Reese James, Chebolu Apoorv, Shen YouJun, Mihlon Frank
Department of Radiology, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501, USA.
Hampton Roads Radiology Associates, Norfolk, VA, USA.
Radiol Case Rep. 2017 Dec 18;13(1):108-111. doi: 10.1016/j.radcr.2017.10.020. eCollection 2018 Feb.
We report a patient who suffered from esophageal cancer that metastasized to the thyroid. There are only a handful of cases of esophageal cancer with metastases to the thyroid reported in the literature. To our knowledge, this is the first with a diffusely infiltrative pattern (the others were focal masses/nodules). This diffusely infiltrative pattern of metastatic disease is important for radiologists to be aware of because it is particularly difficult to detect and is not characteristically neoplastic by pattern. A diffuse parenchymal abnormality that is bilaterally symmetric is more commonly associated with non-neoplastic diffuse thyroid disease, such as autoimmune thyroid diseases (eg, Graves' disease). As such, in addition to the more common non-neoplastic differential diagnoses associated with diffuse thyroid disease, a diffuse thyroid parenchymal abnormality in a patient with a history of esophageal carcinoma should raise the question of diffuse metastatic infiltration.
我们报告了一名患有转移性甲状腺癌的食管癌患者。文献中仅报道了少数几例食管癌转移至甲状腺的病例。据我们所知，这是首例呈现弥漫浸润性模式的病例（其他病例为局灶性肿块/结节）。转移性疾病的这种弥漫浸润性模式对放射科医生来说很重要，需要加以认识，因为它特别难以检测，且从影像模式上看并无典型的肿瘤特征。双侧对称的弥漫性实质异常更常见于非肿瘤性弥漫性甲状腺疾病，如自身免疫性甲状腺疾病（如格雷夫斯病）。因此，除了与弥漫性甲状腺疾病相关的更常见的非肿瘤性鉴别诊断外，有食管癌病史的患者出现弥漫性甲状腺实质异常应引发弥漫性转移浸润的疑问。
