30 例同步性甲状腺髓样癌和乳头状癌。
Thirty synchronous medullary and papillary thyroid carcinomas.
机构信息
Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
Division of Pathology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
出版信息
Front Endocrinol (Lausanne). 2023 Mar 31;14:1153248. doi: 10.3389/fendo.2023.1153248. eCollection 2023.
SYNOPSIS FOR TABLE OF CONTENTS
An exceptional number of synchronous MTC/PTC in the same thyroid gland is presented. This may be the most numerous case series reported in the literature. Synchronous PTC/MTC in the same thyroid gland were classified into 4 subtypes and the clinical and pathological aspects as well as the results are presented.
BACKGROUND AND OBJECTIVES
The synchronous occurrence of multiple neoplastic processes in the thyroid gland is unusual. We investigated the clinicopathological features of 30 medullary thyroid carcinomas (MTC) in association with papillary (PTC).
METHOD
Retrospective analysis of operated patients for thyroid tumors. Synchronous PTC/MTC in the same thyroid gland were classified into 4 subtypes: (type I) True mixed MTC/PTC, MTC and PTC closely intermingled. (Type II) Collision MTC/PTC, i.e. tumors that meet at the same site, invade each other and appear as a single mass in the thyroid gland, i.e. MTC and PTC merge. (Type III) Synchronous anatomically separate tumors in the same thyroid lobe, i.e. separated from each other by non-tumorous thyroid parenchyma. (Type IV) Synchronous tumors occurring in separate anatomical lobes or in the isthmus. Clinical and pathological data were reviewed. Location: Department of thyroid surgery, China-Japan Union Hospital, Jilin University. Time frame: 14 years (June 2008-November 2022).
RESULTS
Thirty patients were identified with an overall prevalence of 28621 (0.1%). 17 (56.7%) were male, 13 (43.3%) female, mean age 51.3 ± 11.0 years, mean BMI 23.6 ± 3.6kg/m. Mean duration of symptoms was 11.2 ± 18.4 months. Mean calcitonin level was 133.7 ± 196.4 pg/ml. Fine needle aspiration (FNA) was offered in 21 cases: 9 (42.9%) were suspected carcinoma, 9 (42.9%) PTC, 1 (4.8%) MTC, 2 (9.4%) MTC/PTC. Pathology revealed type I 4 (13.3%), type II 2 (6.7%), type III 14 (46.7%), type IV 10 (33.3%). The mean diameter of MTC was 1.6 ± 2.0cm, 18 (60%) were micro-MTC. The mean diameter of PTC was 0.9 ± 1.9 cm, 26 (86.7%) were micro-PTC. In 16 (53.3%) micro-PTC/-MTC occurred in synchronous sequence. Four patients had a recurrence: 2 had to be re-operated due to MTC recurrence, 2 died due to distant metastases (bone, liver).
CONCLUSION
We report an exceptional number of MTC/PTC in the same thyroid gland. This may be the most numerous case series reported in the literature. The clinical and pathological aspects as well as the results are presented.
目录概要
呈现了同一甲状腺中异常数量的同步 MTC/PTC。这可能是文献中报道的最多病例系列。同一甲状腺中的同步 PTC/MTC 分为 4 种亚型，并介绍了其临床和病理特征以及结果。
背景和目的
甲状腺中多种肿瘤同时发生的情况并不常见。我们研究了 30 例与甲状腺髓样癌 (MTC) 相关的甲状腺乳头状癌 (PTC) 的临床病理特征。
方法
回顾性分析甲状腺肿瘤手术患者。同一甲状腺中的同步 PTC/MTC 分为 4 种亚型：(I 型)真正混合的 MTC/PTC，MTC 和 PTC 紧密交织。(II 型)碰撞 MTC/PTC，即肿瘤在同一部位相遇，相互侵犯，在甲状腺内呈现单个肿块，即 MTC 和 PTC 融合。(III 型)同一甲状腺叶内的同步解剖分离肿瘤，即彼此之间由非肿瘤性甲状腺实质分隔。(IV 型)发生在不同解剖叶或峡部的同步肿瘤。回顾性分析了临床和病理数据。地点：吉林大学中日联谊医院甲状腺外科。时间范围：14 年（2008 年 6 月至 2022 年 11 月）。
结果
共发现 30 例患者，总患病率为 28621（0.1%）。17 例（56.7%）为男性，13 例（43.3%）为女性，平均年龄 51.3 ± 11.0 岁，平均 BMI 23.6 ± 3.6kg/m。平均症状持续时间为 11.2 ± 18.4 个月。平均降钙素水平为 133.7 ± 196.4 pg/ml。21 例患者进行了细针穿刺抽吸 (FNA)：9 例（42.9%）疑似癌，9 例（42.9%）PTC，1 例（4.8%）MTC，2 例（9.4%）MTC/PTC。病理显示 I 型 4 例（13.3%），II 型 2 例（6.7%），III 型 14 例（46.7%），IV 型 10 例（33.3%）。MTC 的平均直径为 1.6 ± 2.0cm，18 例（60%）为微 MTC。PTC 的平均直径为 0.9 ± 1.9cm，26 例（86.7%）为微 PTC。16 例（53.3%）微 PTC/-MTC 呈同步序列发生。4 例患者复发：2 例因 MTC 复发而再次手术，2 例因远处转移（骨、肝）死亡。
结论
我们报告了同一甲状腺中异常数量的 MTC/PTC。这可能是文献中报道的最多病例系列。介绍了其临床和病理特征以及结果。
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