RESUMO
Antecedentes: el carcinoma diferenciado de tiroides en quiste tirogloso (CaQT) es una entidad rara. La incidencia de CaQT es de 1 a 2%. Usualmente su forma de presentación clínica es indistinguible de una lesión benigna y el diagnóstico definitivo es postquirúrgico. No hay en la actualidad un consenso sobre la indicación de tiroidectomía total, radioablación con iodo y/o terapia supresiva con levotiroxina luego de ser extirpado quirúrgicamente...
Introduction: the development of well -differentiated thyroid carcinoma in thyroglossal duct cysts (TGDCa) is uncommon. The incidence of TGDCa lies within 1 to 2%. Usually the clinical appearance is indistinguishable from a benign thyroglossal duct cyst. The definitive diagnosis is post-operative. After the surgery of choice, the other alternative treatments such as thyroidectomy, radioiodine and L-T4 therapy are controversial...
Antecedentes: o carcinoma diferenciado de tireoide em cisto tirogloso (CaQT) é uma entidade rara. A incidência de CaQT é de 1 a 2 por cento. Em geral, a sua forma de apresentação clínica é indistinguível de uma lesão benigna e o diagnóstico definitivo é pós-cirúrgico. Não existe atualmente um consenso sobre a indicação de tiroidectomia total, radioablação com iodo e/ou terapia supressiva com levotiroxina após ser extirpado cirurgicamente...
Assuntos
Masculino , Feminino , Humanos , Adolescente , Adulto , Criança , Adulto Jovem , Pessoa de Meia-Idade , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/terapia , Cisto Tireoglosso/diagnóstico , Cisto Tireoglosso/terapia , Algoritmos , ConsensoRESUMO
OBJECTIVE: To present a report series of five cases, compare their clinical evolution, and establish the appropriate treatment. METHODS: A retrospective study was performed with the clinical records from three health institutions in Mexico City, Mexico, in order to search for patients with histologic diagnosis of thyroglossal duct carcinoma and were classified by different risk stratifications to compare their outcome. RESULTS: We found five patients, three females and two males, mean age 49 years. Four were treated by Sistrunk's procedure, total thyroidectomy, radioiodine ablation, and thyroxine suppression; one patient underwent Sistrunk's procedure only. Four patients were classified in the low- and median-risk group and had good outcome; one patient was in the high-risk group and had poor outcome. CONCLUSIONS: The thyroglossal duct cyst must be studied in the adult population through fine-needle aspiration biopsy (FNAB) and a frozen section in cases in which FNAB is inconclusive or unavailable. When a diagnosis of a thyroglossal cyst carcinoma is made, an evaluation of the thyroid gland during surgery must be done as well as a careful examination to identify suspicious lymph nodes and neck dissection should be reserved for confirmed adenopathies. When an thyroglossal duct cyst has been excised using Sistrunk's procedure and the definitive histologic analysis reports malignancy, the thyroid gland must be studied. The extension of the surgery must be handled according to the criteria established for differentiated thyroid cancer.
Assuntos
Carcinoma Papilar/complicações , Cisto Tireoglosso/complicações , Neoplasias da Glândula Tireoide/complicações , Adulto , Carcinoma Papilar/terapia , Humanos , Masculino , Prontuários Médicos , México , Pessoa de Meia-Idade , Estudos Retrospectivos , Cisto Tireoglosso/terapia , Neoplasias da Glândula Tireoide/terapia , Resultado do TratamentoRESUMO
Se relata el caso de un paciente de 4 años, quien desde los 3 años presentó una masa en la región cervical de crecimiento progresivo. Hace 9 meses presentó tos, disfonía, disfagia e hipopirexia, manifestaciones que se exacerbaron en los últimos 3 meses. Previa la consulta alza térmica (38,5ïC), tos no productiva, odinodisfagia y adinamia; al examen físico orofaringe congestiva, amígdalas hipertróficas, masa renitente de 3x2x3 cm ubicada a nivel de la línea media en la región cervical anterior, no dolorosa a la palpación y no adherida a planos profundos; además adenomegalia cervical de la cadena superior. En los exámenes complementarios y de imagen, la ultrasonografía cervical demostró la presencia de una masa quística...