Radical resection and improvised manubriosternal reconstruction technique for solitary manubriosternal metastasis from papillary thyroid cancer

摘要

Introduction Thyroid papillary carcinoma rarely present as manubriosternum metastasis. The standard treatment for patients with metastatic disease is iodine ablation therapy. A surgical resection is a good option for patients with resectable limited bony metastasis. Case presentation We report a case of a 50-year-old female with thyroid gland enlargement. Positron emission tomography scan (PET) showed a solitary manubriosternal metastasis. The patient underwent total thyroidectomy and claviculo-manubriosternal en-bloc resection and improvised reconstruction using Methyl methacrylate marlex mesh plate (MMS). Post-operative recovery was uneventful, and the patient received adjuvant radioactive iodine (RAI) treatment. At five year follow up patient remained disease-free. Conclusion In conclusion, we report a case of papillary carcinoma of thyroid with solitary manubriosternal metastasis treated with total thyroidectomy and radical en-bloc resection of clavicular heads, manubriosternal and reconstruction by our modified reconstruction technique, which provides the best MMS plate stability, cosmoses, and good disease-free survival. In solitary bony metastasis for thyroid cancer, radical resection followed by a RAI ablation, is the best treatment modality.