Attie J N, Setzin M, Klein I
Department of Surgery, North Shore University Hospital, Manhasset, New York.
Am J Surg. 1993 Oct;166(4):428-30. doi: 10.1016/s0002-9610(05)80348-4.
Differentiated thyroid cancer most commonly presents as a thyroid nodule. Cervical node metastases are commonly observed. In the present report, we describe the clinical presentation, pathologic findings, surgical approach, and follow-up of 43 patients in whom the initial presentation of thyroid cancer was that of an enlarged cervical lymph node. At surgery, 65% of the patients had additional lymph node involvement. The thyroid pathology was papillary carcinoma in all patients, and, in two thirds of patients, the thyroid primary was 1 cm or smaller in size. Forty patients underwent thyroidectomy and modified neck dissection; 3 were treated by thyroidectomy alone. One patient died of disease, 7 were lost to follow-up after 4 to 27 years, 5 died of unrelated causes, and the remaining 30 are alive and free of disease 1.5 to 33.5 years after surgery (mean: 14.8 years).
分化型甲状腺癌最常见的表现是甲状腺结节。颈部淋巴结转移很常见。在本报告中，我们描述了43例最初表现为颈部淋巴结肿大的甲状腺癌患者的临床表现、病理结果、手术方式及随访情况。手术时，65%的患者有额外的淋巴结受累。所有患者的甲状腺病理均为乳头状癌，三分之二的患者甲状腺原发灶大小为1厘米或更小。40例患者接受了甲状腺切除术和改良颈部淋巴结清扫术；3例仅接受了甲状腺切除术治疗。1例患者死于疾病，7例在4至27年后失访，5例死于无关原因，其余30例在手术后1.5至33.5年（平均：14.8年）存活且无疾病。
