Department of Endocrinology, Washington Hospital Center, Washington, DC 20910, USA.
J Clin Endocrinol Metab. 2011 Sep;96(9):2684-91. doi: 10.1210/jc.2011-0611. Epub 2011 Jul 13.
More than 99% of thyroid cancers arise eutopically within the thyroid gland. The most frequent sites of ectopic thyroid tissue are lingual, sublingual, thyroglossal, laryngotracheal, and lateral cervical. Thyroid tissue can also be found in remote structures that were associated with the thyroid anlage during development, including the esophagus, mediastinum, heart, aorta, adrenal, pancreas, gallbladder, and skin. Ectopic thyroid tissue can be subject to the same pathological processes as normal eutopic thyroid tissue such as inflammation, hyperplasia, and tumorigenesis. The aim of this review is to describe aspects of thyroid cancer arising from the ectopic thyroid tissue in the neck in regard to epidemiology, diagnosis, and treatment and to present an illustrative series of cases of ectopic thyroid cancer.
We have searched the PubMed database for articles including the keywords "ectopic thyroid cancer" published between January 1, 1960, and January 1, 2011. As references, we used clinical case series, case reports, review articles, and practical guidelines focused on ectopic thyroid cancer confined to the neck region.
The possibility of an ectopic thyroid cancer should be considered in the differential diagnosis of a pathological mass in the neck. Treatment of ectopic cervical thyroid cancer is based predominantly on the surgical excision of the malignant lesion. Management strategies, including performance of total thyroidectomy, neck dissection, and treatment with radioiodine, should be based on individualized risk stratification.
超过 99%的甲状腺癌起源于甲状腺内的正常位置。异位甲状腺组织最常见的部位是舌、舌下、甲状舌骨、喉气管和颈侧。甲状腺组织也可在与甲状腺原基发育过程中相关的远处结构中发现,包括食管、纵隔、心脏、主动脉、肾上腺、胰腺、胆囊和皮肤。异位甲状腺组织可能经历与正常甲状腺组织相同的病理过程,如炎症、增生和肿瘤形成。本综述的目的是描述颈部异位甲状腺组织中甲状腺癌的发生情况,包括流行病学、诊断和治疗,并介绍一组异位甲状腺癌的病例。
我们在 PubMed 数据库中搜索了包含关键词“ectopic thyroid cancer”的文章,这些文章发表于 1960 年 1 月 1 日至 2011 年 1 月 1 日之间。作为参考文献,我们使用了专注于局限于颈部区域的异位甲状腺癌的临床病例系列、病例报告、综述文章和实用指南。
在鉴别颈部病理性肿块时,应考虑到异位甲状腺癌的可能性。异位颈甲状腺癌的治疗主要基于恶性病变的手术切除。管理策略,包括全甲状腺切除术、颈清扫术和放射性碘治疗,应基于个体化的风险分层。