Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press64910.17650/2222-1468-2021-11-2-64-71CLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙThyroid carcinoma with thymus-like differentiation (CASTLE) tumor: а сase reportКарцинома щитовидной железы с тимусоподобной дифференцировкой (CASTLE): клинический случайhttps://orcid.org/0000-0002-6581-633XIlyinA. A.ИльинА. А.
Russian Federation

10 Marshala Zhukova St., 249031 Obninsk

249031 Калужская обл., Обнинск, ул. Маршала Жукова, 10

https://orcid.org/0000-0003-0857-321XPolkinV. V.ПолькинВ. В.
Russian Federation

Vyacheslav Viktorovich Polkin

10 Marshala Zhukova St., 249031 Obninsk

Вячеслав Викторович Полькин

249031 Калужская обл., Обнинск, ул. Маршала Жукова, 10

polkin83@mail.ruhttps://orcid.org/0000-0001-9831-4814IsaevP. A.ИсаевП. А.
Russian Federation

10 Marshala Zhukova St., 249031 Obninsk

249031 Калужская обл., Обнинск, ул. Маршала Жукова, 10

https://orcid.org/0000-0002-9756-6275SevrukovF. E.СеврюковФ. Е.
Russian Federation

10 Marshala Zhukova St., 249031 Obninsk

249031 Калужская обл., Обнинск, ул. Маршала Жукова, 10

https://orcid.org/0000-0002-4335-973XDvinskychN. Yu.ДвинскихН. Ю.
Russian Federation

10 Marshala Zhukova St., 249031 Obninsk

249031 Калужская обл., Обнинск, ул. Маршала Жукова, 10

https://orcid.org/0000-0002-4840-7163RyzhenkovaM. I.РыженковаМ. И.
Russian Federation

10 Marshala Zhukova St., 249031 Obninsk

249031 Калужская обл., Обнинск, ул. Маршала Жукова, 10

https://orcid.org/0000-0001-7689-6032IvanovS. A.ИвановС. А.
Russian Federation

10 Marshala Zhukova St., 249031 Obninsk

249031 Калужская обл., Обнинск, ул. Маршала Жукова, 10

https://orcid.org/0000-0002-3071-3971KaprinA. D.КапринА. Д.
Russian Federation

3 2nd Botkinsky Dr., Moscow 12528

125284 Москва, 2-й Боткинский пр-д, д. 3

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Health of RussiaМедицинский радиологический научный центр им. А.Ф. Цыба – филиал ФГБУ «Научный медицинский исследовательский центр радиологии» Минздрава РоссииNational Medical Research Radiological Center, Ministry of Health of RussiaФГБУ «Научный медицинский исследовательский центр радиологии» Минздрава России0808202111264710808202108082021Copyright ©; 2021, Ilyin A.A., Polkin V.V., Isaev P.A., Sevrukov F.E., Dvinskych N.Y., Ryzhenkova M.I., Ivanov S.A., Kaprin A.D.Copyright ©; 2021, Ильин А.А., Полькин В.В., Исаев П.А., Севрюков Ф.Е., Двинских Н.Ю., Рыженкова М.И., Иванов С.А., Каприн А.Д.2021Ilyin A.A., Polkin V.V., Isaev P.A., Sevrukov F.E., Dvinskych N.Y., Ryzhenkova M.I., Ivanov S.A., Kaprin A.D.Ильин А.А., Полькин В.В., Исаев П.А., Севрюков Ф.Е., Двинских Н.Ю., Рыженкова М.И., Иванов С.А., Каприн А.Д.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/649

Thyroid carcinoma with thymus-like differentiation (Carcinoma Showing Thymus-Like Differentiation, CASTLE) is an extremely rare disease. It arises from the thymus tissue ectopic into the tissue of the thyroid gland, usually in patients 40–50 years old. In this work, we present an observation of the development of CASTLE in a patient at a young age. A 21-year-old woman was admitted to our clinic with a volumetric education in the projection of the left lobe of the thyroid gland. Ultrasound revealed a 5-centimeter thyroid tumor. Surgery was performed in the scope of thyroidectomy, selective cervical dissection (level VI). Morphological and immunohistochemical studies showed that cancer has a thymus-like differentiation (CASTLE). After 32 months, she recurred to the lymph nodes of the neck (level IV on the left). She underwent repeated surgery, after which she was observed without signs of relapse for 120 months. The rarity of the pathology leads to difficulties in establishing a diagnosis at the preoperative stage and in choosing the optimal treatment tactics during treatment and further follow-up.

Карцинома щитовидной железы с тимусоподобной дифференцировкой (Carcinoma Showing Thymus-Like Differentiation, CASTLE) – крайне редко встречающееся заболевание. Данный тип опухоли возникает из ткани тимуса, эктопированной в ткань щитовидной железы, обычно в возрасте 40–50 лет. В настоящей работе мы приводим клиническое наблюдение развития CASTLE у молодой пациентки, 21 года, поступившей в нашу клинику с объемным образованием в проекции левой доли щитовидной железы. По данным ультразвукового исследования обнаружена опухоль щитовидной железы размером 5 см. Было проведено хирургическое вмешательство в объеме тиреоидэктомии, селективной шейной лимфодиссекции (уровень VI). Морфологическое и иммуногистохимическое исследования показали, что рак имеет тимусоподобную дифференцировку (CASTLE). Через 32 мес у пациентки возник рецидив заболевания в лимфатические узлы шеи (уровень IV, слева). Выполнено повторное хирургическое вмешательство, после которого в течение 120 мес признаков рецидива не наблюдается. Редкая встречаемость патологии обусловливает трудности в постановке диагноза на дооперационном этапе, выборе оптимальной лечебной тактики и дальнейшем диспансерном наблюдении.

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