Subha Sethu T, Bakri Mohd-Adzreil, Salleh Hisyam, Doi Mohamad, Nordin Abdul-Jalil
Department of Otorhinolaryngology, Faculty of Medicine & Health Sciences, University Putra Malaysia, Selangor, Malaysia.
Department of Otorhinolaryngology, Hospital Serdang, Selangor, Malaysia.
Iran J Otorhinolaryngol. 2018 Jan;30(96):49-54.
Papillary thyroid carcinoma (PTC) constitutes 75-85% of all thyroid cancers. PTC usually presents as a subtle, commonly slow-growing, painless thyroid mass or a solitary nodule in the neck. This presentation of a cystic neck lump, without the presence of a thyroid nodule, may imitate the course of a benign disease, thus delaying diagnosis and proper treatment.
Three cases that had been initially presented as a cystic neck lesion in which a benign etiology was considered primarily were compiled in this study. PTC was only diagnosed after surgical excision of these cystic neck lesions in the first two cases, and after performing fine needle aspiration cytology (FNAC) and an 18fluorine-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET CT) scan in the latter case.
PTC can sometimes present as a cystic neck mass; a presentation which is usually related to a benign lesion. This case series emphasizes that patients who appear to have a solitary cystic neck mass must be treated with a high index of clinical suspicion. Although not a first-line imaging modality, 18F-FDG-PET can be extremely useful in assessing patients with a cystic neck lesion, where diagnosis is still uncertain after standard investigations such as ultrasonography and FNAC have been performed.
甲状腺乳头状癌（PTC）占所有甲状腺癌的75 - 85%。PTC通常表现为隐匿性、通常生长缓慢、无痛性的甲状腺肿块或颈部孤立性结节。这种颈部囊性肿块的表现，若不存在甲状腺结节，可能类似良性疾病的病程，从而延误诊断和恰当治疗。
本研究汇总了3例最初表现为颈部囊性病变且起初主要考虑为良性病因的病例。在前两例中，仅在手术切除这些颈部囊性病变后才诊断出PTC，在后一例中则是在进行细针穿刺细胞学检查（FNAC）及18氟 - 氟脱氧葡萄糖正电子发射断层扫描计算机断层扫描（18F - FDG - PET CT）后才确诊。
PTC有时可表现为颈部囊性肿块；这种表现通常与良性病变相关。本病例系列强调，对于看似有孤立性颈部囊性肿块的患者，必须高度怀疑并进行临床评估。虽然18F - FDG - PET并非一线成像方式，但在评估颈部囊性病变患者时极为有用，尤其是在诸如超声检查和FNAC等标准检查后诊断仍不明确的情况下。
