摘要
甲状腺癌是颈部肿瘤中最常见的恶性肿瘤,但甲状腺癌脑转移发病率很低。本文报道1例63岁女性,因发现额部进行性增大包块2年入院,额部凸起肿物大小约6 cm×8 cm,边界清楚,质地稍韧,活动度差,局部无红肿、破溃,无波动感;双侧甲状腺Ⅲ度肿大,甲状软骨下方、气管旁右侧延伸至胸锁乳突肌中份处扪及包块,质硬,边界欠清,活动度差。头颅MRI增强示额部见多发团状、结节状异常信号影,中线位置不均匀轻中度强化,右侧病灶额部明显强化,额骨骨质呈溶骨性骨质破坏,临近双侧额叶受压推移。胸部CT检查发现甲状腺右侧叶及峡部占位。完善术前准备后,行全冠入路额部病损切除术。术中完整切除肿瘤及受累颅骨、硬脑膜,并予以人工硬膜水密缝合硬脑膜。术后头颅CT示肿瘤及侵犯颅骨完整切除。术后病理诊断为甲状腺癌脑转移。术后1个月随访患者无任何不适。
Thyroid cancer is the most common malignant tumor among neck tumors,but the incidence of brain metastasis from thyroid cancer is very low.This article reports a case of a 63-year-old female who was admitted to the hospital due to a progressively enlarging mass on her forehead discovered over two years.The mass on the forehead measured approximately 6 cm×8 cm,with clear boundaries,slightly firm texture,and poor mobility.There was no local redness,swelling,ulceration,or fluctuation.Bilateral thyroid gland showed gradeⅢenlargement,and a mass was palpated below the thyroid cartilage,extending from the right side of the trachea to the middle portion of the sternocleidomastoid muscle.The mass was hard,with poorly defined boundaries and poor mobility.Contrast-enhanced MRI of the head revealed multiple clustered and nodular abnormal signal shadows on the forehead,with heterogeneous mild to moderate enhancement along the midline.The right lesion showed significant enhancement on the forehead,and the frontal bone exhibited osteolytic destruction,with compression and displacement of the adjacent bilateral frontal lobes.Chest CT examination revealed a space-occupying lesion in the right lobe and isthmus of the thyroid gland.After completing preoperative preparations,a total cranial approach frontal lesion resection was performed.During the surgery,the tumor along with the involved skull and dura mater were completely removed,and an artificial dura mater was used for watertight dural closure.Postoperative head CT showed complete resection of the tumor and the invaded skull.Postoperative pathological diagnosis confirmed brain metastasis from thyroid cancer.At the one-month follow-up,the patient reported no discomfort.
作者
龚光辉
龚明
徐志豪
GONG Guang-hui;GONG Ming;XU Zhi-hao(Department of Neurosurgery,Xingyi People's Hospital,Xingyi 562400,China)
出处
《中国临床神经外科杂志》
2025年第6期382-384,共3页
Chinese Journal of Clinical Neurosurgery
关键词
甲状腺癌
脑转移
显微手术
Thyroid cancer
Brain metastasis
Microsurgey
