患者,女性,77岁。双侧颈部肿物3个月,生长快,憋气感。无甲亢症状及声音嘶哑,腹泻等。临床拟诊“甲状腺癌”。既往无甲状腺肿大史。居住地无“地方性甲状腺肿”流行,家族肿瘤史阴性。 体查 一般状况略差,浅表淋巴结未触及。胸腹阴性。心电图正常。 颈部检查 双侧甲状腺肿大,质软,形态不规则。左侧8×7cm,右侧7×6cm,和周围组织无明显粘连,界清,活动。气管左移,未触及肿大淋巴结。颈部平片:颈前巨大软组织影,不规则,有钙斑,气管受压左移,疑有向纵隔及气管内转移可能。胸片未见异常。常规化验无特殊。 治疗情况 术前先服Lugols液治疗半月,肿物变硬、缩小,同时应用抗菌素。于1979年9月27日行 Patient, female, 77 years old. Bilateral neck mass 3 months, rapid growth, suffocation. No hyperthyroidism symptoms, hoarseness, diarrhea, etc. Clinically diagnosed as “thyroid cancer.” No past goiter history. There was no epidemic of “endemic goiter” in the place of residence, and the family history of oncology was negative. The physical examination was slightly worse and the superficial lymph nodes were not touched. Thoracic and abdominal negative. ECG is normal. Neck examination Bilateral goiter, soft, irregular shape. The left side is 8×7cm, the right side is 7×6cm, and there is no obvious adhesion to the surrounding tissues. Tracheal left, without touching the enlarged lymph nodes. Neck plain film: large soft tissue shadow in front of the neck, irregular, with calcium spots, tracheal pressure left, suspected of transfer to the mediastinum and trachea possible. No abnormal chest radiograph. No special routine tests. Treatment conditions Before surgery, Lugols solution was used to treat for half a month. The tumor became hard and shrinking, and antibiotics were applied. On September 27, 1979