囊胞性結節内出血を契機に反回神経麻痺が出現した腺腫様甲状腺腫の1例

A case of recurrent laryngeal nerve paralysis caused by adenomatous goiter with haemorrhage in cystic nodule

はじめに

　甲状腺腫瘍による反回神経麻痺は，悪性腫瘍を示唆する所見である。一方で，その頻度は悪性腫瘍と比較すると低いが，甲状腺良性疾患による反回神経麻痺の報告もされている^1,2）。今回われわれは，囊胞性結節内出血を契機に反回神経麻痺が出現し，穿刺による貯留液吸引後に反回神経麻痺が改善した腺腫様甲状腺腫の1例を経験したので，臨床経過ならびに文献的考察を含めて報告する。

　Preoperative recurrent laryngeal nerve（RLN）paralysis associated with thyroid disease is indicative of malignant tumor. However, there have been few reports of RLN paralysis caused by benign thyroid disease in Japan. We presented a case of RLN paralysis secondary to adenomatous goiter with haemorrhage in cystic nodule and improved by aspiration of the blood. Most of haemorrhage in cystic nodule will reduce naturally. But the case of huge mass which extended to substernal, we should be careful of RLN paralysis because it can be recovered by early treatment.