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甲状腺滤泡癌的不寻常表现,特别强调其治疗。

Unusual presentation of follicular carcinoma thyroid with special emphasis on their management.

作者信息

Panda Sangram Keshari, Patro Byomokesh, Samantaroy Manas Ranjan, Mishra Jagadananda, Mohapatra K C, Meher R K

机构信息

Department of General Surgery, SCB Medical College, Cuttack, Odisha 753003, India.

Department of General Surgery, SCB Medical College, Cuttack 753003, India.

出版信息

Int J Surg Case Rep. 2014;5(7):408-11. doi: 10.1016/j.ijscr.2014.03.006. Epub 2014 May 9.

Abstract

INTRODUCTION

Follicular carcinoma of thyroid usually behaves in an indolent manner with low metastatic potential. Distant metastases as initial presentation is rare in follicular carcinoma; especially in young patients.

PRESENTATION OF CASE

We report the clinical, pathological features and the management of three different cases of follicular carcinoma of the thyroid with unusual presentations at the time of diagnosis. First case presented as thyroid abscess, second case with a large skull swelling in a pre-exiting goiter and the third case with a swelling in the sternum.

DISCUSSION

Follicular carcinoma of thyroid is the second category of well-differentiated thyroid cancer that constitutes about 10% of all thyroid malignancies. Blood borne metastasis is common with spread to lung, bone and other solid organs. In less than 10% cases of follicular carcinoma, there is evidence of lymphatic involvement. The patients' presentations above are highly unusual.

CONCLUSION

Recognizing these cases has a significant impact on clinical decision-making and prognosis of the patients. Treatment in these patients should be individualized and an alternative therapeutic approach should be considered.

摘要

引言

甲状腺滤泡癌通常表现为惰性生长,转移潜能较低。远处转移作为首发表现在滤泡癌中较为罕见,尤其是在年轻患者中。

病例介绍

我们报告了三例甲状腺滤泡癌的临床、病理特征及诊治情况,这三例患者在诊断时均有不寻常的表现。第一例表现为甲状腺脓肿,第二例在原有甲状腺肿的基础上出现巨大颅骨肿胀,第三例表现为胸骨肿物。

讨论

甲状腺滤泡癌是分化型甲状腺癌的第二类,约占所有甲状腺恶性肿瘤的10%。血行转移常见,可转移至肺、骨和其他实体器官。在不到10%的滤泡癌病例中,有淋巴受累的证据。上述患者的表现非常不寻常。

结论

认识这些病例对患者的临床决策和预后有重大影响。这些患者的治疗应个体化,并应考虑采用替代治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e75/4064430/0a5ad0aef98c/gr1.jpg

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