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Gland Surgery Feb 2022Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. PTC is slow growing, and prognosis after surgery is excellent. However, PTC is associated...
Metastasis to lymph nodes at the contralateral entrance point to the recurrent laryngeal nerve in unilateral thyroid papillary carcinoma: a case report and literature review.
BACKGROUND
Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. PTC is slow growing, and prognosis after surgery is excellent. However, PTC is associated with a high incidence of cervical lymph node metastasis, and usually metastasizes from the central lymph nodes to the ipsilateral cervical and mediastinal lymph nodes. Anatomic studies have shown that the thyroid gland and surrounding tissue have an abundant lymphatic network that facilitates tumor dissemination and lymph node metastasis, there may be many ways to connect lymph nodes on both sides of the neck of patients, which needs further research and discussion.
CASE DESCRIPTION
We report the case of a 45-year-old female who was diagnosed with thyroid cancer of the right lobe and right lateral lymph node metastasis by fine-needle aspiration (FNA). During surgery, 0.2 mL of carbon nanoparticle (CN) suspension was injected into the right lobe of the thyroid gland, which resulted in black staining of a lymph node at the contralateral entrance point to the recurrent laryngeal nerve (LN-epRLN). The black-stained lymph node was resected, and the pathology results revealed lymph node metastasis from thyroid cancer. The left lobe of the thyroid was benign.
CONCLUSIONS
Retro-tracheal periesophageal lymph node metastasis may be a rare metastatic pathway in thyroid cancer.
PubMed: 35284314
DOI: 10.21037/gs-22-46 -
Yonsei Medical Journal Feb 1999We report a case of an extremely rare neoplasm, malignant granular cell tumor (MGCT). The patient was a 21-year-old woman, who was 5 months pregnant. The tumor occurred...
We report a case of an extremely rare neoplasm, malignant granular cell tumor (MGCT). The patient was a 21-year-old woman, who was 5 months pregnant. The tumor occurred in the retrotracheal space, extending from the level of the larynx to the thoracic inlet. In addition, there were multiple, variable-sized tumor nodules within both lung fields on chest CT scan. Histologically, tissue biopsied from the periphery of the tumor consisted of solid sheets of large ovoid cells with ample, eosinophilic cytoplasm, eccentric nuclei, and prominent nucleoli. Each cell showed slight atypism of the nuclei. There was a focal necrosis at the periphery of the lesion. These cells stained strongly for S-100 protein, neuron-specific enolase (NSE) and CD68. On electron microscopy, the tumor cells contained autophagic vacuoles. The patient refused further treatment and died 7 months later. The exact cause of death was not known. Until now, the diagnosis of MGCTs has been made only when metastasis and an aggressive clinical course are identified, although some observers advocate that some histologic features such as nuclear pleomorphism, necrosis, and the presence of any mitotic activity are indicative of malignancy. These histologic findings are not easily detectable in every case of MGCT, as in our case. So the diagnosis of a MGCT should be considered in cases with aggressive clinical findings and some histologic features, such as necrosis, nuclear atypism, and mitotic activities, which could suggest the malignant behavior of this neoplasm.
Topics: Adult; Female; Granular Cell Tumor; Head and Neck Neoplasms; Humans; Pregnancy; Trachea
PubMed: 10198610
DOI: 10.3349/ymj.1999.40.1.76 -
Radiology Case Reports Jun 2020Ectopic parathyroid adenoma in the mediastinum has been reported in several publications; however, its location in the posterior mediastinum, especially a retro-tracheal...
Ectopic parathyroid adenoma in the mediastinum has been reported in several publications; however, its location in the posterior mediastinum, especially a retro-tracheal location, has been rarely reported. We report a case of a 61-year-old patient who presented with clinical symptoms of malignant hypercalcemia due to a retro-tracheal mediastinal parathyroid adenoma. The surgical excision normalized the phosphocalcic balance with improvement in the patient's clinical symptoms. An ectopic hypersecreting parathyroid adenoma with life-threatening hypercalcemia should prompt radiological assessment and appropriate surgical management to prevent significant clinical complications.
