肺へ節外浸潤した甲状腺乳頭癌縦隔リンパ節転移の1例

Papillary Thyroid Cancer Metastasizing Anterior Mediastinal Lymph Node with Extra-nodal Invasion to the Lung：Report of a Case

はじめに　2回の心臓血管外科手術後に3回目の胸骨正中切開アプローチで，右肺上葉合併切除を伴って摘出された，甲状腺乳頭癌の縦隔リンパ節転移の症例を経験したので報告する．

We describe a 79-year-old female with a prior history of two times of mitral valve surgery and pacemaker implantation. She was transferred to our hospital presenting bloody sputum with dyspnea. Chest enhanced computed tomography （CT） showed a large anterior mediastinal mass of 64×52 mm in size. She underwent surgery for the mediastinal tumor through third time median sternotomy approach. As the tumor was suspected of infiltrating to the lung, combined resection of right upper lobe was additionally performed. Histological examination revealed papillary thyroid carcinoma metastasizing anterior mediastinal lymph node with extra-nodal invasion to the lung. After surgery, echography detected primary lesion in the left lobe of thyroid gland, and the patient was finally diagnosed as papillary thyroid cancer metastasizing mediastinal lymph node. Two months later, she underwent total thyroidectomy.