分化型甲状腺癌误诊及再手术治疗

Misdiagnosis and reoperation in differentiated thyroid carcinoma

目的 探讨分化型甲状腺癌误诊误治原因及再手术治疗的指征和再手术方法。方法 对近 10年收治的因误诊误治后给予再手术的 2 4例分化型甲状腺癌资料进行回顾性分析。结果 误诊原因有 :首次在他院按甲状腺瘤作肿瘤摘除或腺叶部分切除术 2 0例 ,在我院术中冷冻切片证实误诊 4例。再手术病理有残癌占 41 7% ,有颈淋巴结转移占2 0 8%。结论 对甲状腺单发结节应通过各种检查排除恶性的可能。首次手术误诊后应尽早行再手术治疗 。

Objective To investigate the causes of misdiagnosis and the indication of differentiated thyroid carcinoma(DTC) and its reoperation. Methods A retrospective analysis was performed for 24 cases of misdiagnosed and reoperated DTC treated in our hospital in recent 10 years. Results Causes of misdiagnosis consisted of 20 cases of tumour enucleation or partial lobectomy carried out in other hospitals as for simple adenoma and 4 cases of inadequate operation because of wrong pathological diagnosis of intraoperative biopsy in our hospital. Conclusion In thyroid solitary nodular lesions, every effort should be made to exclude the malignancy. Once it is proved to be misdiagnosed, reoperation with adequate technique should be performed as soon as possible.