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子宫颈鳞状细胞癌转移至甲状腺:一例报告

Squamous cell carcinoma of the uterine cervix metastasising to the thyroid gland: a case report.

作者信息

Ravindrakumar Sanjeevan, Thalahitiyage Nanduni, Harivallavan Nagenthiram, Jayarajah Umesh, Rodrigo Vitharanage Srimantha Dewsiri

机构信息

Department of Surgery, District General Hospital Chilaw, Putlam, Chilaw, Sri Lanka.

出版信息

Surg Case Rep. 2021 Dec 15;7(1):255. doi: 10.1186/s40792-021-01341-1.

Abstract

BACKGROUND

Carcinoma of the uterine cervix (cervical cancer) metastasising to the thyroid gland is a rare phenomenon and only a few cases have been reported. We discuss a patient with cervical cancer presenting with thyroid and cervical lymph node metastasis, exploring the diagnostic difficulty, evaluation and treatment options.

CASE PRESENTATION

A previously well 56-year-old female presented with multiple neck lumps for 4 months duration. Examination of the neck revealed multiple firm/hard left cervical lymph nodes with a hard thyroid nodule. There were no abdominal masses however, vaginal examination revealed a hard, unhealthy cervix. Contrast enhanced computed tomography revealed a growth in the uterine cervix with lymph node enlargement in the abdomen, chest and neck along with multiple thyroid nodules. Biopsy of the cervix and cervical lymph node and fine needle aspiration cytology of the thyroid nodules were performed, all revealing a squamous cell carcinoma. Pan-endoscopy performed to rule out any concurrent cancer of the upper aerodigestive tract was negative. The patient was started on palliative therapy, but succumbed to the disease after 6 months.

DISCUSSION AND CONCLUSION

Patients who present with a thyroid nodule along with multiple cervical lymph nodes should be thoroughly assessed for possible metastatic cancers. Metastasis to the thyroid gland indicates a poor prognosis in the background of carcinoma or the uterine cervix. More awareness among the public and primary care providers is necessary regarding freely available screening programmes for early detection of cervical cancer.

摘要

背景

子宫颈癌转移至甲状腺是一种罕见现象,仅有少数病例报道。我们讨论一例子宫颈癌患者出现甲状腺及颈部淋巴结转移的情况,探讨其诊断难点、评估及治疗方案。

病例介绍

一名56岁既往健康的女性,出现多个颈部肿块4个月。颈部检查发现左侧多个质地硬/坚硬的颈部淋巴结及一个坚硬的甲状腺结节。未触及腹部肿块,然而,阴道检查发现宫颈硬且不健康。增强计算机断层扫描显示子宫颈有肿物,腹部、胸部及颈部淋巴结肿大,同时还有多个甲状腺结节。对宫颈及颈部淋巴结进行活检,对甲状腺结节进行细针穿刺细胞学检查,结果均显示为鳞状细胞癌。为排除上消化道同时存在的癌症而进行的全内镜检查结果为阴性。患者开始接受姑息治疗,但6个月后死于该疾病。

讨论与结论

出现甲状腺结节及多个颈部淋巴结的患者应全面评估是否存在可能的转移性癌症。在子宫颈癌背景下,转移至甲状腺提示预后不良。公众及基层医疗服务提供者需要更多地了解可免费获得的宫颈癌筛查项目,以便早期发现宫颈癌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b87/8674393/ad5b0fc40ec2/40792_2021_1341_Fig1_HTML.jpg

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