- 期刊
甲狀腺乳突癌引起頸部疼痛：病例報告
Papillary Thyroid Carcinoma with Neck Pain: A Case Report
摘要
甲狀腺乳突癌是一種常見且分化良好的甲狀腺癌，臨床上常因爲患者頸部有腫塊或淋巴腫大而被發現。其病程進展緩慢，且較少同時併發多處轉移，預後較其他類型的甲狀腺癌爲佳。此病的診斷，主要經超音波導引細針抽吸組織作病理學檢查後，進一步確診。實驗室檢查甲狀腺功能可能低下或呈正常的表現。本研究病例爲82歲男性，因頸部疼痛而至復健科門診就醫，初步頸部X光檢查僅有頸椎退化的現象，故且安排復健治療。經過約4個月持續復健，患者症狀沒有改善，於是安排頸部核磁共振檢查，即發現有腫瘤轉移壓迫左側頸部神經根。經過藥物和放射線的治療之後，患者頸部疼痛獲得顯著改善，並後續在腫瘤科和新陳代謝科門診追蹤治療。本報告對於因甲狀腺乳突癌造成頸部疼痛，作一討論和文獻回顧，以供日後臨床診療參考。
並列摘要
Papillary thyroid carcinoma is a type of well-differentiated thyroid cancer. This type of cancer is often diagnosed in patients found with palpable neck mass or lymph node enlargement. The clinical characteristics of papillary thyroid carcinoma are slow disease progression, less tendency for distant metastasis, and better prognosis than other types of thyroid cancer. The diagnosis of thyroid cancer is primarily based on the identification of pathological tissue obtained through echo-guide fine needle aspiration biopsy. In laboratory examinations, these patients may or may not be present with hypothyroidism. The subject in our case study is a 82-year-old male patient. He complains of radiating pain from neck to left shoulder and visits our outpatient department for treatment. Cervical spine X-ray only revealed spondylosis without bone lesion. Rehabilitation program was arranged for 4 months. However, neck pain was not improved after treatment. Tumor metastasis with nerve compression and vertebral body invasion were found by C-spine MRI. After radiotherapy and medication, patient's neck pain symptoms were greatly improved. This case study reminds us that even a common symptom may be a clue of a more malignant disease.