Macák J, Dvorácková J, Michal M, Vaverková H, Nĕmec J
Ustav Patologie Lékarské fakulty Univerzity Palackého, Olomouc.
Vnitr Lek. 1997 Sep;43(9):602-6.
The concurrent finding of two thyroid carcinomas is rare. The authors present two patients with the concurrent occurrence of two tumours. In the first case--a 51-year-old man--the authors found a medullary carcinoma in the right lobe and a medullary papillary carcinoma in the left thyroid lobe. The medullary papillary carcinoma metastatized into the mediastinal lymph nodes and into the mediastinal tissues in the area above the tracheal bifurcation. From the morphological and immunohistological aspect in the primary tumour of the left lobe as well as in the mediastinum two different clones of tumour cells were found (the medullary component of the tumour responded positively to antibodies against calcitonin and the papillary component to serum against thyroglobulin. The patient was treated by radiotherapy. The tumour progressed however markedly in its medullary component and the patient died one and a half year after the first symptoms from generalization of the tumour. The second patient, a woman, had an occult papillary carcinoma in the right lobe and in the left lobe a of a medullary papillary carcinoma (follicular variant). This type of tumour also metastatized into a cervical lymph node in the area of the left lobe. The patient was treated by radioiodine. Nine months after bilateral thyroidectomy she has no signs of progression of the tumour.
同时发现两个甲状腺癌的情况较为罕见。作者报告了两名同时出现两个肿瘤的患者。在第一个病例中,一名51岁男性,作者在其右叶发现了髓样癌,在左叶发现了髓样乳头状癌。髓样乳头状癌转移至纵隔淋巴结及气管分叉上方区域的纵隔组织。从左叶原发肿瘤及纵隔的形态学和免疫组织学方面来看,发现了两种不同的肿瘤细胞克隆(肿瘤的髓样成分对降钙素抗体呈阳性反应,乳头状成分对甲状腺球蛋白血清呈阳性反应)。该患者接受了放射治疗。然而,肿瘤的髓样成分进展明显,患者在出现首发症状一年半后因肿瘤广泛转移而死亡。第二名患者是一名女性,右叶有隐匿性乳头状癌,左叶有髓样乳头状癌(滤泡变体)。这种类型的肿瘤也转移至左叶区域的一个颈部淋巴结。该患者接受了放射性碘治疗。双侧甲状腺切除术后九个月,她没有肿瘤进展的迹象。