PDF(Pubmed)
Abstract：
UNASSIGNED: Intrathyroid thymic carcinoma (ITTC) is a rare neoplasm of the thyroid, which accounts for less than 0.15% of all thyroid malignancies. The coexistence of ITTC and papillary thyroid carcinoma (PTC) is an extremely rare condition reported only in a limited number of cases.
UNASSIGNED: A 26-year-old female presented with a growing neck mass, hoarseness, and dysphagia over four months. Ultrasonography revealed that the entire left lobe and the isthmus of the thyroid were replaced with a hypoechoic mass. Moreover, it revealed two hypoechoic nodules in the right thyroid. The patient underwent a total thyroidectomy and paratracheal lymph node dissection. Histopathological examinations revealed the coexistence of ITTC and PTC in the same thyroid. In immunohistochemical analyses, the ITTC was positive for CD5, P63, CD117, and CK 5/6 and negative for thyroglobulin, calcitonin, and TTF 1. At the same time, PTC was positive for TTF 1 and thyroglobulin and negative for CD5, P63, and CK 5/6. The patient received postoperative radiotherapy and remained well with no evidence of recurrence during one month follow-up.
UNASSIGNED: Distinguishing ITTC from other thyroid malignancies before the surgery is challenging due to its non-specific presentations. Therefore, the diagnosis relies on postoperative studies, especially immunohistochemistry. The recommended treatment approach to improve survival in ITTC cases is total thyroidectomy combined with cervical lymph node dissection, followed by postoperative radiotherapy. The coexistence of ITTC and PTC may indicate the similarity in the underlying mechanisms of these tumors. However, further investigations are needed to understand this potential correlation.
UNASSIGNED: A 26-year-old female presented with a growing neck mass, hoarseness, and dysphagia over four months. Ultrasonography revealed that the entire left lobe and the isthmus of the thyroid were replaced with a hypoechoic mass. Moreover, it revealed two hypoechoic nodules in the right thyroid. The patient underwent a total thyroidectomy and paratracheal lymph node dissection. Histopathological examinations revealed the coexistence of ITTC and PTC in the same thyroid. In immunohistochemical analyses, the ITTC was positive for CD5, P63, CD117, and CK 5/6 and negative for thyroglobulin, calcitonin, and TTF 1. At the same time, PTC was positive for TTF 1 and thyroglobulin and negative for CD5, P63, and CK 5/6. The patient received postoperative radiotherapy and remained well with no evidence of recurrence during one month follow-up.
UNASSIGNED: Distinguishing ITTC from other thyroid malignancies before the surgery is challenging due to its non-specific presentations. Therefore, the diagnosis relies on postoperative studies, especially immunohistochemistry. The recommended treatment approach to improve survival in ITTC cases is total thyroidectomy combined with cervical lymph node dissection, followed by postoperative radiotherapy. The coexistence of ITTC and PTC may indicate the similarity in the underlying mechanisms of these tumors. However, further investigations are needed to understand this potential correlation.
摘要：
■甲状腺内胸腺癌（ITTC）是一种罕见的甲状腺肿瘤，占所有甲状腺恶性肿瘤的不到0.15％。ITTC和甲状腺乳头状癌（PTC）共存是一种极为罕见的疾病，仅在有限的病例中报道。
■一名26岁的女性颈部肿块增大，声音嘶哑,和吞咽困难超过四个月。超声检查显示，甲状腺的整个左叶和峡部被低回声肿块取代。此外，显示右侧甲状腺有两个低回声结节.患者接受了甲状腺全切除术和气管旁淋巴结清扫术。组织病理学检查显示，同一甲状腺中ITTC和PTC共存。在免疫组织化学分析中，ITTC对CD5，P63，CD117和CK5/6呈阳性，对甲状腺球蛋白呈阴性，降钙素,和TTF1。同时,PTC对TTF1和甲状腺球蛋白呈阳性，对CD5，P63和CK5/6呈阴性。患者接受了术后放疗，在一个月的随访中没有复发的迹象。
■在手术前将ITTC与其他甲状腺恶性肿瘤区分开来由于其非特异性表现而具有挑战性。因此,诊断依赖于术后研究,尤其是免疫组织化学.在ITTC病例中提高生存率的推荐治疗方法是甲状腺全切除术联合颈淋巴结清扫术,术后放疗。ITTC和PTC的共存可能表明这些肿瘤的潜在机制相似。然而,需要进一步的调查来了解这种潜在的相关性。
■一名26岁的女性颈部肿块增大，声音嘶哑,和吞咽困难超过四个月。超声检查显示，甲状腺的整个左叶和峡部被低回声肿块取代。此外，显示右侧甲状腺有两个低回声结节.患者接受了甲状腺全切除术和气管旁淋巴结清扫术。组织病理学检查显示，同一甲状腺中ITTC和PTC共存。在免疫组织化学分析中，ITTC对CD5，P63，CD117和CK5/6呈阳性，对甲状腺球蛋白呈阴性，降钙素,和TTF1。同时,PTC对TTF1和甲状腺球蛋白呈阳性，对CD5，P63和CK5/6呈阴性。患者接受了术后放疗，在一个月的随访中没有复发的迹象。
■在手术前将ITTC与其他甲状腺恶性肿瘤区分开来由于其非特异性表现而具有挑战性。因此,诊断依赖于术后研究,尤其是免疫组织化学.在ITTC病例中提高生存率的推荐治疗方法是甲状腺全切除术联合颈淋巴结清扫术,术后放疗。ITTC和PTC的共存可能表明这些肿瘤的潜在机制相似。然而,需要进一步的调查来了解这种潜在的相关性。
