首页|局部晚期甲状腺癌多学科诊治1例报告

局部晚期甲状腺癌多学科诊治1例报告

Multidisciplinary treatment of locally advanced thyroid cancer:a case report

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分化型甲状腺癌(DTC)是最常见的内分泌肿瘤,其特点为发病率高、复发率较低、病死率低.局部晚期甲状腺癌(LATC)在临床中少见,预后较差,是甲状腺癌患者主要的死亡原因之一.2024年8月,吉林大学中日联谊医院甲状腺外科收治1例61岁男性患者,因"颈部肿物术后16年,肿物增大破溃3个月"入院.体查见左侧锁骨上窝一大小约12 cm×12 cm肿物,形态不规则,表面呈暗红色,部分区域已破溃、出血,并附有脓苔.入院后提请多学科治疗综合协作组(MDT)会诊,行第5次手术(左侧颈部肿物切除术、左侧颈部淋巴结清扫术、颏下肿物切除术、游离皮瓣移植术),术后第10天痊愈出院,术后1个月于我院复查,颈部超声未见明显异常,局部皮肤愈合良好,移植皮瓣成活.本文回顾该例LATC患者的MDT治疗经过,结合国内外文献,对LATC特点进行总结,为该病的综合性治疗提供经验和参考.
Differentiated thyroid carcinoma (DTC) is the most common endocrine tumor,characterized by high incidence,low recurrence rate,and low mortality. Locally advanced thyroid cancer (LATC) is rare in clinical practice,with poor prognosis,and is one of the leading causes of death among thyroid cancer patients. In August 2024,the Thyroid Surgery Department of China-Japan Union Hospital of Jilin University admitted a 61-year-old male patient with a history of "neck mass surgery 16 years ago and progressive enlargement with ulceration of the mass over the past 3 months." Physical examination revealed an irregularly shaped mass measuring approximately 12 cm × 12 cm in the left supraclavicular fossa,with a dark red surface,ulceration,bleeding,and necrotic exudate in some areas. After admission,a multidisciplinary team (MDT) consultation was initiated,and the patient underwent his fifth surgery,which included resection of the left cervical mass,left cervical lymphadenectomy,resection of a submental mass,and free flap transplantation. The patient was discharged on postoperative day 10 in good condition. One month after surgery,a follow-up ultrasound at our hospital showed no significant abnormalities in the neck,with good healing of the local skin and survival of the transplanted flap. This article reviews the MDT treatment process of this LATC case and summarizes the characteristics of LATC based on domestic and international literature,providing experience and references for the comprehensive treatment of this disease.

Thyroid NeoplasmsThyroid Cancer,PapillaryPatient Care Team

付言涛、吴广智、刘彦希、张大奇、李婧婷

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吉林大学中日联谊医院甲状腺外科,吉林长春 130000

甲状腺肿瘤 甲状腺癌,乳头状 病人医疗小组

2024

中国普通外科杂志
中南大学

中国普通外科杂志

CSTPCD北大核心
影响因子:1.623
ISSN:1005-6947
年,卷(期):2024.33(11)