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남태영 (F/61) 30617980
C.C> Both flank pain (Rt>Lt) onset : 1YA, aggrav : 3MA
BHx>
#1 1YA Sx develop -> CPA WNL -> observation
#2 03/3 : Sx aggrav -> X-ray : T8 osteolytic lesion
Chest CT : Lt thyroid soft tissue density, T8 lesion
BS : T8 & Rt clavicle uptake increase
MRI : T8 mass forming lesion
CT-guided Bx : mets of papillay thyroid Ca
Thyroid sono : Lt. lobe 3.5*1.8*4 sized mass
#3 03/5 : Total thyroidectomy done (Bx : follicular carcinoma)
#4 03/6 : MRI - no interval change
#5 03/7 : I131 scan - remnant thyroid, Lt axilla, T spine uptake
increased -> Adm for op
P/E>
MLT (+) SLR (full/full)
Patrick (-/-)
Motor
IP 3/3 Hansting 5-/5 Quad 5-/5 TA 5/5- EPH 5/5-
EDL, FHL, FDL, TP 5/5
Sensory, circulation : intact / intact
KJ ++/++ AJ +/+
Urination/defectation : no problem
Imp> Thyroid Ca with bone metastasis, T8
Prog>
03/8/1 Op done
Intralesional mass excision
Ant. partial corpectomy T8
Ant. fusion with rib bone graft
Ant. stabilization with instrumentation T7-9 (Kaneda)