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经内镜超声引导下细针穿刺活检术前诊断甲状腺乳头状癌胰腺转移:1例病例报告并文献复习

Pancreatic metastasis of papillary thyroid carcinoma preoperatively diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report with review of literatures.

作者信息

Murakami Yuko, Shimura Tatsuo, Okada Ryo, Kofunato Yasuhide, Ishigame Teruhide, Yashima Rei, Nakano Keiichi, Suzuki Shinichi, Takenoshita Seiichi

机构信息

Department of Organ Regulatory Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.

Department of Thyroid and Endocrinology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.

出版信息

Clin J Gastroenterol. 2018 Dec;11(6):521-529. doi: 10.1007/s12328-018-0875-z. Epub 2018 Jun 8.

Abstract

Pancreatic metastatic tumors from thyroid carcinoma are extremely rare. We report a case of an 80-year-old female with a pancreatic metastatic tumor derived from papillary thyroid carcinoma which was initially resected 158 months prior to detection of the metastatic pancreatic tumor. The patient has encountered cervical lymph-node metastasis on three occasions following the initial operation. Metastatic pancreatic lesions and cervical lymph nodes were first detected using 18-fluorodeoxyglucose positron-emission tomography/computed tomography, and she was preoperatively diagnosed using endoscopic ultrasound-guided fine-needle aspiration biopsy. A coin lesion, 10 mm in size, was detected in the left lung by chest computed tomography with no abnormal uptake in 18-fluorodeoxyglucose positron-emission tomography/computed tomography. Distal pancreatectomy and cervical lymph-node dissection were performed. Adjuvant chemotherapy with weekly paclitaxel was administered because anaplastic transformation had been detected in one of the cervical lymph nodes. The patient eventually died from multiple lung metastases 11 months after removing the metastatic pancreatic lesion. We reported a rare case of a pancreatic metastatic tumor from thyroid carcinoma, and found that 18-fluorodeoxyglucose positron-emission tomography/computed tomography and endoscopic ultrasound-guided fine-needle aspiration biopsy are useful for preoperatively diagnosing tumors.

摘要

甲状腺癌胰腺转移瘤极为罕见。我们报告一例80岁女性,其胰腺转移瘤源自甲状腺乳头状癌,该转移瘤在最初切除原发肿瘤158个月后才被发现。患者在初次手术后曾三次出现颈部淋巴结转移。首先通过18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)检测到胰腺转移灶和颈部淋巴结转移,随后通过超声内镜引导下细针穿刺活检进行术前诊断。胸部计算机断层扫描在左肺发现一个10毫米大小的硬币样病灶,18F-FDG PET/CT未显示异常摄取。患者接受了胰体尾切除术和颈部淋巴结清扫术。由于在一个颈部淋巴结中检测到间变转化,因此给予每周一次紫杉醇的辅助化疗。患者在切除胰腺转移灶11个月后最终死于多发肺转移。我们报告了一例罕见的甲状腺癌胰腺转移瘤病例,并发现18F-FDG PET/CT和超声内镜引导下细针穿刺活检有助于术前肿瘤诊断。

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