Handa Hideo, Gomi Daisuke, Fukushima Toshirou, Kobayashi Takashi, Sekiguchi Nodoka, Sakamoto Akiyuki, Tsukahara Yoshiko, Matsushita Hirohide, Sasaki Shigeru, Mamiya Keiko, Koizumi Tomonobu, Ichiyama Takashi
Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan.
Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Japan.
Intern Med. 2018 Jan 1;57(1):31-35. doi: 10.2169/internalmedicine.9234-17. Epub 2017 Oct 16.
A 63-year-old woman underwent thyroidectomy for papillary thyroid adenocarcinoma and cervical lymph node resection. Pathological analyses revealed the presence of signet cell carcinoma in a resected lymph node, which were apparently different from the pathological findings of thyroid carcinoma. No evidence of a primary tumor could be found elsewhere despite detailed examinations, including esophagogastroduodenoscopy, colonoscopy, capsule endoscopy, CT scan, and fluorodeoxyglucose-positron emission tomography. Two and half years later, the patient developed multiple bone metastases and the pathological findings confirmed the presence of signet cell carcinoma. The primary origin remained undetermined. Metastatic signet ring cell carcinoma of unknown primary origin is extremely rare.
一名63岁女性接受了甲状腺乳头状腺癌甲状腺切除术及颈部淋巴结切除术。病理分析显示，在切除的淋巴结中存在印戒细胞癌，这明显不同于甲状腺癌的病理表现。尽管进行了包括食管胃十二指肠镜检查、结肠镜检查、胶囊内镜检查、CT扫描和氟脱氧葡萄糖正电子发射断层扫描在内的详细检查，但在其他部位未发现原发性肿瘤的证据。两年半后，患者出现多处骨转移，病理检查结果证实存在印戒细胞癌。原发灶仍未确定。原发灶不明的转移性印戒细胞癌极为罕见。
