A Case of Mediastinum Goiter and Lung Metastasis after Surgery for Transverse Colon Cancer Undergoing Simultaneous Surgery

Abstract

The patient was a 63-year-old woman. One year after surgery for transverse colon cancer, a chest CT scan showed a 1-cm nodule in the periphery of S1+2 of the left lung, and pulmonary metastasis was suspected. In addition, a mediastinal goiter, which had been followed up in another department, tended to increase in size and was accompanied by tracheal deviation. We admitted that the goiter should also be resected in terms of anesthesia and postoperative respiratory control for lung metastasis, and performed simultaneous operation. The operation was started by adding a median sternotomy to the collar incision of the neck. The mediastinal goiter was resected by dissection at the isthmus and the lower part of the right lobe. After that, right unilateral ventilation was performed with a bronchial blocker, and partial resection of the upper lobe was performed for a tumor in S1+2 of the left lung. A hoarseness was observed temporarily after the operation, but was relieved and she was discharged from the hospital. The pathological diagnosis was adenomatous goiter and lung metastasis of transverse colon cancer.

Mediastinum goiter without subjective symptoms is indicated for surgery if it causes tracheal deviation, and the removal may be necessary for anesthesia and respiratory control when pulmonary resection is planned.