原发性甲状腺间叶肿瘤的诊断与治疗综合指南。
Comprehensive guidance on the diagnosis and management of primary mesenchymal tumours of the thyroid gland.
机构信息
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH, USA.
出版信息
Lancet Oncol. 2020 Nov;21(11):e528-e537. doi: 10.1016/S1470-2045(20)30332-6.
Most primary thyroid tumours are of epithelial origin. Primary thyroid mesenchymal tumours are rare but are being increasingly detected. A vast majority of thyroid mesenchymal tumours occur between the fourth and seventh decades of life, presenting as progressively enlarging thyroid nodules that often yield non-diagnostic results or spindle cells on fine needle aspiration biopsy. Surgery is the preferred mode of treatment, with adjuvant chemoradiotherapy used for malignant thyroid mesenchymal tumours. Benign thyroid mesenchymal tumours have excellent prognosis, whereas the outcome of malignant thyroid mesenchymal tumours is variable. Each thyroid mesenchymal tumour is characterised by its unique histopathology and immunohistochemistry. Because of the rarity and aggressive nature of malignant thyroid mesenchymal tumours, a multidisciplinary team-based approach should ideally be used in the management of these tumours. Comprehensive guidelines on the management of thyroid mesenchymal tumours are currently lacking. In this Review, we provide a detailed description of thyroid mesenchymal tumours, their clinical characteristics and tumour behaviour, and provide recommendations for the optimal management of these tumours.
大多数原发性甲状腺肿瘤来源于上皮组织。原发性甲状腺间叶组织肿瘤较为罕见，但检出率逐渐增高。绝大多数甲状腺间叶组织肿瘤发生于 40 岁至 70 岁之间，表现为逐渐增大的甲状腺结节，常导致细针抽吸活检结果不明确或出现梭形细胞。手术是首选的治疗方式，恶性甲状腺间叶组织肿瘤还需要辅助放化疗。良性甲状腺间叶组织肿瘤预后良好，而恶性甲状腺间叶组织肿瘤的预后存在差异。每种甲状腺间叶组织肿瘤都具有独特的组织病理学和免疫组织化学特征。由于恶性甲状腺间叶组织肿瘤较为罕见且侵袭性较强，这些肿瘤的治疗最好采用多学科团队方法。目前，关于甲状腺间叶组织肿瘤的管理尚无综合指南。在这篇综述中，我们详细描述了甲状腺间叶组织肿瘤的临床特征和肿瘤行为，并为这些肿瘤的最佳治疗方法提供了建议。
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