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Metastização ganglionar cervical : forma de apresentação de carcinoma papilar da tiróide
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Este trabalho incide sobre o caso clínico de uma adolescente que se dirigiu ao SU de Pediatria do Hospital de Santa Maria por massa cervical com aumento de volume. Após a colheita de história clínica, realização de exame objectivo e de exames complementares de diagnóstico, a doente foi submetida a hemitiroidectomia, tendo sido diagnosticada com “Metástase ganglionar quística de carcinoma papilar da tiróide”.
Importa destacar e alertar neste caso que, na maior parte dos casos, as adenopatias cervicais correspondem a massas benignas, encaminhando-nos para outro diagnóstico. No entanto, há que estar desperto para a possibilidade de aparecimento de casos como o descrito neste relatório, pois, apesar de raro nas crianças, o carcinoma papilar da tiróide é a patologia endocrinológica mais frequente. Já a metastização ganglionar cervical surge muitas vezes como forma de apresentação inicial da doença. O tratamento consiste em tiroidectomia total, seguida de administração de iodo radioactivo e terapêutica hormonal de substituição com Levotiroxina. Após tratamento, o prognóstico neste grupo etário é excelente.
This report focus on the clinical case of an adolescent girl that headed to the Pediatric emergency unit of Hospital de Santa Maria due to a neck mass with increasing volume. After collecting the clinical history, realising the physical examination and complementary diagnosis exams the patient was submitted to a hemitiroidectomy, having been diagnosed with a “Cystic Lymph node metastasis of a papillary thyroid carcinoma” It is must highlighted and noticed that in most cases cervical adenopathies are benign, that lead us to another diagnosis. However, one must be aware of the possible appearance of cases such as the one described in this report, since, although rare among children, the papillary thyroid carcinoma is the most frequent endocrinological disease. Conversely, ganglionar cervical metastisation often occurs as an initial form of the disease. Treatment consists of total tiroidectomy, followed by radioiodine and hormonal replacement therapeutics with Levotiroxina. After treatment, prognosis in this age group is excellent.
This report focus on the clinical case of an adolescent girl that headed to the Pediatric emergency unit of Hospital de Santa Maria due to a neck mass with increasing volume. After collecting the clinical history, realising the physical examination and complementary diagnosis exams the patient was submitted to a hemitiroidectomy, having been diagnosed with a “Cystic Lymph node metastasis of a papillary thyroid carcinoma” It is must highlighted and noticed that in most cases cervical adenopathies are benign, that lead us to another diagnosis. However, one must be aware of the possible appearance of cases such as the one described in this report, since, although rare among children, the papillary thyroid carcinoma is the most frequent endocrinological disease. Conversely, ganglionar cervical metastisation often occurs as an initial form of the disease. Treatment consists of total tiroidectomy, followed by radioiodine and hormonal replacement therapeutics with Levotiroxina. After treatment, prognosis in this age group is excellent.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Metastização ganglionar Infância Carcinoma papilar da tiróide