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BMJ Case Reports 2012; doi:10.1136/bcr.02.2012.5747
  • Unexpected outcome (positive or negative) including adverse drug reactions

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

  1. Fausto F Palazzo
  1. Department of Endocrine Surgery, Hammersmith Hospital, London, UK
  1. Correspondence to Mr Philip Touska, phil.touska{at}doctors.org.uk

Summary

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.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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