共查询到19条相似文献,搜索用时 78 毫秒
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目的 探讨甲状腺髓样癌临床特点、诊断要点及治疗原则.方法 回顾性分析2005年1月至2012年12月20例甲状腺髓样癌患者的临床资料,全组病例均经病理证实为甲状腺髓样癌,颈淋巴结转移9例,远处转移1例,总颈部淋巴结转移率达50%.20例均行手术治疗,至少行患侧腺叶及峡部切除16例,占80% (16/20),其中行甲状腺全切除9例.结果 术后常规监测血清降钙素,复发2例.术后随访17例,超过5年者9例,5年生存率达77.8%.结论 甲状腺髓样癌术前诊断困难,多数依赖组织病理学检查确诊,强调细针穿刺细胞学检查的重要性,治疗以根治性手术为主,术后监测降钙素能及早发现局部复发和转移. 相似文献
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目的:总结甲状腺髓样癌(medullary thyroid cancer, MTC)的超声特征并分析其对MTC诊断的临床价值。方法:回顾性分析2013年4月至2018年11月郑州大学第一附属医院甲状腺外科收治并经手术确诊的91例MTC患者(共103个结节),其中男36例,女55例,收集其术前超声影像学特征及血清降钙素水... 相似文献
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目的 探讨甲状腺髓样癌(MTC)的病理学特点,诊断和治疗选择。方法 对1982-2001年经治的32例MTC的临床和病理资料进行分析总结。结果 32例均予手术切除原发灶或加行颈淋巴结清扫术。均经病理证实,淋巴结转移率为65.4%。术后5年、10年生存率分别为77.8%,62.5%。结论 MTC具有多分化肿瘤的特点,可产生多种神经内分泌物质,少数病人可出现类癌综合征或顽固性腹泻。MTC的治疗以根治性切除为原则,而又要比其他类型的甲状腺癌更为积极,决不可任意缩小手术范围。 相似文献
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甲状腺髓样癌(MTC)来源于滤泡旁C细胞,占甲状腺癌的5%~10%,其中25%具有遗传性.MTC能够较早的出现淋巴结及远处转移,故早期诊断及治疗尤为重要.本文描述了MTC实验室及影像学等方面的主要表现,并对最新的治疗手段及预防性措施进行了阐述. 相似文献
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Medullary carcinoma of the thyroid: Prognostic factors and treatment recommendations 总被引:3,自引:0,他引:3
Pascal R. Fuchshuber MD PhD Thom R. Loree MD FACS Wesley L. Hicks Jr. DDS MD Richard T. Cheney MD Donald P. Shedd MD FACS 《Annals of surgical oncology》1998,5(1):81-86
Background: Because medullary thyroid carcinoma accounts for only 7% of all thyroid malignancies, data to support treatment strategies are scarce.
Methods: We retrospectively reviewed treatment and outcome in 34 patients with MTC treated at Roswell Park between 1961 and 1995. Univariate analysis was performed using the variables age, sex, tumor size, N stage, and M stage.
Results: Median survival was 4.7 years, with 51% and 32% of patients alive at 5 and 15 years, respectively. Nodal metastases were seen in 76% and distant metastases in 67% of all patients. More than 60% of the patients with nodal metastases survived longer than 10 years. Once diagnosed with distant metastases, 90% of the patients died within 5 years. Local failure rate with lobectomy was 44%, compared to 10% after total thyroidectomy (P<.02). Age, extrathyroid extension, and M stage portend a poor outcome. Nodal status had no statistically significant impact on survival.
Conclusion: Survival with tumors confined to the thyroid gland is independent of nodal status. Long-term survival in patients with distant metastases is rare. This study underscores the role of total thyroidectomy in the initial treatment and the need to develop effective adjuvant therapy for MTC.Presented at the 50th Annual Cancer Symposium of The Society of Surgical Oncology, Chicago, Illinois, March 20–23, 1997. 相似文献
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目的:探讨甲状腺结节患者血清降钙素(Ct)检测对甲状腺髓样癌(MTC)的诊断价值。方法:回顾性分析2016年10月—2017年8月1922例因甲状腺结节就诊于郑州大学第一附属医院甲状腺外科并行手术治疗的患者资料。所有患者术前均常规行血清Ct检测,术后均有明确的常规病理结果。分析Ct水平与MTC的关系、用受试者工作特征曲线分析Ct对MTC的诊断效能。结果:在1922例甲状腺结节患者中,新发现的MTC患者有12例(0.62%)。在术前血清Ct值为10~100pg/mL的155例、100~500pg/mL的12例和500pg/mL的10例中,术后确诊为MTC的分别为1例(0.65%)、1例(8.33%)和9例(90.00%)。在血清Ct500pg/mL的9例MTC患者中,有8例(88.89%)出现了不同程度的颈部淋巴结转移。血清Ct诊断MTC的截断值为258.5pg/mL,敏感性为90.91%,特异性为96.99%。结论:术前常规检测血清Ct有助于MTC的早期诊断,对患者接受彻底的手术治疗,避免二次手术有十分重要的意义。 相似文献
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Eleftherios Koudounarakis Alexander Karatzanis Alkiviadis Chatzidakis Maria Tzardi George Velegrakis 《International journal of surgery case reports》2014,5(1):5-7
INTRODUCTION
A few cases of concomitant medullary and papillary carcinoma in the same thyroid nodule have been described in the literature. However, the presence of multiple foci of both types of malignancy in the same gland is very rare.PRESENTATION OF CASE
A 39 year-old female with multiple thyroid nodules, elevated serum calcitonin levels and elastographic findings suggestive of thyroid malignancy, underwent total thyroidectomy and central neck dissection. Histology revealed the presence of one focus of medullary and one focus of papillary carcinoma on each thyroid lobe. Subsequently, the patient underwent treatment with radioactive iodine.DISCUSSION
This is the third case of synchronous multifocal medullary and papillary thyroid carcinoma reported in the literature. Several theories for the simultaneous development of these malignant entities have been proposed.CONCLUSION
Ultrasound elastography can be a useful, noninvasive tool in the assessment of thyroid nodules. 相似文献16.
