甲状腺罕见的神经母细胞瘤.pptVIP

The thyroid: an extremely rare primary siteof neuroblastoma Introductio The thyroid is a rare primary site of neuroblastoma (NB) that has not been described in the literature. Neuroblastoma in adolescents is uncommon , and distant multiple metastases to the skin in children are also rare We describe the unique presentation of NB in the pediatric population wherein an 11-year-old boy was diagnosed with NB of the thyroid with regional lymph node and distant multiple subcutaneous metastases. Case report The 11-year-old boy presented to the pediatrics clinic with complaints of fever and thyroid swelling in the neck for the past 4 months and swelling over the scalp for the past 3 months Subsequently, he noticed multiple small areas of subcutaneous abdominal swelling for the preceding 15 days. The patient had no history of exposure to radiation or any significant family or past history. On examination, the area of neck swelling was 5 x 6 cm in size, nodular, and more prominent on the right side. It was firm and moved with deglutition. Scalp swelling was present in the left parietal area. It was 4 x 5 cm in size and soft. The 3 areas of subcutaneous abdominal swelling were 1 x 1 cm each, nontender, and mobile in the epigastric region. There was no palpable lymphadenopathy. On routine hematologic examination, hemoglobin was 11 g%, total leukocyte count was 7000/mm3 of blood with normal differential distribution, and erythrocyte sedimentation rate was increased. A thyroid function test and biochemical tests were within normal limits. X-ray of the skull demonstrated subcutaneous scalp swelling with no bony involvement. Ultrasound examination of the thyroid showed an enlarged right lobe of the thyroid and isthmus showing multiple nodules with multiple enlarged right cervical l