Lee Woohyung, Yi Nam-Joon, Kim Hyeyoung, Choi Youngrok, Park Minsu, Hong Geun, Choi June Young, Chung Hyun Hoon, Lee Kwang-Woong, Park Do-Joon, Min Hye Sook, Chung June-Key, Suh Kyung-Suk
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Korean J Hepatobiliary Pancreat Surg. 2012 Aug;16(3):123-7. doi: 10.14701/kjhbps.2012.16.3.123. Epub 2012 Aug 31.
A 35-year-old woman was determined to have an ovarian cyst and underwent a right ovarian cystectomy at 10 weeks of gestation. A histopathological examination revealed follicular carcinoma arising in a teratoma. No evidence of metastasis was found after delivery. She underwent a total thyroidectomy, followed by radioactive iodine (RAI) therapy. However, her serum thyroglobulin level increased to 1,437 ng/ml (normal range: 0-52 ng/ml) after 10 months. Radioiodine scintigraphy and abdominal computed tomography revealed liver metastasis and peritoneal seeding. She underwent debulking surgery of the liver, right salpinx, and peritoneal seeding nodules. A pathological examination showed metastatic follicular carcinoma with focal poorly differentiated features. Adjuvant RAI therapy was restarted, and her serum thyroglobulin levels returned to normal. In conclusion, metastatic lesions were successfully treated with a combination of debulking surgery and RAI therapy. Close medical follow-up monitoring serum thyroglobulin levels is mandatory in such patients.
一名35岁女性被诊断患有卵巢囊肿，并在妊娠10周时接受了右侧卵巢囊肿切除术。组织病理学检查显示畸胎瘤中出现滤泡癌。分娩后未发现转移迹象。她接受了全甲状腺切除术，随后进行放射性碘（RAI）治疗。然而，10个月后她的血清甲状腺球蛋白水平升至1437 ng/ml（正常范围：0 - 52 ng/ml）。放射性碘闪烁扫描和腹部计算机断层扫描显示肝转移和腹膜种植。她接受了肝脏、右侧输卵管和腹膜种植结节的减瘤手术。病理检查显示为转移性滤泡癌，具有局灶性低分化特征。辅助性RAI治疗重新开始，她的血清甲状腺球蛋白水平恢复正常。总之，通过减瘤手术和RAI治疗相结合成功治疗了转移性病变。对此类患者必须密切进行医学随访，监测血清甲状腺球蛋白水平。
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