Warman Meir, Lipschitz Noga, Ikher Sergey, Halperin Doron
Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, P.O.B. 1, Rehovot 76100, Israel ; Hebrew University Hadassah Medical School, Ein Kerem, P.O.B. 1200, Jerusalem 91120, Israel.
ISRN Otolaryngol. 2011 May 31;2011:582374. doi: 10.5402/2011/582374. Print 2011.
Introduction. Collision tumor of the thyroid gland is defined when independent and histologically distinct tumors coexist within the gland. The presence of both papillary and squamous cell carcinoma in the thyroid gland is unusual. Suggested etiologies include embryonic remanents of squamous epithelium, chronic inflammation, or thyroid malignancies promoting squamous metaplasia. Case Presentation. An elderly patient presented with a rapid enlargement of a long-standing right thyroid nodule. The tumor was locally invasive and unresectable. Pathology revealed the diagnosis of papillary and squamous cell carcinoma of the thyroid gland. Possible primary sites for squamous cell carcinoma in upper aerodigestive tract were excluded. The patient outcome was fatal although palliative chemoradiotherapy. Discussion. Collision tumor of papillary and squamous cell carcinoma of the thyroid gland is a rare entity that may imply bad prognosis, as to the presence of the squamous portion. The best treatment includes resection of the tumor; unfortunately it is not possible in most cases.
引言。甲状腺碰撞瘤是指在甲状腺内同时存在独立的、组织学上不同的肿瘤。甲状腺内同时存在乳头状癌和鳞状细胞癌的情况并不常见。推测的病因包括鳞状上皮的胚胎残留、慢性炎症或促使鳞状化生的甲状腺恶性肿瘤。病例报告。一名老年患者因长期存在的右侧甲状腺结节迅速增大前来就诊。肿瘤具有局部侵袭性且无法切除。病理检查确诊为甲状腺乳头状癌和鳞状细胞癌。排除了上呼吸道消化道鳞状细胞癌的可能原发部位。尽管进行了姑息性放化疗，但患者最终死亡。讨论。甲状腺乳头状癌和鳞状细胞癌碰撞瘤是一种罕见的疾病，由于存在鳞状部分，可能预示预后不良。最佳治疗方法是切除肿瘤；不幸的是，在大多数情况下无法做到。
