原发性甲状腺功能亢进症合并甲状腺微小癌:附32例报告

Analysis of 32 cases with primary hyperthyroidism and concurrent thyroid microcarcinoma

目的 探讨原发性甲状腺功能亢进症 (甲亢 )合并甲状腺微小癌的诊断和治疗。方法 回顾性分析 1994年 1月～ 2 0 0 2年 12月收治的经外科手术及病理证实为原发性甲亢合并甲状腺微小癌 3 2例的临床资料。结果 全组微小癌发病率为 1.0 7%。术前无 1例确诊。 3 2例均行双侧甲状腺次全切除术。术中见双侧甲状腺弥漫性肿大 ,11例发现有小结节或星状疤痕样改变。均无淋巴结转移 ,均末行二次手术。全组病例术后随访 1～ 10 (平均 5 .5 )年均未见甲亢或甲状腺癌复发。结论 甲亢合并甲状腺微小癌的临床诊断较困难 ,多于手术后病理诊断。手术治疗效果良好 ,预后较好 。

Objective To investigate the diagnosis and treatment. Of primary hyperthyroidism and concurrent thyroid microcarcinoma. Methods A retrospective analysis of 32 cases of primary hyperthyroidism and concurrent thyroid microcacinoma proved by postoperative pathology and were admilted between January 1994 and December 2002.Resulth The morbidity was 1.07%.No case had been diagnosed before operation.All of 32 cases underwent bilateral subtotal thyroidectomy.All cases showed diffase goiter and 11 cases showed small thyroid nodules at operation. There was no evidence of lymph node metastasis. No case had reoperation. No case of recurrent hyperthyroidism nor cancer was found during the 1 to 10 (mean5.5)years follow up. Conclusion The clinical diagnosis of primary hyperthyroidism and concurrent thyroid microcarcinoma is difficult and chiefly depends on postoperative pathology. Surgical treatment gives good results and has a better prognosis ,but long term follow up is still needed.