甲状舌管癌的临床诊治并文献复习（附2例报告）

目的通过对甲状舌管癌患者的诊断和治疗，并复习相关文献，总结该病的临床特征和准确制定合理的治疗方案。方法报道2例甲状舌管癌患者的诊治过程，影像学特点及治疗方法。结果2例患者术前均被误诊为甲状舌管囊肿，常规行Sistrunk手术，术后病检1例为甲状舌管乳头状癌，另1例为甲状腺乳头状癌，结合术中所见最后诊断为甲状腺舌管乳头状癌，2例术后复查甲状腺功能均正常，复查甲状腺超声未见明显恶性肿瘤特征，均未行甲状腺手术治疗，1例未做任何其他补充治疗，随访8年无局部复发和转移，另1例行甲状腺素抑制治疗随访1年无复发。结论甲状腺舌管癌临床罕见，术前易误诊为甲状舌管囊肿，术前超声及增强CT有助于诊断，需病理确诊，手术方案的制定需综合考虑，病理分型决定其预后。

Diagnosis and treatment of thyroglossal duct carcinoma: two case reports with literature review

ObjectiveTo study the clinical features of and formulate reasonable treatment scheme for thyroglossal duct carcinoma via summarizing the diagnosis and treatment of this disease with literature review.MethodsClinical data including the diagnosis and treatment process, imaging characteristics and individualized therapy of 2 patients with thyroglossal duct carcinoma were analyzed retrospectively.ResultsBoth patients underwent conventional Sistrunk operation based on the preoperative diagnosis of thyroglossal duct cyst. Postoperative pathology confirmed as thyroglossal duct papillary carcinoma in one case, and thyroid papillary carcinoma in another. The latter one was clinically diagnosed as papillary carcinoma of thyroglossal duct with combination of pathological and intra operative findings. With normal postoperative thyroid function and without clear evidence of malignancy by thyroid ultrasonography, neither received thyroid surgery. 8 year follow up showed neither local recurrence nor metastasis in one case without any supplementary treatment, and one year follow up revealed no recurrence in the other one receiving postoperative thyroid hormone suppression therapy.ConclusionsThyroglossal duct carcinoma is often misdiagnosed preoperatively as thyroglossal duct cyst for its clinical rarity. Preoperative ultrasonography and enhancement computerized tomography contribute to diagnosis. The diagnosis depends upon postoperative pathological examination. Operation plan should be formulated comprehensively. Pathological classification decides its prognosis.