■小儿甲状腺癌是罕见的。大多数病例是高分化甲状腺癌(WDTC)。然而,喉气管侵犯WDTC是不寻常的。本报告详细介绍了英国医学文献中第一例小儿WDTC侵入气管的情况。
■促甲状腺激素,游离三碘甲状腺原氨酸,游离甲状腺素,甲状腺球蛋白,甲状旁腺激素,降钙素,甲状腺球蛋白抗体,胸部磁共振成像,颈部超声,颈部计算机断层扫描,进行细针抽吸。
■一名患有中度持续性哮喘的9岁男孩表现为上呼吸道症状增加。肺活量测定提示固定的上呼吸道阻塞。胸部X光显示左气管移位,和胸部磁共振成像确定了正确的甲状腺肿块。甲状腺球蛋白水平为809ng/mL(正常,≤33ng/mL)。促甲状腺激素的结果,游离三碘甲状腺原氨酸,游离甲状腺素,甲状旁腺激素,降钙素,甲状腺球蛋白抗体正常。颈部超声提示右侧甲状腺叶结节2个。颈部计算机断层扫描显示气管受压。最大结节的细针抽吸产生了不确定意义的异型性。他当地医院的支气管镜检查结果与气管侵犯有关。他接受了甲状腺全切除术,环状气管切除术,重建,和放射性碘治疗(220mCi)。病理显示分化良好的甲状腺乳头状癌,无实性或弥漫性硬化性亚型成分。肿瘤细胞遗传学和单核苷酸多态性微阵列研究显示正常发现。术后一年,颈部超声显示无复发,左甲状腺素治疗时甲状腺球蛋白水平检测不到。
■尚未报道小儿WDTC侵入气管。
UNASSIGNED: Pediatric thyroid cancer is rare. Most cases are well-differentiated thyroid cancers (WDTCs). However, gross laryngotracheal invasion of WDTCs is unusual. This report details the first case in English medical literature of a pediatric WDTC invading the trachea.
UNASSIGNED: Thyroid stimulating hormone, free triiodothyronine, free thyroxine, thyroglobulin, parathyroid hormone, calcitonin, thyroglobulin antibody, chest magnetic resonance imaging, neck ultrasound, neck computed tomography, and fine needle aspiration were performed.
UNASSIGNED: A 9-year-old boy with moderate persistent asthma presented with increasing upper respiratory symptoms. Spirometry suggested a fixed upper airway obstruction. Chest x-ray revealed a left tracheal shift, and chest magnetic resonance imaging identified a right thyroid mass. Thyroglobulin level was 809 ng/mL (normal, ≤33 ng/mL). Results of thyroid stimulating hormone, free triiodothyronine, free thyroxine, parathyroid hormone, calcitonin, and thyroglobulin antibody were normal. Neck ultrasound revealed 2 right thyroid lobe nodules. Neck computed tomography revealed tracheal compression. Fine needle aspiration of the largest nodule yielded atypia of undetermined significance. Bronchoscopy findings at his local hospital were concerning for tracheal invasion. He underwent total thyroidectomy, cricotracheal resection, reconstruction, and radioactive iodine therapy (220 mCi). Pathology demonstrated a well-differentiated papillary thyroid carcinoma without solid or diffuse sclerosing subtype components. Tumor cytogenetic and single nucleotide polymorphism microarray studies showed normal findings. One year postoperatively, neck ultrasound demonstrated no recurrence, and thyroglobulin levels were undetectable while on levothyroxine therapy.
UNASSIGNED: Pediatric WDTC invading the trachea has not been reported.