甲状腺脂肪瘤病与舌鳞癌共存1例。

Jose Paz-Ibarra, Marcio Concepción-Zavaleta, Daniel Mendoza-Quispe, Jacsel Suárez-Rojas, Katia Rivera Fabián, Diana Deutz-Gómez, Juan Quiroz-Aldave, José Somocurcio Peralta, Tula Ayquipa Arróspide
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甲状腺脂肪瘤病是一种甲状腺脂肪组织的弥漫性非肿瘤性浸润,是一种极其罕见的疾病,全世界仅报道了约30例。这些病例中有少数报告甲状腺脂肪瘤病和甲状腺或结肠恶性肿瘤的并发,但从未报告舌癌。一个44岁的女性患者浸润性舌肿块提示癌提出门诊咨询。宫颈影像显示多发性淋巴结病变及弥漫性脂肪浸润的多结节性甲状腺肿,提示甲状腺脂肪瘤病。手术干预包括舌和甲状腺部分切除(分别为左侧半胱氨酸切除术和右侧半甲状腺切除术)和淋巴结切除术。甲状腺标本显示甲状腺间质组织弥漫性脂肪化生,证实偶发性甲状腺脂肪瘤病。在术后随访中,患者出现鳞状细胞癌复发,表现为右侧新发甲状腺结节,左侧淋巴结病变,活检证实,颈部肿块不断扩大并感染。病人出现感染性休克,后来死亡。甲状腺脂肪瘤病引起甲状腺肿胀,临床上可作为甲状腺肿或偶然发现。诊断建议通过宫颈影像学检查(超声、计算机断层扫描或磁共振),但在甲状腺切除术后需要组织学证实。虽然甲状腺脂肪瘤病是良性的,但它可以并发肿瘤疾病,特别是胚胎相关组织(如甲状腺和舌)。本病例报告是文献中第一个描述甲状腺脂肪瘤病和舌癌共存的秘鲁成年患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Coexistence of Thyrolipomatosis and Tongue Squamous Cell Carcinoma: A Case Report.

Thyrolipomatosis, a diffuse non-neoplastic infiltration of fatty tissue in the thyroid gland, is an extremely rare condition with only about 30 cases reported worldwide. A few of these cases report the concurrency of thyrolipomatosis and malignant neoplasms in the thyroid or colon, but never with tongue cancer. A 44-year-old female patient with an infiltrative tongue mass suggestive of carcinoma presented for an outpatient consultation. Cervical imaging revealed multiple lymphadenopathies and a multinodular goitre with diffuse fatty infiltration, suggestive of thyrolipomatosis. Surgical intervention included partial resection of the tongue and thyroid (left hemiglossectomy and right hemithyroidectomy, respectively) and lymphadenectomy. The thyroid specimen showed diffuse fat metaplasia of the stromal thyroid tissue, confirming incidental thyrolipomatosis. During post-operative follow-up, the patient presented with recurrence of squamous cell carcinoma as indicated by new right-sided thyroid nodules, left-sided lymphadenopathies with confirmatory biopsy, and a growing neck mass that became infected. The patient developed septic shock and later died. Thyrolipomatosis causes thyroid swelling and can be clinically detected as goitres or as an incidental finding. Diagnosis is suggested by cervical imaging (ultrasonography, computed tomography or magnetic resonance), but confirmation is histological after thyroidectomy. Although thyrolipomatosis is benign, it could develop concurrently with neoplastic diseases, especially on embryologically related tissues (e.g. thyroid and tongue). This case report is the first in the literature describing the coexistence between thyrolipomatosis and tongue cancer in an adult Peruvian patient.

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