Well-Differentiated Thyroid Carcinoma Presenting with Sternal Invasion: Complex Resection and Reconstruction in the COVID-19 Era

Well-Differentiated Thyroid Carcinoma Presenting with Sternal Invasion: Complex Resection and Reconstruction in the COVID-19 Era

Author Info

Corresponding Author
Andrea Billè
Department of Thoracic Surgery, Guy’s Hospital, Great Maze Pond, London, UK

A B S T R A C T

Background: Advanced thyroid malignancies may invade adjacent structures creating challenging approaches to surgical resection. Methods: We report a 48-year-old gentleman who was found to have a papillary thyroid cancer with invasion of the sternum. Results: The patient presented with pain and swelling in the upper chest. Computed tomography (CT) scanning demonstrated a paratracheal mass with invasion of the manubrium. Core needle biopsy demonstrated papillary thyroid cancer. Surgery was performed during the COVID-19 pandemic. En bloc total thyroidectomy with resection of the manubrium was performed. The defect was closed using a biological mesh, covered with a pectoralis major flap. Final pathology demonstrated a completely excised T4N1bM1 well-differentiated papillary thyroid carcinoma. The patient made an uneventful recovery. Conclusion: En bloc total thyroidectomy with sternal resection can be performed safely with low morbidity. Reconstruction of the sternal defect can be performed with biological mesh and pedicled muscle flap to reduce infection risk.

Article Info

Article Type
Case Report
Publication history
Received: Mon 07, Dec 2020
Accepted: Mon 18, Jan 2021
Published: Sat 30, Jan 2021
Copyright
© 2021 Andrea Billè. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved.
DOI: 10.31487/j.SCR.2021.01.18