PubMed: 32280399
DOI: 10.1016/j.radcr.2020.03.003 -
Multimedia Manual of Cardiothoracic... Jul 2023Uniportal video-assisted thoracic surgery has grown in popularity in recent years, becoming the treatment of choice for minimally invasive resections of mediastinal...
Uniportal video-assisted thoracic surgery has grown in popularity in recent years, becoming the treatment of choice for minimally invasive resections of mediastinal lesions. The many advantages of video-assisted thoracic surgery, including decreasing postoperative pain, morbidity and length of hospitalization, have increased its utilization for optimal patient care. In our case, this approach was used on a 55-year-old female patient who presented with a retrotracheal mass protruding through the thoracic inlet. The resection was performed through the chest via a uniportal video-assisted thoracic surgery technique with an unremarkable operative and postoperative course.
Topics: Female; Humans; Middle Aged; Parathyroid Glands; Thoracic Surgery, Video-Assisted; Pain, Postoperative; Mediastinum; Postoperative Period
PubMed: 37435871
DOI: 10.1510/mmcts.2023.013 -
Journal of Orthopaedic Surgery (Hong... 2019Aberrant left brachiocephalic vein is a rare condition. Its occurrence in patients requiring anterior cervicothoracic approach for severe kyphoscoliosis has not been...
Aberrant left brachiocephalic vein is a rare condition. Its occurrence in patients requiring anterior cervicothoracic approach for severe kyphoscoliosis has not been described. A 16-year-old male with neurofibromatosis and severe upper thoracic kyphoscoliosis presented to us with curve progression. Halo gravity traction was attempted but failed to achieve significant correction. Subsequently, he underwent halo-pelvic traction and later Posterior Spinal Fusion (PSF) from C2 to T10. Second-stage anterior cervicothoracic approach with anterior fibula strut grafting was planned; however, preoperative computed tomography angiography revealed an aberrant left brachiocephalic vein with an anomalous retrotracheal and retroesophageal course, directly anterior to the T5/T6 vertebrae (planned anchor site for fibula strut graft) before draining into superior vena cava. Therefore, surgery was abandoned due to the risks associated with this anomaly. Aberrant left brachiocephalic vein is rare, the presence of which could be a contraindication for anterior cervicothoracic approach. Assessment of the anterior neurovascular structures is crucial in preoperative planning.
Topics: Adolescent; Brachiocephalic Veins; Cervical Vertebrae; Contraindications, Procedure; Humans; Male; Neurofibromatosis 1; Phlebography; Scoliosis; Spinal Fusion; Thoracic Vertebrae; Tomography, X-Ray Computed; Vascular Malformations
PubMed: 31615339
DOI: 10.1177/2309499019879213 -
Surgical Neurology International 2020One of the most serious and potentially life-threatening adverse events associated with anterior cervical spine surgery is postoperative hematoma with acute airway...
BACKGROUND
One of the most serious and potentially life-threatening adverse events associated with anterior cervical spine surgery is postoperative hematoma with acute airway obstruction. The causes of unpredicted delayed bleeding are, however, not fully elucidated. Here, we report a case of delayed arterial bleeding and sudden airway obstruction following a two-level ACDF.
CASE DESCRIPTION
A 52-year-old male presented with the right paracentral disc herniations at the C4-C5 and C5-C6 levels. A two-level ACDF was performed. Notably, on the 5 postoperative day, the patient developed an acute respiratory distress due to a large right lateral retrotracheal hematoma requiring emergency evacuation at the bedside. This was followed by formal ligation of a branch of the right superior thyroid artery in the operating room. In addition, an emergency tracheotomy was performed. By postoperative day 15, the tracheotomy was removed, and the patient was neurologically intact.
CONCLUSION
A superior thyroid artery hemorrhage should be suspected if a patient develops delayed neck swelling with or without respiratory decompensation several days to weeks following an ACDF. Notably, these hematomas should be immediately recognized and treated (i.e., decompression starting at the bedside and completed in the operating room) to prevent catastrophic morbidity or mortality.
