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甲状腺乳头状癌颈部皮肤转移:一例报告并文献复习

Cutaneous metastasis of papillary thyroid carcinoma to the neck: a case report and review of the literature.

作者信息

Reusser Nicole M, Holcomb Maura, Krishnan Bhuvaneswari, Rosen Ted, Orengo Ida F

机构信息

The University of Texas Health Science Center at Houston, Houston, Texas.

出版信息

Dermatol Online J. 2014 Dec 13;21(2):13030/qt78v2d22d.

Abstract

Papillary thyroid carcinoma, the most common subtype of thyroid malignancy, rarely presents with cutaneous metastatic spread. Despite metastatic cutaneous lesions presenting as slow and indolent growing nodules of the head and neck, such lesions most frequently appear in the setting of diffuse and dramatic metastatic disease and a bleak prognosis. Given the rarity of these metastatic lesions, the diagnosis may be delayed, and often the initial diagnosis is incorrect. Several case reports have been published in the literature noting unusual or interesting presentations of thyroid carcinoma with cutaneous metastasis. Here we present a classic case of a patient with a prior diagnosis of thyroid carcinoma presenting with a slowly growing ulcerated lesion on the neck nine years after partial thyroidectomy and characteristic histopathology on microscopic examination. Furthermore we review the literature regarding papillary thyroid carcinoma with cutaneous metastasis and the diagnostic challenge these lesions present to practitioners.

摘要

乳头状甲状腺癌是甲状腺恶性肿瘤最常见的亚型,很少出现皮肤转移扩散。尽管转移性皮肤病变表现为头颈部缓慢生长且无痛的结节,但此类病变最常出现在弥漫性、严重转移性疾病及预后不良的情况下。鉴于这些转移性病变罕见,诊断可能会延迟,而且初始诊断往往有误。文献中已发表了几例病例报告,指出甲状腺癌皮肤转移有不寻常或有趣的表现。在此,我们呈现一例典型病例,患者既往诊断为甲状腺癌,在甲状腺部分切除术后九年,颈部出现一个缓慢生长的溃疡性病变,显微镜检查具有特征性组织病理学表现。此外,我们回顾了有关乳头状甲状腺癌皮肤转移的文献以及这些病变给从业者带来的诊断挑战。

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