Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Cancer Res Treat. 2009 Mar;41(1):56-8. doi: 10.4143/crt.2009.41.1.56. Epub 2009 Mar 31.
We report a case of severe hypothyroidism in a cholangiocarcinoma patient with metastasis to the thyroid gland. A 58-year-old man was admitted for upper abdominal discomfort and multiple palpable neck nodules. Abdominal computed tomography (CT) demonstrated the presence of a 4.7-cm tumor in the right hepatic lobe, and core needle biopsy revealed it to be cholangiocarcinoma. Neck CT showed a diffuse, low attenuation thyroid gland, and fine-needle aspiration (FNA) demonstrated metastatic adenocarcinoma. Thyroid function tests were initially normal, but the size of the thyroid gland decreased and severe hypothyroidism developed after chemotherapy was implemented for cholangiocarcinoma. In a patient with malignant disease and a goiter, the possibility of a metastatic tumor involving the thyroid should be seriously considered. Metastatic thyroid cancer and thyroid dysfunction are probably infrequent, but diagnosis is important in the institution of appropriate therapy.
我们报告一例胆管癌伴甲状腺转移患者发生严重甲状腺功能减退症。一名 58 岁男性因上腹部不适和多个可触及的颈部结节入院。腹部计算机断层扫描（CT）显示右肝叶有一个 4.7 厘米的肿瘤，经核心针活检证实为胆管癌。颈部 CT 显示弥漫性、低衰减的甲状腺，细针抽吸（FNA）显示转移性腺癌。甲状腺功能检查最初正常，但在为胆管癌实施化疗后，甲状腺体积缩小，严重甲状腺功能减退症发生。在患有恶性疾病和甲状腺肿大的患者中，应认真考虑甲状腺转移瘤的可能性。转移性甲状腺癌和甲状腺功能障碍可能不常见，但诊断对于实施适当治疗非常重要。
