McHenry C R, Sandoval B A
Department of Surgery, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA.
Surg Oncol Clin N Am. 1998 Oct;7(4):893-910.
Management of follicular and Hürthle cell neoplasms of the thyroid gland is a common clinical problem. A diagnosis of follicular or Hürthle cell carcinoma cannot be made from a fine-needle aspiration biopsy alone because it requires histologic demonstration of capsular or vascular invasion. Thyroid lobectomy and isthmusectomy is adequate treatment of benign follicular or Hürthle cell adenoma and minimally invasive follicular carcinoma. Total thyroidectomy, radioiodine ablation, and thyrotropin-suppressive doses of thyroid hormone is advocated for the invasive subtype of follicular carcinoma and all Hürthle cell carcinomas. Monitoring of serum thyroglobulin levels postoperatively is important for detection of recurrent disease.
甲状腺滤泡性和许特莱细胞肿瘤的管理是一个常见的临床问题。仅通过细针穿刺活检无法诊断滤泡性或许特莱细胞癌，因为这需要组织学证明有包膜或血管侵犯。甲状腺叶切除术和峡部切除术是治疗良性滤泡性或许特莱细胞腺瘤以及微小浸润性滤泡癌的适当方法。对于浸润性滤泡癌亚型和所有许特莱细胞癌，主张行全甲状腺切除术、放射性碘消融以及甲状腺激素抑制促甲状腺素剂量的治疗。术后监测血清甲状腺球蛋白水平对于检测复发性疾病很重要。
