14年间共存滤泡性甲状腺癌的自主功能性甲状腺结节的纵向变化。

Longitudinal changes in an autonomously functioning thyroid nodule with coexisting follicular thyroid carcinoma over 14 years.

作者信息

Uchida Taisuke, Yamaguchi Hideki, Kawabata Takayuki, Tanaka Hiroyuki, Kawano Fumiaki, Shimoda Kazuya

机构信息

Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

出版信息

Oxf Med Case Reports. 2022 Apr 19;2022(4):omac041. doi: 10.1093/omcr/omac041. eCollection 2022 Apr.

DOI:10.1093/omcr/omac041

PMID:35464892

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9021971/

Abstract

We present a female patient with autonomously functioning thyroid nodule (AFTN) and coexisting follicular thyroid carcinoma (FTC). At age 21, a left thyroid nodule was incidentally detected on computer tomography (CT) scan. At age 33, she had cervical compression and CT showed the left thyroid nodule had increased in size from 13 to 27 mm. Laboratory investigation showed subclinical hyperthyroidism with positive for anti-thyroid peroxidase antibody and normal level of serum thyroglobulin. Repeated fine needle aspiration cytology diagnosed with follicular neoplasm with Hashimoto's thyroiditis. At age 35, she presented with palpitations due to overt hyperthyroidism. The left thyroid nodule increased in diameter to 33 mm, and thyroid scintigraphy showed elevated uptake in the left thyroid nodule, indicating an AFTN. Thyroidectomy was performed, and the left thyroid nodule was pathologically diagnosed with FTC with capsular invasion. In this case, the longitudinal increase in AFTN size suggested FTC and led to thyroidectomy.

摘要

我们报告一名患有自主功能性甲状腺结节（AFTN）并并存滤泡状甲状腺癌（FTC）的女性患者。21岁时，计算机断层扫描（CT）偶然发现左侧甲状腺结节。33岁时，她出现颈部压迫症状，CT显示左侧甲状腺结节大小从13毫米增大至27毫米。实验室检查显示亚临床甲状腺功能亢进，抗甲状腺过氧化物酶抗体呈阳性，血清甲状腺球蛋白水平正常。重复细针穿刺细胞学检查诊断为伴有桥本甲状腺炎的滤泡性肿瘤。35岁时，她因明显的甲状腺功能亢进出现心悸。左侧甲状腺结节直径增至33毫米，甲状腺闪烁显像显示左侧甲状腺结节摄取增加，提示为AFTN。行甲状腺切除术，左侧甲状腺结节经病理诊断为伴有包膜侵犯的FTC。在这种情况下，AFTN大小的纵向增加提示FTC并导致了甲状腺切除术。