Papillary thyroid carcinoma without metastases manifesting as an autonomously functioning thyroid nodule
Papillary thyroid carcinoma without metastases manifesting as an autonomously functioning thyroid nodule
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DOI：
10.1507/endocrj.52.309
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发表时间：
2005-06-01
影响因子：
2
通讯作者：
Nakao, K
中科院分区：
文献类型：
--
作者：
Majima, T;Doi, K;Nakao, K
本报告描述了一名 59 岁女性，其甲状腺结节内患有乳头状甲状腺癌。该患者因体重迅速减轻且左侧颈部肿胀而被转诊至我们诊所。甲状腺超声检查显示增大的左叶下部有不均匀结节。 Tc-99m 和 I-123 甲状腺闪烁扫描成像均显示与结节相对应的热点区域，而其余甲状腺组织中的摄取较低。结节的组织病理学检查显示乳头状腺癌，免疫组织化学显示三碘甲状腺原氨酸和甲状腺素染色较弱但呈阳性。根据这些发现，结节被诊断为功能性乳头状腺癌。尽管在放射性核素同位素扫描中表现为热结节的甲状腺癌极为罕见，但当前的病例具有重要的临床意义，因为它表明热结节的诊断并不总能排除结节内的甲状腺癌，即使是热结节也需要仔细处理，以免忽视恶性肿瘤。
A 59-year-old woman with papillary thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this report. The patient was referred to our clinic because of rapid weight loss and swelling on the left side of the neck. Ultrasonography of the thyroid demonstrated a nonhomogeneous nodule in the lower part of an enlarged left lobe. Both Tc-99m and I-123 thyroid scintigraphic imaging showed a hot area corresponding to the nodule with lower uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed papillary adenocarcinoma, and the immunohistochemistry proved weak but positive staining for triiodothyronine and thyroxine. Based on these findings, the nodule was diagnosed as a functioning papillary adenocarcinoma. Although thyroid carcinoma manifesting as a hot nodule on the radionuclide isotope scan is an extremely rare occurrence, the current case is clinically important because it suggests that the diagnosis of a hot nodule cannot always rule out thyroid carcinoma in the nodule, and that even a hot nodule requires careful management so that the malignancy is not overlooked.