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소아의 미만성 경화 변종 갑상선 유두암: 증례 보고

Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma in a Child: A Case Report

  • 변승희 (충남대학교병원 영상의학과) ;
  • 유선경 (충남대학교병원 영상의학과) ;
  • 강성수 (충남대학교병원 영상의학과) ;
  • 신경숙 (충남대학교병원 영상의학과) ;
  • 이정은 (충남대학교병원 영상의학과)
  • Seung Hee Byun (Department of Radiology, Chungnam National University Hospital) ;
  • Sun Kyoung You (Department of Radiology, Chungnam National University Hospital) ;
  • Seong Su Kang (Department of Radiology, Chungnam National University Hospital) ;
  • Kyung Sook Shin (Department of Radiology, Chungnam National University Hospital) ;
  • Jeong Eun Lee (Department of Radiology, Chungnam National University Hospital)
  • 투고 : 2019.04.04
  • 심사 : 2020.01.01
  • 발행 : 2020.09.01

초록

미만성 경화 변종 갑상선 유두암은 갑상선 유두암의 드문 변종이다. 저자들은 통증을 동반하지 않은 미만성 갑상선 비대를 보였던 9세 여자 환아에서 발생한 미만성 경화 변종 갑상선 유두암의 드문 증례에 대해 보고하고자 한다. 환아는 갑상선 과산화효소 항체에 양성이었고, 처음에는 하시모토 갑상선염으로 진단받았다. 하지만 갑상선 초음파 상에서 미만성 경화 변종 갑상선 유두암의 특징적인 초음파 소견을 보였고, 수술 후 미만성 경화 변종 갑상선 유두암으로 확진되었다. 비록 소아에서 갑상선암은 드물지만 갑상선 비대를 보일 때 미만성 경화 변종 갑상선 유두암의 가능성을 고려해야 한다. 또한 초음파를 시행함으로써 갑상선암의 진단이 지연되는 것을 막을 수 있다.

The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is uncommon. Herein, we report a rare case of DSPTC in a 9-year-old girl who initially presented with a painless diffuse goiter. Thyroid peroxidase antibody testing yielded positive results, and the initial clinical diagnosis was Hashimoto's thyroiditis. However, thyroid ultrasonography revealed characteristic findings of DSPTC, which was confirmed through the postoperative histopathological diagnosis. Although thyroid cancers are rare in the pediatric population, DSPTC should be included in the differential diagnosis of goiter in these patients. Moreover, ultrasonography may prevent a diagnostic delay and facilitate the detection of a concomitant malignancy.

키워드

참고문헌

  1. Crile G Jr, Fisher ER. Simultaneous occurrence of thyroiditis and papillary carcinoma; report of two cases. Cancer 1953;6:57-62  https://doi.org/10.1002/1097-0142(195301)6:1<57::AID-CNCR2820060104>3.0.CO;2-D
  2. Kim KW, Park YJ, Kim EH, Park SY, Park DJ, Ahn SH, et al. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto's thyroiditis. Head Neck 2011;33:691-695  https://doi.org/10.1002/hed.21518
  3. Won JH, Lee JY, Hong HS, Jeong SH. Thyroid nodules and cancer in children and adolescents affected by Hashimoto's thyroiditis. Br J Radiol 2018;91:20180014 
  4. Koo JS, Hong S, Park CS. Diffuse sclerosing variant is a major subtype of papillary thyroid carcinoma in the young. Thyroid 2009;19:1225-1231  https://doi.org/10.1089/thy.2009.0073
  5. Chung BM, Park SH, Kim SJ, Seo JS, Kim YS, Shim HJ, et al. Papillary thyroid carcinoma in children and adolescents. Ultrasound Q 2014;30:193-196  https://doi.org/10.1097/RUQ.0000000000000086
  6. Verburg FA, Van Santen HM, Luster M. Pediatric papillary thyroid cancer: current management challenges. Onco Targets Ther 2017;10:165-175  https://doi.org/10.2147/OTT.S100512
  7. Fukushima M, Ito Y, Hirokawa M, Akasu H, Shimizu K, Miyauchi A. Clinicopathologic characteristics and prognosis of diffuse sclerosing variant of papillary thyroid carcinoma in Japan: an 18-year experience at a single institution. World J Surg 2009;33:958-962  https://doi.org/10.1007/s00268-009-9940-6
  8. Kwak JY, Kim EK, Hong SW, Oh KK, Kim MJ, Park CS, et al. Diffuse sclerosing variant of papillary carcinoma of the thyroid: ultrasound features with histopathological correlation. Clin Radiol 2007;62:382-386  https://doi.org/10.1016/j.crad.2006.11.015
  9. Chen CC, Chen WC, Peng SL, Huang SM. Diffuse sclerosing variant of thyroid papillary carcinoma: diagnostic challenges occur with Hashimoto's thyroiditis. J Formos Med Assoc 2013;112:358-362  https://doi.org/10.1016/j.jfma.2012.07.020
  10. Zhang Y, Xia D, Lin P, Gao L, Li G, Zhang W. Sonographic findings of the diffuse sclerosing variant of papillary carcinoma of the thyroid. J Ultrasound Med 2010;29:1223-1226 https://doi.org/10.7863/jum.2010.29.8.1223