Neck mass

颈部肿块
  • 文章类型: Editorial
    甲状腺癌是一种复杂的疾病,有几种类型,最常见的是分化良好和未分化。后者,“未分化癌”,也称为间变性甲状腺癌(ATC),是一种高度侵袭性的恶性肿瘤,占所有甲状腺癌的0.2%以下,预后不良,中位生存期为5个月。BRAF基因突变是与这种类型的甲状腺癌相关的最常见的分子因素。靶向生物制剂的最新进展,免疫疗法,干细胞疗法,纳米技术,达布拉非尼/曲美替尼联合治疗,免疫检查点抑制剂(ICI)和人工智能提供了新的治疗选择。达拉非尼和曲美替尼的联合治疗是目前BRAF-V600E基因突变患者的标准治疗方法。此外,达布拉非尼/曲美替尼联合治疗,单独使用或与靶向疗法结合使用的ICI为改善这种致命疾病的预后带来了一些希望。年龄更小,早期肿瘤分期和放疗都是预后改善的预后因素.最终,治疗方案应根据监测和流行病学数据针对个体患者量身定制,多学科方法至关重要。
    Thyroid carcinoma is a complex disease with several types, the most common being well-differentiated and undifferentiated. The latter, \"undifferentiated carcinoma\", also known as anaplastic thyroid carcinoma (ATC), is a highly aggressive malignant tumor accounting for less than 0.2% of all thyroid carcinomas and carries a poor prognosis with a median survival of 5 months. BRAF gene mutations are the most common molecular factor associated with this type of thyroid carcinoma. Recent advances in targeted biological agents, immunotherapy, stem cell therapy, nanotechnology, the dabrafenib/trametinib combination therapy, immune checkpoint inhibitors (ICI) and artificial intelligence offer novel treatment options. The combination therapy of dabrafenib and trametinib is the current standard treatment for patients with BRAF-V600E gene mutations. Besides, the dabrafenib/trametinib combination therapy, ICI, used alone or in combination with targeted therapies have raised some hopes for improving the prognosis of this deadly disease. Younger age, earlier tumor stage and radiotherapy are all prognostic factors for improved outcomes. Ultimately, therapeutic regimens should be tailored to the individual patient based on surveillance and epidemiological data, and a multidisciplinary approach is essential.
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  • 文章类型: Case Reports
    通常,甲状腺被认为是转移性疾病较少的器官,甲状腺结直肠转移(CMT)的报道很少,尤其是,甲状腺转移瘤的临床体征是主诉。CMT发生在晚期结直肠癌中,与预后差和生存期短有关。
    在这种情况下,我们报道了一例以颈部肿块征象为CMT首发表现的患者.患者于2019年6月接受了甲状腺部分切除术,甲状腺癌的免疫组织化学发现提示胃肠道腺癌的可能性。该患者于2019年7月接受了结肠镜检查,发现结肠肿块。病理检查诊断为直肠腺癌。患者接受新辅助化疗,手术治疗,术后辅助化疗和靶向治疗。患者于2022年6月死亡。
    转移疾病根本不会被忽视,当病人抱怨颈部肿块的迹象时。Further,结直肠癌患者一旦发生甲状腺结节,应考虑转移癌的可能性。尽管原发肿瘤的生物学特征和分期对预后有重要影响,积极的标准化治疗也有帮助。
    UNASSIGNED: Commonly, the thyroid gland is regarded as an organ with fewer metastatic diseases, and colorectal metastasis to the thyroid (CMT) is rarely reported, especially, with that the clinical sign of thyroid metastasis nidus is the chief complaint. The CMT occurs in advanced colorectal cancer and is associated with poor prognosis and short survival.
    UNASSIGNED: In this case, we reported a patient with the sign of neck mass as the first manifestation of CMT. The patient underwent a partial thyroidectomy in June 2019, immunohistochemical findings of thyroid carcinoma suggested the possibility of adenocarcinoma of gastrointestinal tract. The patient underwent a colonoscopy in July 2019 and a colonic mass was found. Pathological examination diagnosed rectal adenocarcinoma. The patient underwent neoadjuvant chemotherapy, surgical treatment, postoperative adjuvant chemotherapy and targeted therapy. The patient died in June 2022.
    UNASSIGNED: The metastasis disease would not be ignored at all, when a patient complains at signs of neck mass. Further, the possibility of metastasis cancer should be considered once thyroid nodules occur in patients with colorectal cancer. Even though the biological characteristics and stage of the primary tumor have an important impact on the prognosis, positive standardized treatments can also be helpful.
