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病例报告:伴有甲状腺功能亢进和胸骨后甲状腺肿的McCune-Albright综合征的外科治疗:一例病例报告及文献综述

Case report: Surgical treatment of McCune-Albright syndrome with hyperthyroidism and retrosternal goiter: A case report and literature review.

作者信息

Xing Zhiwei, Tao Gongshuai, Pan Wanwan, Wu Delin, Pan Tingting, Wan Lingfeng, Ma Xiaopeng, Wang Yangyi

机构信息

Graduate School, Wannan Medical College, Wuhu, China.

Department of Thyroid and Breast Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.

出版信息

Front Surg. 2023 Jan 6;9:921427. doi: 10.3389/fsurg.2022.921427. eCollection 2022.

Abstract

INTRODUCTION

McCune-Albright syndrome (MAS) is a low-incidence syndrome consisting of the clinical triad of fibrous structural dysplasia of bone, endocrine disease, and skin pigmentation. Thyroid dysfunction is the second most common endocrine dysregulation in MAS. However, there are no treatment guidelines for MAS complicated with hyperthyroidism. Notably, no case of MAS complicated with retrosternal goiter and hyperthyroidism has been reported to our knowledge.

CASE PRESENTATION

We report a 27-year-old man with MAS who developed the typical triad of bone fibrous dysplasia, skin pigmentation and hyperthyroidism, complaining of recent fast-growing neck mass and difficulty in breathing. Hyperthyrodism was under control by Thiamazole, and computed tomography showed an enlarged thyroid extending retrosternally. We performed a total thyroidectomy on the patient. At the 1-year follow-up, the patient's dyspnea, hyperthyroidism, and bone pain were all significantly alleviated.

REVIEW

We searched the literature for previous case reports concerning MAS patients complicated with thyroid dysregulation. A total of 17 articles and 22 patients were identified to form our database. Among them, 9 studies clearly mentioned surgical intervention in 11 patients, and prognoses were also reported. Surgery was the most common intervention chosen and indicated a satisfactory prognosis.

CONCLUSION

We report a rare case of MAS patient complicated with retrosternal goiter and hyperthyroidism. Our review provides an overview of MAS cases requiring interventions on thyroid function, and total thyroidectomy should be a proper treatment for these patients.

摘要

引言

McCune-Albright综合征(MAS)是一种发病率较低的综合征,由骨纤维结构发育不良、内分泌疾病和皮肤色素沉着三联征组成。甲状腺功能障碍是MAS中第二常见的内分泌失调。然而,目前尚无针对MAS合并甲状腺功能亢进的治疗指南。值得注意的是,据我们所知,尚未有MAS合并胸骨后甲状腺肿和甲状腺功能亢进的病例报道。

病例报告

我们报告一例27岁患有MAS的男性患者,出现了骨纤维发育不良、皮肤色素沉着和甲状腺功能亢进的典型三联征,主诉近期颈部肿物生长迅速且呼吸困难。甲巯咪唑控制了甲状腺功能亢进,计算机断层扫描显示甲状腺肿大并延伸至胸骨后。我们对该患者实施了甲状腺全切除术。在1年的随访中,患者的呼吸困难、甲状腺功能亢进和骨痛均明显缓解。

文献回顾

我们检索了有关MAS合并甲状腺功能失调患者的既往病例报告。共识别出17篇文章和22例患者以形成我们的数据库。其中,9项研究明确提及了对11例患者的手术干预,并报告了预后情况。手术是最常选择的干预方式,且预后良好。

结论

我们报告了一例罕见的MAS患者合并胸骨后甲状腺肿和甲状腺功能亢进的病例。我们的文献回顾提供了对需要干预甲状腺功能的MAS病例的概述,甲状腺全切除术应是这些患者的合适治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad5a/9852710/eb944fc7c8fb/fsurg-09-921427-g001.jpg

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