Suzuki Shuhei, Fujisaki Shigeru, Takashina Motoi, Sakurai Kenichi, Maeda Tetsuyo, Nagashima Saki, Tomita Ryouichi, Takayama Tadatoshi
Dept. of Surgery, Fujisaki Hospital.
Gan To Kagaku Ryoho. 2014 Nov;41(12):2512-4.
We describe a case of a 52-year-old man who presented with a neck tumor. Ultrasonography and a neck computed tomography (CT) scan revealed a large, 6-cm mass in the left thyroid lobe. Analysis of cytological specimens obtained from the mass indicated the tumor was classIV (indicative of anaplastic carcinoma). In addition, chest CT revealed multiple small nodules in the lung, which we suspected were metastases from the primary thyroid carcinoma. To relieve pressure symptoms in the neck, we performed left hemithyroidectomy and lymph node dissection. Six months after surgery, a chest CT scan revealed enlargement of a nodule in the left lung. CT-guided biopsy of the left lung mass indicated a histopathological diagnosis of metastasis from anaplastic carcinoma. Four cycles of paclitaxel chemotherapy suppressed enlargement of the lung tumor. The patient's general condition gradually deteriorated; however, and he died 15 months after surgery. Anaplastic carcinoma of the thyroid is generally considered to be one of the most aggressive cancers encountered in humans. In this case, surgical intervention led to improved clinical symptoms and prognosis.
我们描述了一例52岁男性颈部肿瘤患者。超声检查及颈部计算机断层扫描(CT)显示左甲状腺叶有一个6厘米的大肿块。对从肿块获取的细胞学标本分析表明该肿瘤为IV级(提示未分化癌)。此外,胸部CT显示肺部有多个小结节,我们怀疑这些是原发性甲状腺癌的转移灶。为缓解颈部压迫症状,我们进行了左侧甲状腺叶切除术及淋巴结清扫术。术后6个月,胸部CT扫描显示左肺一个结节增大。对左肺肿块进行CT引导下活检,组织病理学诊断为未分化癌转移。四个周期的紫杉醇化疗抑制了肺部肿瘤的增大。然而,患者的一般状况逐渐恶化,术后15个月死亡。甲状腺未分化癌通常被认为是人类遇到的最具侵袭性的癌症之一。在本病例中,手术干预改善了临床症状并延长了生存期。