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  • 文章类型: Journal Article
    血管外皮细胞瘤(HPCs)是罕见的血管肿瘤,头颈部血管外皮细胞瘤(HNHPC)占所有HPCs的11%至16%,可能发生在任何年龄。然而,根据最近的一项研究,HNHPC最常见于中年人,女性患者略有优势。在目前的情况下,我们报道了HNHPC的成功治疗。
    Hemangiopericytomas (HPCs) are rare vascular tumors, and head and neck hemangiopericytoma (HNHPC) accounts for 11% to 16% of all HPCs, possibly occurring at any age. However, according to a recent study, HNHPC was most frequently observed in middle-aged adults and had a slight predominance of female patients. In the present case, we report the successful treatment of HNHPC.
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  • 文章类型: Case Reports
    成浆细胞淋巴瘤(PBL)是人类罕见的淋巴瘤形式。PBL起源于成浆细胞,通常在口腔/颈部出现肿胀/肿块。一只7岁的杂种狗因口腔和颈部肿块而出现。细胞学和组织病理学提示圆形细胞肿瘤,怀疑是淋巴瘤。免疫组织化学(IHC)染色面板显示CD18阳性,因此支持圆形细胞肿瘤的诊断,但T细胞和B细胞淋巴瘤阴性,CD3、CD20和PAX-5。其他标志物包括细胞角蛋白AE1/3(用于上皮细胞来源),CD31(内皮细胞),SOX10(用于黑色素瘤),IBa-1(用于组织细胞肉瘤),CD117(肥大细胞瘤)均为阴性。MUM-1(用于浆细胞分化)是强阳性的,并且CD79a(B细胞和浆细胞)也是少量阳性的。根据组织病理学和免疫组织化学结果结合临床表现,有可疑的PBL诊断.根据现有文献,这可能是第一例被怀疑为PBL的狗。
    Plasmablastic lymphoma (PBL) is a rare form of lymphoma in people. PBL originates from plasmablasts and usually presents with swelling/mass in the mouth/neck. A 7-year-old Mongrel dog was presented for a large oral and neck mass. Cytology and histopathology were suggestive of a round cell tumor that was suspected to be lymphoma. An immunohistochemical (IHC) stain panel showed positive for CD18, thus supporting the diagnosis of round cell tumor, but negative for T- and B-cell lymphomas, CD3, CD20, and PAX-5. Other markers including cytokeratin AE1/3 (for epithelial cell origin), CD31 (for endothelial cells), SOX10 (for melanoma), IBa-1 (for histiocytic sarcoma), and CD117 (for mast cell tumor) were all negative. MUM-1 (for plasma cell differentiation) was strongly positive and CD79a (B cell and plasma cells) was also scantly positive. Based on the histopathology and immunohistochemistry results in combination with the clinical presentation, a suspected diagnosis of PBL was made. As per available literature, this is perhaps the first highly suspected case of PBL in a dog.
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  • 文章类型: Case Reports
    精原细胞瘤约占恶性睾丸肿瘤的98%,通常表现为无痛,睾丸中明显的固体肿块。仅表现为孤立性颈部肿块的精液瘤非常罕见。此病例报告描述了一名先前健康的35岁男性,他有3个月的右颈部偶然发现肿块的历史。他没有睾丸症状。他做了颈部超声检查,超声造影,计算机断层扫描和正电子发射断层扫描。血清人绒毛膜促性腺激素(3.90mIU/ml)升高,甲胎蛋白(3.79ng/ml)在正常范围内。临床检查和影像学检查未发现任何可疑的睾丸癌征象。颈部肿块活检证实了转移性精原细胞瘤的诊断。病例报告介绍了精原细胞瘤的超声和对比增强超声特征,并提供了有关精原细胞瘤这种非常罕见的转移部位的文献更新。
    Seminoma accounting for approximately 98% of malignant testicular tumours and it typically presents as a painless, palpable solid mass in the testis. Seminomas presenting only as a solitary neck mass are very rare. This case report describes a previously healthy 35-year-old male that presented with a 3-month history of the incidental discovery of a mass in his right neck. He had no testicular symptoms. He underwent neck ultrasound, contrast-enhanced ultrasound, computed tomography and positron emission tomography. Serum human chorionic gonadotropin (3.90 mIU/ml) was raised and alpha-fetoprotein (3.79 ng/ml) was within normal limits. Clinical examination and imaging examinations did not find any suspicious signs of testicular cancer. Biopsy from the neck mass confirmed the diagnosis of metastatic seminoma. The case report presents the ultrasound and contrast-enhanced ultrasound characteristics of seminoma and provides an update of the literature regarding this very rare metastatic site for seminomas.
