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甲状舌管脂肪瘤:一例罕见病例报告。

Thyroglossal duct lipoma: A rare case report.

作者信息

Tsai Ming-Shao, Chang Geng-He, Chuang Huei-Chieh, Lin Wan-Ni, Tsai Yao-Te

机构信息

Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital.

Health Information and Epidemiology Laboratory of Chiayi Chang Gung Memorial Hospital, Chiayi.

出版信息

Medicine (Baltimore). 2020 May 29;99(22):e20392. doi: 10.1097/MD.0000000000020392.

Abstract

RATIONALE

Thyroglossal duct cyst (TGDC), the most common midline neck mass, has several histological diagnoses other than cyst in the literature. We present the first case of thyroglossal duct lipoma.

PATIENT CONCERNS

A 63-year-old woman presented with a painless soft midline neck mass for more than 3 years, which enlarged in size and caused a lump sensation during swallowing.

DIAGNOSES

Sonography revealed a 3.5 × 3.0 × 3.0-cm homogenous isoechoic oval lesion without an acoustic shadow beyond the thyroid glands. An ultrasound-guided biopsy revealed abundant sheets of fat cells with infiltration of some lymphocytes and histiocytes. Computed tomography revealed a 3.5 × 3.0 × 3.0-cm well-circumscribed ovoid mass with Hounsfield unit (HU) between -50 and -100 and a thyroglossal duct remnant. All these findings supported the diagnosis of thyroglossal duct lipoma.

INTERVENTIONS

The patient underwent Sistrunk operation for excision of the neck tumor, and pathological examination revealed an adipose tumor surrounded by benign thyroid tissue, confirming the diagnosis of thyroglossal duct lipoma.

OUTCOMES

Neither postoperative complication nor recurrence was noted at the 18-month follow-up.

LESSONS

This is the first case of thyroglossal duct lipoma in the literature. Our study extends the disease spectrum of thyroglossal duct mass and suggests that clinicians should consider thyroglossal duct lipoma in the differential diagnosis of a midline neck mass.

摘要

原理

甲状舌管囊肿(TGDC)是最常见的颈部中线肿块,文献中除囊肿外还有几种组织学诊断。我们报告首例甲状舌管脂肪瘤病例。

患者情况

一名63岁女性出现无痛性颈部中线软性肿块3年多,肿块大小增大,吞咽时产生肿块感。

诊断

超声检查显示甲状腺外有一个3.5×3.0×3.0厘米的均匀等回声椭圆形病变,无声影。超声引导下活检显示大量脂肪细胞片,伴有一些淋巴细胞和组织细胞浸润。计算机断层扫描显示一个3.5×3.0×3.0厘米边界清晰的卵圆形肿块,亨氏单位(HU)在-50至-100之间,并有甲状舌管残余。所有这些发现均支持甲状舌管脂肪瘤的诊断。

干预措施

患者接受了Sistrunk手术以切除颈部肿瘤,病理检查显示为一个被良性甲状腺组织包围的脂肪性肿瘤,证实了甲状舌管脂肪瘤的诊断。

结果

18个月随访时未发现术后并发症或复发。

经验教训

这是文献中首例甲状舌管脂肪瘤病例。我们的研究扩展了甲状舌管肿块的疾病谱,并提示临床医生在颈部中线肿块的鉴别诊断中应考虑甲状舌管脂肪瘤。

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