Abstract
We report a 49-year-old woman with advanced thyroid carcinoma that could be resected by left lobectomy with partial resection of the left internal jugular vein, recurrence nerve and esophageal muscle.
She visited our department with the complaint of hoarseness, difficulty in swallowing and limited neck movements.
In preoperative angiography, the left jugular vein was not visualized and the common carotid artery was pushed to the external anterior region. Direct invasion to esophageal muscle was suspected on CT.
A tumor (15×15 cm in size, 400 g in weight) was found in the left lobe of the thyroid, with many small cysts. In the center of the tumor, there was a parenchymal hard nodule and fibrosed bundle, indicating malignancy.
The left jugular vein and recurrence nerve were completely involved and direct invasion of about 3 cm to esphageal muscle was noticed.
The common carotid artery and trachea were not directly invaded and could be dissected.
The tumor was histopathologically diagnosed as papillary carcinoma, and direct invasion to esophageal muscle was demonstrated.
