Siddiq S, Ahmad I I, Colloby P
Heartlands Hospital, Birmingham, United Kingdom.
J Surg Case Rep. 2010 May 1;2010(3):2. doi: 10.1093/jscr/2010.3.2.
Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites. We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma. Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.
甲状腺癌较为罕见，占所有恶性肿瘤的1%，通常表现为颈部肿块。与滤泡状甲状腺癌不同，乳头状甲状腺癌往往不会转移至远处部位。我们报告一例以孤立性无症状骨盆骨转移为表现的乳头状甲状腺癌病例，并强调目前骨转移的治疗方法。一名59岁女性在腹部计算机断层扫描时偶然发现右髂骨有一个4.5厘米的软组织肿块。病变活检证实为转移性甲状腺癌。患者无颈部肿块病史，头颈部检查正常。进一步影像学检查证实甲状腺右叶有局灶性活性。遂行甲状腺全切除术及Ⅵ区颈部淋巴结清扫术，组织学检查证实为乳头状癌滤泡变体。已证明早期发现骨转移可改善预后，甲状腺癌应被视为潜在的原发性恶性肿瘤。
