Room No. 334, Resident Doctors Hostel, Masjid Moth, All India Institute of Medical Sciences, New Delhi 110029, India.
Singapore Med J. 2013 Jul;54(7):e146-8. doi: 10.11622/smedj.2013115.
Thyroid tumours with both papillary and medullary carcinoma features are rare and represent less than 1% of all thyroid malignancies. These tumours have a different clinical presentation and biological behaviour from tumours that have only papillary or medullary carcinoma features. The phenomenon of mixed thyroid tumours can be observed in two settings--a mixed tumour showing dual differentiation, or a collision tumour. For a precise diagnosis of this rare mixed thyroid carcinoma, fine needle aspiration cytology results should be correlated with serum calcitonin and thyroglobulin levels. The diagnosis should also be confirmed using immunocytochemistry. Surgery is the treatment of choice, and the role of postoperative radioiodine is controversial. We herein report the case of a 35-year-old man with a mixed medullary-papillary carcinoma of the thyroid, which presented with C-cell hyperplasia, granulomatous inflammation and metastasis to the cervical lymph nodes. The patient was treated with total thyroidectomy and nodal clearance. This case highlights the need for awareness of coexistent entities as they warrant separate treatments.
具有乳头状癌和髓样癌特征的甲状腺肿瘤较为罕见，占所有甲状腺恶性肿瘤的比例不足 1%。这些肿瘤的临床表现和生物学行为与仅有乳头状癌或髓样癌特征的肿瘤不同。混合性甲状腺肿瘤有两种表现形式——一种是具有双重分化的混合性肿瘤，另一种是碰撞性肿瘤。为了对这种罕见的混合性甲状腺癌做出准确诊断，细针抽吸细胞学检查结果应与降钙素和甲状腺球蛋白水平相关联。诊断还应使用免疫细胞化学来确认。手术是治疗的首选，术后放射性碘的作用存在争议。我们在此报告 1 例 35 岁男性患者，患有甲状腺混合性髓样-乳头状癌，表现为 C 细胞增生、肉芽肿性炎症和颈部淋巴结转移。患者接受了甲状腺全切除术和淋巴结清扫术。该病例强调需要认识到共存实体的存在，因为它们需要进行单独的治疗。
