甲状腺机能亢进并甲状腺癌11例报告

Hyperthyroidosis Associated with Thyroid Carcinoma.A Report of 11 Cases

本文报道11例甲亢合并甲状腺癌病例,占甲亢手术病人的3.4％。可发生于不同类型的甲亢病人,病理检查呈局灶性徽小癌6例占54.5％,多数病例要靠术后病理诊断。分析术前误诊原因:①临床上对本病缺乏应有认识。②大部分病例的癌肿尚属早期,常难发现。③对甲亢患者^(131)I扫描为冷结节,合并甲状腺癌的警惕性不够。治疗原则应同甲状腺癌,但对术后才明确诊断,肿瘤属于微小隐性癌,不一定要做二期手术,可术后口服甲状腺素随访观察。

Eleven cases of hyperthyoidosis associated with thyroid carcinoma, accounting for 3.4% of cases un- dergone operations for hyperthyroidosis are reported. Thyroid carcinoma may be found in patients with different types of hyperthyroidosis. Pathological findings revealed focal microcarcinoma in 6 of the cases (54.5%). In most of the cases, the diagnosis was made by pathological examination after operation. The reasons for misdiagnosis:(1)ignorance in clinical practices; (2)small size of the tumors especially in early stage of the disease. In those hyperthyroidosis patients with 'cold nodule'on isotope scanning the risk of coexistance of thyroid carcinoma is rather low . The principle of treatment is the same as thyroid carcinoma. For those with marked microcarcinoma identified after operation, immediate secondary opera- tion is not necessary,and thyroxin should be administrated with follow up observation.