Objective To analyze the causes and preventive measures of thyroid cancer misdiagnosed by CT as nodu-lar goiter and thyroid adenoma.Methods The clinical data of 12 patients with thyroid cancer misdiagnosed in our hospital from February 2020 to March 2022 were retrospectively analyzed.Results All 12 patients were treated with single,painless mass in the anterior neck(5 cases on the right side and 7 cases on the left side),and all of them had enlarged thyroid gland.Multiple enlarged cervical lymph nodes were palpated in 5 patients,and pressure symptoms such as hoarseness and dyspnea were found in 5 patients.The swelling material was hard and the activity of swallowing was poor in 5 patients.Of the 12 ca-ses,7 had irregular shape and 4 had clear boundary.In 3 cases,the tumor was infiltrated near the trachea,muscle or blood vessel,the capsule was incomplete in 4 cases,and the cervical lymph nodes were enlarged in 5 cases.All the 12 cases showed uneven enhancement by enhanced scan.The patients were misdiagnosed as thyroid adenoma in 7 cases and nodular goiter in 5 cases,all of which were to be treated by operation.They were confirmed as thyroid cancer by intraoperative frozen section and postoperative pathological examination.The pathological type was papillary adenocarcinoma.The duration of mis-diagnosis was 2-3 days.Among the 12 cases,8 cases underwent adenolobectomy,4 cases underwent adenolobectomy + isth-musectomy,5 cases underwent removal of enlarged neck lymph node on the affected side,and postoperative radiotherapy was given to 6 cases.Oral thyroxine tablets were given to 12 cases to prevent recurrence.At 1-year follow-up,all patients survived without recurrence.Conclusion Patients with thyroid cancer often have no obvious symptoms in the early stage and mostly presented with painless neck masses.If the CT images are not typical and the cytological examination of acupuncture is not performed early,preoperative misdiagnosis is more likely to occur.It is necessary to improve the vigilance of the disease,carefully inquire about the history,carefully perform physical examination,be familiar with CT imaging signs,conduct early needle aspiration cytology and pathological examination,to effectively avoid preoperative misdiagnosis.
维普
万方数据