Department of Thoracic Surgery, Athens Naval and Veterans Hospital, Athens, Greece.
Surg Today. 2012 Sep;42(9):895-8. doi: 10.1007/s00595-012-0192-y. Epub 2012 May 11.
A 70-year-old woman was admitted to our department for investigation and treatment of a progressively enlarging multinodular goiter and a fast growing mass infiltrating the sternum. The patient was euthyroid, but computed tomography (CT) and ultrasonography showed a mass in the anterior mediastinum infiltrating the sternum, with a dominant nodule in the right lobe of the thyroid. Fine needle aspiration biopsy results from both the cervical and the mediastinal masses were suggestive of follicular thyroid carcinoma. The patient underwent total thyroidectomy, thymectomy, and total removal of the mass, along with parts of the sternum, sternocleidomastoid muscle, and attached ribs. The thoracic wall was reconstructed with gortex dual mesh covered by muscle flaps from both pectoralis major muscles. Pathological analysis of both masses confirmed the fine needle aspiration findings and the patient received three cycles of radioactive iodine treatment. She had an uneventful postoperative course, but died of a stroke 8 years later.
一位 70 岁女性因逐渐增大的多结节性甲状腺肿和胸骨浸润的快速生长肿块而被收入我科接受检查和治疗。患者甲状腺功能正常,但计算机断层扫描(CT)和超声检查显示前纵隔肿块浸润胸骨,甲状腺右叶有一个优势结节。颈部和纵隔肿块的细针抽吸活检结果提示为滤泡性甲状腺癌。患者接受了全甲状腺切除术、胸腺切除术以及肿块的全部切除,包括部分胸骨、胸锁乳突肌和附着肋骨。使用戈尔双网覆盖胸大肌的肌皮瓣重建胸壁。两个肿块的病理分析均证实了细针抽吸活检的结果,患者接受了三次放射性碘治疗。她术后恢复顺利,但 8 年后因中风去世。