Nagireddy Tejus V, Vaidya Advait A, Gupta Samir, Kshirsagar Pankaj, Kamble Tushar
Department of Surgical Oncology, Dr. D.Y.Patil Medical College, Hospital and Research Center, Dr D Y Patil Vidyapeeth, Pune 411018, Maharashtra, India.
J Surg Case Rep. 2023 Feb 22;2023(2):rjad058. doi: 10.1093/jscr/rjad058. eCollection 2023 Feb.
Primary ectopic mediastinal thyroid is rare, seen in <1% of patients with ectopic thyroid. A patient with two ectopic foci in mediastinum is even rare. Our patient presented with chronic cough and discomfort. CT scan revealed a huge 7 cm × 7 cm (right) and 5 cm × 5 cm (left) mass in mediastinum. IR-guided biopsy of the right side mass showed an ectopic thyroid tissue (ETT). Due to close proximity with major vessels, sternotomy is done and the two masses are excised. The masses were not connected in any way with each other as well as with the orthotopic thyroid in the neck. Pathology revealed colloid goiter. Surgical excision of a mediastinal mass is warranted. This helps in both the diagnosis and potentially be the primary treatment as well. Patients with ectopic thyroid disease are rare, and a presentation of two ETTs on both sides of mediastinum is very rare.
原发性纵隔甲状腺罕见，在异位甲状腺患者中发生率低于1%。纵隔内有两个异位病灶的患者更为罕见。我们的患者表现为慢性咳嗽和不适。CT扫描显示纵隔内有一个巨大肿块，右侧大小为7 cm×7 cm，左侧为5 cm×5 cm。在介入放射学（IR）引导下对右侧肿块进行活检，显示为异位甲状腺组织（ETT）。由于肿块与主要血管关系密切，遂行胸骨切开术并切除两个肿块。两个肿块彼此之间以及与颈部的原位甲状腺均无任何连接。病理检查显示为胶样甲状腺肿。手术切除纵隔肿块是必要的。这有助于诊断，也可能是主要治疗方法。患有异位甲状腺疾病的患者很罕见，纵隔两侧出现两个ETT的情况则极为罕见。
