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以气道阻塞为主要表现的婴儿甲状腺血管瘤。

Airway obstruction as the primary manifestation of infantile thyroid hemangioma.

机构信息

Department of Pediatric, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P. R. China.

Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P. R. China.

出版信息

Ital J Pediatr. 2020 Oct 19;46(1):157. doi: 10.1186/s13052-020-00904-6.

Abstract

BACKGROUND

Thyroid hemangioma mostly occurs in adults and is extremely rare in infants. So far, only four pediatric cases of thyroid hemangioma have been reported, one of which has only been clinically diagnosed. Most of the reported cases are of cavernous hemangiomas; capillary hemangioma cases are very rare. To date, there are no reports on capillary thyroid hemangioma in an infant. Therefore, here we present the case of an infant with a primary capillary hemangioma of the thyroid gland, and discuss its treatment and follow-up.

CASE PRESENTATION

A2-month-old infant with normal thyroid function presented with airway obstruction as the primary manifestation of thyroid hemangioma. The main symptoms were laryngeal wheezing and dyspnea. Ultrasonography revealed hypoechoic lesions at the lower pole of the bilateral thyroid. Computed tomography revealed enlargement of the thyroid gland, inhomogeneous parenchyma enhancement, and multiple thyroid nodules. However, these imaging modalities were unable to provide an exact diagnosis and the nature of the mass remained unknown prior to an operation. Therefore, a postoperative histopathological examination was undertaken, which revealed capillary thyroid hemangioma. The symptoms significantly improved by a combined treatment involving surgery and oral propranolol.

CONCLUSION

When a well-defined capsulate mass is detected on the medical image, the possibility of primary thyroid hemangioma must be considered.

摘要

背景

甲状腺血管瘤多发生于成人,在婴儿中极为罕见。迄今为止,仅报道过 4 例小儿甲状腺血管瘤病例,其中仅 1 例为临床诊断。大多数报道的病例为海绵状血管瘤;毛细血管状血管瘤病例非常罕见。到目前为止,尚未有婴儿毛细甲状腺血管瘤的报道。因此,我们在此介绍 1 例婴儿原发性甲状腺毛细血管瘤病例,并讨论其治疗和随访。

病例介绍

一名 2 个月大的婴儿,甲状腺功能正常,以甲状腺血管瘤导致的气道阻塞为主要表现。主要症状为喉喘鸣和呼吸困难。超声检查显示双侧甲状腺下极低回声病变。计算机断层扫描显示甲状腺肿大,实质不均匀增强,多个甲状腺结节。然而,这些影像学检查无法提供明确的诊断,在手术前肿块的性质仍不清楚。因此,进行了术后组织病理学检查,结果显示为毛细甲状腺血管瘤。手术联合口服普萘洛尔治疗后,症状明显改善。

结论

当在影像学检查上发现界限清楚的包被性肿块时,必须考虑原发性甲状腺血管瘤的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a8e/7574318/4711f1b91c87/13052_2020_904_Fig1_HTML.jpg

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