原发性甲状腺鳞状细胞癌是一种极为罕见且进展迅速的恶性肿瘤,并且很容易被误诊为急性甲状腺炎、桥本甲状腺炎或其他的包括甲状腺乳头状癌、甲状腺髓样癌、甲状腺滤泡样癌在内的其他类型的甲状腺恶性肿瘤疾病。关于原发性甲状腺鳞状细胞癌的报道也非常稀少,而且其预后通常较差,同时缺乏有效的治疗手段。因此,迫切需要更多的病例资料来扩充人们对此疾病的认知。
Primary thyroid squamous cell carcinoma is an extremely rare and rapidly progressive malignancy that can easily be misdiagnosed as acute thyroiditis, Hashimoto’s thyroiditis, or other types of thy-roid malignancies including Papillary thyroid carcinoma, medullary thyroid carcinoma, follicular thyroid carcinoma. Reports of primary thyroid squamous cell carcinoma are also very sparse, and the prognosis is generally poor, and effective treatments are lacking. Therefore, more case data are urgently needed to expand people’s knowledge of this disease.
Primary thyroid squamous cell carcinoma is an extremely rare and rapidly progressive malignancy that can easily be misdiagnosed as acute thyroiditis, Hashimoto’s thyroiditis, or other types of thyroid malignancies including Papillary thyroid carcinoma, medullary thyroid carcinoma, follicular thyroid carcinoma. Reports of primary thyroid squamous cell carcinoma are also very sparse, and the prognosis is generally poor, and effective treatments are lacking. Therefore, more case data are urgently needed to expand people’s knowledge of this disease.
治疗过程:于2021-03-11行甲状腺癌根治术;术中所见:双叶甲状腺肿大并可见多个结节,最大约30 mm * 40 mm;与气管粘连;术中取标本行术中冰冻病理检查。术后病理(图2(a)、图2(b)):镜下见肿瘤细胞呈鳞状细胞分化,浸润周围甲状腺组织及滤泡性腺瘤,间质纤维显著增生,肿瘤侵犯甲状腺被膜,免疫组化:CK5/6(+),P40(+),CK19(+),TTF-1(+),PAX-8(+),CEA(−),Galectin-3(弱+),calcitonin(−),ki67(约15%+)。符合(右叶甲状腺)甲状腺鳞状细胞癌(中分化);滤泡性腺瘤(左叶甲状腺),结节性甲状腺肿,伴局灶钙化。
席乃特,曹明溶. 原发性甲状腺鳞状细胞癌1例Primary Thyroid Squamous Cell Carcinoma: A Case Report[J]. 临床医学进展, 2022, 12(04): 2836-2841. https://doi.org/10.12677/ACM.2022.124407
参考文献References黄煜庆, 曹君, 葛明华. 原发性甲状腺鳞状细胞癌诊治研究进展[J]. 中国医药, 2018, 13(1): 147-149.尹峰燕, 张晓健, 张晓舟, 等. 原发性甲状腺鳞癌的临床诊治与生存分析[J]. 肿瘤基础与临床, 2018, 31(4): 354-356.Yasumatsu, R., Sato, M., Uchi, R., et al. (2018) The Treatment and Outcome Analysis of Primary Squamous Cell Carcinoma of the Thyroid. Auris Nasus Larynx, 45, 553-557. <br>https://doi.org/10.1016/j.anl.2017.07.009Bolfi, F., Domingues, M.A.C., Sobrinho-Simoes, M., et al. (2014) Primary Squamous Cell Carcinoma of the Thyroid Diagnosed as Anaplastic Carcinoma: Failure in Fine-Needle Aspiration Cytology? Case Reports in Pathology, 2014, Article ID: 301780. <br>https://doi.org/10.1155/2014/301780Kallel, S., Kallel, R., Ayadi, S. and Ghorbel, A. (2018) Primary Squamous Cell Carcinoma of the Thyroid Associated with Papillary Thyroid Carcinoma and Hashimoto’s Thyroid. European Annals of Otorhinolaryngology, Head and Neck Diseases, 135, 291-293. <br>https://doi.org/10.1016/j.anorl.2018.05.012Chaudhary, R.K., Barnes, E.L. and Myers, E.N. (1994) Squamous Cell Carcinoma Arising in Hashimoto’s Thyroiditis. Head & Neck, 16, 582-585. <br>https://doi.org/10.1002/hed.2880160615Goldberg, H.M. and Harvey, P. (1956) Squamous Cell Cysts of the Thy-roid with Special Reference to the Aetiology of Squamous Epithelium in the Human Thyroid. British Journal of Surgery, 43, 565-569.
