Intrathyroidal carotid artery and nonrecurring right recurrent laryngeal nerve: A case report

Head Neck. 2017 Dec;39(12):E123-E126. doi: 10.1002/hed.24970. Epub 2017 Oct 11.

Abstract

Background: When performing thyroidectomy, knowledge of normal anatomy and variants is vital to avoid injuring nearby structures. Typically, the bilateral carotids course posterolateral to the thyroid gland. We describe a rare variant of an intrathyroidal carotid artery, not previously described in the literature.

Methods: A 23-year-old woman with a strong family history of thyroid cancer presented with a left thyroid nodule, and a fine-needle aspiration biopsy revealing papillary thyroid carcinoma. She underwent total thyroidectomy.

Results: Intraoperatively, the carotid was found coursing centrally through the right lobe parenchyma, associated with an ipsilateral nonrecurrent recurrent laryngeal nerve (NRLN) entering the cricothyroid joint superolaterally.

Conclusion: This is, to our knowledge, the first report of such an anatomic variant in the medical literature. Aberrant carotid artery anatomy may potentially cause life-threatening surgical complications and should be considered preoperatively. Furthermore, recognition of concurrent recurrent laryngeal nerve (RLN) anomalies with vascular variations allows identification of nonrecurrent nerves.

Keywords: anatomic variant; arteria lusoria; intrathyroidal carotid artery; nonrecurring recurrent laryngeal nerve; thyroidectomy.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Papillary / diagnostic imaging
  • Carcinoma, Papillary / surgery*
  • Carotid Artery, Common / abnormalities*
  • Computed Tomography Angiography / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional
  • Incidental Findings
  • Intraoperative Complications / diagnosis
  • Intraoperative Complications / surgery*
  • Recurrent Laryngeal Nerve / abnormalities*
  • Risk Assessment
  • Thyroid Cancer, Papillary
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy / adverse effects
  • Thyroidectomy / methods*
  • Treatment Outcome
  • Ultrasonography, