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甲状腺与淋巴结的罕见碰撞：一例报告及文献综述

A Rare Collision in Thyroid and Lymph Node: A Case Report and Review of Literature.

作者信息

V Gowtham K, Kajamohideen Suhaildeen, M Arthi, Joseph Leena D, Parthasarathy Ilango

机构信息

Surgical Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

出版信息

Cureus. 2025 Jun 17;17(6):e86190. doi: 10.7759/cureus.86190. eCollection 2025 Jun.

DOI:10.7759/cureus.86190
PMID:40677447
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12268773/
Abstract

Synchronous papillary and medullary thyroid carcinomas are exceptionally rare. This case report describes a 13-year-old girl with familial medullary thyroid cancer linked to germline rearranged during transfection (RET) proto-oncogene mutation, with a high risk of early onset and aggressive disease, who underwent total thyroidectomy with prophylactic neck dissection. Histopathology revealed distinct papillary and medullary thyroid cancers in separate thyroid lobes, which was a type IV synchronous tumor, with one lymph node showing metastatic deposits from both tumors. This case highlights the rare occurrence, diagnostic challenges of such dual malignancies, emphasizing the need for genetic testing and vigilant long-term follow-up.

摘要

同步性甲状腺乳头状癌和髓样癌极为罕见。本病例报告描述了一名13岁女孩，患有与种系转染重排（RET）原癌基因突变相关的家族性甲状腺髓样癌，具有早发和侵袭性疾病的高风险，她接受了甲状腺全切除术及预防性颈部淋巴结清扫术。组织病理学显示，在不同的甲状腺叶中存在明显的甲状腺乳头状癌和髓样癌，这是一种IV型同步性肿瘤，有一个淋巴结显示出来自两种肿瘤的转移灶。本病例突出了这种双重恶性肿瘤的罕见性、诊断挑战，强调了基因检测和长期密切随访的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/b40a151d16b4/cureus-0017-00000086190-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/e931d80928f8/cureus-0017-00000086190-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/d7d9b6435c59/cureus-0017-00000086190-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/e545add87714/cureus-0017-00000086190-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/d890f54d18ba/cureus-0017-00000086190-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/98a917d055da/cureus-0017-00000086190-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/dc44692d4367/cureus-0017-00000086190-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/9bb2c08bf3fb/cureus-0017-00000086190-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/b40a151d16b4/cureus-0017-00000086190-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/e931d80928f8/cureus-0017-00000086190-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/d7d9b6435c59/cureus-0017-00000086190-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/e545add87714/cureus-0017-00000086190-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/d890f54d18ba/cureus-0017-00000086190-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/98a917d055da/cureus-0017-00000086190-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/dc44692d4367/cureus-0017-00000086190-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/9bb2c08bf3fb/cureus-0017-00000086190-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12268773/b40a151d16b4/cureus-0017-00000086190-i08.jpg

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本文引用的文献

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Thirty synchronous medullary and papillary thyroid carcinomas.30 例同步性甲状腺髓样癌和乳头状癌。
Front Endocrinol (Lausanne). 2023 Mar 31;14:1153248. doi: 10.3389/fendo.2023.1153248. eCollection 2023.
2
The Growth Kinetics of Collision Nodal Metastasis from Medullary and Papillary Thyroid Carcinomas: A Case Report.甲状腺髓样癌和乳头状癌碰撞结节转移的生长动力学：病例报告
Eur Thyroid J. 2021 Jul;10(4):345-352. doi: 10.1159/000511184. Epub 2020 Nov 10.
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Efficacy of Selpercatinib in -Altered Thyroid Cancers.塞尔帕替尼在改变的甲状腺癌中的疗效。
N Engl J Med. 2020 Aug 27;383(9):825-835. doi: 10.1056/NEJMoa2005651.
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Medullary thyroid carcinoma of unknown primary origin with synchronous finding of papillary thyroid carcinoma.未明原发灶的甲状腺髓样癌伴发甲状腺乳头状癌。
Endokrynol Pol. 2020;71(2):200-201. doi: 10.5603/EP.a2020.0003. Epub 2020 Feb 25.
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Synchronous papillary thyroid carcinoma and medullary thyroid carcinoma - a pitfall waiting to happen.同步性甲状腺乳头状癌和甲状腺髓样癌——一个随时可能出现的陷阱。
Malays J Pathol. 2017 Aug;39(2):171-174.
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Collision and composite tumors; radiologic and pathologic correlation.碰撞瘤和复合瘤；放射学与病理学相关性。
Abdom Radiol (NY). 2017 Dec;42(12):2909-2926. doi: 10.1007/s00261-017-1200-x.
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On the Origin of Cells and Derivation of Thyroid Cancer: C Cell Story Revisited.论细胞的起源与甲状腺癌的发生：C细胞故事再探
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Simultaneous occurrence of medullary and papillary thyroid microcarcinomas: a case series and review of the literature.甲状腺髓样癌和乳头状微小癌同时发生：病例系列及文献复习
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