关键词：异位甲状腺；甲状腺肿瘤；侧方异位甲状腺
摘要 目的：探讨异位甲状腺及其肿瘤的临床病理学特点及诊治原则。方法：对32例舌根甲状腺及6例其它中线部位的异位甲状腺之临床病理学资料进行了分析。对59例因“侧方异位甲状腺”而行同侧或双侧甲状腺切除的术后病理亦作了分析。结果：32例舌根甲状腺无症状者11例，有症状性者21例，完全性异位16例，部分性异位16例，16例给予甲状腺素治疗仅1例无效，8例行手术切除术后病理显示2例腺瘤性甲状腺肿、2例甲状腺腺瘤、1例甲状腺滤泡癌和3例正常甲状腺组织。所有的因“侧方异位甲状腺”而行正常位置甲状腺切除术后病理均找到甲状腺原发癌。结论：甲状腺胚胎发育异常是异位甲状腺的主要原因。通常位于中线部位。异位甲状腺可以发生正常位置甲状腺可发生的所有病变。“侧方异位甲状腺”应定义为颈动脉鞘外侧，基本上都是隐性甲状腺癌的转移灶，行同侧甲状腺腺叶切除是必须的。
Ectopic Thyroid and Tumor Arising in Ectopic Thyroid
Yang Hongjian Rapoport
(Department of Head and Neck Surgery, Zhejiang Provincial Cancer Hospital, Hangzhou)
Abstract Purpose : To study the clinical and pathological characteristics and management of ectopic thyroid and tumor arising in it. Methods : The clinical and pathological data of 32 cases of lingual thyroid and 6 cases of other midline ectopic thyroid were analysed. The pathology of 59 cases of “ lateral ectopic thyroid ” after ipsilateral or bilateral thyroidectomy were analysed as well. Results : Thirty - two lingual thyroids included asymptomatic 11 and symptomatic 21, and completely ectopic 16, incompletely ectopic 16 cases. There were 16 cases treated with thyroid hormone,and this method failed only in one case. Eight cases underwent surgical excision and postoperative pathologic examination showed 2 cases of nodular goiter, 2 cases of thyroid adenoma, 1 case of follicular carcinoma and 3 cases of normal thyroid tissue. We have found that postoperative pathologic examination revealed primary thyroid carcinoma in all ectopic thyroids treated with ipsilateral thyroidectomy. Conclusion : Ectopic thyroid is a congenital anomaly resulted from the embryologic defects of the medial anlage of the thyroid. It is usually located in the midline. Any disease or pathologic changes seen in the normally seated thyroid gland may occur in ectopic thyroid. The definition of “ lateral ectopic thyroid ” requires the nodule to be lateral to the carotid sheath and it is usually the metastasis of a latent thyroid cancer and an ipsilateral thyroidectomy is mandatory.
Key Words Ectopic thyroid Thyroid tumor Lateral ectopic thyroid
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