부산대학교 도서관

We successfully removed recurrent papillary carcinoma of thyroid which firmly adhered to the common carotid artery (CCA) by resecting the CCA followed by revasculaization with a radial artery graft in two cases.A 71- and a 67-year-old women developed recurrence of papillary carcinoma of thyroid at cervical lymph nodes. Preoperative ultrasonogram and computed tomogram revealed a suspicious invasion to the CCA. Brain spectogram (BSP) following balloon occlusion test (BOT) showed a>70% fall in the cerebral blood flow. Therefore the reconstruction of CCA was indicated in both cases.At surgery, the metastatic lymph nodes were unable to be dissected from CCA because of their firm adhesion to the arterial wall. Thus, we bypassed CCA using a radial artery graft, and then removed the metastatic lymph nodes en bloc with CCA. The postoperative courses were uneventful in both cases. The pathological examination proved tight compression but no invasion of papillary carcinoma to the arterial wall. There was dense cicatricial tissue adjacent to CCA in both cases.Removal of CCA is accompanied with cerebral ischemia and infarction. Hence, preoperative estimation of the risk of cerebral ischemia is imperative. BSP following BOT is useful for this aim.