초록
갑상선 암의 췌장 전이는 드물다. 갑상선 암의 추적관찰을 위해 일반적으로 시행하는 방사선 요오드 스캔에서는 복부 전이 민감도가 낮으며 양전자 방출 단층 촬영이나 전산화 단층 촬영에서 발견된 췌장 종괴는 원발 췌장암과 감별이 어렵다. 최근 내시경 초음파가 활성화되면서 췌장 종괴의 진단에 있어 정확도가 높아졌으며 동시에 조직 검사까지 시행 가능하여 유용한 검사로 사용되고 있다. 저자 등은 췌장암과 감별하기 쉽지 않았으나 조영 증강 내시경적 초음파 및 미세 바늘 세포 흡입술을 통해 진단된 갑상선 유두암의 췌장전이 1예를 보고하는 바이다.
Papillary thyroid cancer (PTC) has a good prognosis and a low incidence of distant metastases. It is extremely rare for PTC to metastasize to the pancreas. Only five cases have been previously reported worldwide. Most cases are discovered incidentally by abdominal computed tomography (CT) or positron emission tomography-CT (PET-CT) during follow-up studies after thyroidectomies. Pancreatic metastasis of PTC is usually unidentifiable by a whole-body I131 scan, a common follow-up modality. When a pancreatic mass is found in patients with PTC, it must be differentiated from pancreatic cancer. In previous reports, patients with pancreatic metastases of PTC underwent operations for therapeutic diagnosis or underwent fine needle aspiration biopsies (FNAB). However, it is unclear whether the benefit of an operation outweighs the risk. We experienced a case of PTC with pancreatic metastasis that was found on PET-CT. Contrast-enhanced endoscopic ultrasonography (EUS) was performed to evaluate the characteristics of the pancreatic mass and pathological confirmation was obtained cytologically via EUS-FNA.
