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目的 :探讨小儿甲状腺癌的一种特殊临床表现。方法 :对 1970～ 1998年我们收治的 15岁以下小儿甲状腺癌 31例分析发现有 7例以颈淋巴结肿大作为就诊第一症状。结果 :7例中甲状腺微小癌 4例 ,普通类型甲状腺癌 3例。所有病例在院外均以颈部良性病变而屡遭误诊。院内外局部淋巴结活检4例 ,穿刺细胞学检查 1例 ,甲状腺B超 3例有阳性发现。对单侧 5例行甲状腺患侧叶、峡部及对侧叶部分切除并同侧颈淋巴结清扫 ,对双侧 2例行甲状腺近全切并双侧颈淋巴结清扫。 7例中获访 6例 ,5例无瘤存活 ,平均 63个月。结论 :颈淋巴结肿大可以是小儿甲状腺癌的第一或唯一表现 ,常被误诊为颈部良性病变 ,值得引起重视
Objective: To investigate a special clinical manifestation of pediatric thyroid cancer. Methods: From 1970 to 1998, we analyzed 31 cases of pediatric thyroid cancer under 15 years of age and found that 7 cases had cervical lymph node enlargement as the first symptom. Results: Among the 7 cases, 4 were thyroid microcarcinoma and 3 were thyroid carcinoma. All cases were repeatedly misdiagnosed as benign cervical lesions in the hospital. 4 cases of nosocomial lymph node biopsy, puncture cytology in 1 case, thyroid B-3 positive findings. On the unilateral 5 cases of thyroid disease ipsilateral leaf, isthmus and contralateral lobectomy and ipsilateral neck lymph node dissection, two cases of bilateral thyroidectomy and bilateral cervical lymph node dissection. Six of the seven patients were visited, and five patients survived without any tumor, with an average of 63 months. CONCLUSIONS: Cervical lymph node enlargement may be the first or only manifestation of pediatric thyroid cancer and is often misdiagnosed as benign cervical neoplasia, deserving attention