甲状腺癌合并颈内静脉瘤栓7例分析  

Internal jugular vein tumour thrombus compliated with thyroid carcinoma：report of 7 cases

作　　者：倪松[1] 朱一鸣[1] 李德志[1] 刘文胜[1] 刘绍严[1] 王晓雷[1] 

机构地区：[1]中国医学科学院 北京协和医学院肿瘤医院头颈外科,北京100021

出　　处：《中华解剖与临床杂志》2015年第6期556-558,共3页Chinese Journal of Anatomy and Clinics

摘　　要：目的：探讨甲状腺癌合并颈内静脉瘤栓的诊断与治疗。方法回顾性分析2010年1月—2014年12月中国医学科学院肿瘤医院收治的7例甲状腺癌合并颈内静脉瘤栓患者的临床资料。术前 CT 证实7例甲状腺癌患者均合并颈内静脉瘤栓。5例行根治切除,其中2例切除颈内静脉及内部瘤栓、3例切除瘤栓而保留颈内静脉；2例行姑息切除。术后病理提示4例为未分化癌,3例为分化型甲状腺癌。结果4例未分化癌患者（2例行根治切除,2例行姑息切除）均于术后6个月内死于广泛的局部复发及远处转移；3例分化型甲状腺癌患者术后分别随访了39、40、44个月,均存活且无肿瘤复发。结论对于甲状腺癌合并颈内静脉瘤栓的患者,CT 有助于明确诊断并根据瘤栓的位置制定手术方案；对于分化型甲状腺癌患者,应尽量行根治术,可获得较好的治疗效果。Objective To investigate the treatment of thyroid cancer with internal jugular vein （IJV） tumour thrombus. Methods Seven cases of thyroid cancer with IJV tumour thrombus treated in Cancer Hospital Chinese Academy of Medical Sciences from 2010 to 2014 were retrospectively analyzed. Computerized tomography （CT） showed all cases had thrombus extended to the IJV. Two cases received palliative resection and five achieved radical resection, including two cases in which the emboli were removed together with the IJVs, and three cases in which IJVs were saved after emboli removal. Post-operative pathology revealed four undifferentiated carcinoma and three differentiated thyroid cancer. Results Four patients with undifferentiated carcinoma died in six months（two cases received palliative resection and two achieved radical resection）. Three patients with differentiated thyroid cancer had long survival.Conclusions For patients with thyroid carcinoma with IJV tumor emboli, CT is helpful for diagnosis and treatment. For patients with differentiated thyroid cancer, radical resection should be performed to achive good results.

关 键 词：甲状腺癌 颈内静脉 瘤栓 

分 类 号：R736.1[医药卫生—肿瘤]