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  • 文章类型: Case Reports
    背景:1型神经纤维瘤病(NF1)是一种遗传性常染色体显性遗传病,影响身体的许多部位,伴有咖啡斑,骨骼畸形,和脊柱侧弯.尚未报道患有脊柱侧凸和无痛性肿块的NF1家族病例。
    方法:我们描述了一名15岁的男性患者,其颈部左侧无痛性肿块持续10年并伴有脊柱侧弯的情况。他的右肩比左肩低5厘米左右,他左边的脸变形了,左侧颌下皮肤松弛。折叠和下垂明显,运动不良。计算机断层扫描显示颈部受累,上胸壁,和周围的左肩,伴有骨改变和脊柱侧凸。组织学评估显示表皮下淡蓝色粘液样变性,真皮中的纤维梭形细胞,编织排列。他的母亲有相同的病史。诊断为左颈部神经纤维瘤病。在几次访问中连续切除肿瘤组织的各个部分。手术八个月后,有轻微的再生趋势。
    结论:这个进展缓慢的NF1病例强调了早期诊断和治疗以减少其对患者生长发育的影响的重要性。
    BACKGROUND: Neurofibromatosis type 1 (NF1) is an inherited autosomal dominant disorder affecting many parts of the body with café au lait spots, skeletal deformity, and scoliosis. A familial case of NF1 with scoliosis and a painless mass had not yet been reported.
    METHODS: We describe the case of a 15-year-old male patient with a painless lump on the left side of his neck for 10 years and scoliosis. His right shoulder was about 5 cm lower than the left, the left side of his face was deformed, and the left submandibular skin was relaxed. The folding and drooping were obvious and movement was poor. Computed tomography revealed the involvement of the neck, upper chest wall, and surrounding left shoulder, accompanied by bone changes and scoliosis. Histological evaluation showed subepidermal pale blue mucoid degeneration, fibrous fusiform cells in the dermis in a fascicular, woven arrangement. His mother had the same medical history. The diagnosis was neurofibromatosis of the left neck. Various parts of the tumor tissue were serially resected during several visits. Eight months after surgery, there was a slight tendency to regrow.
    CONCLUSIONS: This case of slow-progressing NF1 highlights the importance of early diagnosis and treatment to reduce its impact on the patient\'s growth and development.
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  • 文章类型: Case Reports
    背景:Rosai-Dorfman病(RDD)是一种罕见的良性增殖性疾病,其病因尚不清楚,可能与感染或无法解释的免疫功能障碍有关。作者介绍了一名10岁患者的肺部受累RDD病例。
    方法:一名10岁女孩发现她的左颈部淋巴结肿大超过7个月,最大范围约为6.5cm×5.9cm×8.1cm。颈部磁共振成像显示左侧颈部多发肿块,在T1加权图像上具有低信号强度,在T2加权图像上具有高信号强度。恶性肿瘤,淋巴结转移的可能性很高,最初考虑。同时,肺部计算机断层扫描显示不同大小的多个结节散布在肺的两侧,具有均匀的内部密度。因此,考虑了可能的转移性肿瘤。最后,经病理及免疫组化证实RDD。根据抗菌谱,克林霉素服用2周,醋酸泼尼松给药7周。九个月后,左颈部溃疡比以前好,但影像学显示病变未得到控制。
    结论:RDD的诊断不能通过单一工具进行,其治疗是一个长期的探索过程。后续行动是必要的。
    BACKGROUND: Rosai-Dorfman disease (RDD) is a rare benign proliferative disease whose etiology is not clear and may be related to infection or unexplained immune dysfunction. The authors present a case of RDD with lung involvement in a 10-year-old patient.
    METHODS: A 10-year-old girl found that her left cervical lymph nodes were enlarged for more than 7 mo, and the largest range was about 6.5 cm × 5.9 cm × 8.1 cm. Cervical magnetic resonance imaging showed multiple masses in the left neck, with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. A malignant tumor, with a high possibility of lymph node metastasis, was initially considered. At the same time, lung computed tomography showed multiple nodules of different sizes scattered on both sides of the lung, with uniform internal density. Thus, a possible metastatic tumor was considered. Finally, RDD was diagnosed by pathology and immunohistochemistry. According to the antibiogram, clindamycin was administered for 2 wk, and prednisone acetate was administered for 7 wk. Nine months later, the ulcer in the left neck was better than before, but the imaging showed that the lesion was not controlled.
    CONCLUSIONS: The diagnosis of RDD cannot be made by a single tool and its treatment is a long-term exploratory process. Follow-up is necessary.
