Ruano Campos Adriana, Rivera Alonso Daniel, Ochagavía Cámara Santiago
MD, Hospital Clínico San Carlos, Surgery Department, Complutense University of Madrid, Madrid, Spain.
Pol Przegl Chir. 2019 Jul 16;92(1):52-54. doi: 10.5604/01.3001.0013.2952.
Differential diagnosis of a cervical lesion corresponding with papillary thyroid carcinoma (PTC) after benign total thyroidectomy can be a real challenge.
A cervical thyroid remnant compatible with papillary carcinoma was incidentally found ten years after total thyroidectomy for a non-functional multinodular goitre. Histological analysis of fine needle puncture aspiration (FNPA) was highly suggestive for PTC. Surgical excision of the cervical lesion was performed. Specimen study demonstrated a classic variant of PTC contacting a peripheral margin, applying ablative treatment with radioactive iodine postoperatively.
The patient did not present signs of recurrence during follow-up. Small thyroid remnants after benign thyroidectomy are often left behind, although their risk of malignancy is exceptional.
It is important to individualize therapeutic approach when facing this rare entity. We decided to treat the patient by removing the lesion followed by ablation therapy with successful results. PTC: Papillary thyroid carcinoma FNPA: Fine needle puncture aspiration.
在良性甲状腺全切除术后，对与甲状腺乳头状癌（PTC）相符的颈部病变进行鉴别诊断可能是一项真正的挑战。
在因非功能性多结节性甲状腺肿行甲状腺全切除术后十年，偶然发现一个与乳头状癌相符的颈部甲状腺残余组织。细针穿刺抽吸（FNPA）的组织学分析高度提示为PTC。对颈部病变进行了手术切除。标本研究显示为PTC的一种经典变体，其与周边边缘接触，术后应用放射性碘进行消融治疗。
患者在随访期间未出现复发迹象。良性甲状腺切除术后的小甲状腺残余组织通常会残留，尽管其恶变风险极低。
面对这种罕见情况时，个体化治疗方法很重要。我们决定通过切除病变然后进行消融治疗来治疗该患者，结果成功。PTC：甲状腺乳头状癌；FNPA：细针穿刺抽吸
