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甲状舌管囊肿癌1例罕见病例及文献复习

A Rare Case of Thyroglossal Duct Cyst Cancer and Literature Review.

作者信息

Mittal Ashima, Sandhu Ariel, Chhetri Mamta, Jaiswal Gayatri

机构信息

Department of Endocrinology, Allegheny General Hospital, Pittsburgh, PA 15212, USA.

Department of Pathology, Allegheny General Hospital, Pittsburgh, PA 15212, USA.

出版信息

JCEM Case Rep. 2023 Apr 11;1(2):luad036. doi: 10.1210/jcemcr/luad036. eCollection 2023 Mar.

Abstract

Thyroglossal duct cyst is the most common thyroid developmental abnormality with a prevalence of 7%, but thyroglossal duct cyst cancer is rare. The incidence of thyroglossal duct cyst cancer is about 1%. The diagnosis is limited by low yield on fine-needle aspiration biopsy (FNAB), and most cases are diagnosed after surgery. There is a paucity of data on the utility of thyroglobulin washout for diagnosis of thyroglossal duct cyst cancer, and it has not been mentioned in previous case reports/series. Papillary thyroid cancer is the most common pathology. Preoperative planning is important as the decision about total thyroidectomy with the Sistrunk procedure (excision of the thyroglossal duct cyst, middle part of hyoid bone, and surrounding tissue around the thyroglossal tract) depends on the presence of clinical or radiological thyroid abnormality. Thyroglossal duct cyst cancer has an excellent prognosis. However, owing to a lack of standard of care for this type of thyroid cancer, there is institutional variability in management. We present a case of thyroglossal duct cyst cancer in a man presenting with painless midline neck swelling. Imaging was suspicious for thyroglossal duct cyst cancer. FNAB was benign. The patient underwent the Sistrunk procedure and pathology was positive for papillary thyroid cancer.

摘要

甲状舌管囊肿是最常见的甲状腺发育异常,患病率为7%,但甲状舌管囊肿癌罕见。甲状舌管囊肿癌的发病率约为1%。细针穿刺活检(FNAB)的诊断率较低,限制了诊断,大多数病例在手术后才得以确诊。关于甲状腺球蛋白洗脱在甲状舌管囊肿癌诊断中的应用的数据较少,且之前的病例报告/系列中均未提及。甲状腺乳头状癌是最常见的病理类型。术前规划很重要,因为是否采用Sistrunk手术(切除甲状舌管囊肿、舌骨中部以及甲状舌管周围组织)进行甲状腺全切除术的决定取决于临床或影像学上甲状腺异常的情况。甲状舌管囊肿癌预后良好。然而,由于缺乏针对这类甲状腺癌的护理标准,管理上存在机构差异。我们报告一例男性甲状舌管囊肿癌病例,患者表现为无痛性颈部中线肿胀。影像学检查怀疑为甲状舌管囊肿癌。FNAB结果为良性。患者接受了Sistrunk手术,病理检查显示为甲状腺乳头状癌阳性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/654b/10580443/024d28f541dd/luad036f1.jpg

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