Ayaz T, Sahin S B, Sahin O Z, Akdogan R, Gücer R
Department of Internal Medicine, Recep Tayyip Erdogan University, Faculty of Medicine,Rize, Turkey.
Department of Endocrinology, Recep Tayyip Erdogan University, Faculty of Medicine,Rize, Turkey.
Hippokratia. 2015 Jan-Mar;19(1):85-7.
Anaplastic thyroid carcinoma (ATC) has the most aggressive progression among thyroid malignancies. Most of the patients have metastasis, especially to the lungs, liver and regional lymph nodes, at the time of diagnosis. Gastrointestinal tract metastasis of ATC has been rarely reported. We report a case who presented with gastrointestinal bleeding and was diagnosed with ATC accompanied with gastric, skin, lung and adrenal gland metastases.
A 72-year-old male patient presented with one month history of neck mass, weight loss and weakness and three-day-history of melena. On examination his thyroid gland was tender on palpation and hyperplasic, multiple, painful, solid, and fixed nodules were palpated.Ultrasonographic neck examination demonstrated an enlarged thyroid gland and multiple hypoechoic nodules including cystic degenerative areas; the largest 28 x 23 mm in size. Thyroid fine needle aspiration biopsy was performed and biopsy results indicated ATC. Gastroscopy, performed due to the gastrointestinal bleeding, detected a 4 x 6 mm polypoid lesion on sternal pili of the gastric cardia and histopathological examination of its biopsy demonstrated metastasis of ATC.
We reported a case of ATC with gastric, skin, lung and adrenal gland metastases, initially presenting with gastrointestinal bleeding due to the gastric metastasis. Hippokratia 2015, 19 (1): 85-87.
间变性甲状腺癌(ATC)在甲状腺恶性肿瘤中进展最为迅速。大多数患者在确诊时已发生转移,尤其是肺、肝和区域淋巴结转移。ATC的胃肠道转移鲜有报道。我们报告一例以胃肠道出血为表现,诊断为ATC并伴有胃、皮肤、肺和肾上腺转移的病例。
一名72岁男性患者,有1个月颈部肿块、体重减轻和乏力病史,以及3天黑便病史。检查时,触诊甲状腺有压痛且增生,可触及多个疼痛性实性固定结节。颈部超声检查显示甲状腺肿大,多个低回声结节,包括囊性变区域;最大者大小为28×23mm。进行了甲状腺细针穿刺活检,活检结果提示为ATC。因胃肠道出血进行胃镜检查,在胃贲门部胸骨柄处发现一个4×6mm的息肉样病变,其活检组织病理学检查显示为ATC转移。
我们报告了一例伴有胃、皮肤、肺和肾上腺转移的ATC病例,最初因胃转移而出现胃肠道出血。《希波克拉底》2015年,第19卷(1):85 - 87页。