包绕食管、下咽的甲状腺肿瘤(附6例报告)

Thyroid neoplasma encircling the esophagus and/or laryngeal pharynx

为了解包绕食管、下咽的甲状腺肿瘤在诊断和治疗上是否有其独特性，我们对６例该类型病例的术前诊断、手术处理进行回顾性总结。结果发现６例次患者的临床表现中，吞咽梗噎感占６６．７％；４例次患者术前Ｂ超提示肿瘤包绕食管、下咽；３例次患者术前经ＣＴ证实；近半数患者需术中明确。手术均采用先断峡部，由内往外翻的术式，行完整的腺叶切除，病理结果５例为滤泡性腺瘤，１例为乳头状腺癌。该结果揭示包绕食管、下咽的甲状腺瘤在诊断和治疗上有其独自的临床特点。

To summarize the pre-operational diagnosis and the operational treatment of thyroid neoplasm thatencircles the esophagus and/or laryngeal pharynx and to find out whether there are any special features in thediagnosis and treatment, we conducted the retrospective summarization of six such kinds of cases. The resultsshowed that in the clinical manifestation of six cases, swallowing obstruction accounts for 66.7%,in that of fourcases, pre-operational Ultrasonic type B exmaninations indicate that the thyroid neoplasm encircles theesophagus and/or laryngeal pharynx, in that three cases, the pre- operational CT proves that nearly half of thepatiente need operations to determine the location of the tumor. In all the operations, the cutting of the isthumusof thyreoideae is performed first, followed by turning the gland inside out, and finaly the removal of the lobe. Thepathological results indicated that five cases were folliculi adenoma and one case was papilliforumadenocarcinoma. The results suggest that the diagnosis and treatment of the thyroid neoplasm that encircle theesophagus and/or laryngeal pharynx do have their special features.