Dortch John D, Eck Dustin, Hakaim Albert G, Casler John D
Department of Surgery, Mayo Clinic, Jacksonville, FL, United States.
Department of Surgery, Mayo Clinic, Jacksonville, FL, United States.
Int J Surg Case Rep. 2014;5(12):1028-30. doi: 10.1016/j.ijscr.2014.10.012. Epub 2014 Oct 23.
Cervical thoracic duct cyst (CTDC) is a rare cause of lateral neck mass. Surgical excision with ligation of the cervical thoracic duct is the current standard for definitive management with symptomatic patients. We report the first case of an alternative method of management performing a cyst venous anastomosis for decompression.
A 77 year old female presented with a six month history of left arm pain, swelling and a left-sided cystic neck mass. She was treated with cyst-venous anastomosis between the cyst wall and the left internal jugular vein. At two year follow-up, she has had resolution of pain and no recurrence of the mass.
Many potential etiologies have been proposed for CTDC, though surgical management of this rare problem has consistently required cyst excision and thoracic duct ligation. Few innovative modes of therapy have been developed to address this problem in a less invasive manor. Maintaining a more natural thoracic duct anatomy decreases the likely of complications associated with duct ligation.
Cyst-venous anastomosis for the management of CTDC provides an effective, novel form of treatment which maintains the integrity of the thoracic duct and avoids potential complications associated with duct ligation.
颈胸导管囊肿（CTDC）是颈部外侧肿块的罕见病因。对于有症状的患者，手术切除并结扎颈胸导管是目前的标准确定性治疗方法。我们报告了首例采用囊肿静脉吻合术进行减压的替代治疗方法。
一名77岁女性，有6个月左臂疼痛、肿胀及左侧颈部囊性肿块的病史。她接受了囊肿壁与左颈内静脉之间的囊肿静脉吻合术治疗。在两年的随访中，她的疼痛已缓解，肿块未复发。
尽管对于CTDC提出了许多潜在病因，但对这个罕见问题的手术治疗一直需要囊肿切除和胸导管结扎。很少有创新的治疗方式被开发出来以采用侵入性较小的方式解决这个问题。保持更自然的胸导管解剖结构可降低与导管结扎相关的并发症的可能性。
采用囊肿静脉吻合术治疗CTDC提供了一种有效、新颖的治疗形式，可保持胸导管的完整性并避免与导管结扎相关的潜在并发症。
