Clinical treatment of metastatic papillary thyroid carcinoma in cervical lymph nodal with occult primary sites
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摘要: 目的:探讨原发灶不明的颈部淋巴结甲状腺乳头状转移癌的诊断、治疗和预后。方法:总结2009-2015年5例原发灶不明的颈部淋巴结甲状腺乳头状转移癌患者的临床资料。结果:依据术前检查,2例仅行颈部淋巴结切除,另3例行甲状腺次全切或全切加颈清;病理结果均显示颈部为甲状腺乳头状癌,原发灶甲状腺正常。随访时间1~7年,无复发。结论:原发灶不明的颈部淋巴结甲状腺乳头状转移癌是否切除甲状腺宜慎重。Abstract: Objective: To discuss the diagnosis, treatment and prognosis of metastatic papillary thyroid carcinoma in cervical lymph nodal with occult primary sites.Method: The clinical data of 5 patients involved papillary thyroid carcinoma with cervical lymph nodal metastasis with occult primary sites from 2009 to 2015 were analyzed.Result: According to preoperation examinations, two of them only underwent neck lymph node resection and three patients underwent asubtotal or total thyroidectomy plus neck lymph node dissection. All the pathological results showed that there were metastatic papillary thyroid carcinoma in cervical lymph nodal, but the primary sites of thyroid tissue were normal. After 1 to 7 year follow-up, there was no recurrence.Conclusion: Whether to take the thyroidectomy need to be carefully considered thyroidectomy in patients with metastatic papillary thyroid carcinoma in cervical lymph nodal with occult primary sites.
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[1] ROH J L, KIM J M, PARK C I.Lateral cervical lymph node metastases from papillary thyroid carcinoma:pattern of nodal metastases and optimal strategy for neck dissection[J].Ann Surg Oncol, 2008, 15:1177-1182.
[2] PODNOS Y D, SMITH D, WAGMAN L D, et al.The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer[J].Am Surg, 2005, 71:731-734.
[3] GHARIB H, PAPINI E, GARBER J R, et al.American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules-2016 Update[J].Endocrine Pract, 2016, 22:622-639.
[4] MECHANICK J I, CAMACHO P M, COBIN R H, et al.American Association of Clinical Endocrinologists Protocol for Standardized Production of Clinical Practice Guidelines-2010update[J].Endocr Pract, 2010, 6:270-283.
[5] HAUGEN B R, ALEXANDER E K, BIBLE K C, et al.2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid, 2016, 26:1-133.
[6] CHEN A Y, JEMAL A, WARD E M.Increasing incidence of differentiated thyroid cancer in the United States, 1988-2005[J].Cancer, 2009, 115:3801-3807.
[7] ANASTASILAKIS A D, POLYZOS S A, MAKRAS P, et al.Papillary thyroid microcarcinoma presenting as lymph node metastasis-a diagnostic challenge:case report and systematic review of literature[J].Hormones (Athens), 2012, 11:419-427.
[8] ATT IE J N, SETZIN M, KLEIN I.Thyroid carcinoma presenting as an enlarged cervical lymph node[J].Am J Surg, 1993, 166:428-430.
[9] MACERI D R, BABYAK J, OSSAKOW S J.Lateral neck mass.Sole presenting sign of metastatic thyroid cancer[J].Arch Otolaryngol Head Neck Surg, 1986, 112:47-49.
[10] COLEMAN S C, SMITH J C, BURKEY B B, et al.Long-standing lateral neck mass as the initial manifestation of well-differentiated thyroid carcinoma[J].Laryngoscope, 2000, 110:204-209.
[11] VERGE J, GUIXA J, ALEJO M, et al.Cervical cystic lymph node metastasis as first manifestation of occult papillary thyroid carcinoma:report of seven cases[J].Head Neck, 1999, 21:370-374.
[12] FLANAGAN D, GIBB P, SKENE A, et al.What should we do?Papillary thyroid carcinoma in a lymph node but normal thyroid tissue-how should we proceed?the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology[J].Eur J Surg Oncol, 2000, 26:177-180.
[13] SIDHU S, LIOE T F, CLEMENTS B.Thyroid papillary carcinoma in lateral neck cyst:missed primary tumour or ectopic thyroid carcinoma within a branchial cyst[J]?J Laryngol Otol, 2000, 114:716-718.
[14] LIVOLIS V A.Thyroid papillary carcinoma in lateral neck cyst:missed primary tumour or ectopic thyroid carcinom a within a branchial cyst[J]?J Laryngol Otol, 2001, 115:614-615.
[15] GONZALEZ-GARCIA R, ROMAN-ROMERO L, SASTRE-PEREZ J, et al.Solitary cystic lymph neck node metastasis of occult thyroid papillary carcinoma[J].Med Oral Patol Oraly Cirugia Bucal, 2008, 13:E796-E799.
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