ÖZET
Amaç:
Folliküler tip tiroid karsinomu (FTK) nadiren spinal metastazla belirti verir. Böyle bir olgu sunmayı ve bu konuda literatür taramayı amaçladık.
Yöntem:
Lomber 2 spinal metastazla belirti veren 45 yaşında erkek FTK olgusu sunuldu ve literatürde benzer 26 olgu bulundu. Tüm olguların özellikleri değerlendirildi.
Bulgular:
Toplam 27 olgu 55,2±15 yaşındaydı (35-88 arasında, ortalama ± SS) ve erkek/kadın oranı 12/15 idi. Başvuruda 19 olguda kol ve/veya bacaklarda güçsüzlük vardı ve 9’u mobilize olamıyordu. Spinal tümör 14 olguda total, 5 olguda subtotal çıkarıldı. Yirmi olguya radyoaktif iyot tedavisi eklendi. Olguların 23’ü 3-214 ay (43,7±53,2, ortalama ± SS) süreyle izlenmişti, sadece 4 olgu başvurudan 214, 66, 36 ve 7 ay sonra ölmüştü. Halen sağ olan 19 olgunun 13’ü nörolojik olarak normaldi. Uygulanan cerrahi tipi (total çıkarmaya karşılık diğer cerrahi tipleri) son durumu etkileyen tek faktör olarak saptandı. Tümörü total çıkarılan hastalarda sondurum anlamlı olarak daha iyiydi.
Sonuç:
Folliküler tip tiroid karsinomunun spinal metastazla belirti vermesi çok nadirdir. Ancak total tümör çıkarılması ve adjuvan tedaviyle prognoz iyidir. Spinal tümörlü hastalarda bu kanser tipi de ayrıcı tanıda akılda tutulmalı ve tarama testleri yapılmalıdır.
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