Chest wall resection and reconstruction using titanium micromesh covered with Marlex mesh for metastatic follicular thyroid carcinoma: a case report.
BACKGROUND
The distant metastases from differentiated thyroid carcinomas are often untreatable. In particular, bone metastasis is significantly related to poor prognosis since radioactive iodine therapy is generally less effective. Therefore, surgical resection is considered one of the treatments for patients with bone metastases. We report chest wall resection and reconstruction using titanium micromesh covered with polypropylene mesh (Marlex mesh) for metastatic rib bones as a result of follicular thyroid carcinoma.


METHODS
A 51-year-old man was referred to our institution with a painful chest wall tumor. He presented with a 15 x 10 cm bony swelling on the left chest wall and multiple small lung nodules from follicular thyroid carcinoma. Completion total thyroidectomy, chest wall resection and reconstruction using titanium micromesh covered with Marlex mesh were performed. There were no critical complications associated with surgical treatments and tumor pain disappeared during the postoperative period. Then, he received radioactive iodine therapy and the uptake of radioactive iodine was well observed in bilateral lung fields.


CONCLUSIONS
Reconstruction using titanium micromesh covered with Marlex mesh is possible for repairing the wide chest wall resection required for thyroid carcinoma metastasis. This technique would help to enhance treatment efficacy in the combination therapy of radioactive iodine and surgery in patients with large thyroid carcinoma metastasis in the chest wall.
Suganuma
Nobuyasu
N
Department of Surgery, Yokohama City University Hospital and Medical Center Fukuura, Kanazawa, Yokohama, Kanagawa Japan.
Wada
Nobuyuki
N
Arai
Hiromasa
H
Nakayama
Hirotaka
H
Fujii
Keita
K
Masudo
Katsuhiko
K
Yukawa
Norio
N
Rino
Yasushi
Y
Masuda
Munetaka
M
Imada
Toshio
T