Tunio Mutahir A, Al Asiri Mushabbab, Fagih Mosa, Akasha Rashad
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia.
Head Neck Oncol. 2012 Mar 27;4:8. doi: 10.1186/1758-3284-4-8.
Thyroid gland lacks squamous epithelium (except in some rare situations like embroyonic remnants or in inflammatory processes); for that reason the primary squamous cell carcinoma (SCC) of thyroid is extremely rare entity, seen only in less than 1% of all thyroid malignancies and is considered almost fatal. So, far, only few case reports have been published in literature.
Herein we present a 54 years old Saudi female with 3 months history of progressive neck swelling and hoarse voice, who was referred to us by her primary care physician as suspected case of anaplastic carcinoma of thyroid for radical external beam radiation therapy (EBRT). Fine Needle aspiration cytology (FNAC) revealed squamous cell carcinoma. Computed tomography (CT) neck showed 10 × 10 cm mass in left lobe of thyroid invading trachea and skin. Extensive staging work up ruled out the possibility of any primary site of SCC other than thyroid gland. Tumor was found unresectable and was referred to radiation oncology. She received palliative EBRT 30 Gy in 10 fractions. After completion of EBRT, there was progression of disease and patient died 3 months after completion of EBRT by airway compromise.
Primary SCC of thyroid is rare and aggressive entity. FNAC is reliable and effective tool for immediate diagnosis. Surgery is a curative option, but it is not always possible as most of cases present as locally advanced with adjacent organs involvement. EBRT alone was found ineffective. Aggressive combined modality (debulking surgery, radiation and chemotherapy) shall be considered for such cases.
甲状腺缺乏鳞状上皮（胚胎残余或炎症过程等一些罕见情况除外）；因此，甲状腺原发性鳞状细胞癌（SCC）是极其罕见的实体，仅见于不到1%的甲状腺恶性肿瘤，且几乎被认为是致命的。迄今为止，文献中仅发表了少数病例报告。
在此，我们报告一名54岁的沙特女性，有3个月进行性颈部肿胀和声音嘶哑的病史，其初级保健医生将其作为疑似间变性甲状腺癌病例转诊至我们这里，以进行根治性外照射放疗（EBRT）。细针穿刺细胞学检查（FNAC）显示为鳞状细胞癌。颈部计算机断层扫描（CT）显示甲状腺左叶有一个10×10 cm的肿块，侵犯气管和皮肤。广泛的分期检查排除了甲状腺以外任何SCC原发部位的可能性。发现肿瘤无法切除，遂转诊至放射肿瘤科。她接受了10次分割、共30 Gy的姑息性EBRT。EBRT完成后，疾病进展，患者在EBRT完成3个月后因气道受压死亡。
甲状腺原发性SCC罕见且具有侵袭性。FNAC是立即诊断的可靠有效工具。手术是一种治愈性选择，但由于大多数病例表现为局部晚期并累及邻近器官，并非总是可行。单独的EBRT被发现无效。对于此类病例，应考虑积极的综合治疗方式（减瘤手术、放疗和化疗）。
