گزارش یک مورد نادر کانسر پاپیلاری تیروئید عود کننده با عمر طولانی

نوع مقاله : گزارش مورد

نویسندگان

1 دانشیار غدد و متابولیسم، مرکز تحقیقات سندرم متابولیک، دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 دانشیار جراحی توراکس، دانشگاه علوم پزشکی مشهد، مشهد، ایران

3 کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

تومورهای تیروئید از شایعترین نئوپلاسم های سیستم آندوکرین می باشند. کانسر تیروئید از نظر آسیب شناسی اشکال متفاوتی داردکه شامل انواع پاپیلاری،فولیکولر،آناپلاستیک وکانسر مدولاری می باشد. papillary thyroid carcinoma (PTC) شایعترین نئوپلاسم تیروئید است.این کانسر معمولا بصورت ندول تیروئید تظاهر می کندوضمن معاینه فیزیکی یا بصورت یافته ی اتفاقی در بررسی تصویر برداری مشخص میشود. امروزه به دلیل استفاده از روشهای غربالگری ، کانسرپاپیلاری تیروئید در مراحل اولیه که سایز کوچکی دارد ، تشخیص داده می شود وبه همین دلیل در اکثر موارد پیش اگهی خوبی دارد و فقط 20% بیماران بعداز جراحی دچار عود می شوند. کانسر پاپیلاری از نظر آسیب شناسی انواع متفاوتی داردکه نوع hobnail و tall cell وcolumnar cell رشد سریع و پیش آگهی بدتری دارند. خانم 84 ساله ای سابقه ی کانسر پاپیلاری تیروئید از 32 سال قبل داشته است .او قبلا 2 بار تحت عمل جراحی تیروئید ودرمان با ید رادیواکتیو قرارگرفته است . نامبرده با عود کانسربصورت توده حجیم گردنی که منجر به اختلال در تنفس و خوردن غذا شده بود، مراجعه کرد . بیمار برای سومین بار تحت عمل جراحی موفقیت آمیز تیروئید قرار گرفت وبا حال عمومی خوب بیمارستان را ترک کرد. این مورد نشان میدهد که کانسر پاپیلاری تیروئید ممکن است رشد آهسته وعود مکرر داشته باشد. تکرار عمل جراحی مناسب می تواند نجات دهنده باشد ومنجر به بهبود کیفیت زندگی و طول عمر این بیماران شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

A Rare Presentation of Recurrent Papillary Thyroid Carcinoma with Long Survival; a Case Report

نویسندگان [English]

  • Fariborz Samini 1
  • Ali Sadrizadeh 2
  • Seyedeh Motahareh Mirdoosti 3
1 Associate Professor of Endocrinology, Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Professor of Thoracic Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Medical Student, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Thyroid neoplasms are the most common endocrine tumors. Thyroid cancers have multiple pathological variants including papillary, follicular, anaplastic and medullary. Papillary thyroid carcinoma (PTC) is the most common thyroid tumor. PTC usually presents with a thyroid nodule; it comes to clinical attention in early stages during routine physical examinations or as an accidental finding in imaging studies.
Screening programs results in detection of small PTCs in early stage of disease, therefore the prognosis is quite good, and only 20 percent of patients experience recurrence of the disease after surgery. PTC has different pathological kinds, which hobnail, tall cell and columnar cell have rapid growth and poor prognosis.
Here, we report an 84- year- old woman who had papillary thyroid cancer (PTC) since 32 years ago. She had two previous thyroid surgery and was treated with radioactive iodine (RAI) and was on levothyroxine replacement. she came to endocrine clinic with recurrence of papillary thyroid cancer (PTC) that was presented with extremely huge anterior neck mass which caused difficulty in breathing and eating. The patient undergone a third surgery, which was life-saving and discharged from hospital in good general condition.
This shows that PTC may have a natural course of recurrence that grows slowly. These patients may have long survival and proper repeated surgical intervention can be a life-saving approach.

کلیدواژه‌ها [English]

  • Papillary Thyroid Carcinoma
  • Long Survival
  • Case Report

مراجع

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 68، شماره 3
مرداد-شهریور 1404
مرداد و شهریور 1404

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