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[卵巢甲状腺肿中的甲状腺癌:诊断与治疗]

[Thyroid carcinoma on struma ovarii: Diagnosis and treatment].

作者信息

Lebreton Coriolan, Al Ghuzlan Abir, Floquet Anne, Kind Michèle, Leboulleux Sophie, Godbert Yann

机构信息

Institut Bergonié, département d'oncologie médicale, 229, cours de l'Argonne, 33076 Bordeaux, France.

Institut Gustave-Roussy, service d'anatomopathologie, 114, rue Édouard-Vaillant, 94805 Villejuif, France.

出版信息

Bull Cancer. 2018 Mar;105(3):281-289. doi: 10.1016/j.bulcan.2017.11.014. Epub 2018 Feb 17.

Abstract

Thyroid carcinoma on struma ovarii (TCSO) is a rare ovarian tumour, derivate from monodermic teratomas. It represents about 0.01% of overall ovarian tumours and 5 to 10% of struma ovarii. The diagnosis is histologic and retrospective after pelvic surgery; radiographic imaging being unspecific. Because of its rarity, the treatment of TCSO is not consensual and should be validated in multidisciplinary team involved in rare ovarian carcinoma. The first treatment is a surgical removal, with a laparoscopic approach. A fertility-conservative surgery is recommended for young women. If the tumour is unresectable and/or with metastatic spread, an adjuvant iodine 131 treatment might be proposed after thyroidectomy. Recurrence of TCSO should be taken care of as a thyroid carcinoma with tyrosine kinase inhibitor in case of progressive distant relapse, refractory to iodine 131 treatment. If the recurrence is localised, a complete surgery is the preferred option. There is no gold standard for the follow up.

摘要

卵巢甲状腺肿合并甲状腺癌(TCSO)是一种罕见的卵巢肿瘤,源自单胚层畸胎瘤。它约占卵巢肿瘤总数的0.01%,占卵巢甲状腺肿的5%至10%。诊断需在盆腔手术后进行组织学检查且为回顾性诊断;影像学检查不具有特异性。由于其罕见性,TCSO的治疗尚无共识,应由参与罕见卵巢癌治疗的多学科团队进行验证。首选治疗方法是手术切除,采用腹腔镜手术方式。对于年轻女性,建议进行保留生育功能的手术。如果肿瘤无法切除和/或有转移扩散,甲状腺切除术后可能建议进行辅助碘131治疗。对于TCSO复发,如果远处复发进展且对碘131治疗耐药,应像治疗甲状腺癌一样使用酪氨酸激酶抑制剂进行处理。如果复发局限,首选彻底手术。随访尚无金标准。

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