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右锁骨上窝副神经节瘤:误诊为甲状腺肿物。

A Paraganglioma in the Right Supraclavicular Fossa: Mistaken for a Thyroid Mass.

作者信息

Nikolopoulos Elias, Ploumidou Katherine, Sourla Antigoni, Kittas Christos

机构信息

Department of Otolaryngology, Head and Neck Surgery, Omilos Iatrikou Athinon, Athens, GRC.

Department of Otolaryngology, Children's Hospital Aglaia Kiriakou, Athens, GRC.

出版信息

Cureus. 2021 Mar 8;13(3):e13773. doi: 10.7759/cureus.13773.

Abstract

Paragangliomas are rare lesions of the endocrine system that can be treated either by embolization preoperatively followed by surgical excision or by surgical excision or radiotherapy. In this report, we present an extremely rare location of a nonfunctional paraganglioma in the head and neck region, located in the right supraclavicular fossa, which was misdiagnosed as a thyroid tumor, in a 72-year-old female patient. Imaging revealed a 2.5 × 4.5 × 2 cm well-defined vascularized mass. Fine-needle aspiration (FNA) on the tumor was not diagnostic initially; however, a third attempt revealed thyroid cells suggesting the existence of an ectopic thyroid tumor. FNA was additionally performed on the right thyroid lobe, revealing atypical follicular colloid cells of the Bethesda 3 category. Therefore, the excision of the ectopic thyroid tumor along with right lobectomy was planned. No embolization was initiated preoperatively in this case. Histopathology revealed that the supraclavicular mass was a paraganglioma. Paragangliomas supplied by the subclavian, innominate, and common carotid artery are rarely reported, and to our knowledge, this is the third case to be reported worldwide.

摘要

副神经节瘤是内分泌系统的罕见病变,可通过术前栓塞后手术切除、手术切除或放射治疗来治疗。在本报告中,我们介绍了一名72岁女性患者,其头颈部区域出现了一个极其罕见的无功能副神经节瘤,位于右锁骨上窝,最初被误诊为甲状腺肿瘤。影像学检查显示一个2.5×4.5×2厘米边界清晰的血管化肿块。对该肿瘤进行细针穿刺抽吸(FNA)最初未能明确诊断;然而,第三次穿刺发现了甲状腺细胞,提示存在异位甲状腺肿瘤。此外,对右侧甲状腺叶进行了FNA,结果显示为贝塞斯达3类非典型滤泡胶体细胞。因此,计划切除异位甲状腺肿瘤并进行右侧甲状腺叶切除术。该病例术前未进行栓塞治疗。组织病理学检查显示,锁骨上肿块为副神经节瘤。由锁骨下动脉、无名动脉和颈总动脉供血的副神经节瘤很少见,据我们所知,这是全球第三例报告的此类病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2db2/8027543/9a9a68fe290a/cureus-0013-00000013773-i01.jpg

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