Cha Wonjae, Kong Il Gyu, Kim Heejin, Hah J Hun, Sung Myung-Whun
Department of Otorhinolaryngology - Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
Head Neck. 2014 May;36(5):E48-51. doi: 10.1002/hed.23518. Epub 2014 Mar 10.
Transaxillary robotic (TAR) thyroidectomy has been performed for better aesthetic results by many surgeons. In this report, we describe a rare case of a desmoid tumor developed after TAR thyroidectomy, which is speculated to be a late-term complication.
A 61-year-old woman with a history of papillary microcarcinoma had experienced a large left neck mass that had grown over 2 years. The patient underwent TAR thyroidectomy (right lobectomy and isthmectomy) via the right axilla almost 2.5 years previously. Physical examination revealed a 6-cm, firm mass fixed to the left anterior neck. The mass was fixed to the omohyoid muscle. The 5.9- × 4.7- × 4.5-cm tumor with the surrounding muscles was excised in an en bloc fashion. Pathologic examination confirmed the diagnosis of a desmoid tumor.
This case suggests that desmoid tumors could develop late after TAR thyroidectomy. Thus, careful observation of the surgical wound may be necessary after TAR thyroidectomy.
许多外科医生已开展经腋窝机器人辅助甲状腺切除术(TAR)以获得更好的美学效果。在本报告中,我们描述了1例TAR甲状腺切除术后发生硬纤维瘤的罕见病例,推测这是一种晚期并发症。
一名有乳头状微癌病史的61岁女性,左侧颈部有一个大肿块,已生长2年多。该患者于近2.5年前经右腋窝接受了TAR甲状腺切除术(右侧叶切除术和峡部切除术)。体格检查发现左侧颈前有一个6厘米的质地坚硬的肿块,该肿块与肩胛舌骨肌固定。将这个5.9×4.7×4.5厘米的肿瘤及其周围肌肉整块切除。病理检查确诊为硬纤维瘤。
该病例提示硬纤维瘤可能在TAR甲状腺切除术后晚期发生。因此,TAR甲状腺切除术后可能需要仔细观察手术伤口。