PDF(Pubmed)
Abstract：
UNASSIGNED: The majority of surgical thyroid disorders are treated by thyroidectomy (total or hemithyroidectomy). Anatomical variants of embryologic origin may threaten the effectiveness of thyroid surgery and complete removal of thyroid tissue.
METHODS: A female patient who underwent a total thyroidectomy, postoperatively had normal serum thyroid-stimulating hormone (TSH) levels without hormone replacement. Serum TSH and thyroglobulin levels were within normal range. A thyroid nuclear scan and chest magnetic resonance imaging (MRI) indicated a large retrosternal thyroid remnant. Clinical discussion: Separated thyroid remnant in the thyrothymic tract, forgotten during primary surgery, was the source of hormone production. Total thyroidectomy was not achieved due to embryologic remnant, and complete resection of thyroid tissue was affected by separated retrosternal thyrothymic rest.
CONCLUSIONS: Surgeon awareness of anatomic variants of embryological origin undoubtedly improves thyroid surgery outcomes. Beside the anatomically based approach, total thyroidectomy could be achieved by an embryologically based approach.
METHODS: A female patient who underwent a total thyroidectomy, postoperatively had normal serum thyroid-stimulating hormone (TSH) levels without hormone replacement. Serum TSH and thyroglobulin levels were within normal range. A thyroid nuclear scan and chest magnetic resonance imaging (MRI) indicated a large retrosternal thyroid remnant. Clinical discussion: Separated thyroid remnant in the thyrothymic tract, forgotten during primary surgery, was the source of hormone production. Total thyroidectomy was not achieved due to embryologic remnant, and complete resection of thyroid tissue was affected by separated retrosternal thyrothymic rest.
CONCLUSIONS: Surgeon awareness of anatomic variants of embryological origin undoubtedly improves thyroid surgery outcomes. Beside the anatomically based approach, total thyroidectomy could be achieved by an embryologically based approach.
摘要：
■大多数外科甲状腺疾病通过甲状腺切除术（全甲状腺切除术或半甲状腺切除术）进行治疗。胚胎起源的解剖变异可能威胁到甲状腺手术的有效性和甲状腺组织的完全切除。
方法：一名接受全甲状腺切除术的女性患者，术后血清促甲状腺激素(TSH)水平正常,无激素替代.血清TSH和甲状腺球蛋白水平均在正常范围内。甲状腺核扫描和胸部磁共振成像（MRI）显示胸骨后甲状腺残留较大。临床讨论：甲状腺胸腺中分离的甲状腺残留物，在初级手术中被遗忘，是激素产生的来源.由于胚胎残留，甲状腺全切除术未实现，甲状腺组织的完全切除受分离的胸骨后甲状腺其余的影响。
结论：外科医生对胚胎起源的解剖变异的认识无疑可以改善甲状腺手术的结局。除了基于解剖学的方法，甲状腺全切除术可以通过基于胚胎学的方法实现.
方法：一名接受全甲状腺切除术的女性患者，术后血清促甲状腺激素(TSH)水平正常,无激素替代.血清TSH和甲状腺球蛋白水平均在正常范围内。甲状腺核扫描和胸部磁共振成像（MRI）显示胸骨后甲状腺残留较大。临床讨论：甲状腺胸腺中分离的甲状腺残留物，在初级手术中被遗忘，是激素产生的来源.由于胚胎残留，甲状腺全切除术未实现，甲状腺组织的完全切除受分离的胸骨后甲状腺其余的影响。
结论：外科医生对胚胎起源的解剖变异的认识无疑可以改善甲状腺手术的结局。除了基于解剖学的方法，甲状腺全切除术可以通过基于胚胎学的方法实现.
