| 胡金芳,黄诚友,霍景山,等.以胸前肿痛为首发症状的甲状腺滤泡癌并胸骨、耻骨转移 1例[J].安徽医药,2025,29(6):1230-1233. |
| 以胸前肿痛为首发症状的甲状腺滤泡癌并胸骨、耻骨转移 1例 |
| Thyroid follicular carcinoma with initial symptom of chest pain and metastases to the sternum and pubic bone: case report |
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| DOI：10.3969/j.issn.1009-6469.2025.06.034 |
| 中文关键词: 甲状腺滤泡癌 骨转移 病理诊断 甲状腺切除术 131I治疗 |
| 英文关键词: Thyroid follicular carcinoma Bone metastasis Pathological diagnosis Thyroidectomy 131I therapy |
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| 中文摘要: |
| 目的探讨以胸前肿痛为首发症状的甲状腺滤泡癌并胸骨、耻骨转移的治疗经验。方法总结佛山市中医院 2023年 10月收治的以胸前肿痛为首发症状的甲状腺滤泡癌并胸骨、耻骨转移病人 1例的诊断过程和治疗方案。结果将病人拟“胸骨病变”收入该院，入院后胸骨病变处穿刺活检病理:转移性甲状腺滤泡癌，并侵犯骨组织。完善相关检查，排除手术禁忌证后行甲状腺全切除术及中央区淋巴结清扫术，术后病理符合甲状腺滤泡癌，分别于 11月 13日、 11月 21日行耻骨、胸骨继发恶性肿瘤放射治疗， 11月 27日行碘 131(131I)第一疗程治疗，现病人一般情况可，拟行 131I下一疗程治疗。结论甲状腺滤泡癌并胸骨、耻骨转移临床罕见，结合病理活检、影像学检查和免疫组织化学分析，最终确诊并采取了手术治疗、放射治疗及 131I治疗的综合治疗方案。强调在临床实践中对不典型症状需提高警惕性，以及多模式治疗在甲状腺滤泡癌伴远处转移中的重要性。早期诊断和个体化治疗策略对于改善病人预后至关重要。 |
| 英文摘要: |
| Objective To explore the therapeutic experience of thyroid follicular carcinoma with initial symptoms of presternal painand metastases to the sternum and pubic bone.Methods The diagnostic process and treatment plan were summarized for a patient ofthyroid follicular carcinoma with presternal pain as the initial symptom and sternum and pubic bone metastasis, who was admitted toFoshan Hospital of Traditional Chinese Medicine in October 2023.Results The patient was admitted to hospital under the presump-tion of "sternal lesion." A biopsy of the sternal lesion after admission revealed metastatic thyroid follicular carcinoma, which invadedthe bone tissue. After completing relevant examinations and excluding contraindications for surgery, a total thyroidectomy and centralcompartment lymph node dissection were performed. The postoperative pathology report was consistent with thyroid follicular carcino-ma. Radiation therapy for secondary malignant tumors of the pubic bone and sternum was conducted on November 13 and November21, respectively. The first course of 131I treatment was carried out on November 27. The patient's general condition remained stable, and a subsequent course of 131I treatment was planned. Conclusions Follicular thyroid carcinoma with sternum and pubis metastasis isclinically rare. The diagnosis was confirmed through pathological biopsy, imaging tests, and immunohistochemical analysis. A compre-hensive treatment plan, including surgical intervention, radiotherapy, and 131I therapy, was implemented. This case highlights the impor-tance of maintaining a high level of suspicion for atypical symptoms in clinical practice and underscores the significance of multimodaltherapy in managing follicular thyroid carcinoma with distant metastasis. Early diagnosis and individualized treatment strategies arecrucial for improving patient prognosis. |
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