Objective: To study the surgical management of the thyroid carcinoma with the upper mediastinal invasion.
Methods: Among the 560 thyroid carcinoma cases receiving surgery from 1988 to 1999, there were 10 cases of the upper mediastinal, the 10 cases were retrospectively analyzed for their preoperative diagnosis, surgical methods and postoperative complications.
Results: The upper mediastinal invasion rate of the 560 cases was 1.9% (10/516). There are three paths for the upper mediastinal invasion: (1) Trachea esophagus groove and upper mediastinal lymphatic node metastasis. (2) Tumor direct invasion. (3) Primary malignant substernal goiter. Operative methods include: (1) Tumor removal without using sternum incision. (2) Tumor removal with sternotomy. (3) Extension operation with sternum or/and clavicle bones removal. The number of those cases who survived 1, 3, 5, 10 years were 10, 8, 6, 4 respectively. Radical removal of tumors was achieved in 9 cases. The complications occurred were: 2 cases of chylous fistula; 2 cases of vocal paralysis; 1 case of thyrocervical trunk artery bleeding; 1 case of phrenic nerve paralysis; 1 case of pneumothorax.
Conclusions: Surgery can be adopted for treating thyroid carcinoma with the upper mediastinal invasion, and it can have a good long-term prognosis.
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