Kachhawa G, Kumar S, Singh G, Mathur S, Kumar L, Sharma J
All India Institute of Medical Sciences, New Delhi, India.
J Surg Case Rep. 2011 Aug 1;2011(8):5. doi: 10.1093/jscr/2011.8.5.
Strumal carcinoid develops in a germ cell tumor characterized by an intimate mixture of thyroid and carcinoid. Unlike other carcinoid tumors, most patients with strumal carcinoid have no symptoms of carcinoid syndrome; few are reported to cause severe constipation. We report a case of a 60-year-old female patient presenting with severe progressive constipation and painful defecation for last few years. A right ovarian tumor was discovered during clinical examination. CT scan revealed a large lobulated solid cystic right adenexal mass suggestive of monomorphic teratoma, which was successfully removed surgically. The histopathology confirmed the diagnosis of strumal carcinoid tumor. Her constipation completely disappeared post surgery. These tumors are known to produce a biologically active substance like peptide YY, which has a pharmacologic inhibitory action on intestinal motility. This was presumably the cause of the constipation in this patient rather than a mechanical effect of the tumor.
甲状腺类癌发生于一种以甲状腺组织和类癌紧密混合为特征的生殖细胞肿瘤中。与其他类癌肿瘤不同，大多数甲状腺类癌患者没有类癌综合征的症状；据报道，很少有患者会导致严重便秘。我们报告一例60岁女性患者，在过去几年中出现严重进行性便秘和排便疼痛。临床检查时发现右侧卵巢肿瘤。CT扫描显示右侧附件区有一个大的分叶状实性囊性肿块，提示为单形性畸胎瘤，该肿瘤通过手术成功切除。组织病理学证实为甲状腺类癌肿瘤。术后她的便秘完全消失。已知这些肿瘤会产生一种生物活性物质，如肽YY，它对肠道蠕动有药理抑制作用。这可能是该患者便秘的原因，而非肿瘤的机械性影响。
