下颌骨升支转移性甲状腺癌1例报道并文献复习  

Thyroid cancer metastases to the ascending ramus of the mandible: a case report and literature review

作　　者：王芳 艾昭东 王志远 陈杰 WANG Fang;AI Zhao-dong;WANG Zhi-yuan;CHEN Jie(Department of Head and Neck Surgery,Hunan Cancer Hospital the Affiliated Cancer Hospital of Xiangya Medical College Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅医学院附属肿瘤医院湖南省肿瘤医院头颈外科

出　　处：《中国耳鼻咽喉颅底外科杂志》2020年第1期92-94,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨滤泡型甲状腺癌(FTC)下颌骨升支骨转移的临床诊治经验。方法回顾性分析1例下颌骨升支转移性甲状腺癌患者的病例资料,通过对该疾病相关文献的复习,进而对该疾病的临床特点、诊断与治疗进行讨论。结果本例患者术前行CT示甲状腺左叶肿块性质待定,考虑甲状腺癌;左侧下颌骨升支骨质破坏并软组织形成,考虑骨巨细胞瘤。行甲状腺次全切,并将下颌骨部分升支及肿块一并切除。术后病理证实下颌骨肿物为滤泡性甲状腺癌转移。术后1年患者复查未见复发及转移。结论滤泡型甲状腺癌的细胞异型性小,术中快速病理诊断困难,发生下颌骨转移更为罕见。无论是影像学医生还是临床医生都要仔细阅读影像图片,并结合病史评估患者全身多发肿块的来源,作出相对正确的诊疗计划,避免误诊。Objective To explore the clinical diagnosis and treatment of follicular thyroid carcinoma(follicular thyroid carcinoma,FTC) with mandibular metastasis.Methods A case of thyroid cancer with mandibular metastasis was reviewed, and the clinical characteristics, diagnosis and treatment of the disease were discussed by reviewing the relevant literature of the disease.Results The patient underwent preoperative CT scanning: The nature of the left thyroid lobe mass is to be determined, which was considered thyroid cancer;the left ascending branch of the mandible is damaged and soft tissue is formed. Considering the possibility of giant cell tumor of bone. The subtotal thyroidectomy was performed, and the ascending branches and masses of the mandible were removed. Postoperative pathology confirmed follicular thyroid cancer metastasis.Postoperative reexamination showed no recurrence or metastasis after one year.Conclusion The cell atypia of follicular thyroid carcinoma is relatively less obvious, and its rapid pathological diagnosis is difficult during operation, and mandibular metastases are rare. Both imaging doctors and clinicians must carefully read the imaging pictures, evaluate the source of multiple tumors in the whole body based on the medical history,so as to make a relatively correct diagnosis and treatment plan to avoid misdiagnosis.

关 键 词：滤泡型甲状腺癌 下颌骨 骨转移 诊断 治疗 

分 类 号：R739.91[医药卫生—肿瘤]