A study of eight cases of thyroid cancer undergoing mediastinal surgery with bone resection

In cases of thyroid cancer with mediastinal extension or mediastinal lymph node metastasis, surgery is recommended not only for tumor control but also airway preservation and protection of the great vessels, but there are no clear guidelines on surgical methods.In this study, we reviewed eight cases of thyroid cancer that underwent osteotomy at our department between January 2016 and December 2023.Surgical procedures included L-shaped osteotomy in two cases, partial resection of the manubrium and clavicle in two cases, and the transmanubrial osteomuscular sparing approach in three cases.The surgical method was selected based on the localization of the lesion, and all surgeries were performed solely by our department.Of the eight cases, five were differentiated carcinoma and three were non-differentiated carcinoma.Complete resection was achieved in all five cases of differentiated carcinoma.Surgical complications associated with osteotomy included major vessel injury in two cases and wound infection in one case.We conclude that the choice of surgical approach based on tumor localization is critical, and that osteotomy is a safe and effective surgical approach.