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伴有气管侵犯的乳头状甲状腺癌。

Papillary thyroid carcinoma with invasion of the trachea.

作者信息

Mohtasib Mohammad Eid Al, Sharabate Khulood Mohammad Marwan, Dweik Raghad Faisal Yahia, Shawar Fatimah Iyad Azmi, Shehadeh Daleen Ashraf Azmi

机构信息

Al Ahli Hospital.

Palestine Polytechnic University, Hebron, Palestine.

出版信息

Ann Med Surg (Lond). 2024 Jun 4;86(8):4820-4824. doi: 10.1097/MS9.0000000000002233. eCollection 2024 Aug.

Abstract

INTRODUCTION

Papillary thyroid carcinoma typically has a favourable survival rate and a low recurrence rate. However, extrathyroidal extension has a significant negative impact on survival. Among the extrathyroidal extensions, invasion of the trachea by papillary thyroid carcinoma is rare and serves as a marker of more aggressive tumour behaviour. This case report aims to highlight the unusual clinical course of papillary thyroid carcinoma.

CASE PRESENTATION

A 75-year-old female patient from Gaza has been diagnosed with papillary thyroid carcinoma in 2020. With mediastinal lymph node invasion. she underwent total thyroidectomy and neck dissection and mediastinal lymph node dissection. After the surgery, the patient did not follow up regularly or receive radioiodine treatment. On 2023 presented with hemoptysis, shortness of breath computed tomography (CT) and bronchoscopy reveal thyroid cancer with tracheal invasion, which has invaded the trachea to the left side. The authors treat the patient by bronchoscopy debulking and sent for oncological management.

DISCUSSION

Papillary thyroid carcinoma is the most common type of thyroid cancer and generally has a good prognosis. Tumour staging through various imaging techniques is crucial for determining the next steps. Cases involving tracheal invasion should undergo bronchoscopy for tumour debulking. Surgical management followed by iodine therapy has shown positive outcomes.

CONCLUSION

When patients with Papillary thyroid carcinoma have haemoptysis, and the imaging examinations reveal a space-occupying lesion in airway, clinicians should focus on Papillary thyroid carcinoma with tracheal invasion, a bronchoscopic examination must be immediately performed because the subsequent surgical management depends on the degree of tracheal invasion.

摘要

引言

甲状腺乳头状癌通常具有良好的生存率和较低的复发率。然而,甲状腺外侵犯对生存率有显著负面影响。在甲状腺外侵犯中,甲状腺乳头状癌侵犯气管较为罕见,是肿瘤侵袭性更强的行为标志。本病例报告旨在突出甲状腺乳头状癌不寻常的临床病程。

病例介绍

一名来自加沙的75岁女性患者于2020年被诊断为甲状腺乳头状癌,伴有纵隔淋巴结侵犯。她接受了全甲状腺切除术、颈部淋巴结清扫术和纵隔淋巴结清扫术。术后,患者未定期随访或接受放射性碘治疗。2023年,患者出现咯血、气短,计算机断层扫描(CT)和支气管镜检查显示甲状腺癌侵犯气管,已侵犯至气管左侧。作者通过支气管镜减瘤术治疗该患者,并将其送去进行肿瘤学管理。

讨论

甲状腺乳头状癌是最常见的甲状腺癌类型,一般预后良好。通过各种影像学技术进行肿瘤分期对于确定后续步骤至关重要。涉及气管侵犯的病例应进行支气管镜检查以减瘤。手术治疗后进行碘治疗已显示出积极效果。

结论

当甲状腺乳头状癌患者出现咯血,且影像学检查显示气道有占位性病变时,临床医生应关注甲状腺乳头状癌侵犯气管的情况,必须立即进行支气管镜检查,因为后续的手术治疗取决于气管侵犯的程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12dc/11305793/398e1ebc548c/ms9-86-4820-g003.jpg

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