Raveendran Nair Anila Kunjulekshmi Amma, George Nebu A, Kumar Rejnish, Sreekumar A, Jayasree K
Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Indian J Pathol Microbiol. 2018 Apr-Jun;61(2):242-244. doi: 10.4103/IJPM.IJPM_169_17.
A 58-year-old female, a known diabetic and hypertensive, presented with left-sided swelling on the anterior aspect of the neck of 1-year duration, which was rapidly increasing in size for the past 6 months. She was on Eltroxin for hypothyroidism for the past 1 year. Computed tomography study of the neck showed a nodule in the left lobe of thyroid which on fine-needle aspiration was suspicious for malignancy. Total thyroidectomy with left posterolateral lymph node dissection was done. Histopathological examination showed sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) of the thyroid gland with lymph node metastasis. SMECE of the thyroid was initially thought to be a low-grade malignancy with indolent clinical behavior. However, our case showed extra thyroidal spread with lymph node metastasis, necessitating adjuvant therapy for our patient. Such aggressive behavior has been noted in few earlier case reports also.
一名58岁女性，已知患有糖尿病和高血压，颈部前方左侧肿胀1年，在过去6个月中大小迅速增加。她在过去1年中因甲状腺功能减退服用左甲状腺素。颈部计算机断层扫描显示甲状腺左叶有一个结节，细针穿刺怀疑为恶性。进行了全甲状腺切除术及左后外侧淋巴结清扫术。组织病理学检查显示甲状腺硬化性黏液表皮样癌伴嗜酸性粒细胞增多（SMECE）并有淋巴结转移。甲状腺SMECE最初被认为是一种临床行为惰性的低级别恶性肿瘤。然而，我们的病例显示有甲状腺外扩散和淋巴结转移，因此需要对我们的患者进行辅助治疗。在早期的一些病例报告中也注意到了这种侵袭性的行为。
