Pre-operative embolisation of the thyroid artery in a patient with a large papillary carcinoma of the thyroid.
OBJECTIVE
To demonstrate the usefulness of pre-operative selective embolisation of the thyroid arteries in an unusual case with a large, vascular thyroid tumour.


METHODS
A 29-year-old man presented with a large papillary carcinoma of the thyroid (weighing approximately 300 g on palpation) with extension to the mediastinum and compression of the trachea. A computed tomography scan of the neck and thorax revealed a large tumour the solid part of which was enhanced after contrast medium application, indicating a substantial vascular supply. Pre-operative selective embolisation of both superior thyroid arteries and one inferior thyroid artery, using gelatin sponge particles, was performed 4 days before surgery, under conventional angiography. After selective embolisation of these thyroid arteries, the patient experienced mild anterior neck pain and mild fever. This procedure allowed a significant reduction in blood perfusion to the tumour, which facilitated its surgical removal without blood transfusion.


CONCLUSIONS
Pre-operative selective embolisation of both superior thyroid arteries and one inferior thyroid artery may be an effective, minimally invasive procedure for patients with a large, vascular thyroid tumour.
Department of Otolaryngology, University of Toyama, Japan. hshojaku@med.u-toyama.ac.jp
H
H
Shojaku
H
H
Takakura
Y
Y
Watanabe
H
H
Seto
D000328:Adult; D000792:Angiography / Q000379:methods; D001158:Arteries; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005334:Fever / Q000209:etiology; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019547:Neck Pain / Q000209:etiology; D011300:Preoperative Care / Q000379:methods*; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000098:blood supply*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D014057:Tomography, X-Ray Computed
D003287:Contrast Media