嗜铬细胞瘤合并甲状腺乳头状癌(附1例报告)

Pheochromocytoma with papillary thyroid carcinoma:one case report

嗜铬细胞瘤是一种少见的神经内分泌肿瘤,大多散发,约1/3为遗传性基因突变引起。甲状腺乳头状癌来源于甲状腺滤泡细胞,是最常见的恶性肿瘤。然而,嗜铬细胞瘤合并甲状腺乳头状癌的相关报道很少。我院一例41岁男性肾上腺嗜铬细胞瘤合并甲状腺乳头状癌。病人因细针穿刺诊断为甲状腺乳头状癌而入院手术。由于手术当天血压异常升高而手术暂停。行进一步血生化及CT检查,结果考虑可能合并肾上腺嗜铬细胞瘤。经多学科讨论,决定先行肾上腺手术,恢复后再行甲状腺癌根治术。嗜铬细胞瘤和甲状腺乳头状癌的同时存在究竟是一种巧合还是RET基因或未知的遗传基因突变引起,目前尚不清楚。需要积累这种组合病例以及基因检测,作进一步研究。

Pheochromocytoma is one of rare tumors of neuroendocrine.Most of the tumors are sporadic with about 1/3 of them caused by genetic mutations.Papillary thyroid carcinoma(PTC)from thyroid follicular cells is the most common ma-lignant tumors.However,pheochromocytoma with PTC is rarely reported.Here we present a case report of an 41-year-old male patient found to have an adrenal pheochromocytoma combined with PTC,and PTC was diagnosed first with fine needle aspiration.The patient admitted to hospital,and surgery would be prepared when abnormal blood pressure rose,and opera-tion was suspended.Further CT scan and blood biochemical examination were performed,and concurrent adrenal pheochro-mocytoma was considered.Multidisciplinary team decided to perform adrenal surgery priority.When the recovery of patient appeared after first operation,radical thyroidectomy was performed.Whether the co-existence of pheochromocytoma and PTC is coincidence or caused by RET gene or unknown inherited genetic mutations is unclear,so accumulation of studies with more combined cases should be done and genetic testing data are needed.