Arezzo A, Patetta R, Ceppa P, Borgonovo G, Torre G, Mattioli F P
Cattedra di Chirurgia Generale, Dipartimento di Chirurgia e Metodologia Integrate, University of Genova, Italy.
Am Surg. 1998 Apr;64(4):307-11.
We report a case of mucoepidermoid carcinoma of the thyroid gland. The simultaneous association of papillary and mucoepidermoid carcinoma in a Hashimoto's thyroiditis makes the present observation unusual. Surgery was limited due to local extension of the neoplasm. The patient consequently underwent external radiotherapy followed by radiometabolic therapy. The patient survived 11 months after diagnosis. As far as the histogenesis of the neoplasm is concerned, we believe that mucoepidermoid areas correspond to squamous and mucinous metaplasia of a preexisting papillary carcinoma. Transition areas between elements morphologically characteristic of both neoplasms were observed. Histochemical and immunohistochemical studies confirmed the diagnosis of a carcinoma with multiple aspects showing a focal positive reaction for thyroglobulin or keratin antisera. Therefore, this demonstrates different functional activities of the neoplastic cells. There is still debate about adjuvant therapies, the results of which appear for the moment very poor.
我们报告一例甲状腺黏液表皮样癌。桥本甲状腺炎中乳头状癌与黏液表皮样癌同时存在，使本病例观察结果非同寻常。由于肿瘤局部侵犯，手术范围受限。因此，患者接受了外照射放疗，随后进行放射性代谢治疗。患者在诊断后存活了11个月。就肿瘤的组织发生而言，我们认为黏液表皮样区域对应于先前存在的乳头状癌的鳞状化生和黏液化生。观察到两种肿瘤形态学特征性成分之间的过渡区域。组织化学和免疫组织化学研究证实了癌的诊断，多个方面显示对甲状腺球蛋白或角蛋白抗血清呈局灶性阳性反应。因此，这表明肿瘤细胞具有不同的功能活性。关于辅助治疗仍存在争议，目前其结果似乎非常不理想。
