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Branchial Cleft Cyst as the Initial Impression of a Metastatic Thyroid Papillary Carcinoma: Two Case Reports

鰓裂囊腫為轉移性甲狀腺乳突癌的初期表現:二病例報

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摘要


鰓裂囊腫是側頸部囊腫中最常見的病灶,常發生在三十多歲,無性別傾向,少數鰓裂囊腫會與從口、鼻、咽、及甲狀腺之轉移性惡性腫瘤有關;潛隱性甲狀乳突癌轉移常以側頸部實心腫塊表現,僅有很少的病例以鰓裂囊腫特徵為初期症狀。我們報告二位轉移性甲狀腺乳突癌的患者,以側頸部囊腫為表現的臨床病例,術前診斷皆為鰓裂囊腫,經由完整的手術切除及病理組識學檢查,一例為甲狀腺乳突癌淋巴轉移之囊性變化,另一例為鰓裂囊腫併同時存在之甲狀乳突癌淋巴轉移。對臨床上表現,或組識學上證明為鰓裂囊腫的患者,轉移性甲狀腺乳突癌應須納入鑑別診斷。

並列摘要


Branchial cleft cysts are the most common lesions in lateral neck cysts, predominantly occurring in the fourth decade of life and without sexual propensity. Rare branchial cleft cysts are associated with malignant tumors metastatic from the oral cavity, nasal cavity, pharynx or thyroid gland. Occult thyroid papillary carcinomas often present as a solid mass in the lateral neck, with only a few cases revealing a branchial cleft cyst as the initial manifestation. Herein, we report two cases of metastatic thyroid papillary carcinoma that presented as lateral neck cysts, with preoperative diagnosis of branchial cleft cyst. Finally, after complete surgical resection and histopathologic examination, one case was diagnosed as cystic change of metastatic lymph node from thyroid papillary carcinoma, and the other was determined to be a branchial cleft cyst with concurrent lymph node metastasis from thyroid papillary carcinoma. When a branchial cleft cyst is diagnosed by clinical or histopathologic examination, a metastatic thyroid papillary carcinoma should be considered as part of the differential diagnosis.

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