Sadacharan Dhalapathy, Mahadevan Shriraam, Muthukumar Sankaran, Dinesh Shanmugasundaram
Department of Endocrine Surgery, Madras Medical College, Chennai, Tamil Nadu, India Department of Endocrinology and Endocrine Surgery, Endocrine and Speciality clinic, Chennai, Tamil Nadu, India.
Department of Endocrinology and Endocrine Surgery, Endocrine and Speciality clinic, Chennai, Tamil Nadu, India Department of Endocrinology, Sri Ramachandra Medical College, Chennai, Tamilnadu, India.
BMJ Case Rep. 2015 May 15;2015:bcr2015209809. doi: 10.1136/bcr-2015-209809.
A 31-year-old woman with papillary carcinoma of the thyroid with right cervical lymph nodal metastasis underwent total thyroidectomy with modified radical neck dissection. At follow-up 6 weeks after surgery, she had not developed clinical features of hypothyroidism and her thyroid-stimulating hormone (TSH) was within normal limits. Further evaluation including technetium scintigraphy of the thyroid and MRI of the chest confirmed thyroid tissue, thyrothymic thyroid rest (TTR), in the superior mediastinum. The patient's TSH elevated well after reoperation of TTR. She underwent radioiodine ablative therapy and suppressive thyroxine therapy as per the protocol for well-differentiated thyroid cancer follow-up. The clinical importance of these embryological rests of thyroid tissue, especially in the management of thyroid malignancies, is discussed in this report.
一名31岁患有甲状腺乳头状癌并伴有右颈部淋巴结转移的女性接受了甲状腺全切除术及改良根治性颈清扫术。术后6周随访时，她尚未出现甲状腺功能减退的临床症状，促甲状腺激素（TSH）在正常范围内。包括甲状腺锝扫描和胸部MRI在内的进一步评估证实，上纵隔存在甲状腺组织，即胸腺甲状腺残余（TTR）。TTR再次手术后患者的TSH显著升高。她按照分化型甲状腺癌随访方案接受了放射性碘消融治疗和甲状腺素抑制治疗。本报告讨论了这些甲状腺组织胚胎残余的临床重要性，尤其是在甲状腺恶性肿瘤的管理方面。
