[Papillary Thyroid Cancer Metastasizing Anterior Mediastinal Lymph Node with Extra-nodal Invasion to the Lung:Report of a Case].

We describe a 79-year-old female with a prior history of two times of mitral valve surgery and pacemaker implantation. She was transferred to our hospital presenting bloody sputum with dyspnea. Chest enhanced computed tomography (CT) showed a large anterior mediastinal mass of 64×52 mm in size. She underwent surgery for the mediastinal tumor through third time median sternotomy approach. As the tumor was suspected of infiltrating to the lung, combined resection of right upper lobe was additionally performed. Histological examination revealed papillary thyroid carcinoma metastasizing anterior mediastinal lymph node with extra-nodal invasion to the lung. After surgery, echography detected primary lesion in the left lobe of thyroid gland, and the patient was finally diagnosed as papillary thyroid cancer metastasizing mediastinal lymph node. Two months later, she underwent total thyroidectomy.