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本文报道11例甲亢合并甲状腺癌病例,占甲亢手术病人的3.4％。可发生于不同类型的甲亢病人,病理检查呈局灶性徽小癌6例占54.5％,多数病例要靠术后病理诊断。分析术前误诊原因:①临床上对本病缺乏应有认识。②大部分病例的癌肿尚属早期,常难发现。③对甲亢患者~(131)I扫描为冷结节,合并甲状腺癌的警惕性不够。治疗原则应同甲状腺癌,但对术后才明确诊断,肿瘤属于微小隐性癌,不一定要做二期手术,可术后口服甲状腺素随访观察。
This article reports 11 cases of hyperthyroidism with thyroid cancer, accounting for 3.4% of patients with hyperthyroidism. Can occur in different types of patients with hyperthyroidism, pathological examination showed focal small cancer in 6 cases accounted for 54.5%, most cases rely on postoperative pathological diagnosis. Analysis of preoperative misdiagnosis reasons: 1 clinically lack of understanding of the disease. 2 In most cases, the cancer is still early and difficult to find. 3 The ~(131)I scan of patients with hyperthyroidism was cold nodules and the vigilance of thyroid cancer was insufficient. The principle of treatment should be the same as that of thyroid cancer, but it is only diagnosed after the operation. The tumor is a subtle hidden cancer, and it is not necessary to perform secondary surgery. Oral thyroxine can be followed up after surgery.