Gutiérrez J M, Fernández A, Eire P F, Mariño J M, Olivas J M, Alonso L A, Peramato P G, Pereira P L, Queizán A, Utrilla J G
Departamento de Cirugía Pediátrica, Hospital Infantil La Paz, Facultad de Medicina, Universidad Autónoma, Madrid.
Cir Pediatr. 1990 Apr;3(2):73-5.
This is a review of the surgical treatment in six patients with papillary carcinoma of the thyroid. The mean age at the time of diagnosis was eight years (range four-twelve years). Clinical presentation was: all patients had a palpable thyroid tumor, palpable lymph nodes in four and one with lung metastases. The initial surgical treatment was lobectomy and modified regional lymph nodes resection. Four patients underwent a second operation for multifocal disease, palpable lymph node or thyroid tumor. The interval from initial surgical management to the detection of recurrence ranging from one month to four years. In three patients the remaining thyroid gland was removed. Radioiodine, external irradiation and chemotherapy were given during the postoperative. The median follow-up was eight years (range one-fifteen years). All patients are alive with thyroid hormone therapy by hypothyroidism. There were no hypoparathyroidism or injuries to the recurrent laryngeal nerve. The results of this study suggest that the surgical approach in papillary carcinoma of the thyroid is total thyroidectomy because reoperation were performed in four patients.
这是一篇关于6例甲状腺乳头状癌患者外科治疗的综述。诊断时的平均年龄为8岁（范围4 - 12岁）。临床表现为：所有患者均可触及甲状腺肿瘤，4例可触及淋巴结，1例有肺转移。初始手术治疗为甲状腺叶切除术和改良区域淋巴结切除术。4例患者因多灶性病变、可触及淋巴结或甲状腺肿瘤接受了二次手术。从初始手术治疗到复发检测的间隔时间为1个月至4年。3例患者切除了剩余的甲状腺。术后给予放射性碘、外照射和化疗。中位随访时间为8年（范围1 - 15年）。所有患者通过甲状腺激素替代治疗维持甲状腺功能减退状态存活。无甲状旁腺功能减退或喉返神经损伤。本研究结果表明，甲状腺乳头状癌的手术方式应为全甲状腺切除术，因为有4例患者接受了再次手术。
