CC : Lt. neck mass, Syncope
PI : 2018³â 11¿ù ÁÂÃø °©»ó¼± °áÀý ¹× ÁÂÃø °æºÎ Á¾¹°·Î º»¿ø ³»ºÐºñ ³»¿øÇϽŠºÐÀ¸·Î US FNA »ó Thyroid cancer /c neck metastasis ÀÇ½ÉµÇ¾î ¼ö¼úÀû Ä¡·á ÀÇ·ÚµÊ.
2019³â 1¿ù 31ÀÏ, 2¿ù 2ÀÏ syncope Áõ»óÀ¸·Î ER °æÀ¯ÇÏ¿© ³»°ú ÀÔ¿ø. ÀÔ¿ø ÈÄ CT angio perfusion ¹× ½ÉÃÊÀ½ÆÄ »ó ƯÀÌ¼Ò°ß ¾øÀ½.
Lt. carotid artery ±Ùó mass effect·Î ÀÎÇÑ vagal nerve compressionÀÌ ¿øÀÎÀÏ °¡´É¼ºÀÌ ¸¹À½.
2019³â 2¿ù 8ÀÏ Total thyroidectomy /c Both CCND /c Lt. SND (level : IIa~V) ¼ö¼ú ½ÃÇà¹ÞÀ½.
• Thyroid gland, left lobe, fine needle aspiration:
- Satisfactory for evaluation.
- MALIGNANCY.
- Carcinoma
• Lymph node, level IV, left, fine needle aspiration:
- Satisfactory for evaluation.
- Consistent with metastatic carcinoma.
IJVÀ» º¸Á¸ÇÏÁö ¸øÇÏ¿´°í IJV°ú subclavian veinÀÌ ¸¸³ª´Â ºÎÀ§±îÁö cancer°¡ ħ¹üÇÏ°í ÀÖ¾î ¿ÏÀüÈ÷ Á¦°ÅÇÏÁö ¸øÇÏ°í ÀϺΠ³²°ÜµÒ
(Ç÷°ü¿Ü°ú ±³¼ö¿Í »óÀÇÇÑ °á°ú ³ªÀÌ¿Í °©»ó¼±¾Ï ÀÓÀ» °í·ÁÇÔ)
• Thyroid gland, left lobe, hemithyroidectomy:
- Anaplastic thyroid carcinoma, with
1) a component of papillary thyroid carcinoma
2) squamous differentiation
3) extrathyroidal extension
4) clear but close resection margin
• Thyroid gland, right lobe, hemithyroidectomy:
- Papillary microcarcinoma, 3mm
- Adenomatous hyperplasia.
• Lymph node, neck, level VI, left, dissection : No tumor (0/1).
• Lymph node, neck, level VI, right, dissection : Carcinoma, metastatic (1/1).
• Lymph node, neck, level IIA, left, dissection : No tumor (0/1).
• Lymph node, neck, level IIB, left, dissection : No tumor (0/4).
• Lymph node, neck, level III, left, dissection : Carcinoma, metastatic (4/11).
• Lymph node, neck, level IV, left, dissection : No tumor (0/3).
• Lymph node, neck, level V, left, dissection : No tumor (0/1).
• Blood vessel, external jugular vein, left, excision : No tumor.
• Blood vessel, internal jugular vein, left, excision : Carcinoma, metastatic (4/5).