PMC4643343_01
An enhanced CT scan revealed a large mediastinal goiter extending beyond the aortic arch, which was likely the cause of the patient's dyspnea.
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AbTPO 6.2 IU/ml, Calcitonin < 0.50. An ultrasound showed that a hypoechoic mass with internal heterogeneity spread bilateral lobe and lower pole of the right lobe was not well defined. An enhanced CT scan showed that there was a large mediastinal goiter extending to the aortic arch, which was the primary cause of her dyspnea (Fig. 1).
(a: photograph of the operative field) Pediatric extension retractors (Kent Retractor Set, Takasago Medical Industry, Tokyo, Japan) have two posts, a bridging arch, a reel and a trammel shape retractor.(b: an enlarged view of Fig. 2a) We placed the trammel shape retractor under the breastbone. Pulling up the clavicles, the operative field was enlarged. (c: schema of Fig. 2b) The aortic arch was clearly visible (arrow), and the thyroid was resected safely. (d) The excised specimen was 13 x 10 x 5 cm in size and weighed 220 g.
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We decided to perform a total thyroidectomy to relieve her symptoms (Fig. 2a). Takasago Medical Industry, Tokyo, Japan), the operative field was enlarged to allow better access. The aortic arch was clearly visible and the thyroid was resected safely (Fig. 2b). The excised specimen was 13 x 10 x 5 cm in size and weighed 220 g (Fig. 2c).