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1034 
Ano: 2012  Vol. 16   Num. Suppl. 1  - May - (158º)
DOI: 10.7162/S1809-977720120S1PC-056
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Seção: XXXIX CONVENTUS - Oral Presentation
Texto Text in English
MEDULLARY CARCINOMA OF THE THYROID GLAND IN A YOUNG PATIENT. A CASE REPORT
MEDULLARY CARCINOMA OF THE THYROID GLAND IN A YOUNG PATIENT. A CASE REPORT
Author(s):
José Ortiz, Esteban Espínola, Alvaro Vincenty, Hernan Ortiz, Jorge Arias, José Quiroz
Resumo:

El carcinoma medular de la glándula tiroides es un tumor neuroendócrino productor de calcitonina y otras sustancias como serotonina, prostaglandinas, antígeno carcinoembrionario (CEA). Constituye el 8 % de todos los canceres tiroideos y se presenta en forma esporádica (80%) y familiar (20%) Clínicamente se presenta como un nódulo tiroideo duro e indoloro, frecuentemente con adenopatías cervicales. La exéresis quirúrgica ofrece la única oportunidad real de curación para el carcinoma medular de tiroides dado que no existe evidencia firme sobre la utilidad de los tratamientos adyuvantes. Paciente de sexo masculino, 38 años de edad, con antecedentes de tumoración cervical de crecimiento progresivo, no dolorosa, refiere disfonía intermitente que cede con antinflamatorios. Al examen físico se palpa en cuello conglomerado de adenopatías yugulocarotideas altas derechas, no dolorosas, fijas de aproximadamente 4 cm de diámetro mayor y aumento de glándula tiroides a expensas de lóbulo derecho. A la laringoscopia indirecta se constata cuerda vocal derecha parética Se realiza PAAF de región yugulocarotidea alta derecha que informa acumulos de células epiteliales sin atipia significativas en el contexto de ganglios metastasicos. La tomografía de cuello con contraste informa proceso expansivo en region cervical derecha de probable origen tiroideo más adenomegalias cervicales derechas. Se realiza tiroidectomía total mas vaciamiento cervical posterolateral lado derecho y control del lado izquierdo. Se envía muestra a anatomía patológica, que informa carcinoma medular de tiroides con metástasis en niveles ganglionares II, III, IV, VII. Se remite a paciente a oncología para radioterapia.

Abstract:

Medullary carcinoma of the thyroid gland is a neuroendocrine tumor-producing calcitonin and other substances such as serotonin, prostaglandins, carcinoembryonic antigen (CEA). It constitutes 8% of all thyroid cancers and is present in sporadic (80%) and family (20%) clinically presents as a painless hard and thyroid nodules, often with cervical lymphadenopathy. The surgery maneuver offers the only real chance of cure for medullary thyroid carcinoma since there is no firm evidence about the usefulness of adjuvant therapies. Male patient, 38 years old with a history of cervical tumor growth progressive, painless, intermittent dysphonia is that subsides with anti-inflammatory. On physical examination palpates conglomerate adenopathy in the neck jugular right carotid high, painless, fixed approximately 4 cm in diameter and no increase of thyroid gland expansion right lobe. The indirect laryngoscopy is paretic right vocal cord notes It is realized PAAF of carotid high right jugular region that informs accumulations of epithelial cells without significant atypia in the context of metastatic lymph nodes. The tomography of the neck with contrast informs an expansive process in the right cervical region of probable thyroid origin more right cervical lymphadenopathy. Total thyroidectomy is performed over the right posterolateral neck dissection and control on the left. If the pathology shows that informs medullary thyroid carcinoma with lymph node metastases in levels II, III, IV, VII. Send the patient of oncology for radiotherapy.

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