Shandong University, Cheeloo College of Medicine, Jinan, Shandong, China.
Department of Breast and Thyroid Surgery, Shandong Provincial Hospital, Jinan, Shandong, China.
Medicine (Baltimore). 2024 Feb 16;103(7):e37246. doi: 10.1097/MD.0000000000037246.
Papillary thyroid cancer is an inert malignant tumor with a good response to surgical treatment, low recurrence and metastasis rate, and good prognosis. Diffuse sclerosing thyroid cancer is an invasive subtype that is more common in young people, with a higher rate of lymph node metastasis and recurrence, and a relatively poor prognosis.
A 13-year-old girl underwent radical surgery for diffuse sclerosing thyroid cancer. Eight years later, due to a large number of lymph node metastases, she underwent another radical surgery on her neck lymph nodes.
The patient thyroid ultrasound and neck enhanced CT indicated that the patient had multiple enlarged lymph nodes in the neck with irregular morphology and structure, and the possibility of metastatic lymph nodes was high. Subsequently, the patient underwent thyroid fine-needle aspiration and the results showed that cancer cells were detected in both cervical lymph nodes.
The patient was diagnosed with bilateral cervical lymph node metastases after thyroid surgery.
After the second surgery, the patient recovered well, and no residual or focal iodine uptake tissue was found on the enhanced CT examination.
As diffuse sclerosing thyroid cancer is prone to lymph node and recurrent metastases, once it is diagnosed, radical treatment should be actively performed. Postoperative adjuvant radiation therapy should be administered according to the patient condition and regular follow-ups should be conducted to monitor neck lymph node metastasis.
甲状腺乳头状癌是一种惰性恶性肿瘤,对手术治疗反应良好,复发和转移率低,预后良好。弥漫性硬化性甲状腺癌是一种侵袭性亚型,更常见于年轻人,淋巴结转移和复发率较高,预后相对较差。
一名 13 岁女孩因弥漫性硬化性甲状腺癌接受了根治性手术。八年后,由于大量淋巴结转移,她在颈部淋巴结再次接受了根治性手术。
患者甲状腺超声和颈部增强 CT 显示颈部有多个肿大的淋巴结,形态和结构不规则,高度提示转移淋巴结的可能性。随后,患者进行了甲状腺细针抽吸,结果显示颈部淋巴结中均检测到癌细胞。
甲状腺手术后,患者被诊断为双侧颈淋巴结转移。
第二次手术后,患者恢复良好,增强 CT 检查未见残留或局灶性碘摄取组织。
弥漫性硬化性甲状腺癌易发生淋巴结和复发性转移,一旦确诊,应积极进行根治性治疗。根据患者情况,应给予术后辅助放疗,并定期随访以监测颈部淋巴结转移。