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不可触及的复发性乳头状甲状腺癌的金属丝定位切除病例报告及头颈部病理学中金属丝引导切除的讨论

A Case Report of Wire-localised Excision of Impalpable Recurrent Papillary Thyroid Carcinoma and Discussion of Wire-guided Excision in the Head and Neck Pathology.

作者信息

Farrell Eric, B Speaker Richard, O'Driscoll Donal, Skinner Liam

机构信息

Specialist Trainee in ORL HNS, Royal College of Surgeons in Ireland, Dublin, Ireland.

Department of Radiology, University Hospital Waterford, Ireland.

出版信息

Curr Med Imaging. 2023 Aug 8. doi: 10.2174/1573405620666230808161931.

Abstract

INTRODUCTION/BACKGROUND: Wire localisation techniques are used widely for precision surgery in many specialities. This convenient technique has not yet become mainstream in the field of head and neck surgery. With limited space and many vital structures coursing through the head and neck region, pathological nodes that are difficult to palpate can be a challenge for clinicians.

CASE PRESENTATION

A patient with a history of papillary thyroid cancer treated with surgery and radioactive iodine had a single pathological node detected on ultrasound surveillance. An isolated recurrence of papillary thyroid carcinoma was confirmed. An excisional biopsy was performed using ultrasound wire guidance to successfully remove the diseased node with minimal morbidity.

CONCLUSION

Wire-guided lymph node excision biopsy is a safe and effective method that can be applied to multiple pathologies. As of yet, it is not routine practice to employ this technique. Larger studies would increase the generalisability and safety profile of this technique in the head and neck region.

摘要

引言/背景:金属丝定位技术在许多专科的精准手术中被广泛应用。这种便捷技术在头颈外科领域尚未成为主流。由于头颈部区域空间有限且有许多重要结构穿行,难以触及的病理性淋巴结对临床医生来说可能是一项挑战。

病例介绍

一名有乳头状甲状腺癌手术及放射性碘治疗史的患者,在超声监测中发现一个病理性淋巴结。确诊为乳头状甲状腺癌孤立复发。采用超声引导下金属丝定位进行切除活检,成功切除病变淋巴结,且并发症极少。

结论

金属丝引导下淋巴结切除活检是一种安全有效的方法,可应用于多种病理情况。目前,采用该技术并非常规做法。更大规模的研究将提高该技术在头颈部区域的通用性和安全性。

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