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患者男,27岁。因颈部肿物渐增大2年伴呼吸困难2个月收入院。查体,一般情况好,左甲状腺可触及肿物3×3.5×4cm,结节状,质硬,活动差,边界不清,无压痛,肿物随吞咽上下活动。颈部无肿大淋巴结。B超示甲状腺实质性肿物,细针穿刺未查到癌细胞。吸碘率及1_3T_4正常。拟诊甲状腺癌在全麻下行根治术。术中所见:肿物来自甲状腺左叶,质脆、呈豆渣样,与周围肌肉粘连,并向右叶及胸骨后延伸。行左甲状腺及峡部全切,右甲状腺叶次全切除术。同时切除部分受浸软化的气管软骨,行气管切开置入气管套管,彻底止血,冲洗创口,置胶管引流,术后恢复良好。术后病理诊断,甲状腺恶性神经鞘瘤。随访3个月,病人健
Male patient, 27 years old. As the neck mass gradually increases for 2 years with breathing difficulties 2 months income hospital. Physical examination, generally good, left thyroid palpable mass 3 × 3.5 × 4cm, nodular, hard, poor activity, the border is unclear, no tenderness, tumor up and down activities with swallowing. No enlarged lymph nodes in the neck. B-mode ultrasound showed a solid tumor of the thyroid gland. Fine-needle aspiration did not detect cancer cells. Iodine absorption rate and normal 1_3T_4. Diagnosed thyroid cancer under general anesthesia radical surgery. Intraoperative findings: The mass was from the left lobe of the thyroid gland. It was brittle and bean-like. It adhered to surrounding muscles and extended back to the right lobe and sternum. The left thyroid gland and isthmus were completely cut, and the right thyroid gland was subtotal. At the same time, part of the tracheal cartilage, which was softened by immersion, was removed, tracheostomy was performed by tracheotomy, hemostasis was completely performed, the wound was rinsed, and the drainage was placed on the hose. The postoperative recovery was good. Postoperative pathological diagnosis, thyroid malignant schwannoma. Follow-up 3 months, patient health