Tumour reduction with a Cavitron Ultrasonic Surgical Aspirator[R] in the palliative care of anaplastic thyroid cancer.
A 54-year-old euthyroid woman, who had undergone a total thyroidectomy and lymph node clearance three months prior, presented with a large ulcerating thyroid mass fixed to the underlying structures. This tumour was a follicular variant of a papillary tumour, with anaplastic dedifferentiation. I-123 scintigraphy confirmed metastases to the skull, chest, abdomen and pelvis. A computed tomography scan showed infiltration and fixation to the underlying structures in the neck. She had not experienced any voice changes. External beam radiation failed to produce a response. The patient was in a pitiful state. She could not flex her neck, and there was an offensive smell from the constantly oozing tumour (Figure 1). It was felt that tumour debulking and iodine ablation were the best available palliative therapies. The CUSA[R] was used for tumour reduction, while preserving the functional structures. The tumour was successfully reduced in size with an operative blood loss of under 500 ml. Mild oozing from the tumour bed was easily controlled with Surgicel[R] and mild pressure. The results of the debulking surgery are shown in Figure 2. The open wound required a small absorbent gauze, while the use of a scarf made the patient appear natural and presentable.
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JHR Becker, [1,2] F Ghoor [1,2]
 Department of General Surgery, Sefako Makgatho Health Sciences University, Pretoria, South Africa
 Dr George Mukhari Academic Hospital, Pretoria, South Africa
Corresponding author: JHR Becker (email@example.com)
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|Title Annotation:||CASE REPORT|
|Author:||Becker, J.H.R.; Ghoor, F.|
|Publication:||South African Journal of Surgery|
|Date:||Jun 1, 2016|
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