Benis Éva, Szilágyi Anna, Izbéki Ferenc, Varga István, Altorjay Áron
Fejér Megyei Szent György Egyetemi Oktató Kórház Általános Sebészeti Osztály Székesfehérvár Seregélyesi út 3. 8000.
Fejér Megyei Szent György Egyetemi Oktató Kórház Patológiai Osztály Székesfehérvár.
Orv Hetil. 2014 Jun 8;155(23):918-21. doi: 10.1556/OH.2014.29934.
The authors present a case of a primary angiosarcoma of the thyroid gland with an intestinal metastasis. The 59-year-old female patient with tarry stool and anemia was referred to the outpatient hospital. Her past history included a thyroid "cold" nodule. Gastroscopy and colonoscopy failed to identify the origin of gastrointestinal bleeding, however, capsule endoscopy verified synchronous tumors in the small intestine. The distal tumor showed signs of bleeding and caused bowel obstruction. An urgent operation was performed and the tumorous part of the ileum was resected. Histology of the removed specimen indicated cleft-like spaces in the mucosa with CD31+ epithelial cells. Pathological report described metastatic epithelial angiosarcoma with an unknown origin. Before chemotherapy the patient underwent total thyroidectomy and histology confirmed malignancy similar to that found in the intestinal surgical specimens. This case seems particularly interesting, because bleeding from intestinal metastasis leaded to the diagnosis of the primary tumor located in the thyroid gland.
作者报告了一例甲状腺原发性血管肉瘤伴肠转移的病例。一名59岁的女性患者，有柏油样便和贫血症状，被转诊至门诊。她既往有甲状腺“冷”结节病史。胃镜和结肠镜检查未能确定胃肠道出血的来源，但胶囊内镜检查证实小肠存在同步肿瘤。远端肿瘤有出血迹象并导致肠梗阻。遂进行了紧急手术，切除了回肠的肿瘤部分。切除标本的组织学检查显示黏膜中有裂隙样间隙，有CD31+上皮细胞。病理报告描述为转移性上皮血管肉瘤，起源不明。化疗前患者接受了甲状腺全切除术，组织学检查证实为恶性肿瘤，与肠道手术标本中发现的肿瘤相似。该病例似乎特别有趣，因为肠道转移灶出血导致了位于甲状腺的原发性肿瘤的诊断。
