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原发性甲状腺鳞状细胞癌伴严重呼吸道狭窄及气管内侵犯:一例报告并文献复习

Primary thyroid squamous cell carcinoma with severe respiratory stenosis and endotracheal invasion: a case report with literature review.

作者信息

Liu Xueliang, Ma Shang, Zheng Yuxin, Xu Zeming, Hao Hui, Ma Hongyan, Xu Qian

机构信息

Department of Thyroid and Breast Surgery, Cangzhou People's Hospital, Cangzhou, China.

Department of Oncology, Cangzhou People's Hospital, Cangzhou, China.

出版信息

Front Med (Lausanne). 2025 Jul 25;12:1631714. doi: 10.3389/fmed.2025.1631714. eCollection 2025.

Abstract

INTRODUCTION

Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare and highly aggressive malignant tumor with a poor prognosis. Although surgery, chemotherapy and other treatment methods have been reported, the current treatment modality has not reached a consensus. This study discusses the diagnosis and treatment of a case of PSCCT with severe respiratory stenosis and endotracheal invasion and reviews the relevant literature. We report the disease of rapidly enlarging mass leading to asphyxiation to raise clinicians' awareness of this condition.

CASE PRESENTATION

We report a 76-year-old woman presenting with an enlarging right thyroid mass accompanied by severe dyspnea and hoarseness. Computed tomography (CT) scan disclosed a large solid heterogenous nodule with calcification in the right thyroid lobe and prominent adjacent lymph nodes. PSCCT was confirmed by postoperative histopathology and immunohistochemistry. Thyroidectomy with partial tracheectomy and tracheostomy was performed to relieve the patient's dyspnea. The patient has been discharged after receiving post-operative supportive care.

CONCLUSION

Clinicians should pay attention to the rapidly enlarging neck mass as it may cause asphyxiation and avoid the loss of treatment opportunities.

摘要

引言

甲状腺原发性鳞状细胞癌(PSCCT)是一种罕见且侵袭性很强的恶性肿瘤,预后较差。尽管已经报道了手术、化疗等治疗方法,但目前的治疗方式尚未达成共识。本研究讨论了一例伴有严重呼吸道狭窄和气管侵犯的PSCCT病例的诊断和治疗,并回顾了相关文献。我们报告了因肿块迅速增大导致窒息的病例,以提高临床医生对这种疾病的认识。

病例介绍

我们报告一名76岁女性,出现右侧甲状腺肿块增大,并伴有严重呼吸困难和声音嘶哑。计算机断层扫描(CT)显示右侧甲状腺叶有一个大的实性异质性结节,伴有钙化,且相邻淋巴结肿大。术后组织病理学和免疫组化证实为PSCCT。行甲状腺切除术、部分气管切除术和气管造口术以缓解患者的呼吸困难。患者在接受术后支持治疗后已出院。

结论

临床医生应注意迅速增大的颈部肿块,因为它可能导致窒息,避免失去治疗机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9946/12331759/4147bc7da346/fmed-12-1631714-g001.jpg

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