A rare complication: lymphocele following a re-operative right thyroid lobectomy for multinodular goitre.
Lymphatic leakage is a rare complication of thyroid surgery, the risk of which increases in the presence of malignancy and correlates with the extent of surgery. Although primarily associated with left-sided thoracic duct injuries, lymphatic leaks may occur following right-sided neck dissections for metastatic thyroid cancer. However, the development of a lymphocele following a right-sided lobectomy for benign disease is exceptionally rare. The authors present the case of a patient who developed a cervical lymphocele 10 days after a re-operative right thyroid lobectomy for a multinodular goitre. The patient was successfully managed conservatively with a combination of dietary modification and high-dose octreotide. The reason for her presentation was most likely the result of an occult injury to a congenitally-aberrant lymphatic duct, brought into the operative field by postsurgical adhesions. The case serves to highlight the importance of subtle variations in lymphatic anatomy in the context of a re-operative thyroidectomy.
Department of Endocrine Surgery, Hammersmith Hospital, London, UK. phil.touska@doctors.org.uk
Philip
P
Touska
Vasilis A
VA
Constantinides
Fausto F
FF
Palazzo
D018752:Diet, Fat-Restricted; D004322:Drainage; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D008210:Lymphocele / Q000628:therapy*; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy*; D013965:Thyroidectomy
D015282:Octreotide