endosergЭндокринная хирургияEndocrine Surgery2306-35132310-3965Типография «Печатных дел Мастер»10.14341/serg12937endoserg-12937Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCASE REPORTSКлиническое наблюдение метастатического поражения щитовидной железы у пациентки с раком прямой кишкиClinical observation of thyroid metastatic lesion in a patient withrectal cancerhttps://orcid.org/0000-0001-5889-7138БликянК. М.BlikyanK. M.

Бликян Карина Михайловна, к.м.н. 

344022, Ростов-на-Дону, пер. Нахичеванский, д. 29

Karina M. Blikyan, MD, PhD

29 Nahichevansky av., Rostov-on-Don

blikjankarina@mail.ruhttps://orcid.org/0000-0002-3317-0108ЛукьяновС. В.LukyanovS. V.

Лукьянов Станислав Викторович, к.м.н., доцент

Ростов-на-Дону

Stanislav V. Lukyanov MD, PHD, assistant professor

Rostov-on-Don

svluk@rambler.ruhttps://orcid.org/0000-0002-6853-766XАльникинА. Б.AlnikinA. B.

Альникин Александр Борисович, к.м.н., доцент

Ростов-на-Дону

Aleksandr B. Alnikin, MD, PHD, assistant professor

Rostov-on-Don

270079@gmail.comhttps://orcid.org/0000-0002-4691-417XЛукьяновН. С.LukyanovN. S.

Лукьянов Никита Станиславович, врач-хирург

Ростов-на-Дону

Nikita S. Lukyanov

Rostov-on-Don

lukrus61@gmail.comhttps://orcid.org/0000-0002-0258-5378КоноваленкоП. В.KonovalenkoP. V.

Коноваленко Полина Владимировна, врач-хирург

Ростов-на-Дону

PolinaV. Konovalenko

Rostov-on-Don

polinakonovalenko@bk.ruФГБОУ ВО Ростовский государственный медицинский университет Министерства здравоохранения Российской ФедерацииРоссияRostov State Medical UniversityRussian FederationФГБОУ ВО Ростовский государственный медицинский университет Министерства здравоохранения Российской ФедерацииРоссияRostov State Medical UniversityRussian Federation2025010220261934046Copyright © Бликян К.М., Лукьянов С.В., Альникин А.Б., Лукьянов Н.С., Коноваленко П.В., 20262026Бликян К.М., Лукьянов С.В., Альникин А.Б., Лукьянов Н.С., Коноваленко П.В.Blikyan K.M., Lukyanov S.V., Alnikin A.B., Lukyanov N.S., Konovalenko P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surg-endojournals.ru/jour/article/view/12937

Метастатические поражения щитовидной железы встречаются крайне редко: в англоязычной литературе ранее сообщалось только о 24 клинических наблюдениях метастазирования колоректального рака в щитовидную железу. Мы представляем редкий клинический случай метастатического канцероматоза щитовидной железы у пациентки 39 лет, перенесшей комбинированное лечение по поводу рака прямой кишки. В 2018 г. пациентке была выполнена лапароскопически-ассистированная передняя резекция прямой кишки с расширенной лимфаденэктомией и привентивная илеостомия по поводу рака прямой кишки (аденокарцинома) с последующими 8 курсами химиотерапии. Впервые узел в правой доле ЩЖ обнаружен в августе 2020 г., тогда же была выполнена тонкоигольная аспирационная биопсия, цитологическая картина которой была характерна для папиллярной карциномы, VI класс по Bethesda. В сентябре 2020 г. пациентке было проведено оперативное вмешательство в объеме тиреоидэктомия, лимфаденэктомия II, III, IV, V, VI уровней шеи справа. С целью уточнения гистогенеза опухолевых очагов выполнено иммуногистохимическое исследование (СК-7, СК-20, CDX-2 (DAK-CDX-2), SATB-2 (EP281)). При гистологическом исследовании правой доли щитовидной железы был выявлен метастаз низкодиф ференцированной аденокарциномы кишечного типа с десмопластической реакцией стромы, обширными оча гами некроза, опухолевые тромбы в просвете кровеносных и лимфатических сосудов. В 3 лимфатических узлах также были выявлены метастазы низкодифференцированной аденокарциномы с субтотальным замещением ткани лимфатических узлов.

Metastatic lesions of the thyroid gland are extremely rare: in the English-language literature, only 24 clinical cases of colorectal cancer metastasis to the thyroid gland were previously reported. We present a rare clinical case of metastatic thyroid carcinomatosis in a 39-year-old female patient who underwent combined treatment for rectal cancer. In 2018, the patient underwent a laparoscopic-assisted anterior resection of the rectum, with extended lymphadenectomy and preventive ileostomy for rectal cancer (adenocarcinoma), followed by 8 courses of chemotherapy. For the first time, a node in the right lobe of the thyroid gland was detected in August 2020, at the same time a fine-needle aspiration biopsy was performed, the cyto logical picture of which was characteristic of papillary carcinoma, class VI according to Bethesda. In September 2020, the patient underwent surgery in the amount of thyroidectomy, lymphadenectomy III, IV, VI levels of the neck on the right. In order to clarify the histogenesis of tumor foci, an immunohistochemical study was performed (SK-7, SK-20, CDX-2 (DAK-CDX-2), SATB-2 (EP281)). Histological examination of the right lobe of the thyroid gland revealed a metastasis of low-grade adenocarcinoma of the intestinal type with a desmoplastic reaction of the stroma, extensive foci of necrosis, and tumor thrombi in the lumen of blood and lymphatic vessels. In 3 lymph nodes, metastases of poorly differentiated adenocarcinoma with subtotal replacement of lymph node tissue were also detected.

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The authors declare that there are no conflicts of interest present.