甲状舌管癌伴系统性红斑狼疮1例

Thyroglossal duct carcinoma combined with systemic lupus erythematosus:one case report

1病例报告患者,女,27岁,于1年前无明显诱因下自觉颈前区肿块,无疼痛感,无呼吸困难、声音嘶哑、吞咽苦难,病程中肿块缓慢生长,患者遂至我院就诊。查体可触及颈前区舌骨水平位一4cm×3cm无痛性肿块,光滑,界清,有波动感,随吞咽上下活动。双侧甲状腺区未触及明显肿块,双侧颈部也未触及明显肿大淋巴结。患者否认有颈部放射史或颈部手术史。行颈部超声检查示颈部正中舌骨水平混合回声团块,大小为38 mm×24 mm。双侧甲状腺、甲状旁腺区未见明显异常,双侧颈部未见明显肿大淋巴结。

Thyroglossal duct carcinoma is a malignant tumor which occurs in the thyroglossal duct cyst.The incidence of thyroglossal duct carcinoma has been reported as approximately 1%.Up to now,just about 250 cases of thyroglossal duct carcinoma have been reported in the literature,most of which are single case reports and small case series.In most cases,the diagnosis of the thyroglossal duct carcinoma is not made until the histologic examination after surgery operation.The preoperative examination such as CT or fine needle aspiration cytology can help the preoperative diagnosis.But the surgical treatment for the thyroglossal duct carcinoma is still controversial.Now we report a case of a thyroglossal duct carcinoma combined with systemic lupus erythematosus.The patient herself found an anterior neck mass in the median submental region one year ago.The preoperative CT examination suggested thyroglossal duct cyst with pouch canceration(papillary carcinoma).Then she underwent a Sistrunk procedure and level I neck dissection,and the histopathological diagnosis was thyroglossal duct carcinoma.Thepatient was treated with levothyroxine therapy at suppressive dose after the surgery.Now the patient is at regularfollow-up with no relapse occur.