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  • 文章类型: Case Reports
    Thyroglossal duct cyst (TGDC) is a congenital neck malformation, with a rate of approximately 7% in paediatric patients. TGDC is rarely detected in infants aged younger than 1 year. Even though TGDC is histologically benign, it is associated with preterm delivery or sudden infant death due to airway obstruction, with a mortality rate of 30% to 40%. We report a rare case of a neonate who presented with a large left lateral neck mass. At 7 to 8 months of gestation, magnetic resonance imaging of the foetal neck showed that there was a high possibility of a cervical cystic lymphangioma. The patient had normal vital signs and was afebrile. She was immediately transferred to our Ear, Nose, and Throat Department for further diagnosis and treatment. A computed tomography scan confirmed a large cystic mass that was positioned against a thyroglossal duct. Excision of the mass in the left neck was performed under general anaesthesia without resecting part of the hyoid bone. A histopathological examination confirmed the diagnosis of a TGDC. Follow-up at 1 year showed no recurrence.
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  • 文章类型: Journal Article
    未经证实:高龄患者的颈动脉体瘤(CBT)切除尚未得到重视。
    UNASSIGNED:本研究旨在评估高龄患者CBT切除术的临床特征和围手术期合并症,并验证“孤岛”技术在CBT切除术中的应用。
    UNASSIGNED:8例接受CBT切除的高龄(≥60岁)患者作为研究组(SG)。另外29例年龄较小(<45岁)的CBT摘除患者被分配为对照组(CG)。比较两组围手术期问题。
    UNASSIGNED:“孤岛”技术成功应用于所有37例患者的CBT切除术。Shamblin分类I的患病率,II,SG中的III肿瘤为12.5%,62.5%,25%;而CG为10.3%,55.2%,和34.5%,分别。在7例CG患者中观察到双侧CBT,而在SG中未观察到双侧CBT。SG中1例(12.5%)患者需要血管重建,而CG中有8例(27.6%)患者需要。SG中37.5%的患者发生术后声带麻痹,而在CG中常见的是声带麻痹(34.5%)和吞咽困难(6.9%)。除了术后住院时间(P=0.004),手术时间无显著差异,术中失血,两组之间观察到或死亡(P>.05)。
    UNASSIGNED:在适当选择的患者中,对高龄患者进行CBT治疗是合理的。“孤岛”技术对于CBT切除是安全的,并发症发生率似乎很低。
    UNASSIGNED: Resection of carotid body tumor (CBT) in patients of advanced ages has not been appreciated.
    UNASSIGNED: This study aims to assess the clinical characteristics and perioperative comorbidities for CBT resection in patients of advanced age and to validate the application of an \"isolated island\" technique for extirpation of CBT.
    UNASSIGNED: Eight patients of advanced age (≥60 years) who underwent CBT resection were enrolled as the study group (SG). Another 29 patients of younger age (<45 years old) underwent CBT extirpation were assigned as the control group (CG). The perioperative issues were compared between these 2 groups.
    UNASSIGNED: The \"isolated island\" technique was successfully applied for resection of CBT in all 37 patients. The prevalence of Shamblin classification I, II, and III tumors in the SG was 12.5%, 62.5%, and 25%; whereas in the CG was 10.3%, 55.2%, and 34.5%, respectively. Bilateral CBT was observed in 7 patients of the CG and none in the SG. Vascular reconstruction was required for 1 (12.5%) patient in the SG, while it was required for 8 (27.6%) patients in the CG. Postoperative vocal cord palsy occurred in 37.5% of patients in SG, whereas the vocal cord palsy (34.5%) and dysphagia (6.9%) were commonly encountered in CG. In addition to postoperative length of stay (P = .004), no significant difference for operative time, intraoperative blood loss, or mortality were observed between these 2 groups (P > .05).
    UNASSIGNED: Extirpation of CBT in patients of advanced age is rationale in appropriately selected patients. The \"isolated island\" technique is safe for CBT resection with seemingly low complication rates.
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  • 文章类型: Journal Article
    Synovial sarcomas commonly occur in the soft tissue of the extremities, while a primary occurrence in the mediastinum is quite rare. The current study reports the case of an 11-year-old male who presented with a neck mass, which computed tomography showed was due to a giant mediastinal mass involving the thyroid gland. The tumor was resected by thoracotomy and diagnosed as monophasic synovial sarcoma by histopathology. The patient received adjuvant combination chemotherapy and radiation therapy following surgery. At the 3-month follow-up, no local tumor recurrence was found. The present case report highlights the significance of recognizing the unusual presentation and clinical manifestation of synovial sarcoma to aid clinical management. Written informed consent was obtained from the patient\'s family.
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