Evenson A Mowschenson P Wang H Connolly J Mendrinos S Parangi S Hasselgren PO 《American journal of surgery》2007,193(6):707-712
BACKGROUND: Hyalinizing trabecular adenoma (HTA) is an uncommon benign thyroid tumor that can present as a solitary thyroid nodule, a prominent nodule in a multinodular goiter, or as an incidental finding in a thyroidectomy specimen. The clinical significance of the lesion is that it is frequently misdiagnosed as papillary carcinoma on fine-needle aspiration cytology or as papillary or medullary carcinoma on histopathological section. We reviewed our recent experience with 7 patients diagnosed with HTA. METHODS: Fine-needle aspiration biopsy was performed in 7 patients presenting with a solitary thyroid nodule (n = 4) or a multinodular goiter (n = 3). The patients underwent total thyroidectomy (n = 6) or hemithyroidectomy (n = 1). RESULTS: In 4 patients, the preoperative cytology was suggestive of papillary carcinoma, in 2 patients suspicious, and in 1 patient positive for papillary carcinoma. On histopathological section, 2 patients had a microscopic HTA, 2 patients had HTA in 1 or 2 nodules of a multinodular goiter, and 3 patients had HTA in a solitary nodule. Except in 1 patient, who had a microscopic focus (3.2 mm) of papillary carcinoma, there was no evidence of malignancy in the surgical specimens on permanent histopathological section. CONCLUSIONS: Although HTA is a rare condition of the thyroid, the surgeon needs to be aware of this entity to be able to better discuss the pathological findings with the patient, particularly since some pathologists and endocrinologists believe that HTA may represent a malignant neoplasm of low metastatic potential. 相似文献
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Tavares MR Michaluart P Montenegro F Arap S Sodre M Takeda F Brandao L Toledo S Ferraz A 《Surgery today》2008,38(6):499-504
PURPOSE: Total thyroidectomy (TT) with level VI and VII central neck dissection is the initial treatment for medullary thyroid carcinoma (MTC) without identifiable neck metastasis. Level II to V lateral neck dissection is performed if neck metastasis is present or suspected. We conducted this study to identify the frequency and clinical determinants of skip neck metastasis in MTC. METHODS: We reviewed the medical records of 32 patients who underwent TT and bilateral neck dissection for MTC. The clinical features were correlated with pN status in the central versus lateral compartments of the neck. RESULTS: Neck lymph node metastasis (pN+) was found in 20 patients (62.5%) and skip metastases were found in 7 (35%) patients. The sensitivity of the pN status of the central compartment of the neck to predict the pN status of the lateral compartment of the neck was 53.8% and specificity was 63.2%. We found pN+ in 90% of the patients with lymph nodes >15 mm in diameter versus 50% in those with lymph nodes <15 mm in diameter. CONCLUSIONS: There is skip metastasis in MTC. It is unsafe to use the lymph node status of the central compartment of the neck to define the pN status of the lateral neck. A lymph node greater than 15 mm in diameter is related to pN status. 相似文献
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Raval MV Sturgeon C Bentrem DJ Elaraj DM Stewart AK Winchester DJ Ko CY Reynolds M 《Journal of pediatric surgery》2010,45(10):1947-1954
Purpose
Lymph node metastases (LNM) from medullary thyroid cancer (MTC) are common in adults and are a poor prognostic factor. Less is known about LNM in children, who often have hereditary forms of MTC. Guidelines recommend prophylactic thyroidectomy in early childhood, but randomized prospective trials are not feasible. We hypothesized that LNM is associated with poor prognosis in children.Methods
Patients with MTC 21 years or younger from the National Cancer Data Base from 1985 to 2007 were studied. Multivariable logistic regression was used to identify factors associated with lymph node evaluation. Survival was estimated using the Kaplan-Meier method.Results
Of 430 patients, 276 (64.2%) had nodal evaluation with LNM present in 121 (28.1%). Older patients, those with tumors larger than 2 cm, and those with involved margins were more likely to have LNM (all P < .05). Patients undergoing total thyroidectomy, those with involved margins, and older patients were more likely to undergo lymph node evaluation after controlling for patient, tumor, and hospital factors (all P < .05). Over time an increasing number of patients with MTC have undergone total thyroidectomy. Patients 16 to 21 years of age had lower 10-year overall survival compared to patients 0 to 15 years old (88.7% vs 98.1%, P = .005). Lymph node metastases were also associated with decreased 10-year overall survival (84.4% vs 100%, P < .001).Conclusions
In pediatric MTC, LNM predict poorer overall survival. Adequate lymph node assessment can provide valuable prognostic information for the pediatric MTC patient. Lymph node assessment should be considered for older pediatric patients undergoing surgery for hereditary MTC or biopsy confirmed MTC. 相似文献19.
Pakarinen MP Rintala RJ Koivusalo A Heikkinen M Lindahl H Pukkala E 《Journal of pediatric surgery》2005,40(10):1532-1534