Fan Jing-Jing, Chen Qiang
1 Clinical Laboratory, Luoyang No. 1 Hospital of TCM, Luoyang, China.
2 Department of Surgical Oncology, Henan Key Laboratory of Cancer Epigenetics, Cancer Institute, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
J Int Med Res. 2019 Aug;47(8):4039-4042. doi: 10.1177/0300060519862455. Epub 2019 Aug 2.
Thyroid cancer is common in China. Thyroid adenocarcinoma metastases can be local or distal metastasis. Local metastasis presents as a hard and fixed lymph node in the neck, while distant metastases are found in the lung, skull, vertebrae, and pelvis. However, thyroid follicular carcinomas are mostly observed in hematogenous metastases. The thyroid adenocarcinoma and follicular carcinoma of the thyroid gland are often misdiagnosed. Here, we report the case of a 53-year-old female patient. More than 2 years after her initial diagnosis, her left chest wall was physically examined. The results revealed a progressive enlargement that had a hard quality, poor activity, unclear boundary, pressure pain, and percussion pain. Thyroid follicular cell carcinoma was subsequently diagnosed and treated surgically. The thyroid carcinoma had multiple bone metastases, and the thyroid follicular carcinoma had spread to the chest wall through the blood vessels. Thus, preoperative procedures and follow-up should be strengthened because early pathological thyroid follicular carcinoma and thyroid adenoma can easily be misdiagnosed. Pathologic consultation and follow-ups should be strengthened to prevent misdiagnosis.
甲状腺癌在中国很常见。甲状腺腺癌转移可发生局部转移或远处转移。局部转移表现为颈部坚硬、固定的淋巴结,而远处转移则见于肺、颅骨、椎骨和骨盆。然而,甲状腺滤泡癌大多表现为血行转移。甲状腺腺癌和甲状腺滤泡癌常被误诊。在此,我们报告一例53岁女性患者的病例。在她初次诊断超过2年后,对其左胸壁进行体格检查。结果显示有进行性肿大,质地坚硬,活动度差,边界不清,压痛和叩击痛。随后诊断为甲状腺滤泡细胞癌并进行了手术治疗。该甲状腺癌有多处骨转移,甲状腺滤泡癌已通过血管扩散至胸壁。因此,应加强术前检查和随访,因为早期甲状腺滤泡癌和甲状腺腺瘤很容易被误诊。应加强病理会诊和随访以防止误诊。