Öz
Tiroid bezi primer yassı epitel hücreli karsinomu tüm tiroid kanserlerinin yaklaşık %1’ini oluşturan nadir bir hastalıktır. Hastalar genellikle büyüyen bir boyun kitlesi ile başvururlar. Bu makalede, ilk bulgusu boyunda apse olan ve tiroid bezinin primer skuamöz hücreli karsinomu tanısı alan 76 yaşında bir kadın hastayı sunduk. Hasta kliniğimize yutma güçlüğü, nefes almada zorluk, boyun sağ kısmında son 1 haftadır iyice büyüyen hiperemik kitle şikayetleri ile başvurdu. Fizik muayenede sağ boyun bölgesinde fluktuasyon gösteren, hiperemik kitle izlendi. Boyun ve üst toraks manyetik rezonans görüntülemesinde tiroid bezi sağ kısmında, kistik ve nekrotik alanlar içeren ve retrosternal uzanım gösteren, sağ juguler ven ve ana karotid arteri saran kitle izlendi. İnsizyonel biyopsi yapıldı. Histopatolojik tanı skuamöz hücreli karsinom olarak rapor edildi. Komşu dokulardaki ileri invazyon ve infiltrasyon nedeniyle onkoloji konseyi tarafından inoperabl kabul edildi. Tiroid bezi primer skuamöz hücreli karsinomu, kötü prognozlu, agresif seyirli ve nadir bir kanserdir. Derin boyun apsesi şikâyeti ile başvuran hastalarda, tanı ve tedavideki gecikmelerden kaçınmak için altta yatan bir tiroid skuamöz hücreli karsinomu bulunabileceği akılda tutulmalıdır.
Anahtar Kelimeler
Kaynakça
- Zhou XH. Primary squamous cell carcinoma of the thyroid. Eur J Surg Oncol 2002;28(1):42-5.
- Jones JM, McCluggage WG, Russell CF. Primary squamous carcinoma of the thyroid. Ulster Med J 2000;69(1):58-60.
- Soon SR, Kanagalingam J, Johari S, Yuen HW. Head and neck cancers masquerading as deep neck abscesses. Singapore Med J 2012;53(12):840-2.
- Lin YY, Hsu CH, Lee JC, et al. Head and neck cancers manifested as deep neck infection. Eur Arch Otorhinolaryngol 2012;269(2):585-90.
- Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterizations of life-threatening deep cervical space infections: A review of one hundred ninety-six cases. Am J Otolaryngol 2003;24(2):111-7.
- Ridder GJ, Technau-Ihling K, Sander A, Boedeker CC. Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg 2005;133(5):709-14.
- Batchelor NK. Primary squamous cell carcinoma of the thyroid: An unusual presentation. J Bronchology Interv Pulmonol 2011;18(2):168-70.
Öz
Primary squamous cell carcinoma of the thyroid gland (PSCCT) is a rare disease which accounts less than 1% of all thyroid cancers. Patients usually present with enlarging neck mass. In this paper we presented a 76-year-old female patient with PSCCT whose initial finding was a cervical abscess. To our knowledge this is the first PSCCT case in the literature presenting as cervical abscess. The patient was referred to our clinic with dysphasia, shortness in breathing and hyperemic right neck mass, growing in size for 1 week. On physical examination a fluctuant and hyperemic mass was observed at the right cervical region. Magnetic resonance imaging of neck and upper thorax revealed a mass in the area of right thyroid gland, including cystic and necrotic component, progressing to the retrosternal area, surrounding right jugular vein and common carotid artery. An open biopsy was performed. The histopathological diagnosis was squamous cell carcinoma. Because of the extended invasion and infiltration of adjacent tissues, the patient was accepted as inoperable in oncologic council. PSCCT is a rare and aggressive neoplasm of the thyroid gland with poor prognosis. In a patient with deep neck spaces abscess, an underlying PSCCT should be kept in mind to avoid delays in the diagnosis and treatment.
Anahtar Kelimeler
Kaynakça
- Zhou XH. Primary squamous cell carcinoma of the thyroid. Eur J Surg Oncol 2002;28(1):42-5.
- Jones JM, McCluggage WG, Russell CF. Primary squamous carcinoma of the thyroid. Ulster Med J 2000;69(1):58-60.
- Soon SR, Kanagalingam J, Johari S, Yuen HW. Head and neck cancers masquerading as deep neck abscesses. Singapore Med J 2012;53(12):840-2.
- Lin YY, Hsu CH, Lee JC, et al. Head and neck cancers manifested as deep neck infection. Eur Arch Otorhinolaryngol 2012;269(2):585-90.
- Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterizations of life-threatening deep cervical space infections: A review of one hundred ninety-six cases. Am J Otolaryngol 2003;24(2):111-7.
- Ridder GJ, Technau-Ihling K, Sander A, Boedeker CC. Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg 2005;133(5):709-14.
- Batchelor NK. Primary squamous cell carcinoma of the thyroid: An unusual presentation. J Bronchology Interv Pulmonol 2011;18(2):168-70.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Haziran 2019 |
| Gönderilme Tarihi | 5 Ocak 2018 |
| Yayımlandığı Sayı | Yıl 2019 |