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颈部甲状腺切除术后残留的胸骨后甲状腺肿和胸腺脂肪瘤

Residual Retrosternal Goiter and Thymolipoma After Cervical Thyroid Resection.

作者信息

Yankov Georgi, Alexieva Magdalena, Mekov Evgeni V

机构信息

Department of Thoracic Surgery, University Hospital "St. Ivan Rilski," Medical University of Sofia, Sofia, BGR.

Department of Pulmonary Diseases, Medical University of Sofia, Sofia, BGR.

出版信息

Cureus. 2024 Oct 16;16(10):e71627. doi: 10.7759/cureus.71627. eCollection 2024 Oct.

Abstract

Retrosternal goiters (RGs) are thyroid enlargements that extend into the mediastinum, representing 1%-20% of all goiters. While typically benign, their anatomical location can lead to significant clinical symptoms due to the compression of surrounding structures such as the trachea, esophagus, and major vessels. Surgical resection is the preferred treatment, particularly in symptomatic cases or when malignancy is suspected. In rare cases, RGs may co-occur with other mediastinal tumors, such as thymolipomas, complicating both diagnosis and management. We present a 39-year-old female with a residual retrosternal goiter after previous insufficient resection only of the cervical thyroid mass, leaving the mediastinal part in place. The patient underwent a total median sternotomy, and the retrosternal goiter, along with a concomitant thymolipoma, was successfully extirpated. Postoperative recovery was uneventful, and the patient remains in excellent condition at a seven-month follow-up.

摘要

胸骨后甲状腺肿(RGs)是延伸至纵隔的甲状腺肿大,占所有甲状腺肿的1%-20%。虽然通常为良性,但由于其解剖位置可压迫周围结构,如气管、食管和主要血管,从而导致显著的临床症状。手术切除是首选治疗方法,特别是在有症状的病例或怀疑有恶性肿瘤时。在罕见情况下,RGs可能与其他纵隔肿瘤同时出现,如胸腺脂肪瘤,这会使诊断和管理都变得复杂。我们报告一名39岁女性,此前仅对颈部甲状腺肿块进行了不完全切除,遗留纵隔部分,现患有残余胸骨后甲状腺肿。该患者接受了全胸骨正中切开术,成功切除了胸骨后甲状腺肿及伴发的胸腺脂肪瘤。术后恢复顺利,在七个月的随访中患者状况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae4b/11566647/d630d1dfcb61/cureus-0016-00000071627-i01.jpg

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