A rare complication: lymphocele following a re-operative right thyroid lobectomy for multinodular goitre

Riferimento: 
BMJ Case Rep. 2012 May 23;2012. pii: bcr0220125747.
Autori: 
Touska P, Constantinides VA, Palazzo FF.
Fonte: 
BMJ Case Rep. 2012 May 23;2012. pii: bcr0220125747.
Anno: 
2012
Azione: 
Il paziente, re-operato per cancro alla tiroide metastatico, è stato gestito con successo conservativo con modifiche dietetiche ed alte dosi di octreotide.
Target: 
Octreotide/cancro alla tiroide metastatico.

ABSTRACT
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.