A Case of Giant Papillary Thyroid Carcinoma Resection with Massive Intraoperative Bleeding

Korean Journal of Head & Neck Oncology 2017;33(1):85-89.
Published online May 30, 2017.

Seok Hyun Kim;Jae Hwan Jung;Eui Suk Sung;Jin Choon Lee

술 중 대량 출혈을 동반한 거대 갑상선유두상암종 절제술 1례

김석현;정재환;성의숙;이진춘

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.

Key Words: Giant, Hemorrhage, Papillary thyroid carcinoma, Thyroidectomy