甲狀腺原發性鱗狀上皮細胞癌：病例報告

Primary Squamous Cell Carcinoma of the Thyroid: A Case Report

蕭信昌(Hsin-Chang Hsiao)；陳志明(Chih-Ming Chen)；杜思德(Shih-Te Tu)；陳美玲(Mei-Ling Chen)

甲狀腺腫瘤 ； 鱗狀上皮細胞癌 ； thyroid neoplasm ； squamous cell carcinoma

The Changhua Journal of Medicine

6卷3期（2001 / 07 / 01）

198 - 201

繁體中文

甲狀腺的原發性鱗狀上皮細胞癌(primary squamous cell carcinoma, pure squamous cell carcinoma, pure SCC)是個極少見又具侵犯性的腫瘤，發生的比率僅佔甲狀腺惡性腫瘤1%，其臨床表現及預後與未分化癌(anaplastic carcinoma)類似，都有著極惡性的表現。至於甲狀腺鱗狀上皮細胞的來源至今仍無明確定論，LiVolsi等人(1978)認為其是由濾泡上皮細胞化生變成或是胚胎期如甲狀舌管的殘餘物來的。本院於1999年5月間經歷l名70歲男性病患，以前頸部腫塊及聲音沙啞求診；經內分泌科施行超音波掃瞄及細針抽取，高度懷疑是甲狀腺惡性腫瘤後轉介至本科，在冷凍切片確定是惡性後施以甲狀腺全切除術；病理報告為鱗狀細胞上皮癌，術後仔細評估及排除其他可能的原發位置，下此診斷。病人之後接受放射碘並全身核醫掃瞄，規則門診追蹤，無復發情形。因屬罕見病例，特別提出報告，並回顧文獻以供臨床醫師作參考。

Pure squamous cell carcinoma originating in the thyroid gland is uncommon. The clinical behavior of this tumor resembles that of anaplastic carcinoma, which is one of the most aggressive neoplasms afflicting humans. Metastatic involvement of squamous carcinoma in the thyroid gland is far more common than a primary tumor in the gland, and a careful search for a primary tumor elsewhere is mandatory. In May 1999, we encountered a well-documented case of thyroid cancer with histopathology characteristics of primary squamous carcinoma. A possible primary tumor elsewhere was excluded. Complete excision was performed which provided a disease-free survival for 20 months after the operation. The possible histogenesis of this unusual tumor and the treatment modalities are briefly discussed.