갑상설관낭과 갑상선내에 동시에 발생한 암종: 증례 보고

Concurrent Papillary Carcinoma Arising in Thyroglossal Duct Cyst and Thyroid Gland: A Case Report

  • Kim, Kyoung-Tae (Department of Radiology, Inha University School of Medicine) ;
  • Kim, Yeo-Ju (Department of Radiology, Inha University School of Medicine) ;
  • Kim, Sei-Joong (Department of General Surgery, Inha University School of Medicine) ;
  • Cho, Young-Up (Department of General Surgery, Inha University School of Medicine) ;
  • Jeon, Yong-Sun (Department of Radiology, Inha University School of Medicine) ;
  • Kim, Youn-Jeong (Department of Radiology, Inha University School of Medicine)
  • 발행 : 2011.05.01

초록

갑상설관낭 암종은 드물게 발생하지만 갑상설관낭 암종과 갑상샘 압종이 동시에 발생한 경우는 더욱 드물다. 갑상설관낭의 기본 치료는 Sistrunk 수술이지만 갑상샘 내 암종이 있거나 국소 침윤이 있는 낭종 내에 암종이 발생한 경우 갑상선 절제가 필요하다. 이처럼 수술 전 정확한 영상의학적 진단은 수술에 큰 영향을 미친다. 이에 저자들은 갑상설관낭 암종과 갑상샘 유두암종이 동시에 발생한 증례를 보고하고자 한다. 67세 남자이며, 설골 부위의 만져지는 낭종 안에 벽 내 미세석회화 종괴와 갑상샘 협부에 작은 석회화 종괴가 함께 존재하였다.

The occurrence and diagnosis of thyroglossal duct carcinoma is very rare. The synchronous occurrence of papillary carcinomas arising in a thyroglossal duct cyst (TGDC) and thyroid gland is extremely rare. Sistrunk's surgical technique must always be the initial treatment for a TGDC. However, if there is an intra-thyroidal carcinoma or local invasion, thyroidectomy has to be considered. Accurate pre-operative radiological evaluation should be performed in order to plan a surgical strategy. The aim of this report was to review our experience in the management of papillary thyroid carcinoma associated with TGDC. Our patient was a 67-year-old man who had a mural, micro-calcified nodule within a palpable, thick-walled cyst at the level of the hyoid and synchronously, a small macro-calcified mass in the isthmus of the thyroid gland.

키워드

참고문헌

  1. Van Vuuren PA, Balm AJ, Gregor RT, Hilgers FJ, Loftus BM, Delprat CC, et al. Carcinoma arising in thyroglossal remnants. Clin Otolaryngol Allied Sci 1994;19:509-515 https://doi.org/10.1111/j.1365-2273.1994.tb01279.x
  2. Dedivitis RA, Guimaraes AV. Papillary thyroid carcinoma. In thyroglossal duct cyst. Int Surg 2000;85:198-201
  3. Weiss SD, Orlich CC. Primary papillary carcinoma of a thyroglossal duct cyst: report of a case and literature review. Br J Surg 1991;78:87-89 https://doi.org/10.1002/bjs.1800780127
  4. Prasad MC, Rrangaswamy M, Kumar N, Shukla NK. Papillary carcinoma of a thyroglossal duct remnant with Hashimoto's thyroiditis. Ear Nose Throat J 1990;69:358-360
  5. Massol N, Nizam S & Mazzaferri E. Cystic thyroid nodules: diagnostic and therapeutic dilemmas. Endocrinologist 2002;12:185-198 https://doi.org/10.1097/00019616-200205000-00006
  6. Miccoli P, Minuto MN, Galleri D, Puccini M, Berti P. Extent of surgery in thyroglossal duct carcinoma: reflections of a series of eighteen cases. Thyroid 2004;14:121-123 https://doi.org/10.1089/105072504322880355
  7. Pacheco-Ojeda L, Micheau C, Stafford N, Marandas P, Luboinski B, Martinez AL. Papillary carcinoma in thyroglossal duct remnants. Eur Arch Otorhinolaryngol 1991;248:268-270
  8. Park MH, Yoon JH, Jegal YJ, Lee JS. Papillary thyroglossal duct cyst carcinoma with synchronous occult papillary thyroid microcarcinoma. Yonsei Med J 2010;51:609-611 https://doi.org/10.3349/ymj.2010.51.4.609
  9. Hartl DM, Al Ghuzlan A, Chami L, Leboulleux S, Schlumberger M, Travagli JP. High rate of multifocality and occult lymph node metastases in papillary thyroid carcinoma arising in thyroglossal duct cysts. Ann Surg Oncol 2009;16:2595-2601 https://doi.org/10.1245/s10434-009-0571-9