両側性反回神経麻痺を伴つた胸腔内甲状腺腫の1例

INTRATHORACIC GOITER ASSOCIATED WITH A BILATERAL LARYNGEAL PALSY, A CASE REPORT

　I．はじめに

　頸部甲状腺より胸腔内へ進展したと考えられる甲状腺腫を治療したので報告する。この症例は両側反回神経麻痺を伴い，あたかも悪性甲状腺腫を考えさせた。

　甲状腺腫はわれわれ耳鼻咽喉科医もしばしば経験するところであるが，いつたん腫瘍が胸腔内へ進展した場合には外科領域で取扱われることが多い。このような胸腔内へ進展した甲状腺腫について文献的考察を行ない，両側反回神経麻痺の原因について推論したので，諸賢のご批判を仰ぐ次第である。

　A case of thyroid adenoma associated with bilateral laryngeal palsy is reported. A 47 year old female was first seen with chief complaints of dyspnea and an anterior neck mass.

　Examination revealed bilateral midline fixation of the vocal cords and a large thyroid tumor. The patient is treated by partial thyroidectomyand subsequently by Woodman's operation with successful results. Pathologically the tumor was reported as benign adenoma. Two years postoperatively symptoms pointed to recurrence of the tumor which necessitated a second operation. The tumor was found to be extending intrathoracically.

　The cause of laryngeal palsy, since no operative or pathological findings proved any possible injury to the recurrent nerve, was considered to be due to virus infection of the vocal cords an epidemic observed in early winter of 1970.