An approach for recurrent thyroid carcinoma with a clavicle osteotomy

Özet

Papillary thyroid carcinoma (PTC) has a good prognosis and a low recurrence rate. The recurrent disease mainly involves the neck and distant metastases. The current trend is to incorporate proph-ylactic neck dissection for papillary thyroid carcinoma during the first surgery of papillary carcinoma in order to reduce the risk of recurrence. We are presenting a case of recurrent papillary thyroid carcinoma extending from level V neck node to the infraclavicular space. A clavicular osteotomy was performed for a wider surgical access and to attain a better oncological margin. The majority of recurrent neck diseases occurs at central compartment followed by the level III and level IV neck nodes. Reoperation for recurrent neck diseases poses several significant morbidities such as chylous leaks and venous bleeding especially if the tumor is located at the inferior part of inferior jugular vein, at the level IV neck nodes. The clavicular osteotomy provides better surgical access and thus avo-ids the aforementioned complications. This method is an effective approach for complete removal of a recurrent tumor at the base of the neck with good surgical margin.