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甲状腺原发性未分化多形性肉瘤:一例报告并文献复习

Primary undifferentiated pleomorphic sarcoma of the thyroid: A case report and review of the literature.

作者信息

Chen Qiang, Huang Qing, Yan Jia-Xin, Li Chao, Lang Jin-Yi

机构信息

Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province Graduate School of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China Department of Pathology Department of Head & Neck Surgery Department of Radiation Oncology, Sichuan Cancer Hospital and Research Institute; Sichuan Cancer Control and Prevention Center, Medical College of Electronic Science and Technology University, Chengdu, Sichuan Province, China.

出版信息

Medicine (Baltimore). 2018 Feb;97(7):e9927. doi: 10.1097/MD.0000000000009927.

Abstract

RATIONALE

Primary undifferentiated pleomorphic sarcoma is extremely rare in the thyroid, and can be easily misdiagnosed as anaplastic thyroid cancer.

PATIENT CONCERNS

We present a case of a 71-year-old woman who presented with a rapidly growing painless mass in the neck.

DIAGNOSES-INTERVENTIONS-OUTCOMES: Computed tomography showed a large hypointense mass with hyperdense areas involving whole of the right lobe of thyroid gland and fine-needle aspiration cytology found a few atypical cells. Surgical exploration was performed subsequently and frozen section showed malignant tumor. Therefore, a total thyroidectomy, central, and bilateral lateral neck dissection were performed and adjuvant radiotherapy of 60 Gy was administered. The patient was alive and had no recurrence at 6-month follow-up.

LESSONS

Although primary undifferentiated pleomorphic sarcoma in the thyroid is extremely rare, patients who presented with a rapidly growing painless mass in the neck should be considered and it is essential to excise the tumor completely as soon as possible.

摘要

理论依据

原发性未分化多形性肉瘤在甲状腺中极为罕见,很容易被误诊为间变性甲状腺癌。

患者情况

我们报告一例71岁女性患者,其颈部出现一个迅速生长的无痛性肿块。

诊断-干预-结果:计算机断层扫描显示一个大的低密度肿块,伴有高密度区域,累及整个甲状腺右叶,细针穿刺细胞学检查发现一些非典型细胞。随后进行了手术探查,冰冻切片显示为恶性肿瘤。因此,实施了全甲状腺切除术、中央区及双侧颈侧区清扫术,并给予60 Gy的辅助放疗。患者在6个月的随访中存活且无复发。

经验教训

尽管甲状腺原发性未分化多形性肉瘤极为罕见,但对于颈部出现迅速生长的无痛性肿块的患者应予以考虑,并且尽快彻底切除肿瘤至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e10d/5839869/bd0ff8fe9f90/medi-97-e9927-g001.jpg

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