Bertelli Antonio Augusto T, Massarollo Luiz Cláudio Bosco, Volpi Erivelto Martinho, Ueda Rubens Yassuzo Ykko, Barreto Elci
Departamento de Cirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, SP, Brasil.
Arq Bras Endocrinol Metabol. 2010 Mar;54(3):326-30. doi: 10.1590/s0004-27302010000300012.
Despite the fact that 15% to 20% of sarcomas occur in the head and neck and 80% in adults, only 0.014% are primary thyroid leiomyosarcomas. To the best of our knowledge, only 16 cases have been reported around the world, none in South America. Cytologic diagnosis is challenging and these tumors may be mistaken by more common ones such as anaplastic or medullary carcinomas. The treatment of choice for thyroid leiomyosarcomas is not well established yet because of its poor prognosis. Radical surgery associated with chemoradiotherapy has not been effective and did not improve survival rates. The authors report a case of primary thyroid leiomyosarcoma in a young male, who has been submitted to total thyroidectomy and selective neck dissection. Extensive literature review was performed by the authors. The patient received adjuvant radiotherapy, presenting good postoperative course. After four years evolution, there was no local recurrence or distant metastasis.
尽管15%至20%的肉瘤发生在头颈部，且80%发生于成人，但原发性甲状腺平滑肌肉瘤仅占0.014%。据我们所知，全球仅报告了16例，南美洲尚无相关病例。细胞学诊断具有挑战性，这些肿瘤可能会被误诊为更常见的肿瘤，如未分化癌或髓样癌。由于甲状腺平滑肌肉瘤预后较差，其首选治疗方法尚未明确。与放化疗联合的根治性手术效果不佳，并未提高生存率。作者报告了一例年轻男性原发性甲状腺平滑肌肉瘤病例，该患者接受了全甲状腺切除术和选择性颈清扫术。作者进行了广泛的文献回顾。患者接受了辅助放疗，术后恢复良好。经过四年的随访，未出现局部复发或远处转移。
