Nishida Akiko T, Hirano Shigeru, Asato Ryo, Tanaka Shinzo, Kitani Yoshiharu, Honda Nobumitsu, Fujiki Nobuya, Miyata Kouji, Fukushima Hideyuki, Ito Juichi
Department of Otolaryngology, Head and Neck Surgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
Auris Nasus Larynx. 2008 Sep;35(3):432-6. doi: 10.1016/j.anl.2007.07.008. Epub 2007 Sep 10.
Hyperthyroidism due to thyroid carcinoma is rare, and most cases are caused by hyperfunctioning metastatic thyroid carcinoma rather than primary carcinoma. Among primary hyperfunctioning thyroid carcinoma, multifocal thyroid carcinoma is exceedingly rare, with the only one case being reported in the literature. Here, we describe the case of a 62-year-old woman with multifocal functioning thyroid carcinoma. Technetium-99m (99m Tc) scintigraphic imaging showed four hot areas in the thyroid gland. Histopathological examination of all four nodules revealed papillary carcinoma, corresponding to hot areas in the 99m Tc scintigram. DNA sequencing of the thyrotropin receptor (TSH-R) gene from all nodules revealed no mutation, indicating that activation of TSH-R was unlikely in the pathophysiogenesis of hyperfunctioning thyroid carcinoma in the present case.
甲状腺癌导致的甲状腺功能亢进症较为罕见，大多数病例是由高功能转移性甲状腺癌引起，而非原发性癌。在原发性高功能甲状腺癌中，多灶性甲状腺癌极为罕见，文献中仅报道过一例。在此，我们描述一名62岁患有多灶性功能性甲状腺癌女性的病例。锝-99m（99m Tc）闪烁显像显示甲状腺有四个热区。对所有四个结节进行组织病理学检查，均显示为乳头状癌，与99m Tc闪烁扫描图中的热区相对应。对所有结节的促甲状腺激素受体（TSH-R）基因进行DNA测序，未发现突变，这表明在本病例中，TSH-R激活不太可能参与高功能甲状腺癌的病理生理过程。
