Ma Aiwen, Liu Hongfeng
Peking Union Medical College Hospital, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.
Medicine (Baltimore). 2017 Nov;96(47):e8707. doi: 10.1097/MD.0000000000008707.
Ectopic thyroid is commonly found in the neck region. Intra-abdominal ectopic thyroid is extremely rare, with only 2 cases reported in the pancreatic region. Very few reports have described detailed imaging findings of intra-abdominal ectopic thyroid.
A 73-year-old woman with aggravated recurrent right upper quadrant pain was found to have a retroperitoneal mass at the head of pancreas. Abdominal computed tomography (CT) showed a well-defined, high attenuated (56HU) mass measured of 60 × 50 mm in diameter, that exhibited heterogeneous contrast enhancement throughout the 3 phases.
Neuroendocrine neoplasm was suspected.
Following discussions with the patient, she refused fine needle aspiration cytology; however, she underwent total resection of the mass and had an uneventful clinical course. Histopathological examination showed thyroid tissue with TTF-1 and TGB positivity, and BRAF negativity, indicating a benign variant.
The patient had no signs of relapse with normal thyroid hormone levels after 2 years of follow up.
Ectopic thyroid tissue should be considered when patients present with similar imaging findings in abdomen. We review all reported cases of abdominal ectopic thyroid tissue to provide specific evidence for the diagnosis and treatment of this rare entity.
异位甲状腺常见于颈部区域。腹腔内异位甲状腺极为罕见,胰腺区域仅报道过2例。很少有报告描述腹腔内异位甲状腺的详细影像学表现。
一名73岁女性,右上腹反复疼痛加重,发现胰腺头部有一个腹膜后肿块。腹部计算机断层扫描(CT)显示一个边界清晰、高密度(56HU)的肿块,直径为60×50mm,在三个阶段均表现出不均匀的对比增强。
怀疑为神经内分泌肿瘤。
与患者讨论后,她拒绝了细针穿刺细胞学检查;然而,她接受了肿块的全切除,临床过程顺利。组织病理学检查显示甲状腺组织TTF-1和TGB阳性,BRAF阴性,提示为良性变异。
随访2年后,患者甲状腺激素水平正常,无复发迹象。
当患者腹部出现类似影像学表现时,应考虑异位甲状腺组织。我们回顾了所有报道的腹部异位甲状腺组织病例,为这种罕见疾病的诊断和治疗提供具体依据。