PubMed: 32494399
DOI: 10.25259/SNI_225_2020 -
Clinical Medicine Insights.... 2018Although parathyroid ectopy in the mediastinum has been the subject of several publications, its location in the posterior mediastinum is very rarely reported. We report...
Although parathyroid ectopy in the mediastinum has been the subject of several publications, its location in the posterior mediastinum is very rarely reported. We report a case of a 69-year-old patient who presented with clinical symptoms of malignant hypercalcemia due to a retrotracheal mediastinal parathyroid adenoma. The surgical excision leads to a quick normalisation of the phosphocalcic balance with improvement of the clinical symptoms. Ectopic hypersecreting parathyroid adenoma with life-threatening hypercalcemia should prompt radiological assessment and appropriate surgical management to prevent further clinical complications.
PubMed: 30479491
DOI: 10.1177/1179548418811840 -
Kardiologia Polska 2018
Topics: Aorta, Thoracic; Aortic Arch Syndromes; Brachiocephalic Veins; Child; Echocardiography; Female; Humans; Tomography, X-Ray Computed
PubMed: 29652432
DOI: 10.5603/KP.2018.0086 -
Singapore Medical Journal Nov 2007Parathyroid carcinoma is a rare malignancy of the parathyroid glands, and is the cause of primary hyperparathyroidism in fewer than one percent of cases. Symptoms are...
Parathyroid carcinoma is a rare malignancy of the parathyroid glands, and is the cause of primary hyperparathyroidism in fewer than one percent of cases. Symptoms are mainly due to local compression or hypercalcaemia secondary to markedly elevated parathyroid hormone levels. A minority of patients remain asymptomatic. Mediastinal parathyroid cysts are infrequent and may or may not be functioning. We present an 84-year-old woman with a giant functioning cystic parathyroid carcinoma located in the middle mediastinum. We performed a thorough MEDLINE and LILACS database search on published cases of parathyroid carcinoma and functioning parathyroid cysts, and found no case report with identical features to the one presented here.
Topics: Aged, 80 and over; Airway Obstruction; Biopsy, Fine-Needle; Diagnosis, Differential; Female; Humans; Hyperparathyroidism, Primary; Magnetic Resonance Imaging; Mediastinal Cyst; Mediastinal Neoplasms; Medical Futility; Neoplasm Invasiveness; Parathyroid Glands; Parathyroid Neoplasms; Tomography, X-Ray Computed; Tracheal Diseases
PubMed: 17975683
DOI: No ID Found -
Chinese Journal of Traumatology =... Apr 2010Traumatic retropharyngeal hematoma is a rare condition and may be lethal in some cases. In patients with this condition, the absence of a vertebral fracture or a major...
Traumatic retropharyngeal hematoma is a rare condition and may be lethal in some cases. In patients with this condition, the absence of a vertebral fracture or a major vascular injury is extremely rare. We present the case of a 92-year-old man who hit his forehead by slipping on the floor in his house. He had no symptoms at the time; however, he experienced throat pain and dyspnea at 6 hours after the injury. On arrival, he complained of severe dyspnea; therefore, an emergency endotracheal intubation was performed. A lateral neck roentgenogram after intubation showed dilatation of the retropharyngeal and retrotracheal space and no evidence of a cervical vertebral fracture. Cervical computed tomography (CT) with contrast medium revealed a massive hematoma extending from the retropharyngeal to the superior mediastinal space but no evidence of contrast medium extravasation or a vertebral fracture. However, sagittal magnetic resonance imaging (MRI) revealed an anterior longitudinal ligament (C4-5 levels) injury. We determined that the cause of the hematoma was an anterior longitudinal ligament injury and a minor vascular injury around the injured ligament. Therefore, we recommend that patients with retropharyngeal hematoma undergo sagittal cervical MRI when roentgenography and CT reveal no evidence of injury.
Topics: Aged; Aged, 80 and over; Hematoma; Humans; Longitudinal Ligaments; Magnetic Resonance Imaging; Male; Pharyngeal Diseases; Tomography, X-Ray Computed
PubMed: 20356450
DOI: No ID Found