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伴有同步甲状腺转移的恶性黑色素瘤:病例报告及文献综述

Malignant melanoma with synchronous thyroid metastases: case report and literature review.

作者信息

Costa Maria Manuel, Belo Sandra, Capela-Costa João, Costa Jennifer, Carvalho Davide

机构信息

Department of Endocrinology, Diabetes and Metabolism, Faculty of Medicine University of Porto, Centro Hospitalar São João, Porto, Portugal.

Endocrine Surgery Division, Department of Surgery, Faculty of Medicine University of Porto, Centro Hospitalar São João, Porto, Portugal.

出版信息

Arch Endocrinol Metab. 2017 Mar-Apr;61(2):193-197. doi: 10.1590/2359-3997000000251. Epub 2017 Feb 16.

Abstract

Thyroid metastases are rare in clinical practice. We describe the case of an 85-year-old woman who was referred to our department due to a multinodular goiter with compressive symptoms and subclinical hyperthyroidism. The patient was also undergoing evaluation for a polyp in her left nasal cavity, which was then diagnosed as a malignant melanoma of the nasal mucosa. A thoracoabdominal magnetic resonance imaging obtained for cancer staging revealed a > 50% tracheal obstruction caused by the goiter. The patient underwent simultaneous total thyroidectomy and melanoma excision. Histological analysis of the thyroid showed the presence of multiple metastatic foci from the melanoma. Due to the patient's age, a decision was made to maintain her under surveillance and administer palliative treatment if necessary. Although metastases to the thyroid are rare, they should be considered in the differential diagnosis of thyroid lesions in patients with a known primary tumor. The thyroidectomy, performed in this patient's case, allowed the diagnosis of the metastases and relief of compressive symptoms caused by the goiter.

摘要

甲状腺转移瘤在临床实践中较为罕见。我们描述了一位85岁女性的病例,该患者因多结节性甲状腺肿伴压迫症状和亚临床甲状腺功能亢进症转诊至我科。患者同时正在接受左侧鼻腔息肉的评估,随后被诊断为鼻黏膜恶性黑色素瘤。为进行癌症分期而进行的胸腹磁共振成像显示,甲状腺肿导致气管阻塞超过50%。患者同时接受了甲状腺全切除术和黑色素瘤切除术。甲状腺组织学分析显示存在来自黑色素瘤的多个转移灶。鉴于患者年龄,决定对其进行监测,必要时给予姑息治疗。虽然甲状腺转移瘤很少见,但在已知原发性肿瘤患者的甲状腺病变鉴别诊断中应予以考虑。该患者接受的甲状腺切除术有助于诊断转移瘤并缓解甲状腺肿引起的压迫症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5832/10118863/3a74ae526726/2359-4292-aem-61-02-0193-gf01.jpg

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