Dr. Mahmure URAZ, Dr. Ahmet MİDİ, Dr. Rahmi ÇUBUK, Dr. Neşe YENER, Dr. Alpay ÖRKİ, Dr. Attila SAYGI, Dr. Bülent ARMAN

Primer Mediastinal Ektopik Guatr

Primer ektopik mediastinel guatr nadir görülen bir antite olup, guatr'lı olgularda

Anahtar Kelimeler:

Mediasten, guatr, rezeksiyon

Primary Mediastinal Ectopic Goitres

True primary mediastinal ectopic goiters are quite rare, occurring in less than 1% of all goiters. Ectopic thyroid tissue in embryonic development is the result of abnormal migration of the thyroid gland as it travels from the floor of the primitive foregut to its pretracheal position. We report a case of 54 year old male. He suffered from chest pain, cough and dyspnea on exertion. His medical history had hypertansion and aortic aneurism and no additional disoders. On physical examination thyroid was not palpable. Serum thyroid tests and thyroid nuclear scans were normal. There was a mass lesion on computerized thorax thomography in azygos-caval junction, 45x42mm in size, smooth circumference. There was no endobroncial lesion on fiber optic bronchoscopy. Standart servical mediastinoscopy was performed in order to diagnosis. Pathology reported as a benign thyroid tissue. Because of compression on vena cava superior we resected completly this tumor via right lateral thoracotomy. Postperative period was uneventful. Postoperative pathology was reported also benign thyroid tissue. We present an uncommon true primary ectopic mediastinal goiter resected with complete excison in order to relief of symptoms and to prevent potential venous obstruction and malignant transformation.

Keywords:

Mediastinum, goiter, resection,

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)Gamblin TC, Jennings GR, Christie DB 3rd, Thompson
WM Jr, Dalton ML.: Ectopic Thyroid. Ann Thorac Surg 2003;75:1952-1953.
)Neinas FW, Gorman CA, Devine KD, Woolner LB.: Lingual thyroid. Clinical characteristics of 15 cases. Ann Intern Med 1973;79:205-210. (abstract)
)Fojioka S, Takatsu Y, Tankawa H, Yamanaka K, Ando F.: Intracardiac ectopic thyroid mass. Chest 1996;110: 1366-1368.
)Rose AG, Novitzky D, Price SK.: Heterotopic thyroid
tissue in the heart. Am J Cardiovasc Pathol 1998;1: 401-404.
)Baykut D, Fiegen U, Krian A, Thiel A.: Ectopic thyroid tissue in the left ventricular tract. Ann Thorac Surg. 2000;69:620-621.
)Taylor MA, Brady M, Roberts WC.: Aberrant thyroid gland attached to ascending aorta. Am J Cardiol 1986;57:708. (abstract)
)Sand J, Pehkonen E, Mattila J, Seppanen S, Salmi J.: Pulsating mass at the sternum. A primary carcinoma of ectopic mediastinal thyroid. J Thorac Cardiovasc Surg 1996;112:833-835.
)Kaplan M, Kauli R, Lubin E, Grunebaum M, Laron Z.: Ectopic thyroid gland. A clinical study of 30 children and review. J Pediatr 1978;92:205-209. (abstract)
)Le Roux BT.: Heterotopic mediastinal thyroid. Thorax 1961;16:192-196. (abstract) 54
Şekil 2: Bilgisayarlı Tomografi
Şekil 3 a ve b: a: ilk operasyonda insizyonel biyopsi materyalinde içleri kolloidle dolu fo
likül yapıları, b: rezeksiyon materyalinde tirositlerle döşeli sırt sırta vermiş tiroid folikül
leri ve eski kanama bulgularını gösteren hemosiderin yüklü makrofajların varlığı (Hema
toksilen ve Eozin X200)