甲状腺转移癌(附9例报告)

目的: 探讨甲状腺转移癌的发病特点、诊断及治疗。 方法: 分析甲状腺转移癌9例,中位年龄51岁,原发食管癌3例,肺癌3例,肾透明细胞癌、恶性黑色素瘤、喉癌各1例。针吸穿刺确诊5例,手术切除及确诊4例,其中1例肾透明细胞癌行部分切除及术后放疗,单纯放疗2例,化疗3例。由原发癌至转移间隔1个月～4年,中位时间8个月。患者均以颈前肿物就诊,1例伴声音嘶哑。 结果: B超检查为甲状腺内多发弥漫性低回声团块,部分患者表现为结节性甲状腺肿。1例肾透明细胞癌患者存活7.5年,其余均在10个月内死于广泛转移。 结论: 甲状腺转移癌罕见,但有恶性肿瘤既往史伴有甲状腺肿块的患者应考虑转移癌的可能,诊断依靠B超、针吸活检、免疫组化染色。甲状腺转移预后不良,但肾透明细胞癌甲状腺转移积极治疗仍有望长期生存。

Metastatic Carcinoma of the Thyroids

Objective: To examine the clinical presentation, diagnosis and prognosis of secondary neoplasm of the thyroid. Method: Nine patients with secondary cancer of the thyroid, with a median age of 51, were analyzed retrospectively. All the patients underwent thyroid ultrasonography. Fine-needle aspiration cytology of the thyroid (FNAC) was performed in five of the patients. Tissue diagnosis was obtained by thyroidectomy in four patients. The most frequent original tumor was the esophageal carcinoma (3/9), lung cancer(3/9) and renal clear cell carcinoma(RCC), melanoma, and larynx carcinoma for one case each. The time between diagnosis of the primary tumor and detection of thyroid invasion in the patients ranged from 1 to 48 months (mean, 8). Results: All patients died within ten months, after diagnosis, except for one with RCC who lived for seven years and a half. Conclusion: Metastasis in the thyroid gland was uncommon and may be a diagnostic problem. Its presence often indicated a poor prognosis with the exception of RCC. Ultrasonography, FNAC and immunohistochemistry were valuable for diagnosis.