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目的探讨具特殊影像特征的甲状腺髓样癌(MTC)的临床诊治策略。方法回顾性分析笔者所在医院于2016年11月收治的1例MTC病例的临床资料和诊治经过,并进行文献复习。结果该例患者的颈部超声检查表现为甲状腺腺瘤征象,术前血清降钙素(Ctn)检查结果异常升高,复查Ctn的同时行血清癌胚抗原(CEA)、细针穿刺细胞学检查(FNA)及洗脱液Ctn检查,结果均提示MTC可能。根据术前影像学检查和术中病理检查结果行甲状腺癌根治术,术后病理确诊为MTC。结论超声检查下不典型征象结节往往是MTC误诊的主要原因,故对于尚不能排除MTC可能者应该考虑进一步行血清Ctn、血清CEA、FNA、洗脱液Ctn等检查以明确诊断,避免延误治疗。
Objective To investigate the clinical diagnosis and treatment strategies of medullary thyroid carcinoma (MTC) with special imaging features. Methods Retrospective analysis of the author’s hospital in November 2016 were treated in 1 case of MTC cases of clinical data and diagnosis and treatment after the literature review. Results The neck ultrasound examination of this patient showed signs of thyroid adenoma, preoperative serum calcitonin (Ctn) test results abnormally elevated, Ctn simultaneous review of serum carcinoembryonic antigen (CEA), fine needle aspiration cytology (FNA) and eluate Ctn examination, the results suggest that MTC may. Radical thyroidectomy was performed according to the preoperative imaging examination and intraoperative pathological examination. The postoperative pathology was diagnosed as MTC. Conclusions Atypical nodules under ultrasound examination are the main causes of misdiagnosis of MTC. Therefore, further examination of serum Ctn, serum CEA, FNA and eluate Ctn should be considered to confirm the diagnosis and avoid delay treatment for patients who can not rule out MTC. .