Othman Ramadhan T, Baizeed Azad Mustafa Ahmed, Mohammed Ayad Ahmad
Department of Internal Medicine, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
Department of Dental Basic Sciences, University of Duhok, Kurdistan Region, Iraq.
Int J Surg Case Rep. 2020;70:119-122. doi: 10.1016/j.ijscr.2020.04.064. Epub 2020 May 11.
Squamous cell carcinoma of the thyroid gland is an extremely rare tumor with a very aggressive clinical behavior and poor prognosis. The tumor may arise as a primary tumor within the thyroid gland or as a component of anaplastic or undifferentiated thyroid tumors.
A 70-year-old lady with history of long standing multinodular goiter presented with progressive enlargement of a midline nodule for 3 months which was associated with dyspnea and dry cough. The mass was hard and fixed. The voice was normal, other parts of the general examination were unremarkable. Fine needle aspiration was done for the mass which revealed malignant cells mixed with inflammatory cells. During surgery there was a hard and fixed mass arising from the isthmus of the thyroid gland that was locally invading, complete excision was not possible, debulking was done. Histopathology showed moderately differentiated squamous cell carcinoma of the thyroid gland. The tumor underwent local progression 6 months later and the patient was sent for radiotherapy.
When thyroid tumor is advanced at time of diagnosis, radiotherapy is the main form of treatment which may induce reduction in the size of the tumor and decrease pain, radiotherapy may also be given on neoadjuvant bases which may render resection possible in some patients. The tumor is usually not responsive to chemotherapy. The overall survival is uniformly poor regardless of the primary form of treatment, the median survival of the patients from the time of diagnosis is few months in most cases.
甲状腺鳞状细胞癌是一种极其罕见的肿瘤，具有非常侵袭性的临床行为和较差的预后。该肿瘤可作为甲状腺内的原发性肿瘤出现，也可作为间变性或未分化甲状腺肿瘤的组成部分出现。
一名70岁女性，有长期多结节性甲状腺肿病史，中线结节进行性增大3个月，伴有呼吸困难和干咳。肿块坚硬且固定。声音正常，全身其他检查未见异常。对肿块进行细针穿刺，结果显示恶性细胞与炎性细胞混合。手术中发现甲状腺峡部有一个坚硬且固定的肿块，局部浸润，无法完整切除，仅进行了减瘤手术。组织病理学显示为甲状腺中度分化鳞状细胞癌。6个月后肿瘤出现局部进展，患者接受了放射治疗。
当甲状腺肿瘤在诊断时已处于晚期，放射治疗是主要的治疗方式，可使肿瘤缩小并减轻疼痛，放射治疗也可作为新辅助治疗，使部分患者有可能进行手术切除。该肿瘤通常对化疗无反应。无论采用何种主要治疗方式，总体生存率均较差，大多数情况下，患者从诊断时起的中位生存期为几个月。
