Nakayama Hirotaka, Wada Nobuyuki, Masudo Yoshihiko, Rino Yasushi
Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Surg Today. 2007;37(4):311-5. doi: 10.1007/s00595-006-3395-2. Epub 2007 Mar 26.
We report a case of axillary lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) in a 21-year-old man. The patient presented with bilateral cervical and right axillary lymphadenopathy, and computed tomography (CT) showed a primary tumor of the thyroid and gross lymphadenopathy from the neck to the right axilla. We performed a total thyroidectomy with therapeutic nodal dissection. The resection of the primary thyroid tumor and all the node metastases was curative. Pathological examination confirmed that the resected lesions were PTC and nodal metastases from the primary tumor. Six years after the operation, cervical, upper mediastinal, and axillary lymph node recurrence developed and multiple lung metastases were found on a CT scan. He was treated with radioactive iodine therapy. Axillary LNM from PTC is unusual and seems to be associated with a poor prognosis. Thus, comprehensive treatment strategies are needed to improve the outcome of patients with PTC who present with axillary LNM.
我们报告一例21岁男性甲状腺乳头状癌(PTC)发生腋窝淋巴结转移(LNM)的病例。该患者表现为双侧颈部及右腋窝淋巴结肿大,计算机断层扫描(CT)显示甲状腺原发性肿瘤以及从颈部至右腋窝的明显淋巴结肿大。我们实施了全甲状腺切除术及治疗性淋巴结清扫术。切除原发性甲状腺肿瘤及所有淋巴结转移灶具有治愈效果。病理检查证实切除的病变为PTC及原发性肿瘤的淋巴结转移。术后六年,出现颈部、上纵隔及腋窝淋巴结复发,CT扫描发现多发肺转移。他接受了放射性碘治疗。PTC发生腋窝LNM并不常见,似乎与预后不良相关。因此,需要综合治疗策略来改善出现腋窝LNM的PTC患者的治疗效果。