Wei Xianfeng, Lin Peng, Zhang Shengchi, Li Li, Wang Wei
Department of Otolaryngology Head and Neck, Tianjin First Central Hospital, Tianjin, China.
Tianjin Institute of Otolaryngology, Tianjin, China.
Gland Surg. 2021 Jan;10(1):386-394. doi: 10.21037/gs-20-601.
We report 2 cases of rare thyroid malignancy: angiosarcoma and myoepithelial carcinoma (MC). Thyroid angiosarcomas (TAS) is extremely rare and comprises less than 1% of primary thyroid cancer worldwide. MC usually presents as a slow-growing painless mass arising in the salivary glands. It has not been reported in the thyroid gland. The first case describes a 59-year-old patient who was admitted to hospital with the discovery of thyroid nodule for 1 month. The tumor thrombus was found in the left internal jugular vein and superior thyroid artery during the operation. Diagnosis of angiosarcoma of the thyroid was based on positive endothelial markers such as thrombomodulin and CD31 after total thyroidectomy. The left internal jugular vein, left recurrent laryngeal nerve and anterior cervical banding muscle were invaded by thyroid tumor. No lymph node metastasis was observed. The patient died after 4 years. The second case describes a 55-year-old woman who presented with the discovery of thyroid nodule for 1 month. Right thyroid lobectomy and right neck lymph node functional dissection were carried out. The results from postoperative pathology revealed that papillary carcinoma in right lobe of thyroid and MC next to thyroid were found. Besides, the metastasis of MC was observed at right II-IV level and right VI level. Five years later, the patient was re-admitted to hospital, primarily due to the discovery of anterior cervical tumor for one year. Then, she underwent left thyroid lobectomy and right tumor resection. Postoperative routine pathology showed recurrent MC in the right thyroid. After surgery and radiotherapy, the patient was followed up for 2 years. Angiosarcoma and myoepithelioma should be kept in mind in diagnosis of thyroid malignant tumor.
我们报告2例罕见的甲状腺恶性肿瘤:血管肉瘤和肌上皮癌(MC)。甲状腺血管肉瘤(TAS)极为罕见,在全球原发性甲状腺癌中占比不到1%。MC通常表现为涎腺出现的生长缓慢的无痛性肿块。甲状腺未见相关报道。首例病例为一名59岁患者,因发现甲状腺结节1个月入院。手术中发现左侧颈内静脉和甲状腺上动脉有肿瘤血栓。全甲状腺切除术后,根据凝血调节蛋白和CD31等内皮标志物阳性诊断为甲状腺血管肉瘤。甲状腺肿瘤侵犯左侧颈内静脉、左侧喉返神经和颈前带状肌。未观察到淋巴结转移。患者4年后死亡。第二例病例为一名55岁女性,因发现甲状腺结节1个月就诊。行右侧甲状腺叶切除术及右侧颈部淋巴结功能性清扫术。术后病理结果显示右侧甲状腺叶乳头状癌及甲状腺旁MC。此外,在右侧II-IV区和右侧VI区观察到MC转移。5年后,患者因发现颈前肿物1年再次入院。随后,她接受了左侧甲状腺叶切除术及右侧肿瘤切除术。术后常规病理显示右侧甲状腺复发性MC。手术及放疗后,对患者进行了2年随访。在诊断甲状腺恶性肿瘤时应考虑血管肉瘤和肌上皮瘤。