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达芬奇机器人辅助切除术治疗腹部异位甲状腺:一例报告及文献复习

Da Vinci robot-assisted resection to treat abdominal ectopic thyroid: a case report and literature review.

作者信息

Zhao Zhanwei, Huang Yun, Zhang Xiliang, Zhao Huibin, Yuan Xinpu, Zhao Qiwen, Zhang Chaojun

机构信息

Department of General Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China.

Department of Pathology, The Sixth Medical Center of PLA General Hospital, Beijing, China.

出版信息

Gland Surg. 2021 Jan;10(1):378-385. doi: 10.21037/gs-20-565.

Abstract

Although ectopic thyroid can be found in thoracic locations, the discovery of abdominal ectopic thyroid is often an accidental event. Moreover, abdominal ectopic thyroid is easily misdiagnosed due to the rarity of these cases and the difficulties in the preoperative diagnosis process. Thus, we aimed to assess the prevalence and features of abdominal ectopic thyroid and to highlight the current knowledge about the clinical characteristics and management of this condition by analyzing a case report of abdominal ectopic thyroid and reviewing the literature. A 70-year-old woman with a 3-year history of gradually increasing abdominal distension in the right lower quadrant of the abdomen was admitted to the hospital. Contrast-enhanced computed tomography (CT) of the abdomen revealed a retroperitoneal mass. The patient underwent Da Vinci robotic surgery, and the retroperitoneal mass was completely resected. Subsequently, the pathologic diagnosis of the mass was ET. The patient had no discomfort or symptoms when she was discharged from the hospital and at the postoperative 1, 3, 6, 9 and 12 months follow-up. The summary of literature review suggested that abdominal ectopic thyroid is still rare although there are some reports. Nonetheless, the cause of abdominal ectopic thyroid is unclear, and abdominal ectopic thyroid has the following characteristics: more common in women than in men, asymptomatic in the majority of the cases, difficult to diagnose, and found by excluding metastasis. Most ectopic thyroid is treated with surgery, and minimally invasive techniques have been increasingly performed. This is the first report on Da Vinci robotic resection for large rare retroperitoneal ET, and this case highlights that ET should be considered when patients present with similar imaging findings in the abdomen.

摘要

尽管异位甲状腺可出现在胸部,但腹部异位甲状腺的发现往往是偶然事件。此外,由于此类病例罕见且术前诊断过程存在困难,腹部异位甲状腺很容易被误诊。因此,我们旨在通过分析一例腹部异位甲状腺病例报告并回顾相关文献,评估腹部异位甲状腺的患病率及特征,突出当前关于该疾病临床特征及治疗的认识。一名70岁女性因右下腹部腹胀逐渐加重3年入院。腹部增强计算机断层扫描(CT)显示腹膜后肿块。患者接受了达芬奇机器人手术,腹膜后肿块被完整切除。随后,肿块的病理诊断为异位甲状腺(ET)。患者出院时及术后1、3、6、9和12个月随访均无不适或症状。文献综述总结表明,尽管有一些报道,但腹部异位甲状腺仍然罕见。然而,腹部异位甲状腺的病因尚不清楚,且腹部异位甲状腺具有以下特点:女性多于男性,大多数病例无症状,难以诊断,通过排除转移发现。大多数异位甲状腺采用手术治疗,微创技术的应用越来越多。这是首例关于达芬奇机器人切除巨大罕见腹膜后异位甲状腺的报告,该病例突出了在腹部出现类似影像学表现的患者中应考虑异位甲状腺的情况。

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