Coutinho Henrique, Kikuta Gustavo, Brasil Bernardo, Okida Luis Felipe, Coutinho Joaquim Henrique
Department of Cardiovascular Surgery, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil.
Department of Cardiovascular Surgery, Serra dos Órgãos University Center, Av Delfim Moreira, 2211, vale do Paraíso, Teresópolis, Rio de Janeiro 25976-016, Brazil.
J Surg Case Rep. 2025 Jul 10;2025(7):rjaf220. doi: 10.1093/jscr/rjaf220. eCollection 2025 Jul.
Thyroid tumors represent approximately 1% of neoplasms diagnosed in Brazil, according to data from the National Cancer Institute. Most cases are differentiated carcinomas, with only 5% to 10% producing distant metastases. Follicular carcinoma, the second most common subtype, is known for its angioinvasive characteristics, typically observed microscopically and locally. Extension to large vessels and the heart is exceedingly rare, with only a few cases reported in the literature. This aggressive form of the disease often presents with exuberant symptoms, primarily superior vena cava syndrome and right ventricular outflow tract obstruction. The hematogenous spread characteristic of follicular carcinoma increases the likelihood of distant metastases, though cardiac involvement remains uncommon. Recent studies have suggested that aggressive surgical intervention, when feasible, can significantly improve outcomes in these rare cases. This report illustrates a female patient with asymptomatic intracardiac follicular thyroid carcinoma who underwent successful surgical resection.
根据国家癌症研究所的数据，甲状腺肿瘤约占巴西诊断出的肿瘤的1%。大多数病例为分化型癌，只有5%至10%会发生远处转移。滤泡癌是第二常见的亚型，以其血管浸润特性而闻名，通常在显微镜下和局部观察到。侵犯大血管和心脏极为罕见，文献中仅报道了少数病例。这种侵袭性疾病通常表现为严重症状，主要是上腔静脉综合征和右心室流出道梗阻。滤泡癌的血行转移特征增加了远处转移的可能性，尽管心脏受累仍然不常见。最近的研究表明，在可行的情况下，积极的手术干预可以显著改善这些罕见病例的治疗效果。本报告介绍了一名患有无症状心脏内滤泡性甲状腺癌的女性患者，该患者接受了成功的手术切除。
