Ning Xinyuan, Hittman Jaimie, Lubek Joshua, Malek Rana
Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, USA.
Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Dec;132(6):e190-e197. doi: 10.1016/j.oooo.2021.06.012. Epub 2021 Jun 21.
The occurrence of 2 synchronous primary cancers of different origin in the head and neck region is rare. The incidence of thyroid carcinoma found during surgical resection of primary oral squamous cell carcinoma (SCCa) is about 0.3% to 1.9% of patients. Because of the rarity of cases, there is no consensus on management. To clarify significance and management of such lesions, we report 13 cases in which incidental thyroid carcinoma was discovered during surgical resection for primary oral SCCa. A total of 1295 cases of head and neck SCCa from a 4-year period were reviewed, of which we found 13 cases of concurrent thyroid malignancy, providing an incidence rate of approximately 1%. Of these patients, 61.5% received a total or hemithyroidectomy and, of those, 62.5% received radioactive iodine for their thyroid carcinoma; 38.4% did not receive treatment for their thyroid malignancy. The mortality rate for this case series was 23%, of which all deaths were attributed to complications from SCCa. There were no cases where mortality was related to the thyroid carcinoma. Overall, this is consistent with the consensus that incidental thyroid carcinoma found during oral SCCa resection is insignificant compared with the aggressiveness of the primary malignancy.
头颈部区域出现两种不同起源的同步原发性癌症很罕见。在原发性口腔鳞状细胞癌（SCCa）手术切除过程中发现甲状腺癌的发生率约为患者的0.3%至1.9%。由于病例罕见，对于其治疗尚无共识。为了阐明此类病变的意义和治疗方法，我们报告了13例在原发性口腔SCCa手术切除过程中偶然发现甲状腺癌的病例。回顾了4年间共1295例头颈部SCCa病例，其中发现13例合并甲状腺恶性肿瘤，发生率约为1%。在这些患者中，61.5%接受了全甲状腺切除术或甲状腺半叶切除术，其中62.5%因甲状腺癌接受了放射性碘治疗；38.4%未对其甲状腺恶性肿瘤进行治疗。该病例系列的死亡率为23%，所有死亡均归因于SCCa的并发症。没有死亡与甲状腺癌相关的病例。总体而言，这与以下共识一致，即在口腔SCCa切除过程中偶然发现的甲状腺癌与原发性恶性肿瘤的侵袭性相比意义不大。
