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Abstract：
We present a case of a patient with simultaneous cervical lymph node metastasis of papillary thyroid cancer (PTC) and cecum neuroendocrine tumor (NET). A 45-year-old male patient with the diagnosis of metastatic NET of the cecum underwent fine needle aspiration (FNA) of a positron emission tomography with 18F-fluorodeoxyglucose (18F-FDG PET) positive nodule in the left thyroid lobe. Due to FNA finding suspect of PTC, the patient underwent total thyroidectomy with central neck dissection. Histopathologic finding revealed PTC of the left thyroid lobe and small solitary lymph node PTC metastasis in the central neck region. Postoperative evaluation with neck ultrasound (US) revealed two enlarged suspected lymph nodes in cervical regions III and IV on the left side of the neck and the patient underwent FNA with measurement of thyroglobulin (Tg) in the aspirates. The FNA finding of the cervical lymph node in the region III revealed PTC metastasis with high Tg value in the aspirate, while FNA finding of the cervical lymph node in the region IV revealed NET metastasis with low Tg value in the aspirate. Postoperative serum Tg value was 17.75 µg/L and the patient underwent 5550 MBq iodine-131 (I-131) therapy. A year after I-131 therapy, follow-up neck US demonstrated complete cure of PTC cervical lymph node metastasis in the region III and stable in size NET cervical lymph node metastasis in the region IV. To our knowledge, this is the first report of simultaneous occurrence of cervical lymph node metastases of PTC and NET of the cecum.
摘要：
我们介绍了一例甲状腺乳头状癌（PTC）和盲肠神经内分泌肿瘤（NET）同时发生颈淋巴结转移的患者。一名诊断为盲肠转移性NET的45岁男性患者接受了正电子发射断层扫描的细针抽吸（FNA），左甲状腺叶中有18F-氟脱氧葡萄糖（18F-FDGPET）阳性结节。由于FNA发现了PTC的嫌疑人，患者接受了甲状腺全切除术和中央颈清扫术。组织病理学发现左甲状腺叶PTC和中央颈部小的孤立淋巴结PTC转移。颈部超声（US）的术后评估显示，颈部左侧的III和IV区有两个可疑的淋巴结肿大，患者接受了FNA检查，并测量了抽吸物中的甲状腺球蛋白（Tg）。在III区的颈部淋巴结的FNA发现显示吸出物中具有高Tg值的PTC转移，而在IV区的颈部淋巴结的FNA发现，吸出物中的NET转移具有较低的Tg值。术后血清Tg值为17.75µg/L，患者接受5550MBq碘131（I-131）治疗。I-131治疗一年后,颈部US随访显示，III区PTC颈淋巴结转移完全治愈，IV区NET大小颈淋巴结转移稳定。据我们所知,这是首次同时发生PTC和盲肠NET颈淋巴结转移的报道。
