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伴有同步无症状晚期食管鳞状细胞癌的甲状腺微小乳头状癌:一例报告并文献复习

Papillary thyroid microcarcinoma with synchronous asymptomatic advanced esophageal squamous cell carcinoma: A case report and review of the literature.

作者信息

Cheng Pu, Xiang Yingying, Chen Endong, Zou Zhangyong, Zhang Xiaohua

机构信息

Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China.

出版信息

Oncol Lett. 2015 Feb;9(2):731-734. doi: 10.3892/ol.2014.2748. Epub 2014 Dec 1.

Abstract

Papillary thyroid microcarcinoma (PTMC) is a subset of papillary thyroid carcinoma, with tumors measuring ≤1.0 cm in maximum diameter. Esophageal squamous cell carcinoma (ESCC) is the most common histopathological subtype of the various esophageal malignancies. The present study reports a rare synchronous presentation of PTMC and asymptomatic ESCC manifesting as lateral cervical lymph node enlargement. The patient, a 70-year-old male who presented to the Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China)with no significant symptoms, was identified to have bilateral thyroid nodules by ultrasonography and enlarged lymph nodes on the left side of the neck by palpation. A diagnosis of PTMC with lateral cervical lymph node metastasis was established and the patient underwent right lobectomy, partial left lobectomy and lymph node biopsy. Pathological analysis of the intraoperative frozen biopsy indicated bilateral PTMC and metastatic lymph node SCC from a different primary location. Furthermore, histological examination of the biopsied lymph nodes revealed bilateral PTMC and poorly-differentiated SCC, which was verified as ESCC by gastroscopy and postoperative histopathological examination. A review of the present literature indicated that no similar case has been reported thus far. The patient succumbed three months after attending Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai, China) for additional treatment.

摘要

甲状腺微小乳头状癌(PTMC)是甲状腺乳头状癌的一个亚型,肿瘤最大直径≤1.0厘米。食管鳞状细胞癌(ESCC)是各种食管恶性肿瘤中最常见的组织病理学亚型。本研究报告了一例罕见的PTMC与无症状ESCC同时出现并表现为颈部外侧淋巴结肿大的病例。该患者为一名70岁男性,因无明显症状就诊于温州医科大学附属第一医院(中国温州)外科肿瘤科,超声检查发现双侧甲状腺结节,触诊发现颈部左侧淋巴结肿大。确诊为PTMC伴颈部外侧淋巴结转移,患者接受了右叶切除术、左叶部分切除术和淋巴结活检。术中冰冻活检的病理分析显示双侧PTMC以及来自不同原发部位的转移性淋巴结鳞状细胞癌。此外,活检淋巴结的组织学检查显示双侧PTMC和低分化鳞状细胞癌,经胃镜检查和术后组织病理学检查证实为ESCC。对现有文献的回顾表明,迄今为止尚未报道过类似病例。该患者在前往上海交通大学医学院附属瑞金医院(中国上海)接受进一步治疗三个月后死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10ad/4301557/d20f76c94508/OL-09-02-0731-g00.jpg

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