上颈部甲状腺乳头状癌（UPTC）：一个新提出的术语，用于指代甲状舌管囊肿相关的甲状腺乳头状癌、甲状腺锥体叶乳头状癌和Delphian淋巴结甲状腺乳头状癌转移的复合体。
Upper neck papillary thyroid cancer (UPTC): A new proposed term for the composite of thyroglossal duct cyst-associated papillary thyroid cancer, pyramidal lobe papillary thyroid cancer, and Delphian node papillary thyroid cancer metastasis.
作者信息
Zizic Marica, Faquin William, Stephen Antonia E, Kamani Dipti, Nehme Romy, Slough Cristian M, Randolph Gregory W
机构信息
Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary & Harvard Medical School, Boston, Massachusetts, U.S.A.
Department of Pathology, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, U.S.A.
出版信息
Laryngoscope. 2016 Jul;126(7):1709-14. doi: 10.1002/lary.25824. Epub 2015 Dec 21.
OBJECTIVES/HYPOTHESIS: Thyroglossal duct cyst (TGDC) is a common congenital anomaly, but TGDC carcinoma is rare. Thyroglossal duct cyst carcinoma management is controversial, especially that of the orthotopic thyroid gland. We aim to provide an insight into the pathologic basis of this management controversy through the review of 28 TGDC cancer cases, thus far the largest such series to our knowledge.
STUDY DESIGN
Retrospective.
METHODS
Twenty-eight cases recorded as TGDC cancer in the hospital database were reviewed; their initial clinical diagnosis from medical chart review (DX1) and final pathological review diagnosis (DX2) through pathology slides review by our pathologist (blinded to DX1) were compared. The thyroid gland management and pathology were evaluated.
RESULTS
In the 28 TGDC carcinoma (hospital-recorded diagnosis) patients, DX1 and DX2 were respectively reported as 53% and 14% TGDC carcinoma, 11% and 29% as pyramidal lobe primary, and 4% and 25% as metastatic Delphian node. Thirty-two percent of cases were in the indeterminate category, in both DX1 and DX2, but included different patients. Thyroidectomy was performed in 54% of the cases, papillary thyroid cancer (PTC) was reported in 37% of these thyroid glands. Concurrent thyroid gland malignancy was reported in all Delphian node and pyramidal lobe PTC patients.
CONCLUSION
The diagnosis of TGDC cancer comprises a heterogeneous group that includes true TGDC cancer, pyramidal lobe primary, Delphian node metastasis, and indeterminate cases. We propose a new terminology of upper neck papillary thyroid carcinoma (UPTC) to denote this heterogeneous group and recommend a rational algorithm for management. Correct pathologic subcategory and thyroid ultrasonography are essential for optimal management of thyroid gland in UPTC cases.
LEVEL OF EVIDENCE
- Laryngoscope, 126:1709-1714, 2016.
目的/假设：甲状舌管囊肿（TGDC）是一种常见的先天性异常，但甲状舌管囊肿癌罕见。甲状舌管囊肿癌的治疗存在争议，尤其是原位甲状腺的治疗。我们旨在通过回顾28例甲状舌管囊肿癌病例（据我们所知，这是迄今为止最大的此类病例系列），深入了解这种治疗争议的病理基础。
研究设计
回顾性研究。
方法
回顾医院数据库中记录为甲状舌管囊肿癌的28例病例；比较其通过病历回顾得出的初始临床诊断（DX1）和经我们的病理学家（对DX1不知情）通过病理切片回顾得出的最终病理回顾诊断（DX2）。评估甲状腺的处理和病理情况。
结果
在28例甲状舌管囊肿癌（医院记录诊断）患者中，DX1和DX2分别报告为53%和14%为甲状舌管囊肿癌，11%和29%为锥体叶原发癌，4%和25%为Delphian淋巴结转移癌。32%的病例在DX1和DX2中都属于不确定类别，但涉及不同患者。54%的病例进行了甲状腺切除术，这些甲状腺中37%报告为乳头状甲状腺癌（PTC）。所有Delphian淋巴结和锥体叶PTC患者均报告有并发甲状腺恶性肿瘤。
结论
甲状舌管囊肿癌的诊断包括一个异质性群体，其中包括真正的甲状舌管囊肿癌、锥体叶原发癌、Delphian淋巴结转移癌和不确定病例。我们提出了一种新的术语“上颈部乳头状甲状腺癌（UPTC）”来表示这个异质性群体，并推荐一种合理的治疗算法。正确的病理亚类和甲状腺超声检查对于UPTC病例中甲状腺的最佳管理至关重要。
证据水平
4。《喉镜》，2016年，第126卷，第1709 - 1714页。
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