<br>https://doi.org/10.1002/bjs.18004318203Jones, J.M., Mccluggage, W.G. and Russel, C.F. (2000) Primary Aquamous Carcinoma of the Thyroid. Ulster Medical Journal, 69, 58-60.Handra-Luca, A. (2018) Squamous Cell Dif-ferentiation in Metastatic Papillary Thyroid Carcinoma: Metaplastic Reversion or Progression. Iranian Journal of Pathology, 13, 276-280.Wiseman, S.M., Loree, T.R., Hicks, W.L., et al. (2003) Anaplastic Thyroid Cancer Evolved from Papillary Carcinoma: Demonstration of Anaplastic Transformation by Means of Theinter-Simple Sequence Repeat Polymerase Chain Reaction. Archives of Otorhinolaryngology-Head & Neck Surgery, 129, 96-100. <br>https://doi.org/10.1001/archotol.129.1.96张济, 苏自杰, 张振华, 吴刚, 李闯. 10例原发性甲状腺鳞状细胞癌超声及CT表现[J]. 中国医学影像技术, 2020, 36(4): 627-629.Cho, J.K., Woo, S.H., Park, J., et al. (2015) Primary Squamous Cell Carcinomas in the Thyroid Gland: An Individual Participant Data Meta-Analysis. Cancer Medicine, 3, 1396-1403. <br>https://doi.org/10.1002/cam4.287Koyama, S., Fujiwara, K., Nosaka, K., et al. (2018) Immunohistochemical Features of Primary Pure Squamous Cell Carcinoma in the Thyroid: An Autopsy Case. Case Reports in Oncology, 11, 418-424.
<br>https://doi.org/10.1159/000490410Suzuki, A., Hirokawa, M., Takada, N., et al. (2015) Diagnostic Significance of PAX8 in Thyroid Squamous Cell Carcinoma. Endocrine Journal, 62, 991-995.Kleer, C.G., Giordano, T.J. and Merino, M.J. (2000) Squamous Cell Carcinoma of the Thyroid: An Aggressive Tumor Associated with Tall Cell Variant of Papillary Thyroid Carcinoma. Modern Pathology, 13, 742-746.
<br>https://doi.org/10.1038/modpathol.3880129Au, J.K., Alonso, J., Kuan, E.C., et al. (2017) Primary Squamous Cell Carcinoma of the Thyroid: A Population-Based Analysis. Otolaryngology—Head and Neck Surgery, 157, 25-29. <br>https://doi.org/10.1177/0194599817698436孙启龙, 蔡毅然, 刘伟. 原发性甲状腺鳞癌1例[J]. 中国现代普通外科进展, 2005, 8(1): 62+64.Wygoda, A., Rutkowski, T., Szcześniak-Kłusek, B., et al. (2017) Primary Squamous-Cell Thyroid Carcinoma—A Successful Treatment with Five-Year Follow-Up. Endokrynologia Polska, 68, 592-596.Del Rosario, M., Dasanu, C., Tsai, H., et al. (2017) Primary Squamous Cell Carcinoma of the Thyroid with Complete Response to Radical Radiotherapy and Concurrent Cisplatin-Based Chemotherapy. BMJ Case Reports, 2017, Article ID: bcr2016217143. <br>https://doi.org/10.1136/bcr-2016-217143