Cherian Mathew Pynumootil, Nair Balakrishnan, Thomas Shaji, Somanathan Thara, Sebastian Paul
Division of Surgical Oncology, Regional Cancer Centre, Trivandrum 695011, India.
Head Neck. 2009 Oct;31(10):1387-91. doi: 10.1002/hed.21029.
We report a rare case of synchronous occurrence of thyroglossal duct cyst carcinoma and thyroid carcinoma and discuss its management in detail.
A 59-year-old woman was clinically diagnosed to have a thyroglossal duct cyst and a solitary nodule. Fine-needle aspiration cytology revealed a papillary carcinoma in the thyroglossal duct cyst and a colloid in the thyroid nodule. Sistrunk's procedure along with a total thyroidectomy was performed followed by postoperative radioiodine ablation.
Histopathologic examination revealed thyroglossal duct cyst carcinoma and bilateral foci of papillary carcinoma in the thyroid gland. She has remained free of disease on follow-up.
Most cancers arising in thyroglossal duct cysts are of low risk, and Sistrunk's procedure is an adequate treatment for such cancers. However, for synchronously occurring cancers of the thyroglossal duct cyst and thyroid gland, or high-risk thyroglossal duct cyst cancers, more aggressive treatment comprising total thyroidectomy, Sistrunk's procedure, and radioiodine therapy is indicated.
我们报告一例罕见的甲状舌管囊肿癌与甲状腺癌同时发生的病例,并详细讨论其治疗方法。
一名59岁女性临床诊断为甲状舌管囊肿和一个孤立性结节。细针穿刺细胞学检查显示甲状舌管囊肿内为乳头状癌,甲状腺结节内为胶质。实施了Sistrunk手术及全甲状腺切除术,术后进行放射性碘消融。
组织病理学检查显示甲状舌管囊肿癌以及甲状腺内双侧乳头状癌灶。随访期间她未再患疾病。
大多数起源于甲状舌管囊肿的癌症风险较低,Sistrunk手术是此类癌症的充分治疗方法。然而,对于甲状舌管囊肿与甲状腺同时发生的癌症,或高危甲状舌管囊肿癌,建议采用更积极的治疗方法,包括全甲状腺切除术、Sistrunk手术及放射性碘治疗。