以側頸囊腫表徵之轉移性乳頭狀甲狀腺癌－二例報告

Metastatic Papillary Thyroid Carcinoma presenting as a lateral Cervical Cyst – Report of Two Cases

陳志男(Chih-Nan Chen) ； 劉博仁(Po-Jen Liu) ； 胡璟(Ching Hu) ； 韓鎮安(Chen-An Han) ； 袁本治(Ben-Chih Yuan)

《中華民國耳鼻喉科醫學會雜誌》 33卷5期 (1998/10) Pp. 540-545

https://doi.org/10.6286/1998.33.5.540

摘要

臨床上，側頸囊腫（lateral cervical cyst）以良性者居多，但以側頸囊腫為表徵之轉移性乳頭狀甲狀腺癌（metastatic papillary thyroid carcinoma），則屬罕見。乳頭狀癌是甲狀腺癌中最常見的分類，約佔70%左右，併有頸部淋巴結轉移者約佔30%。一般而言，轉移性乳頭狀甲狀腺癌在年齡低於40歲之年輕病患的臨床表現可能只有側頸部的囊腫且無其他特殊之病變，所以診斷上容易臆診為良性腫瘤，而忽略癌症轉移之可能性，往往經過術後病理切片才證實為乳頭狀甲腺癌轉移所造成。
本科於民國86年1月及87年1月經驗2病例，病患為26歲及22歲男性，皆因左側頸囊腫至本科求診，電腦斷層掃描（CT）及磁振造影（MRI）檢查顯示為一良性囊腫，以細針抽檢（fine needle aspiration），囊腫內含棕色漿液（chocolate-brown serous fluid）。經手術摘除，病理報告為轉移性乳頭狀甲狀腺癌後，病人再接受甲狀腺左全葉切除術（left thyroid lobectomy）及左側改良型頸廓清術（left modified neck dissection），手術後追蹤至今，無復發現象。

關鍵字

側頸囊腫 ； 轉移性乳頭狀甲狀腺癌

並列摘要

Papillary carcinomais the most common type of thyroid cancer. It has a great propensity ot metastasize to cervical lymph nodes. And nodal metastases of papillary carcinoma tend to undergo cystic degeneration, which may result in a misdiagnosis of branchial cyst on physical or microscopic examination.
Lateral cervical cysts most commonly represent benign lesions. Presentation of metastatic papillary carcinoma as a lateral neck cyst is rare. We experienced two cases of metastatic papillary thyroid carcinoma. Both patients, a 26-year-old male and a 22-year-old male, suffered from left lateral neck cyst for several months. CT scan and MRI showed benign cervical cysts. After total excision of cysts, they were diagnosed as metastatic papillary thyroid carcinoma. Then both patients received left lobectomy of thyroid and left modified neck dissection. No regional recurrence or distant metastasis has been found up to now.

並列關鍵字

lateral cervical cyst ； metastatic papillary thyroid carcinoma