Yumoto Shinsei, Baba Yoshifumi, Nomoto Daichi, Oozono Kazutaka, Eto Kojiro, Hiyoshi Yukiharu, Nagai Yohei, Iwatsuki Masaaki, Iwagami Shiro, Miyamoto Yuji, Yoshida Naoya, Mikami Yoshiki, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Department of Diagnostic Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Surg Case Rep. 2019 Aug 30;5(1):137. doi: 10.1186/s40792-019-0695-5.
The incidence of metastatic spread of gastrointestinal malignancies to the thyroid gland is relatively low and most of these malignancies originate from the colorectum. Thyroid metastasis originating from the esophagus is poorly documented.
A 79-year-old man presented with hoarseness of voice and swallowing difficulty. Eighteen months earlier, he had undergone preoperative chemotherapy (S-1 and oxaliplatin [SOX] therapy) and subtotal esophagectomy with regional lymph nodes dissection and retrosternal narrow gastric tube reconstruction for advanced Barrett's esophageal adenocarcinoma. In the ultrasonographic examination, there was a hypoechoic, indistinct border and heterogeneous nodule in the left lobe of the thyroid gland. Pathological examination of an ultrasound-guided fine-needle aspiration showed adenocarcinoma, supporting a diagnosis of esophageal adenocarcinoma metastases in the thyroid.
This is a first case of a patient with thyroid metastasis from Barrett's esophageal adenocarcinoma after subtotal esophagectomy.
胃肠道恶性肿瘤转移至甲状腺的发生率相对较低,且这些恶性肿瘤大多起源于结肠直肠。食管来源的甲状腺转移报道较少。
一名79岁男性因声音嘶哑和吞咽困难就诊。18个月前,他因晚期巴雷特食管腺癌接受了术前化疗(S-1和奥沙利铂[SOX]方案)、食管次全切除术及区域淋巴结清扫术,并进行了胸骨后狭窄胃管重建术。超声检查发现甲状腺左叶有一个低回声、边界不清且内部回声不均匀的结节。超声引导下细针穿刺病理检查显示为腺癌,支持甲状腺转移性腺癌为食管腺癌转移的诊断。
这是首例食管次全切除术后巴雷特食管腺癌发生甲状腺转移的病例。