Faroq Abdulrahman Sangar M, Teksöz Serkan, Ferahman Sina, Demiryas Süleyman, Bükey Yusuf, Özyiğin Ateş
Department of General Surgery, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
Turk J Surg. 2018 Jan 3;34(2):137-139. doi: 10.5152/turkjsurg.2017.3206. eCollection 2018.
Missed gland is an extremely rare condition. It is a mediastinal thyroid mass found after total thyroidectomy. We report a case of missed gland. The patient underwent total thyroidectomy due to multinodular goiter and thyroid stimulating hormone levels did not increase after surgery. Pathological tests revealed a micropapillary carcinoma. Thyroid ultrasonography and scintigraphy scan revealed mediastinal thyroid mass. The patient underwent redo surgery without sternotomy and there was no morbidity after the second surgical procedure. Most missed thyroid gland cases are due to incomplete removal of plunging thyroid goiter during total thyroidectomy. They also can be attributed to a concomitant, unrecognized mediastinal goiter, which is not connected to the thyroid gland with vessels or a thin fibrous band. It should be noted that absence of signs like mediastinal mass or tracheal deviation in preoperative chest X-ray does not exclude substernal goiter. The presence of a missed thyroid gland should be kept in mind when postoperative thyroid stimulating hormone levels remain unchanged.
遗漏甲状腺是一种极其罕见的病症。它是在全甲状腺切除术后发现的纵隔甲状腺肿块。我们报告一例遗漏甲状腺的病例。该患者因多结节性甲状腺肿接受了全甲状腺切除术，术后促甲状腺激素水平未升高。病理检查显示为微乳头状癌。甲状腺超声和闪烁扫描显示纵隔甲状腺肿块。患者接受了无需开胸的再次手术，第二次手术后未出现并发症。大多数遗漏甲状腺病例是由于全甲状腺切除术中坠入性甲状腺肿切除不完全所致。它们也可能归因于同时存在的、未被识别的纵隔甲状腺肿，其与甲状腺无血管或细纤维带相连。应当注意的是，术前胸部X线检查无纵隔肿块或气管偏移等体征并不排除胸骨后甲状腺肿。当术后促甲状腺激素水平保持不变时，应考虑存在遗漏甲状腺的情况。
