-
摘要: 目的: 探讨甲状腺呈胸腺样分化癌(CASTLE)的临床诊断、治疗及预后,提高对CASTLE的认识。方法: 对6例CASTLE患者行Ⅵ区淋巴结清扫+病灶所在甲状腺叶及峡部切除术。术后除1例68岁患者外,其余患者术后第3周行颈前区放疗60 Gy,予以顺铂化疗5个疗程,每次间隔2周。并坚持口服尤甲乐。结果: 所有患者随访期间均存活,无复发和转移。结论: CASTLE的诊断及鉴别诊断有赖于组织病理学及免疫组织化学检测,手术是其主要治疗手段。CASTLE是一种少见的甲状腺恶性肿瘤,进展缓慢,预后较好。Abstract: Objective: To investigate the clinical diagnosis, treatment and prognosis of carcinoma showing thymus-like differentiation (CASTLE) of thyroid, and to improve the understanding of CASTLE.Method: In 6 patients with CASTLE, we performed region VI lymph node dissection, the lesion resection of thyroid lobe and isthmus. After the operation, except one case of 68 years old patient, the rest patients were treated with radiotherapy 60 Gy in anterior cervical region after third week of operation and 5 courses of chemotherapy with cisplatin, each interval of 2 weeks. Insist on the oral Euthyrox.Result: All patients were alive without recurrence and metastasis.Conclusion: The diagnosis of CASTLE depends on the histology and immunohistochemistry. Operation was the main treatment. CASTLE is a rare type of thyroid carcinoma with slow progress and good prognosis.
-
Key words:
- thyroid neoplasms /
- thymoma /
- lymph node dissection
-
[1] ABENI C,OGLIOSI C,ROTA L, et al. Thyroid carcinoma showing thymus-like differentiation:Case presentation of a young man[J].World J Clin Oncol,2014,12:1117-1120.
[2] 林晓燕.甲状腺肿瘤的病理诊断//王强修.现代内分泌肿瘤临床病理学[M].北京:中国医药科技出版社,2011:141-162.
[3] LIU Z,TENG X Y,SUN D X,et al. Clinical analysis of thyroid carcinoma showing thymus-like differentiation:report of 8 cases[J].Int Surg,2013,98:95-100.
[4] HIROKAWA M,KUMA S,MIYAUCHI A. Cytological findings of intrathyroidal epithelial thymoma/carcinoma showing thymus-like differentiation:a study of eight cases[J].Diagn Cytopathol,2012,5:16-20.
[5] KAKUDO K,BAI Y,OZAKI T,et al.Intrathyroid epithelial thymoma (ITET) and carcinoma showing thymus-like differentiation (CASTLE):CD5-positive neoplasms mimicking squamous cell carcinoma of the thyroid[J].Histol Histopathol,2013,28:543-556.
[6] CHOW S M,CHAN J K,TSE L L,et al. Carcinoma showing thymus-like element (CASTLE) of thyroid:combined modality treatment in 3 patients with locally advanced disease[J].Eur J Surg Oncol,2007,33:83-85.
[7] CHANG S,JOO M,KIM H. Cytologic Findings of Thyroid Carcinoma Showing Thymus-like Differentiation:A Case Report[J].Korean J Pathol,2012,46:302-305.
[8] NISA A,BARAKZAI A,MINHAS K, et al.Spindle epithelial tumor with thymus-like differentiation of thyroid gland:report of two case with follow-up[J].Indian J Pathol Microbiol,2010,53:781-784.
[9] CHOI K Y,KWON M J,AHN H K,et al. Extrathyroid carcinoma showing thymus-like differentiation (CASTLE):a new case report and review of the therapeutic role of neck dissection and radiotherapy[J].World J Surg Oncol,2014,12:247-247.
[10] ITO Y,MIYAUCHI A,NAKAMURA Y,et al. Clinicopathologic significance of intrathyroidal epithelial thymoma/carcinoma showing thymus-like differentiation:a collaborative study with Member Institutes of The Japanese Society of Thyroid Surgery[J].Am J Clin Pathol,2007,127:230-236.
计量
- 文章访问数: 77
- PDF下载数: 59
- 施引文献: 0