原发性甲状腺功能亢进症合并甲状腺癌18例分析

目的：探讨原发性甲状腺功能亢进症（甲亢）合并甲状腺癌（甲癌）的诊断和治疗。方法：回顾分析1990年1月于2000年1月手术治疗18例甲亢合并甲癌患者的临床资料，结果：微小癌占83％（15／18）。术前彩超检查15例，14例发现可疑结节；13例行癌侧叶全切除和对侧叶次全切除术，5例行双侧叶次全切除术，其中3例同时行颈淋巴结清扫术，1例二次行颈淋巴结清扫术。随访16例，平均随访7年，1例死于癌肺转移，余者仍存活，结论：术前常规彩超检查发现可疑结节有助于术中冰冻切片病理检查，手术治疗应兼顾甲亢和甲癌。

AN ANALYSIS OF PRIMARY HYPERTHYROIDISM COMPLICATED BY THYROID CANCER--A REPORT OF 18 CASES

Objective:To investigate the diagnosis and surgical treatment of primary hyperthyroidism complicated by thyroid cancer.Methods:Clinical data of 18 patients with primary hyperthyroidism complicated by thyroid cancer from January 1990 to January 2000 were analyzed retrospectively.Results:15 patients(83%) were of papillary thyroid cancer.14 of 15 patients were discovered to have suspectable nodule by preoperative color doppler ultrasonograpy.13 patients undertook lobectomy for the cancer lobe plus opposite subtotal thyroidectomy,and 5 patiends bilateral subtotal thyroidectomy,3 of which received neck lymphadenestomy concurrently in the first time,and 1 in the second time.16 pationts were followed up for an average of 7 years and only one died of lung metastasis.Concluson:Preoperative color doppler ultrasonography may help to establish the diagnosis of thyroid cancer.Consideration must be given to both primary hyperthyroidism and thyroid cancer in the treatment of this kind of patients.