RESUMO
Colon cancer metastases to the thyroid gland are a particularly rare occurrence. Despite the relative amenability of the gland to clinical, radiologic, and pathologic assessment, preoperative distinction between primary and secondary thyroid neoplastic processes remains difficult. Here we describe a case of a patient with a known history of stage IV colon cancer with multiple pulmonary metastases, presenting with a thyroid lesion initially diagnosed as papillary thyroid cancer on fine-needle aspiration biopsy but found to be metastatic colonic adenocarcinoma on post-thyroidectomy pathologic evaluation utilizing immunohistochemical techniques. A review of the literature is also included.
RESUMO
BACKGROUND: Single-incision surgery has gained in popularity, and the recent development of specialized robotic and laparoscopic instruments may remove some of the ergonomic and technical difficulties associated with this approach. However, questions of cost and efficiency remain. METHODS: We prospectively collected perioperative outcome and efficiency (operative time, case volume) data for our single-site robotic cholecystectomy cases and retrospectively reviewed data for our single-incision laparoscopic cholecystectomy cases. RESULTS: There were no differences in patient characteristics or perioperative outcomes between the robotic (n = 20) and laparoscopic (n = 10) groups; operative times were equivalent (84.6 vs 85.5 min; p = 0.8737) and blood loss and complications were minimal. There was a higher robotic case volume, with an average of two robotic cases (range 1-4)/day vs one/day for laparoscopic cases (range 1-1; p = 0.0306). Streamlined instrument costs were essentially equivalent. CONCLUSIONS: Robotic single-site cholecystectomy is a safe, cost-effective alternative to single-incision laparoscopic cholecystectomy in a robot-existing model.