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逆侧转移性乳头性甲状腺癌,并由原发性过高阿尔多斯特隆症复杂化:一个病例报告
Yun-Long Li1, Xu-Liang Xia2, Si-Yuan Zhang2
1Department of Thyroid and Breast Surgery, The Second Affiliated Hospital of Chengdu Medical College - Nuclear Industry 416 Hospital, Chengdu 610051, Sichuan Province, China. liyunlong416@163.com.
World journal of clinical cases
|October 20, 2025
概括
本病例报告详细介绍了一种罕见的乳头甲状腺癌 (PTC) 病例,该病例侵入了50岁男性的迷走神经和内静脉. 早期检测和手术干预对于管理血管和神经参与的高级PTC至关重要.
科学领域:
- 在瘤学瘤学.
- 手术病理学手术病理学
- 头部和部手术 头部和部手术
背景情况:
- 乳头甲状腺癌 (PTC) 是最常见的甲状腺恶性瘤,经常出现淋巴结转移.
- 虽然很少见,但PTC可以侵入局部结构,同时流动神经和主要静脉参与非常罕见.
- 本报告侧重于一个独特的案例,即PTC在当地进行了广泛的入侵.
研究的目的:
- 报告一种罕见的乳头甲状腺癌病例,该病例广泛侵袭迷走神经和内静脉.
- 突出这种先进的局部疾病所带来的诊断和管理挑战.
- 强调在PTC中进行血管和神经参与的彻底手术前评估的重要性.
主要方法:
- 一个50岁的男性的病例介绍,他的部质量和声迅速增长.
- 身体检查显示了一个不动的,不规则的部质量.
- 超声导向细针吸收活检证实乳头甲状腺癌与转移性疾病.
- 在手术前诊断原发性高阿尔多斯特主义.
主要成果:
- 患者出现了6.5厘米左右的部质量,导致声.
- 病理学证实了转移性乳头甲状腺癌.
- 该病例涉及迷走神经和内静脉的完全入侵,这是一个罕见的情况.
- 该患者还有高血压和低血压病史,诊断为原发性高阿尔多斯特隆症.
结论:
- 手术管理是差异化甲状腺癌的主要治疗方法.
- 对主要的血管和神经干扰进行手术前评估对于手术规划至关重要.
- 在晚期病例中,手术期间的神经监测和考虑血管切除/重建是必不可少的.
- 放射性治疗和TSH抑制是额外甲状腺侵袭或转移的重要辅助治疗方法.
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