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患者男性,49岁。颏下无意中发现肿块,逐渐增大5个月,无自觉症状。查体:一般状态良好。BP15.9/10.66kPa,P80次/分。于舌骨前下方可见2×3cm肿物,触之光滑,与皮肤无粘连,呈弹力样硬,可活动。甲状腺不大,无结节,颈淋巴结无肿大,胸腹未见异常。辅助检查: B型超声见颏下2×3.5cm的液性暗区,边界清晰,但是不规整,其内部有较强回声。提示囊性肿物。核素扫描:甲状腺位置及形态正常,腺体内核素分布均匀,肿物位于甲状腺之外。~(131)碘甲状腺功能测定,其值正常。术前诊断甲状腺舌管囊肿。局麻行肿物连同部分舌骨一并切除。切除为囊性肿物2.5×3.5cm,剖开内有咖啡样液体,囊壁有大小不等结节。病理诊断:乳头状腺癌。
The patient male is 49 years old. The underarms inadvertently found a lump and gradually increased for 5 months with no symptoms. Physical examination: The general condition is good. BP15.9/10.66kPa, P80 beats/min. A 2×3cm mass was seen on the front of the hyoid bone. The touch was smooth, no adhesion to the skin, and it was elastic and hard to move. The thyroid gland was small, no nodules, no swelling of the cervical lymph nodes, and no abnormalities in the thorax and abdomen. Auxiliary examination: B-mode ultrasound showed a liquid dark area of 2 x 3.5 cm below the diaphragm, the boundary was clear, but irregular, and there was a strong echo inside. Tip cystic tumor. Radionuclide scan: The position and shape of the thyroid gland are normal, and the distribution of nucleus in the gland is uniform. The tumor is located outside the thyroid gland. ~ (131) iodine thyroid function test, its value is normal. Preoperative diagnosis of thyroglossal cysts. The local anesthesia tumor was removed together with part of the hyoid bone. The resection was a cystic mass of 2.5 x 3.5 cm. There was a coffee-like fluid in the cut and the wall of the capsule had nodules of different sizes. Pathological diagnosis: papillary adenocarcinoma.