甲状腺术后并发颈部侵袭性纤维瘤病1例报道并文献复习  

A case report and literature review of aggressive fibromatosis in the neck after thyroid surgery

作　　者：李婷婷[1] 张竞轶 曾铮 王建华[1] LI Tingting;ZHANG Jingyi;ZENG Zheng;WANG Jianhua(Department of Thyroid and Breast Surgery,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210028,China;Department of Pathology,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210028,China)

机构地区：[1]南京中医药大学附属中西医结合医院甲乳外科,江苏南京210028 [2]南京中医药大学附属中西医结合医院病理科,江苏南京210028

出　　处：《中国医药科学》2024年第8期180-183,共4页China Medicine And Pharmacy

基　　金：南京中医药大学自然科学基金(XZR2020022)。

摘　　要：回顾1例甲状腺乳头状癌(PTC)术后并发颈部侵袭性纤维瘤病(AF)患者的诊治经过及临床病理资料。患者女,25岁,2021年行左PTC根治术,复查甲状腺彩超示右侧甲状腺梭形低回声结节,粗针穿刺考虑为纤维组织增生性病变,基因检测示HRAS、KRAS基因突变。再次入院行右侧颈部肿物切除术,术后病理确诊为AF。结合国内外文献对该病诊疗经验进行总结并归纳其特征,以期为临床工作者更好地了解发病机制和诊疗提供参考。甲状腺术后并发颈部AF多呈局部侵袭,局部复发率高,等待观察是一线治疗手段,综合评估后对进展肿块采取外科治疗,对难以手术治疗的采取全身治疗。A retrospective analysis was conducted on the diagnosis and treatment process and clinicopathological data of a case of aggressive fibromatosis(AF)in the neck after surgery for papillary thyroid carcinoma(PTC).The patient,a 25-year-old female,underwent radical left PTC resection in 2021,and the re-examination of thyroid color ultrasound showed a right thyroid fusiform hypoechoic nodule,and the gross needle aspiration was considered to be a fibrous tissue proliferative lesion,and genetic testing showed HRASand KRAS gene mutations.Upon re-admission to the hospital,a right cervical mass resection was performed,and AF was confirmed by postoperative pathology.Based on domestic and foreign literature,the diagnosis and treatment experience of this disease and its characteristics were summarized,to provide a reference for clinical workers to better understand its pathogenesis,diagnosis,and treatment.It was found that patients with postoperative cervical AF often exhibit local invasion and a high local recurrence rate.Watch and Wait is a first-line treatment method.After comprehensive evaluation,surgical treatment should be taken for progressive masses,while systemic treatment should be taken if surgical treatment is difficult to be conducted.

关 键 词：甲状腺乳头状癌 侵袭性纤维瘤病 甲状腺术后 手术治疗 

分 类 号：R736.1[医药卫生—肿瘤] R739.91[医药卫生—临床医学]