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甲状腺癌治愈后妊娠:病例系列

Pregnancy After Beating Thyroid Cancer: A Case Series.

作者信息

Ganti Shruti, Ethirajan Shanthi, Srinivasan Jayashree, Senathirajah Tharaka

机构信息

Department of Obstetrics and Gynaecology, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.

出版信息

Cureus. 2024 Oct 22;16(10):e72122. doi: 10.7759/cureus.72122. eCollection 2024 Oct.

Abstract

Thyroid cancer is common among women of reproductive age and is a frequently occurring cancer during pregnancy, following breast cancer. Contributing factors include radiation exposure, iodine deficiency, and genetic conditions like multiple endocrine neoplasia type 2 (MEN2). Pregnancy significantly impacts thyroid function, leading to gland enlargement and altered thyroid stimulating hormone (TSH) levels due to hormonal changes, including elevated human chorionic gonadotropin (hCG) and estrogen. When differentiated thyroid cancer (DTC), particularly papillary thyroid carcinoma (PTC), is diagnosed during pregnancy or shortly after, careful management is essential. Treatment usually involves total thyroidectomy, with radioactive iodine therapy delayed until after childbirth. A review of cases indicates that women with PTC can have successful pregnancies with close medical supervision. Despite the complexities of cancer treatment during pregnancy, outcomes for both mother and baby are generally positive. These cases emphasize the importance of a collaborative approach in managing thyroid cancer during pregnancy and highlight the need for further research to optimize treatment and outcomes for both mother and child.

摘要

甲状腺癌在育龄女性中很常见,是孕期仅次于乳腺癌的一种常见癌症。促成因素包括辐射暴露、碘缺乏以及多发性内分泌腺瘤2型(MEN2)等遗传状况。怀孕会显著影响甲状腺功能,由于激素变化,包括人绒毛膜促性腺激素(hCG)和雌激素升高,导致甲状腺肿大以及甲状腺刺激激素(TSH)水平改变。当在孕期或产后不久诊断出分化型甲状腺癌(DTC),尤其是乳头状甲状腺癌(PTC)时,谨慎管理至关重要。治疗通常包括全甲状腺切除术,放射性碘治疗推迟到产后进行。病例回顾表明,患有PTC的女性在密切医疗监督下可以成功怀孕。尽管孕期癌症治疗复杂,但母婴结局总体良好。这些病例强调了在孕期管理甲状腺癌时采用协作方法的重要性,并突出了进一步研究以优化母婴治疗和结局的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4c/11581443/d1dcb8b2089c/cureus-0016-00000072122-i01.jpg

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