Zivaljevic V, Zivic R, Diklic A, Krgovic K, Kalezic N, Vekic B, Stevanovic D, Paunovic I
Endocrine Surgery, Clinical Center of Serbia, Belgrade, Serbia.
Zentralbl Chir. 2011 Aug;136(4):374-8. doi: 10.1055/s-0030-1262541. Epub 2010 Nov 16.
Thyroid gland carcinomas usually appear as afunctional and hypofunctional lesions on thyroid scintigrams, but some rare cases of thyroid carcinoma with scintigraphic hyperfunctional lesions have also been reported. The aim of our retrospective study was to elucidate the frequency of carcinomas in patients operated for solitary hyperfunctional thyroid nodules and to represent their demographic and clinical features.
During one decade (1997/2006), 308 patients were operated for solitary hyperfunctional thyroid nodules in the Centre for Endocrine Surgery in Belgrade.
Malignancy was revealed in 9 cases (about 3 %) by histopathological examination. In 6 cases papillary microcarcinomas were found adjacent to dominant hyperfunctional adenomas, while in 3 cases (about 1 %) real hyperfunctional carcinomas were confirmed. Follicular carcinoma was diagnosed in 2 cases and papillary carcinoma in one. All 3 patients were preoperatively hyperthyroid. In both patients with follicular carcinoma we performed lobectomies. In the third case we carried out a total thyroidectomy considering the intraoperative frozen section finding of a papillary carcinoma.
According to our results the frequency of solitary hyperfunctioning thyroid carcinomas is about 1 %, so that the possibility that a hyperfunctional nodule is malignant should be considered in the treatment of such lesions.
甲状腺癌在甲状腺闪烁扫描图上通常表现为无功能和功能减退性病变，但也有一些甲状腺癌伴有闪烁扫描图上功能亢进性病变的罕见病例报道。我们这项回顾性研究的目的是阐明因孤立性高功能甲状腺结节而接受手术治疗的患者中癌的发生率，并呈现其人口统计学和临床特征。
在十年间（1997/2006年），贝尔格莱德内分泌外科中心有308例患者因孤立性高功能甲状腺结节接受了手术。
经组织病理学检查发现9例（约3%）为恶性。6例中在主要的高功能腺瘤旁发现微小乳头状癌，而3例（约1%）确诊为真正的高功能癌。2例诊断为滤泡癌，1例为乳头状癌。所有3例患者术前均为甲状腺功能亢进。2例滤泡癌患者均接受了叶切除术。第三例患者鉴于术中冰冻切片发现为乳头状癌，故实施了全甲状腺切除术。
根据我们的结果，孤立性高功能甲状腺癌的发生率约为1%，因此在治疗此类病变时应考虑高功能结节为恶性的可能性。
