分化型甲狀腺癌最常見的轉移部位是肺部和骨骼。我們在此報告一例乳突狀甲狀腺癌病例併發肺部和骨骼多處轉移,病人的碘-131掃描系列顯示遠處轉移,在鎝-99m MDP掃描中卻沒有出現骨骼病灶。在甲狀腺癌病患篩選骨骼轉移,鎝-99m MDP掃描是不恰當的工具。這難治的病例並無BRAF-V600E基因突變,針對該項突變是甲狀腺癌預後不良的指標,本例 提出相反的事證。
Lungs and bones are the most common sites of distant metastasis from differentiated thyroid cancer. In this paper, we report a case of papillary thyroid carcinoma with lung and multiple bone metastases in the absence of nodal dissemination. Refractory metastases were displayed on serial I-131 scans, but no bone lesion was seen on her Tc-99m MDP scintigraphy. Tc-99m MDP scan is not appropriate to screen skeletal metastasis in patients with thyroid cancer. Our refractory case with negative BRAF-V600E mutation disputes the role of BRAF mutation as a prognostic marker in PTC.
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