以颈淋巴结肿大为首发症状的小儿甲状腺癌  

Thyroid Carcinoma Taking Cervical Lymph Nodes Metastasis as the First Symptom in Children

作　　者：刘国昌[1] 耿进妹[2] 王圣石[1] 王春华[1] 李鹰[1] 

机构地区：[1]山东省济宁市第一人民医院小儿外科,济宁市272111 [2]山东省济宁医学院,济宁市272113

出　　处：《肿瘤防治杂志》2000年第4期391-392,共2页China Journal of Cancer Prevention and Treatment

摘　　要：目的 :探讨小儿甲状腺癌的一种特殊临床表现。方法 :对 1970～ 1998年我们收治的 15岁以下小儿甲状腺癌 31例分析发现有 7例以颈淋巴结肿大作为就诊第一症状。结果 :7例中甲状腺微小癌 4例 ,普通类型甲状腺癌 3例。所有病例在院外均以颈部良性病变而屡遭误诊。院内外局部淋巴结活检4例 ,穿刺细胞学检查 1例 ,甲状腺B超 3例有阳性发现。对单侧 5例行甲状腺患侧叶、峡部及对侧叶部分切除并同侧颈淋巴结清扫 ,对双侧 2例行甲状腺近全切并双侧颈淋巴结清扫。 7例中获访 6例 ,5例无瘤存活 ,平均 63个月。结论 :颈淋巴结肿大可以是小儿甲状腺癌的第一或唯一表现 ,常被误诊为颈部良性病变 。Objective:To study the special symptom of thyroid carcinoma in children.Methods:31 cases thyroid carcinoma were reviewed from 1970-1998. 7 of 31 cases took cervical lymph nodes metastasis as the first symptom.Results: 4 of 7 cases were tiny cancer(≤1 cm),3 ordinary type cancer.All cases were misdiagnosed by other hospitals.They were comfirmed as thyroid carcinoma by lymph node biopsy or puncture and ultrasonic examination.Five lateral cases underwent lobectomy of the affected side plus the isthmusectomy,the subtotal lobectomy of the opposite side and the affected cervical lymphadenectomy.Two bilateral cases,besides the former operations,underwent bilateral cervical lymphadenectomy.6 of 7 cases have got a follow up. Of them, 5 cases survived without tumors for 63 months on the average.Conclusions:Cervical lymph nodes metastasis may be the first or sole symptom of thyroid carcinoma in children.They can be misdiagnosed as the benign diseases.

关 键 词：甲状腺肿瘤 癌 淋巴结 儿童 诊断 

分 类 号：R736.1[医药卫生—肿瘤]