Karaciğer metastazı ile seyreden medüller tiroid karsinomu: Olgu sunumu

Medüller tiroid karsinomu klinik olarak sıklıkla palpabl servikal lenfadenopati, boyunda hızla büyüyen kitle ve lokal ağrı olarak ortaya çıkar. Az da olsa lokal invazyon nedeniyle disfaji, dispne veya disfoni de gö¬rülebilir. Ancak özellikle familyal olgularda (MEN 2A, MEN 2B ve nonMEN) kronik is¬hal tek semptom olabilir. Biz bu çalışmada 25 yaşında bir erkek hastada yaygın metastaz sonucu diare ile ortaya çıkan ve diagnostik laparoskopi sonrası karaciğerden alınan biopsi ile tanı konulabilen bir MTK olgusunu mevcut literatür ışığında tartıştık.

Medullary thyroid carcinoma with liver metastasis: Case report

Background.- Medullary thyroid carcinoma usually presents with palpable cervical lymphadenopathy, rapidly arising neck mass and local pain. Less frequently, dysphagia, dyspnea and dysphenia can be seen as a result of local invasion. However, especially in familial cases (MEN 2A, MEN 2B and nonMEN), chronic diarrhea can develop as the only symptom. Observation.- In the present study, we present a 25 year-old male patient with distant metastasis of medullary thyroid carcinoma. The diagnosis was confirmed after liver biopsy taken during diagnostic laparoscopy.

PDF

___

1. Ünal G, Çerçel A. Medüller tiroid kanseri. Tiroid Hastalıkları, G.Ünal. İstanbul, Cerrahpaşa Tıp Fakültesi Yayınları 2000; 422-435.
2. Sadler GP, Clark OH, Heerden JA. Thyroid and parathyroid. Schwartz SI, Principles of Surgery. 7* Ed. New York, McGraw-Hill, 1999; 1661-1715.
3. Hazard SB, Hawk WA, Crile G Jr. Medullary (solid) carcinoma of the thyroid: Clinicopathological entity. J Clin Endocrinol Metab 1959; 19:52-75.
4. Wells SA, Chi DD, Toshima K. Predictive DNA testing and prophylactic thyroidectomy in patients at risk for multiple endocrine neoplasia type 2A. Am Surg 1994; 220:237-247.
5. Wells SA. Medullary carcinoma of thyroid gland. World J Surg 2000; 24:952-956.
6. Soh EY, Clark OH. Surgical consideration and approach to thyroid cancer. Endocrinol Metab Clin North Am 1996;25:115-121.
7. Torre GC. Cervicomediastinal extension of thyroid cancer. Am Surg 2000; 66:487-90.
8. Shikare S. Detection of medullary carcinoma of thyroid, with liver metastasis, using 99mTc DMSA (V) scintigraphy. J Postgrad Med 1995; 41:12-3.
9. Machers A. Improved prediction of calcitonin normalization in medullary.thyroid carcinoma patients by quantitative lymph node analysis. Cancer 2000; 88:1909-15.