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Yuki Yamada
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EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.15-14 - Mediastinal Lymph Node Dissection Through Median Sternotomy in Thyroid Carcinoma (Now Available) (ID 2090)
08:00 - 18:00 | Presenting Author(s): Yuki Yamada
- Abstract
Background
Recurrent cervical and mediastinal lymph node metastasis after the surgery of thyroid carcinoma is frequently reported. Generally, surgery is the best treatment but there is still no established standard surgical procedure. In our hospital, we perform the operation through median sternotomy.
Method
Surgical procedure for recurrent cervical and mediastinal lymph node metastasis after thyroid carcinoma varies throughout each institute. Recently, reports of the usage of VATs in these cases are increasing. We report 2 resected cases of cervical and mediastinal lymph node metastasis after thyroid cancer which underwent dissection through median sternotomy.
Result
A 68-year-old Japanese man underwent left thyroid lobectomy for poorly differentiated thyroid cancer in September 2009. The follow-up CT in 2014 showed a multiple mediastinal lymph node metastases. Therefore, the patient underwent mediastinal lymph node dissection through median sternotomy. Pathological findings showed metastasis in 24 of the 42 lymph nodes. During outpatient follow-up, CT revealed a recurrent mass lesion in the vincinity of the right subclavian artery and common carotid artery. Although I131 was administered, the mass did not respond. Therefore surgery therapy was required. The second operation was cervical incision. The pathological findings showed consistent recurrence. The patient was discharged from the hospital on postoperative day 4.
The second patient was a 58-year-old Japanese man who had been treated by subtotal thyroidectomy in May 2008. The patient noticed a gradual increase of a mass near his right lower jaw from 2011. As a result of further examination, mediastinal lymph node metastasis was suspected. The patient underwent mediastinal lymph node dissection through median sternotomy and neck collar incision. Pathological findings showed metastasis in 9 of the 31 lymph nodes. Pathological findings revealed metastasis of papillary thyroid carcinoma. The patient was discharged from the hospital on postoperative day 13.
Conclusion
Recent reports of recurrent cervical and mediastinal lymph node metastasis after thyroid carcinoma suggests using VATs, which may have less complications. In our hospital, the possibility of micrometastases is also considered in cases of post-operative lymph node recurrence. Therefore, we completely resect the mediastinal lymph nodes by median sternotomy approach. We have been promoting mediastinal lymph node dissection for lung cancer surgery at our center, but we would like to report the significance of mediastinal lymph node dissection for recurrence cases after thyroid carcinoma.
