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Situs Inversus Incidentally Found in a Patient with Thyroid Cancer

甲狀腺癌病人意外發現臟器反轉

摘要


一位83歲女性病人因前頸部有腫塊而求診,細胞學檢查證實為甲狀腺乳突癌,且有左側血管及氣管侵犯。病人接受甲狀腺右葉全切除及左葉部分切除,同時進行碘-131廓清治療。治療後影像除左葉區有活性增加外,其左上腹部亦有活性攝取,此一活性並不因喝水或延遲攝影而有所改變。游離鎝-99m胃攝影則在右上腹部顯影。鉈-201造影則進一步證實病人為臟器反轉。原先左上腹部所見碘-131攝取乃為肝臟攝取而非甲狀腺為轉移病灶。病人臟器反轉先前並未被告知,核醫影像則意外呈現此一異常。

並列摘要


An 83-year-old woman was found to have thyroid cancer and received incomplete thyroidectomy due to critical tissue invasion. Post-operative pathological examination showed a picture of papillary carcinoma. She was referred to our department for post-operative radioiodine therapy. Except for radioiodine uptake in thyroid bed, there was an additional accumulation of radioiodide in left upper quadrant of abdomen. Gastric uptake was initially impressed because the uptake pattern did not change after drinking water in a later imaging. However, metastatic lesion there might also be considered because of the age factor and operation findings. 99mTc-pertechnetate imaging showed a gastric uptake in right upper quadrant of abdomen. Thallium- 201 scan further confirmed a picture of situs inversus that did not mention previously. The radiouptake in the unusual location was thus due to hepatic uptake rather than metastasis.

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