Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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A Case of Giant Papillary Thyroid Carcinoma Resection with Massive Intraoperative Bleeding

술 중 대량 출혈을 동반한 거대 갑상선유두상암종 절제술 1례

  • Kim, Seok Hyun (Department of Otorhinolartngology-Head & Neck Surgery, School of Medicine, Pusan National University) ;
  • Jung, Jae Hwan (Department of Otorhinolartngology-Head & Neck Surgery, School of Medicine, Pusan National University) ;
  • Sung, Eui Suk (Department of Otorhinolartngology-Head & Neck Surgery, School of Medicine, Pusan National University) ;
  • Lee, Jin Choon (Department of Otorhinolartngology-Head & Neck Surgery, School of Medicine, Pusan National University)
  • 김석현 (부산대학교 의학전문대학원 이비인후과학교실) ;
  • 정재환 (부산대학교 의학전문대학원 이비인후과학교실) ;
  • 성의숙 (부산대학교 의학전문대학원 이비인후과학교실) ;
  • 이진춘 (부산대학교 의학전문대학원 이비인후과학교실)
  • Received : 2017.05.01
  • Accepted : 2017.05.09
  • Published : 2017.05.30
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Abstract

A 62-year-old female patient had goiter for twenty years. She visited out-patient clinic with a hoarse voice and intermittent breathing difficulties. About protruding 15cm sized mass located the anterior neck and right vocal cord paralysis was observed. Preoperative CT scan was strongly suspected of thyroid gland cancer and cervical lymph node metastasis. Therefore, fine needle aspiration test was performed and surgical treatment was planned with the histopathologic results (papillary thyroid carcinoma). Surgery was performed with total thyroidectomy, bilateral cervical lymph node dissection, and right selective nodal lymph node dissection (level II-V). During operation right thyroid seemed to be adherent to surrounding tissue and the blood vessels were extremely engorged. There was hypotensive crisis because of intraoperative excessive bleeding. However it was managed by repetitive transfusion. The operation was completed without abnormalities. She underwent 4 times of bleeding control operation due to postoperative bleeding. After complications were improved, we are currently undergoing out-patient follow up without morbidity.

Keywords

References

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