甲状腺罕见的神经母细胞瘤课件

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1、Thethyroid:anextremelyrareprimarysiteofneuroblastomaIntroductioThethyroidisarareprimarysiteofneuroblastoma(NB)thathasnotbeendescribedintheliterature.Neuroblastomainadolescentsisuncommon,anddistantmultiplemetastasestotheskininchildrenarealsorareWedescribetheuniquepresentationofNBinthe

2、pediatricpopulationwhereinan11-year-oldboywasdiagnosedwithNBofthethyroidwithregionallymphnodeanddistantmultiplesubcutaneousmetastases.CasereportThe11-year-oldboypresentedtothepediatricsclinicwithcomplaintsoffeverandthyroidswellingintheneckforthepast4monthsandswellingoverthescalpforthe

3、past3monthsA,Enlargedthyroidandscalpswellinginan11-year-oldboy.Subsequently,henoticedmultiplesmallareasofsubcutaneousabdominalswellingforthepreceding15days.Thepatienthadnohistoryofexposuretoradiationoranysignificantfamilyorpasthistory.Onexamination,theareaofneckswellingwas5x6cminsize,

4、nodular,andmoreprominentontherightside.Itwasfirmandmovedwithdeglutition.Scalpswellingwaspresentintheleftparietalarea.Itwas4x5cminsizeandsoft.The3areasofsubcutaneousabdominalswellingwere1x1cmeach,nontender,andmobileintheepigastricregion.Therewasnopalpablelymphadenopathy.Onroutinehemato

5、logicexamination,hemoglobinwas11g%,totalleukocytecountwas7000/mm3ofbloodwithnormaldifferentialdistribution,anderythrocytesedimentationratewasincreased.Athyroidfunctiontestandbiochemicaltestswerewithinnormallimits.X-rayoftheskulldemonstratedsubcutaneousscalpswellingwithnobonyinvolvemen

6、t.Ultrasoundexaminationofthethyroidshowedanenlargedrightlobeofthethyroidandisthmusshowingmultiplenoduleswithmultipleenlargedrightcervicallymphnodesalongwithevidenceofcalcification.Abdominalultrasoundwaswithinnormallimits.X-rayofthechest,spine,andpelvisdidnotrevealanymetastaticfoci.Ate

7、ntativeclinicaldiagnosisofmalignantthyroidmasswithmultiplemetastaseswasmadeFine-needleaspirationofthethyroid,scalp,andareasofsubcutaneousabdominalswellingwasdonewitha23-gaugeneedleand10-mLsyringe.SlideswerewetfixedandairdriedandstainedwithPapanicolaouandLeishman-Giemsastains,respectiv

8、ely.C