(Disclaimer: This article is for general use only. To protect the privacy of Ms. Hou, the information in the following content has been processed)
Abstract: Sister Hou, 43 years old, came to the hospital with a “neck swelling”. She was worried that she had cancer, so she rushed to the hospital for examination. Through preoperative examination and postoperative pathology, she was diagnosed with follicular adenocarcinoma of the thyroid gland. She was given a total thyroidectomy + lymph node dissection in the central area and postoperative adjuvant medication. Her symptoms were relieved and the incision healed well after the operation, and all indicators improved.
Basic information】Female, 43 years old
Disease Type】Follicular adenocarcinoma of the thyroid
Hospital】The First Hospital of Harbin Medical University
Date of consultation】February 2022
Treatment plan】Surgery (total thyroidectomy + central lymph node dissection) + medication (levothyroxine sodium tablets)
Treatment period] Hospitalization for 4 days, outpatient review after 1 month
Treatment effect] The symptoms were relieved, the incision healed well after surgery, and all indicators improved.
I. Initial consultation
Self-report: 2 weeks ago, she unintentionally found a neck mass and occasionally had difficulty in breathing. Examination: asymmetry of the neck, a goose egg-sized mass can be palpated on the right side of the neck. Ultrasensitive thyrotropin: 0.8728 μIU/ml; free thyroxine: 0.97 ng/dl; free triiodothyronine: 2.83 pg/ml; peroxidase antibody: 1.25 IU/ml; thyroglobulin antibody: 1.35 IUml; thyroglobulin >300 ng/ml. ultrasonography of the thyroid gland showed that the size of the right lobe was 4.4 cm×2.54 cm×2.5 cm. CDFI: normal blood supply to the gland; TI-RADS classification: category 3. Combined with Ms. Hou’s medical history and related examinations, she was considered to have a thyroid tumor with compression symptoms. After understanding, Sister Hou decided to be admitted to hospital for treatment.
II. Treatment process
In view of the fact that Sister Hou had developed compression symptoms of thyroid tumor and the possibility of follicular adenocarcinoma of the thyroid could not be excluded, surgery was considered for her. After improving the thyroid CT and the necessary preoperative examination after hospitalization, Sister Hou decided to undergo surgery after full communication with her. Immediately, she underwent a total thyroidectomy + lymph node dissection in the central region, and intraoperative rapid cryopathology confirmed: follicular adenocarcinoma of the thyroid. Since she had follicular adenocarcinoma of the thyroid, she needed to take levothyroxine sodium tablets for long-term endocrine therapy after surgery, and she needed to follow the doctor’s orders for review and adjustment of the dosage if necessary.
(Thyroid CT)
III. Treatment effect
After total thyroidectomy and lymph node dissection in the central region, the pressure of follicular adenocarcinoma on the trachea was relieved, and the tumor’s continued growth, invasion of surrounding vital organs and further metastasis were effectively prevented. After 4 days of hospitalization, Sister Hou’s incision recovered well without any abnormalities such as septicemia, and the review results showed that all indicators tended to improve. Before discharge, she was advised to review her outpatient clinic in 1 month.
IV. Notes
We are glad that after active treatment, Ms. Hou’s discomfort disappeared and the possibility of tumor metastasis was avoided. After her discharge from the hospital, she needs to pay attention to the following matters.
1.Medication: After the surgery, she needs to take oral levothyroxine sodium tablets regularly and quantitatively for endocrine suppression treatment, and avoid foods rich in protein, such as milk and soy milk, which affect the absorption of drugs.
2, diet: because the operation requires tracheal intubation, the trachea and throat may have some discomfort, so it is recommended to have a light diet for a short time after surgery, mainly liquid or semi-liquid, and drink an appropriate amount of water.
3. Incision: The incision of thyroid surgery is generally about 5cm, and the suture is made with absorbable thread during the operation, and no subsequent stitch removal is required. Within 1 week after surgery, avoid water exposure to the incision and strenuous activities of the neck to avoid discomfort.
V. Personal insight
Follicular adenocarcinoma of thyroid is a common malignant tumor of the thyroid gland in middle-aged women. If the size of thyroid nodules is large and the level of thyroglobulin is high in these people, they should be alerted to the possibility of follicular adenocarcinoma of thyroid. When the size of the tumor increases to a certain level, it will compress or invade the adjacent organs, such as trachea, esophagus and laryngeal nerve, and thus produce corresponding symptoms, so standardized surgery and endocrine treatment are needed as soon as possible. Therefore, she needs to undergo regular surgery and endocrine treatment as soon as possible. She also needs to undergo regular review at the outpatient clinic to monitor for recurrence and metastasis of follicular thyroid cancer.