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題 名 | Endobronchial Metastasis from an Occult Papillary Thyroid Carcinoma: A Case Report=潛行性乳頭性甲狀腺癌之支氣管內轉移:一例報告 |
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作 者 | 陳韋序; 王逸熙; 盧永川; 黃昭誠; 王瑞隆; | 書刊名 | 長庚醫學 |
卷 期 | 21:2 1998.06[民87.06] |
頁 次 | 頁200-205 |
分類號 | 415.931 |
關鍵詞 | 遠處轉移; 甲狀腺球蛋白; 支氣管鏡檢法; 咳血; Distant metastasis; Thyroglobulin; Bronchoscopy; Hemoptysis; |
語 文 | 英文(English) |
中文摘要 | 潛行性乳頭性甲狀腺癌(occult papillary thyroid carcinoma)會發生局部的淋巴結轉 移。這種臨床不易察見的小型甲狀腺癌有遠處轉移(distant metastasis)的情形是很罕見的, 而在文獻上則未曾報告過以支氣管內轉移(endobronchial metastasis)來表現的病例。我們報 告一個48歲的男性病人,主訴咳血,其後接受軟式支氣管鏡檢查,發現一單發性支氣管內 腫瘤,經切片證實為轉移性甲狀腺癌。隨後病人接受甲狀腺切除術及劑量150 mCi碘-131 治療,全身掃描時除殘餘甲狀腺外,身體其他部位並無放射活性異常聚積的現象,接著我們 以左全肺切除術來治療此遠處轉移。 雖然癌細胞發生支氣管內轉移時往往也已經轉移到身體其他部位,但是在治療方法的 選擇上仍需視情況而定,並非一味採行姑息治療。一般而言乳頭甲狀腺癌的癒後相當良好, 所以在病人狀況許可之下,針對單發性遠處轉移應該優先考慮進行手術切除。 |
英文摘要 | It is well know that occult papillary thyroid cancers can result in regional lymph node metastasis. However, this small, clinically undetectable cancer rarely causes distant metastasis; moreover, an endobrochial presentation has not been described previously. We report on a 48-year- old man who experienced hemoptysis. A fiberoptic bronchoscopic biopsy established the diagnosis of endobronchial metastasis in the absence of clinically apparent thyroid cancer. After the patient was treated with a total thyroidectomy and radioactive iodine (131I), a whole body radioiodine scan revealed no evidence of distant functioning metastasis. A histological evaluation of the thyroid gland showed the presence of a 0.2×0.2×0.2 cm nodule in the right lobe. A left pneumonectomy was undertaken to treat the distant metastasis of the disease. Since most papillary thyroid carcinomas are curable, an aggressive surgical approach to the solitary metastasis is indicated. |
本系統中英文摘要資訊取自各篇刊載內容。