Page C P, Kemmerer W T, Haff R C, Mazzaferri E L
Ann Surg. 1974 Nov;180(5):799-803. doi: 10.1097/00000658-197411000-00017.
Six cases of thyroid carcinoma arising in a thyroglossal duct cyst are described and combined with previously reported cases to provide a total of 66 cases for retrospective analysis. Most presented as benign thyroglossal duct cyst, and the malignant nature of the lesion was not recognized until the permanent pathology sections were reviewed. Eight of 10 patients with metastatic disease in retrospect had preoperative indications of malignancy as manifest by clinically suspicious nodes or a thyroglossal cyst larger than the mean for the series. The primary cell type in all cases was papillary thyroid carcinoma. Local resection by the Sistrunk method and suppressive doses of thyroid are recommended for the patient with papillary thyroid carcinoma arising in a thyroglossal duct cyst when there is no evidence of extension of the malignancy beyond the confines of the cyst. The patient presenting with metastatic carcinoma should, of course, be treated with appropriate local resection, hormonal manipulation, thyroid ablation, and lymphadenectomy as indicated by his age and sex, the cell type of the tumor, and the extent of local and metastatic disease.
本文描述了6例起源于甲状舌管囊肿的甲状腺癌病例，并结合先前报道的病例，共计66例进行回顾性分析。大多数病例最初表现为良性甲状舌管囊肿，直到永久病理切片复查时才发现病变的恶性本质。回顾性分析发现，10例有转移疾病的患者中，有8例术前有恶性肿瘤的迹象，表现为临床可疑淋巴结或甲状舌管囊肿大于该系列的平均大小。所有病例的主要细胞类型均为甲状腺乳头状癌。当没有证据表明恶性肿瘤超出囊肿范围时，对于起源于甲状舌管囊肿的甲状腺乳头状癌患者，建议采用Sistrunk法进行局部切除，并给予抑制剂量的甲状腺素。当然，对于出现转移性癌的患者，应根据其年龄、性别、肿瘤细胞类型以及局部和转移疾病的程度，进行适当的局部切除、激素治疗、甲状腺消融和淋巴结清扫。
