甲状腺血管周围上皮样细胞肿瘤：1例罕见病例报告
Thyroid perivascular epithelioid cell tumor: A rare case report.
作者信息
Feng Wenqing, Ouyang Binshen, Li Chaofei, Liu Guoliang, Ding Jiazeng, Shen Xiaohui
机构信息
Department of General Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of International Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Int J Surg Case Rep. 2025 Jul;132:111464. doi: 10.1016/j.ijscr.2025.111464. Epub 2025 May 22.
BACKGROUND
Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors with histological and immunophenotypic characteristics of perivascular epithelioid cells, characterized by smooth muscle and melanocytic markers. Herein, we report a case of PEComa originating in the thyroid gland.
CASE PRESENTATION
A 36-year-old woman presented with a thyroid nodule detected on physical examination that gradually enlarged during a 3-year follow-up period. The patient underwent a unilateral thyroidectomy after completing the relevant preoperative investigations. Postoperative pathological immunohistochemical staining was positive for cathepsin K, microphthalmia-associated transcription factor (MiTF), and smooth muscle actin (SMA). The patient was diagnosed with a perivascular epithelioid tumor. The patient's condition stabilized after a short-term follow-up.
DISCUSSION
Perivascular epithelioid cell tumors (PEComas) of the thyroid gland are extremely rare, with only one case reported in the literature. There are no clear criteria for distinguishing benign and malignant PEComas of the thyroid gland. This case suggests that surgical resection is a good management option for this patient, and long-term follow-up is needed to observe the outcome.
CONCLUSION
Surgical resection is safe and feasible for PEComas of the thyroid gland.
背景
血管周上皮样细胞肿瘤（PEComas）是一种罕见的间叶组织肿瘤，具有血管周上皮样细胞的组织学和免疫表型特征，以平滑肌和黑素细胞标志物为特点。在此，我们报告一例起源于甲状腺的PEComa病例。
病例介绍
一名36岁女性在体格检查时发现甲状腺结节，在3年随访期间逐渐增大。患者在完成相关术前检查后接受了单侧甲状腺切除术。术后病理免疫组化染色显示组织蛋白酶K、小眼相关转录因子（MiTF）和平滑肌肌动蛋白（SMA）呈阳性。患者被诊断为血管周上皮样肿瘤。短期随访后患者病情稳定。
讨论
甲状腺血管周上皮样细胞肿瘤（PEComas）极为罕见，文献中仅报道过一例。目前尚无明确标准区分甲状腺良性和恶性PEComas。该病例表明手术切除对该患者是一种良好的治疗选择，需要长期随访以观察预后。
结论
手术切除对甲状腺PEComas是安全可行的。
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