IF 0.6 4区 医学Q3 MEDICINE, GENERAL & INTERNALMedicina-buenos AiresPub Date : 2024-01-01
Luis A Ramírez Stieben, María Cecilia Vargas, David C Polillo, Karin Lufft, Patricia R Saldías, Iván Bedini
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引用次数: 0
摘要
非甲状腺恶性肿瘤转移到甲状腺的情况很少见,但却很严重。它们通常没有症状,表明原发肿瘤已到晚期,预后较差。乳腺癌(BC)转移到甲状腺的情况并不常见。我们介绍了一例 56 岁女性的病例,她有 BC 病史,并伴有结节性甲状腺肿。体检和影像学检查发现甲状腺结节和颈部淋巴结有可疑特征。细针穿刺活检(FNAB)证实甲状腺结节和淋巴结中存在非典型上皮细胞。进一步的评估,包括正电子发射断层扫描、组织活检和免疫组化,支持了甲状腺转移性 BC 的诊断。由于局部病变范围较大,无法进行全甲状腺切除术。患者开始接受利波西利(ribociclib)和来曲唑(letrozole)治疗,但不幸的是,病情进展不利,神经系统出现转移。转移到甲状腺的癌很少见,但由于诊断技术的改进,这种情况有所增加。BC 可以转移到甲状腺。诊断包括成像、FNAB和免疫组化。治疗方法包括手术、放疗和化疗,但预后一般较差。
Metastases to the thyroid gland from nonthyroidal malignant tumors are rare but significant. They are often asymptomatic, indicating advanced-stage primary tumors and poor prognosis. Although infrequently, breast cancer (BC) can metastasize to the thyroid gland. We present the case of a 56-year-old woman with a history of BC who presented with a nodular goiter. Physical examination and imaging revealed a thyroid nodule and cervical lymph nodes with suspicious features. Fine-needle aspiration biopsy (FNAB) confirmed the presence of atypical epithelial cells in the thyroid nodule and lymph nodes. Further evaluation, including positron emission tomography, histological biopsy, and immunohistochemistry, supported the diagnosis of metastatic BC to the thyroid gland. Due to the local extent of the disease, total thyroidectomy was not feasible. The treatment with ribociclib and letrozole was initiated, but unfortunately, the patient had an unfavorable progression with the development of metastasis in the nervous system. Metastatic carcinoma to the thyroid gland is rare but has increased due to improved diagnostic techniques. BC can metastasize to the thyroid. Diagnosis involves imaging, FNAB, and immunohistochemistry. Treatment options include surgery, radiotherapy, and chemotherapy, but the prognosis is generally poor.