Nagashima Saki, Sakurai Kenichi, Fujisaki Shigeru, Suzuki Shuhei, Shibata Masahiko, Tomita Ryouichi, Hara Yukiko, Matsumoto Kyoko, Enomoto Katsuhisa, Amano Sadao
Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2002-4.
We report an unmarried woman with papillary thyroid cancer. The patient was a 20-year-old woman who had neck tumor. The ultrasonography (US), CT, and aspiration biopsy cytology (ABC) were performed. The diagnosis of the tumor was papillary carcinoma of thyroid. The total thyroidectomy plus lymph nodes dissection (D2a) were performed. Two years after the first operation, we recognized lymph nodes swelling at her right neck. The US guided ABC was performed. The diagnosis was the metastasis of lymph node from thyroid cancer. We performed lymph nodes dissection again. Three years after the first operation, we detected the swelleing of lymph nodes again at her right neck. We performed lymph nodes dissection again. We recommended a therapeutic use of iodine radioisotopes. However, she rejected the therapy because she strongly wanted to be pregnant. Generally speaking, it is difficult to determine the therapeutic use of iodine radioisotopes for unmarried women. After seven years from the first operation, she delivered a baby girl. We plan to use of iodine radioisotopes for adjuvant therapy when she delivers her 2nd baby. This case suggested that a treatment strategy for unmarried thyroid cancer patients should be made thoughtfully with care.
我们报告了一名患有甲状腺乳头状癌的未婚女性。患者为一名20岁有颈部肿瘤的女性。进行了超声检查（US）、CT和细针穿刺活检细胞学检查（ABC）。肿瘤诊断为甲状腺乳头状癌。实施了全甲状腺切除术加淋巴结清扫术（D2a）。首次手术后两年，我们发现她右侧颈部淋巴结肿大。进行了超声引导下的ABC检查。诊断为甲状腺癌淋巴结转移。我们再次进行了淋巴结清扫术。首次手术后三年，我们再次发现她右侧颈部淋巴结肿大。我们再次进行了淋巴结清扫术。我们建议进行碘放射性同位素治疗。然而，她拒绝了该治疗，因为她强烈希望怀孕。一般来说，对于未婚女性很难确定是否使用碘放射性同位素进行治疗。首次手术后七年，她生下了一个女婴。我们计划在她生下第二个孩子后使用碘放射性同位素进行辅助治疗。该病例表明，对于未婚甲状腺癌患者的治疗策略应谨慎、周全地制定。
