McNamara Kate, Olaleye Oladejo, Smith Joel, Karamchandani Dheeraj, Watkinson John
Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham, UK.
BMJ Case Rep. 2011 Feb 23;2011:bcr1020103393. doi: 10.1136/bcr.10.2010.3393.
An 85-year-old lady presented with a large midline neck mass. After 8 years of steady growth, the previously asymptomatic mass began to cause stridor and dysphagia. The patient's comorbidities included a previous partial glossectomy for haemangioma of the tongue, chronic obstructive pulmonary disease, congestive cardiac failure and obesity (body mass index >30). CT neck revealed the midline mass was cystic in nature, most likely a thyroglossal duct cyst. This mass was closely related to an angiomatous malformation involving the tongue, floor of mouth and left parotid. Fine needle aspiration cytology was consistent with a colloid goitre characterised as Thy-1. Due to her extensive comorbidities, surgical resection of the midline mass was deemed to be a high-risk procedure. A Sistrunk's procedure was performed. Dissection proved difficult due to the intimately related base of tongue haemangioma. Histopathology confirmed it to be a benign thyroglossal duct cyst. She made an uncomplicated postoperative recovery.
一位85岁女性因颈部中线出现巨大肿块前来就诊。在经历8年的稳定生长后，此前无症状的肿块开始引发喘鸣和吞咽困难。患者的合并症包括曾因舌部血管瘤接受部分舌切除术、慢性阻塞性肺疾病、充血性心力衰竭以及肥胖（体重指数>30）。颈部CT显示中线肿块本质上是囊性的，很可能是甲状舌管囊肿。该肿块与累及舌部、口腔底部及左侧腮腺的血管瘤样畸形密切相关。细针穿刺细胞学检查结果与诊断为Thy-1的胶样甲状腺肿相符。鉴于她存在多种严重合并症，对中线肿块进行手术切除被认为是一项高风险操作。遂实施了Sistrunk手术。由于与舌部血管瘤的基底紧密相连，手术解剖颇具难度。组织病理学证实其为良性甲状舌管囊肿。她术后恢复顺利，未出现并发症。
