Yamagami Yuko, Tori Masayuki, Sakaki Masayuki, Ohtake Shigeaki, Nakahara Masaaki, Nakao Kazuyasu
Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka 543-0035, Japan.
Gen Thorac Cardiovasc Surg. 2008 Nov;56(11):555-8. doi: 10.1007/s11748-008-0307-y. Epub 2008 Nov 12.
To our knowledge, only a few cases of thyroid carcinoma with an extensive tumor thrombus in the atrium have been reported in literature. We describe a unique case of papillary carcinoma of the thyroid with extensive tumor thrombus in the atrium. A 74-year-old man consulted our hospital because of thyroid carcinoma with an extensive tumor thrombus in the atrium. Computed tomography (CT) revealed a 2-cm tumor with extensive continuous tumor thrombus in the left jugular vein, innominate vein, superior vena cava, and atrium. The tumor was resected to reduce the risk of sudden death from tumor embolism into the pulmonary arteries. Histologically, the diagnosis was papillary carcinoma of the thyroid. Thyroid carcinoma, especially papillary carcinoma, rarely develops a macroscopic tumor thrombus. Patients with an extensive tumor thrombus generally have poor prognoses and high mortality. This patient has been followed for 7 months after successful operation without recurrence.
据我们所知，文献中仅报道了少数几例甲状腺癌伴有心房广泛肿瘤血栓的病例。我们描述了一例独特的甲状腺乳头状癌伴有心房广泛肿瘤血栓的病例。一名74岁男性因甲状腺癌伴有心房广泛肿瘤血栓前来我院就诊。计算机断层扫描（CT）显示一个2厘米的肿瘤，在左颈静脉、无名静脉、上腔静脉和心房内有广泛的连续性肿瘤血栓。切除该肿瘤以降低肿瘤栓子进入肺动脉导致猝死的风险。组织学检查诊断为甲状腺乳头状癌。甲状腺癌，尤其是乳头状癌，很少形成肉眼可见的肿瘤血栓。伴有广泛肿瘤血栓的患者通常预后较差且死亡率高。该患者在成功手术后已随访7个月，无复发。
