甲状腺恶性肿瘤并发颈内静脉瘤栓2例并文献复习  

Thyroid tumor complicated with tumor thrombus in internal jugular vein: An analysis of 2 cases and literatures review

作　　者：余招焱[1] 王超宇[1] 彭欢 袁平[1] YU Zhao-yan;WANG Chao-yu;PENG Huan(Department of Vascular and Thyroid Surgery,Guizhou Provincial People's Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院血管甲状腺外科,贵州贵阳550002

出　　处：《中国实用外科杂志》2019年第3期243-246,251,共5页Chinese Journal of Practical Surgery

摘　　要：目的探讨甲状腺肿瘤并发颈静脉瘤栓病人的临床特征及诊治方式。方法检索2000年1月至2018年10月国内期刊发表的关于甲状腺肿瘤并发颈静脉瘤栓病人的个案报道,并结合贵州省人民医院血管甲状腺外科收治的2例病人病例资料,分析病人的临床特征及其治疗方案。结果文献检索获得相关文献10篇,包括23例病人。25例病人中男14例,女11例,年龄44～84(62.9±9.8)岁,瘤栓同侧的甲状腺肿瘤最大径在2.8～8.0 cm。全组病人瘤栓长度在1～30 cm,19例病人中血管内蔓延型瘤栓14例,直接侵犯型瘤栓5例。全组病人肿瘤病理学类型中甲状腺乳头状癌4例,滤泡状癌6例,低分化癌5例,未分化癌8例,肌源性低度恶性肉瘤及硬化性上皮样纤维肉瘤各1例。13例病人中9例病人行颈内静脉切除,4例病人行颈静脉切开取栓术。结论甲状腺肿瘤并发颈静脉瘤栓病人多为血管侵袭能力极强的肿瘤,病人远期预后很差,应积极采取手术治疗去除瘤栓,改善病人的预后。Objective To investigate the clinical features,diagnosis and treatment of thyroid tumor complicated with tumor thrombus in internal jugular vein.Methods Case reports of thyroid tumor complicated with tumor thrombus in internal jugular vein published in domestic journals since January 2000 were retrieved.The clinical features and treatment procedures were analyzed combining with the data of 2 patients admitted to the Department of Vascular and Thyroid Surgery of Guizhou Provincial People’s Hospital.Results A total of 10 reports were retrieved,including 23 patients.Of the 25 patients,14 were males and 11 were females,aged 44-84(62.9±9.8)years.The largest diameter of thyroid tumor was 2.8-8.0 cm.The length of tumor thrombus ranged from 1 cm to 30 cm.Among the 19 cases,14 were derived from intravascular spreading tumor thrombus,and 5 were from direct invasive tumor thrombus.There were 4 cases of papillary carcinoma,6 cases of follicular carcinoma,5 cases of poorly differentiated carcinoma,8 cases of undifferentiated carcinoma,1 case of myogenic sarcoma and 1 case of sclerosing epithelioid fibrosarcoma.Of the 13 cases,9 underwent internal jugular vein resection and 4 underwent thrombectomy.Conclusion Thyroid tumors complicated with tumor thrombus in internal jugular vein are mostly tumors with strong vascular invasion ability.The long-term prognosis of the patients is very poor.Surgical treatment should be actively taken to remove the tumor thrombus and improve the prognosis of the patients.

关 键 词：甲状腺肿瘤 颈静脉瘤栓 临床特征 手术方式 

分 类 号：R6[医药卫生—外科学]