Wang T Y, Lee C H, Yang A H, P'eng F K, Lui W Y
Department of Surgery, Veterans General Hospital-Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 1998 Jun;61(6):353-7.
Metastatic malignant tumors of the thyroid are rarely encountered clinically. Most arise from primary sites in the lung, breast, kidney or gastrointestinal tract. Their clinical presentation may mimic a primary thyroid tumor and include signs and symptoms such as enlargement of the neck, hoarseness and dysphagia. Without a history of carcinoma in other organs, management as for primary thyroid tumor is often undertaken and misdiagnosis is common. This report concerns a 63-year-old female patient with a rapidly progressive enlargement of the neck. She had had a primary leiomyosarcoma lesion in her left leg that had been well controlled after wide excision. Bilateral pulmonary metastases were noted two years later without local recurrence. She receive wedge lung resections several times. To relieve progressive shortness of breath, debulking surgery of the thyroid was performed and metastatic leiomyosarcoma was proved. The related clinical data of this rare metastatic leiomyosarcoma of the thyroid is presented and the literature is reviewed.
甲状腺转移性恶性肿瘤在临床上很少见。大多数起源于肺、乳腺、肾脏或胃肠道的原发部位。其临床表现可能类似原发性甲状腺肿瘤,包括颈部肿大、声音嘶哑和吞咽困难等体征和症状。在没有其他器官癌病史的情况下,通常会按照原发性甲状腺肿瘤进行处理,误诊很常见。本报告涉及一名63岁女性患者,其颈部迅速进行性肿大。她左腿曾有原发性平滑肌肉瘤病灶,广泛切除后病情得到良好控制。两年后发现双侧肺转移,无局部复发。她接受了多次楔形肺切除术。为缓解进行性呼吸急促,对甲状腺进行了减瘤手术,证实为转移性平滑肌肉瘤。本文报道了这种罕见的甲状腺转移性平滑肌肉瘤的相关临床资料并复习了文献。