Bahadir Mehmet Veysi, Girgin Sadullah, Göya Cemil, Büyükbayram Hüseyin, Urakçi Zuhat
Assistant Professor, Department of General Surgery, Dicle University Medical Faculty , 21280, Diyarbakir/Turkey .
Professor, Department of General Surgery, Dicle University Medical Faculty , 21280, Diyarbakir/Turkey .
J Clin Diagn Res. 2016 Jun;10(6):PD30-1. doi: 10.7860/JCDR/2016/19489.8060. Epub 2016 Jun 1.
Primary thyroid fibrosarcoma cases are very rare. Although it is a known fact that soft tissue sarcomas show slow growth, there have been some cases in literature similar to our case in which there was a fast-growing tumour tissue causing breathing and swallowing difficulties due to painless pressure. For diagnosis, there is no specific clinical or radiological finding. We report a 67-year-old male with a mobile fast-growing mass covering almost all over the neck that appeared 2 months prior to the admission. Laboratory findings showed that the patient was euthyroid. Fine needle aspiration biopsy results are consistent with suspicion of a mesenchymal, histiocytic, epithelial or lymphoid tissue origined malignancy. Patient was taken into surgical operation. The thyroid tissue invaded the main vascular structure, trachea and esophagus. Due to this situation R1 resection was applied. Immunohistopathological examination showed a conventional type of fibrosarcoma. After the surgery, radiotherapy and chemotherapy had been planned and applied. Patients died before the radiotherapy sessions ended. It should be kept in mind that a rapid growth in thyroid tissue can be thyroid fibrosarcoma, there could be a rapid clinical course and poor prognosis after operation.
原发性甲状腺纤维肉瘤病例非常罕见。尽管软组织肉瘤生长缓慢是已知事实，但文献中也有一些与我们病例相似的情况，即存在快速生长的肿瘤组织，因无痛性压迫导致呼吸和吞咽困难。对于诊断，没有特定的临床或影像学表现。我们报告一例67岁男性，入院前2个月出现一个可活动的快速生长肿块，几乎覆盖整个颈部。实验室检查结果显示患者甲状腺功能正常。细针穿刺活检结果符合对间充质、组织细胞、上皮或淋巴组织起源恶性肿瘤的怀疑。患者接受了手术。甲状腺组织侵犯了主要血管结构、气管和食管。由于这种情况，进行了R1切除。免疫组织病理学检查显示为传统型纤维肉瘤。手术后，计划并实施了放疗和化疗。患者在放疗疗程结束前死亡。应牢记甲状腺组织快速生长可能是甲状腺纤维肉瘤，术后可能有快速的临床病程和不良预后。
