Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy?
<b>Background:</b> Ectopic organ-associated conditions belong to the larger panel of developmental ailments, and among this challenging medical and surgical chapter, ectopic endocrine glands-related picture is mostly focused on the presence of the ectopic parathyroid and thyroid. Ectopic...
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2024-10-01
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| author | Claudiu Nistor Mihai-Lucian Ciobica Oana-Claudia Sima Anca-Pati Cucu Mihai Costachescu Adrian Ciuche Lucian-George Eftimie Dana Terzea Mara Carsote |
| author_facet | Claudiu Nistor Mihai-Lucian Ciobica Oana-Claudia Sima Anca-Pati Cucu Mihai Costachescu Adrian Ciuche Lucian-George Eftimie Dana Terzea Mara Carsote |
| author_sort | Claudiu Nistor |
| collection | DOAJ |
| description | <b>Background:</b> Ectopic organ-associated conditions belong to the larger panel of developmental ailments, and among this challenging medical and surgical chapter, ectopic endocrine glands-related picture is mostly focused on the presence of the ectopic parathyroid and thyroid. Ectopic thyroid tissue within mediastinum (ETTM) stands for a less common ETT site; while, globally, less than 1% of the mediastinum masses are ETTM. <b>Objective:</b> We aim to introduce a rare case of ETTM in a senior lady to whom one-time synchronous thyroidectomy with ETT removal was successfully performed via a minimally invasive modern procedure upon cervicotomy and intra-operatory use of the Cooper thymectomy retractor. <b>Results:</b> The panel of pros and cons with respect to providing endocrine thoracic surgery for ETTM resection in a 73-year-old subject is discussed amid a PubMed search of original English-language original reports from January 2000 until 15 August 2024 in order to identify similar distinct cases (individuals of 70 years or older who underwent surgery for ETTM). <b>Conclusions:</b> 1. We propose the term “three-leaf-clover thyroid” to capture the imaging essence of having an enlargement of both (eutopic) thyroid lobes and ETTM. 2. The modern surgical approach under these circumstances provided a rapid patient recovery with a low rate of complications and a minimum hospital stay. Hence, the procedure may be expanded to older patients after a careful consideration of their co-morbidities and of the need to releasing connected complaints (e.g., a 7-month history of intermittent dyspneea was found in this case with post-operatory remission). 3. The management remains a matter of individualised decision, and age may not be a limiting factor. 4. At the present time, this case adds to the very limited number of similar published cases in the mentioned age group that we could identify (seven patients, aged between 72 and 84; male-to-female ratio of 5 to 2; the rate of malignant ETTM was 3/7); of these cases, not all were reported to have a trans-cervical approach, and none reported the use of the Cooper thymectomy retractor to help the overall surgical procedure. This innovative surgical procedure offers the advantage of avoiding a sternotomy incision which has clear functional and aesthetic implications, while the video-assisted approach allows optimal visualization of the mediastinal anatomy and safe vascular sealing under visual control, without the risk of a major hemorrhage. |
| format | Article |
| id | doaj-art-630a8e97077241798cdf311fd7d58d4e |
| institution | DOAJ |
| issn | 2039-7283 |
| language | English |
| publishDate | 2024-10-01 |
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| spelling | doaj-art-630a8e97077241798cdf311fd7d58d4e2025-08-20T02:53:33ZengMDPI AGClinics and Practice2039-72832024-10-011462228224410.3390/clinpract14060175Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy?Claudiu Nistor0Mihai-Lucian Ciobica1Oana-Claudia Sima2Anca-Pati Cucu3Mihai Costachescu4Adrian Ciuche5Lucian-George Eftimie6Dana Terzea7Mara Carsote8Department 4—Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, “Carol Davila” University of Medicine and Pharmacy, 0505474 Bucharest, RomaniaDepartment of Internal Medicine and Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaPhD Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 0505474 Bucharest, RomaniaThoracic Surgery Department, “Dr. Carol Davila” Central Emergency University Military Hospital, 010825 Bucharest, RomaniaThoracic Surgery Department, “Dr. Carol Davila” Central Emergency University Military Hospital, 010825 Bucharest, RomaniaDepartment 4—Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, “Carol Davila” University of Medicine and Pharmacy, 0505474 Bucharest, RomaniaDepartment of Pathology, “Dr. Carol Davila” Central Military University Emergency Hospital, 010825 Bucharest, RomaniaDepartment of Pathology, C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, RomaniaDepartment of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania<b>Background:</b> Ectopic organ-associated conditions belong to the larger panel of developmental ailments, and among this challenging medical and surgical chapter, ectopic endocrine glands-related picture is mostly focused on the presence of the ectopic parathyroid and thyroid. Ectopic thyroid tissue within mediastinum (ETTM) stands for a less common ETT site; while, globally, less than 1% of the mediastinum masses are ETTM. <b>Objective:</b> We aim to introduce a rare case of ETTM in a senior lady to whom one-time synchronous thyroidectomy with ETT removal was successfully performed via a minimally invasive modern procedure upon cervicotomy and intra-operatory use of the Cooper thymectomy retractor. <b>Results:</b> The panel of pros and cons with respect to providing endocrine thoracic surgery for ETTM resection in a 73-year-old subject is discussed amid a PubMed search of original English-language original reports from January 2000 until 15 August 2024 in order to identify similar distinct cases (individuals of 70 years or older who underwent surgery for ETTM). <b>Conclusions:</b> 1. We propose the term “three-leaf-clover thyroid” to capture the imaging essence of having an enlargement of both (eutopic) thyroid lobes and ETTM. 2. The modern surgical approach under these circumstances provided a rapid patient recovery with a low rate of complications and a minimum hospital stay. Hence, the procedure may be expanded to older patients after a careful consideration of their co-morbidities and of the need to releasing connected complaints (e.g., a 7-month history of intermittent dyspneea was found in this case with post-operatory remission). 3. The management remains a matter of individualised decision, and age may not be a limiting factor. 4. At the present time, this case adds to the very limited number of similar published cases in the mentioned age group that we could identify (seven patients, aged between 72 and 84; male-to-female ratio of 5 to 2; the rate of malignant ETTM was 3/7); of these cases, not all were reported to have a trans-cervical approach, and none reported the use of the Cooper thymectomy retractor to help the overall surgical procedure. This innovative surgical procedure offers the advantage of avoiding a sternotomy incision which has clear functional and aesthetic implications, while the video-assisted approach allows optimal visualization of the mediastinal anatomy and safe vascular sealing under visual control, without the risk of a major hemorrhage.https://www.mdpi.com/2039-7283/14/6/175ectopic tissuethyroidmediastinumthoracic surgeryendocrine surgeryaging dyspneea |
| spellingShingle | Claudiu Nistor Mihai-Lucian Ciobica Oana-Claudia Sima Anca-Pati Cucu Mihai Costachescu Adrian Ciuche Lucian-George Eftimie Dana Terzea Mara Carsote Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy? Clinics and Practice ectopic tissue thyroid mediastinum thoracic surgery endocrine surgery aging dyspneea |
| title | Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy? |
| title_full | Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy? |
| title_fullStr | Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy? |
| title_full_unstemmed | Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy? |
| title_short | Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy? |
| title_sort | three leaf clover thyroid and minimally invasive trans cervical synchronous thyroidectomy and ectopic mediastinal thyroid tissue removal does the age of the patient count amid a multifaceted strategy |
| topic | ectopic tissue thyroid mediastinum thoracic surgery endocrine surgery aging dyspneea |
| url | https://www.mdpi.com/2039-7283/14/6/175 |
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