{"_buckets": {"deposit": "5073625b-5de9-450a-92d6-c5f935b65463"}, "_deposit": {"id": "8717", "owners": [], "pid": {"revision_id": 0, "type": "depid", "value": "8717"}, "status": "published"}, "_oai": {"id": "oai:niigata-u.repo.nii.ac.jp:00008717", "sets": ["456", "911"]}, "item_7_alternative_title_1": {"attribute_name": "その他のタイトル", "attribute_value_mlt": [{"subitem_alternative_title": "A Case of Asymptomatic Advanced Thyroid Cancer Undergoing Radical Resection under Mediastinal Sternotomy"}]}, "item_7_biblio_info_6": {"attribute_name": "書誌情報", "attribute_value_mlt": [{"bibliographicIssueDates": {"bibliographicIssueDate": "2015-05", "bibliographicIssueDateType": "Issued"}, "bibliographicIssueNumber": "5", "bibliographicPageEnd": "286", "bibliographicPageStart": "281", "bibliographicVolumeNumber": "129", "bibliographic_titles": [{"bibliographic_title": "新潟医学会雑誌"}, {"bibliographic_title": "新潟医学会雑誌", "bibliographic_titleLang": "en"}]}]}, "item_7_description_4": {"attribute_name": "抄録", "attribute_value_mlt": [{"subitem_description": "甲状腺癌のうち乳頭癌(papillary carcinoma)の頻度は90%と大部分を占め, 頸部リンパ節転移の頻度が高く, 高齢者では未分化癌に転化することもある. 今回, 結腸癌術後の全身検索で発見され, 胸骨縦切開を追加して切除可能であった無症候性進行甲状腺癌の1例を経験したので文献的考察を加えて報告する. 症例は76歳, 女性. 上行結腸癌手術後7年目にCA19-9値の上昇傾向を指摘され, CT検査では上縦隔へ進展した7cm大の甲状腺腫瘤と1.5cm大の右頸部リンパ節腫大を認めた. 穿刺吸引細胞診では class III であったが甲状腺癌が強く疑われたため, 手術目的に当科入院となった. 術前の頸部CTおよびMRI検査では, 甲状腺腫瘍は上縦隔まで進展していたが, 明らかな血管への浸潤所見は認めず, 気管支鏡検査では明らかな気管浸潤は認めなかった. 手術を施行し, 右頸部リンパ節を摘出し術中迅速病理診断に提出したところ乳頭癌の診断が得られたため, 甲状腺全摘術および頸部リンパ節郭清の方針となった. 術中所見では, 上縦隔内の無名静脈および右頸動脈への浸潤が疑われ, 切除可能か否かの判定が困難であった. 視野を確保し, 血管等への浸潤の有無を判定するために胸骨縦切開を追加した. その結果, 良好な視野が得られ, 無名静脈, 右左総頸動脈への直接浸潤を認めず, 腫瘍の切離が可能となり, 甲状腺全摘術および頸部リンパ節郭清を施行した. 甲状腺癌, 特に乳頭癌は10年生存率が80～90%と良好であり, また, 放置した場合に気管浸潤, 血管浸潤を伴うと, 生命予後のみならず, 患者QOLも著しく損なわれるので, 可能であるならば積極的に切除を行うことが望ましい.", "subitem_description_type": "Abstract"}]}, "item_7_full_name_3": {"attribute_name": "著者別名", "attribute_value_mlt": [{"nameIdentifiers": [{"nameIdentifier": "60751", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Niwano, Toshiyuki"}]}, {"nameIdentifiers": [{"nameIdentifier": "60752", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Koyama, Yu"}]}, {"nameIdentifiers": [{"nameIdentifier": "60753", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Nagahashi, Masayuki"}]}, {"nameIdentifiers": [{"nameIdentifier": "60754", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Hasegawa, Miki"}]}, {"nameIdentifiers": [{"nameIdentifier": "60755", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Toshikawa, Chie"}]}, {"nameIdentifiers": [{"nameIdentifier": "60756", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Tsuchida, Junko"}]}, {"nameIdentifiers": [{"nameIdentifier": "60757", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Wakai, Toshifumi"}]}, {"nameIdentifiers": [{"nameIdentifier": "60758", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Koike, Terumoto"}]}, {"nameIdentifiers": [{"nameIdentifier": "60759", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Hashimoto, Takehisa"}]}, {"nameIdentifiers": [{"nameIdentifier": "60760", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Tsuchida, Masanori"}]}]}, "item_7_publisher_7": {"attribute_name": "出版者", "attribute_value_mlt": [{"subitem_publisher": "新潟医学会"}]}, "item_7_select_19": {"attribute_name": "著者版フラグ", "attribute_value_mlt": [{"subitem_select_item": "publisher"}]}, "item_7_source_id_11": {"attribute_name": "書誌レコードID", "attribute_value_mlt": [{"subitem_source_identifier": "AN00182415", "subitem_source_identifier_type": "NCID"}]}, "item_7_source_id_9": {"attribute_name": "ISSN", "attribute_value_mlt": [{"subitem_source_identifier": "00290440", "subitem_source_identifier_type": "ISSN"}]}, "item_creator": {"attribute_name": "著者", "attribute_type": "creator", "attribute_value_mlt": [{"creatorNames": [{"creatorName": "庭野, 稔之"}], "nameIdentifiers": [{"nameIdentifier": "60741", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "小山, 諭"}], 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{"subitem_subject": "反回神経浸潤", "subitem_subject_scheme": "Other"}, {"subitem_subject": "気管浸潤", "subitem_subject_scheme": "Other"}, {"subitem_subject": "胸骨縦切開", "subitem_subject_scheme": "Other"}]}, "item_language": {"attribute_name": "言語", "attribute_value_mlt": [{"subitem_language": "jpn"}]}, "item_resource_type": {"attribute_name": "資源タイプ", "attribute_value_mlt": [{"resourcetype": "departmental bulletin paper", "resourceuri": "http://purl.org/coar/resource_type/c_6501"}]}, "item_title": "胸骨縦切開を追加して切除し得た無症候性進行甲状腺癌の1例", "item_titles": {"attribute_name": "タイトル", "attribute_value_mlt": [{"subitem_title": "胸骨縦切開を追加して切除し得た無症候性進行甲状腺癌の1例"}, {"subitem_title": "胸骨縦切開を追加して切除し得た無症候性進行甲状腺癌の1例", "subitem_title_language": "en"}]}, "item_type_id": "7", "owner": "1", "path": ["456", "911"], "permalink_uri": "http://hdl.handle.net/10191/44075", "pubdate": {"attribute_name": "公開日", "attribute_value": "2016-10-04"}, "publish_date": "2016-10-04", "publish_status": "0", "recid": "8717", "relation": {}, 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