甲状舌管癌的诊治分析

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目的探讨甲状舌管癌的临床特点、诊治及预后。方法回顾性分析4例甲状舌管癌患者的临床资料,结合文献探讨其临床、病理特点及合理的治疗方案。4例患者术前均诊断为甲状舌管囊肿,术后病理诊断为甲状舌管癌。4例患者均行手术治疗,2例接受Sistrunk术式(切除范围包括肿物、甲状舌管残余及部分舌骨),1例患者行Sistrunk术式+甲状腺右叶及峡部切除术,1例行Sistrunk术式+甲状腺全切除术+左侧颈淋巴结及中央区淋巴结清扫术。观察效果。结果 4例患者术中、术后均未出现并发症,伤口愈合良好,按期拆线。1例行Sistrunk术式+甲状腺右叶及峡部切除术的患者,随访36个月后发现右侧颈淋巴结肿大,给予行右侧颈淋巴结清扫术+甲状腺左叶切除术,术后证实甲状舌管癌颈淋巴结转移,行放射性碘治疗,随访至今,生存无复发。其余3例患者术后随访时间为22~120个月,至随访截止,患者均生存,且均无肿瘤复发转移。结论甲状舌管癌临床罕见,确诊有赖于病理检查,外科手术是主要的治疗手段,术后需要密切随访。 Objective To investigate the clinical features, diagnosis, treatment and prognosis of thyroglossal cancer. Methods The clinical data of 4 patients with thyrogloal carcinoma were retrospectively analyzed. The clinical, pathological features and reasonable treatment were discussed according to the literature. Four patients were diagnosed as thyroglossal cyst preoperatively, pathologically diagnosed as thyroglossal cancer. All the 4 patients underwent surgical treatment. Two patients underwent Sistrunk procedure (the resection range included the tumor, the residual thyroglossal tongue and some hyoid bone). One patient underwent Sistrunk procedure and the right lobe and isthmus resection were performed in one patient Sistrunk operation + total thyroidectomy + left cervical lymph node and central lymph node dissection. Observe the effect. Results Four patients had no complications during surgery and postoperatively, and the wound healed well and sutured regularly. A case of Sistrunk surgery + right lobe and isthmus in patients with thyroidectomy, follow-up 36 months after the discovery of right cervical lymph node enlargement, given line of right cervical lymph node dissection + left thyroidectomy thyroid tongue confirmed Tuberculous cervical lymph node metastasis, line of radioactive iodine treatment, follow-up so far, no recurrence of survival. The remaining 3 patients were followed up for 22 to 120 months, until the end of the follow-up, patients were alive, and no tumor recurrence and metastasis. Conclusions Thyroid cancer is rare in clinic. The diagnosis depends on the pathological examination. Surgery is the main treatment and requires close follow-up.
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