Slipac Juraj, Janjanin Sasa, Ljepava Dejan, Hutinec Zdenka, Bence-Zigman Zdenka
University of Zagreb, Zagreb University Hospital Center, University Department of Head and Neck Surgery, Zagreb, Croatia.
Coll Antropol. 2012 Nov;36 Suppl 2:63-6.
We are reporting a case of a 42-yr-old female with a history of right breast carcinoma. She was surgically treated (breast quadrantectomy with axillary dissection) and receiving a third cycle of adjuvant chemotherapy when a feeling of a constant pressure in the front of the neck and lack of air occurred. Subsequent work-up revealed a node in the right thyroid lobe with enlarged paratracheal bilateral and right mid and lower jugular lymph nodes. Fine-needle aspiration cytology, repeated within a 20 days window and analyzed by two different cytologists, showed a medullary thyroid carcinoma with a cervical lymph nodes metastasis so the patient underwent total thyroidectomy with selective and paratracheal neck dissection. Histology and immunohistochemistry revealed the specimen to be metastasis of breast carcinoma. During regular follow-up of our patient, eighteen months after initial diagnosis, no new metastases were found. To our best knowledge, this is the first described case of a thyroid metastasis of breast carcinoma that was cytologically misdiagnosed as a medullary thyroid carcinoma.
我们报告一例42岁女性，有右乳腺癌病史。她接受了手术治疗（乳房象限切除术加腋窝淋巴结清扫术），在接受第三个周期辅助化疗时，出现颈部前方持续压迫感和呼吸困难。随后的检查发现右甲状腺叶有一个结节，双侧气管旁及右侧颈中、下淋巴结肿大。在20天内重复进行细针穿刺细胞学检查，并由两名不同的细胞病理学家进行分析，结果显示为甲状腺髓样癌伴颈部淋巴结转移，因此患者接受了全甲状腺切除术及选择性气管旁颈部淋巴结清扫术。组织学和免疫组化显示标本为乳腺癌转移灶。在对我们的患者进行定期随访时，初始诊断18个月后未发现新的转移灶。据我们所知，这是首例细胞学误诊为甲状腺髓样癌的乳腺癌甲状腺转移病例。
