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直肠癌孤立性甲状腺转移:一例报告并文献复习

Solitary thyroid gland metastasis from rectal cancer: A case report and review of the literature.

作者信息

Chen Ying, Kang Qing-Song, Zheng Yan, Li Fei-Bo

机构信息

Second Department of General Surgery, Zhejiang Putuo Hospital, Zhoushan 316100, Zhejiang Province, China.

出版信息

World J Clin Cases. 2023 Jun 26;11(18):4360-4367. doi: 10.12998/wjcc.v11.i18.4360.

Abstract

BACKGROUND

Metastatic carcinoma of the thyroid gland is a rare encounter in clinical practice, but autopsy series showed that it is not so rare. Thyroid metastasis from colorectal cancer (CRC) is rare and has a poor prognosis. We herein report a rare case of solitary thyroid metastasis from rectal cancer combined with needle tract implantation after fine-needle aspiration (FNA) of the thyroid nodule and review the relevant literature.

CASE SUMMARY

A 54-year-old woman with a history of TNM stage III CRC presented a 1.3 cm × 1.0 cm mass in the left thyroid gland. FNA and histological examination of the left thyroid lobe surgical specimen confirmed the diagnosis of isolated metastatic adenocarcinoma from the rectum. Needle tract implantation was observed in the neck 11 mo after the FNA examination. The 2.5-cm seeding lesion was successfully removed by surgery, and the patient recovered well. The literature relevant to this clinical condition, the diagnostic workup, spread pathway, and surgical management of these rare lesions is reviewed.

CONCLUSION

For a patient with a thyroid mass and a history of CRC, metastatic thyroid carcinoma should be considered even if the patient has no evidence of other organ metastasis from CRC. FNA cytological examination of the thyroid mass is useful in the differential diagnosis between primary thyroid disease and metastatic thyroid carcinoma. Thyroid lobectomy of the gland containing the metastatic tumor is suggested in patients with metastatic carcinoma of the thyroid.

摘要

背景

甲状腺转移性癌在临床实践中较为罕见,但尸检系列研究表明其并非如此罕见。结直肠癌(CRC)的甲状腺转移罕见且预后较差。我们在此报告一例罕见的直肠癌孤立性甲状腺转移病例,该病例在甲状腺结节细针穿刺抽吸(FNA)后合并针道种植,并对相关文献进行复习。

病例摘要

一名有TNM III期CRC病史的54岁女性,左侧甲状腺出现一个1.3 cm×1.0 cm的肿块。FNA及左侧甲状腺叶手术标本的组织学检查确诊为来自直肠的孤立性转移性腺癌。FNA检查11个月后在颈部观察到针道种植。通过手术成功切除了2.5 cm的种植性病变,患者恢复良好。本文对与该临床情况相关的文献、这些罕见病变的诊断检查、传播途径及手术管理进行了复习。

结论

对于有甲状腺肿块且有CRC病史的患者,即使没有CRC其他器官转移的证据,也应考虑甲状腺转移性癌。甲状腺肿块的FNA细胞学检查有助于原发性甲状腺疾病与甲状腺转移性癌的鉴别诊断。对于甲状腺转移性癌患者,建议对包含转移瘤的腺叶进行甲状腺叶切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96d0/10336986/0ef273a70fb9/WJCC-11-4360-g001.jpg

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