ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG BỆNH NHÂN UNG THƯ TUYẾN GIÁP THỂ NHÚ BIẾN THỂ XƠ HOÁ LAN TOẢ TẠI BỆNH VIỆN K

Abstract

Objective: To describe some clinical and paraclinical characteristics of the diffuse sclerosing variant (DSV) of papillary thyroid carcinoma (PTC) treated in Vietnam National Cancer Hospital. Patients and methods: A descriptive study was conducted on 50 patients diagnosed with DSV-PTC who underwent surgery in Vietnam National Cancer Hospital from January 2016 to October 2024. Results: The mean age was 32.5 ± 11.2 years; 36% of patients were younger than 30 years, with a range of 6–57 years; female-to-male ratio was 9:1. 70% of patients presented with clinical symptoms such as neck mass, cervical lymphadenopathy, or dysphagia, while 30% were diagnosed during routine examination. On ultrasound, 34% showed diffuse bilateral thyroid involvement; diffuse microcalcifications were seen in 76%, ill-defined margins in 86%; TIRADS 4 accounted for 44%, and TIRADS 5 for 56%. Bilateral thyroid lobe involvement was present in 52%; multiple tumors (≥2) in 54%; tumor size ≥4 cm or suspected invasion of strap muscles in 24%. Suspicious cervical lymph nodes were detected by ultrasound in 68%, unilateral in 40% and bilateral in 20%, with 66% loss of hilar structure and 22% calcification. All patients underwent fine-needle aspiration cytology before surgery, which was positive in 76% and atypical/suspicious in 24%. Conclusions: The diffuse sclerosing variant of papillary thyroid carcinoma is a rare subtype, characterized by earlier age at diagnosis, more prominent clinical and paraclinical findings, and a tendency for extrathyroidal invasion and lymph node metastasis at the time of diagnosis compared with other subtypes.