。组织学检查显示为良性皮质肿瘤。1999年，患者因血糖控制恶化入院时，发现肾上腺肿块复发。根据激素评估，这是一个无功能肿瘤。由于患者最初拒绝手术，于2002年6月进行了肾上腺切除术。组织学检查和甲状腺球蛋白免疫化学鉴定为转移性PTC。重新阅读首次肾上腺切除术的组织学切片与诊断一致。2003年3月完成了甲状腺切除术。尽管给予了碘-131治疗和甲状腺素治疗，但2004年8月发现了骨转移。PTC通常转移至颈部和纵隔淋巴结。远处转移可能发生于骨或肺，但罕见转移至肾上腺。肾上腺转移常与肺或骨转移相关。在我们的患者中，肾上腺转移多年来一直孤立存在。据报道，远处转移出现后生存率会大幅下降。尽管给予了延迟的根治性治疗，但我们的患者在出现转移后仍存活了13年。
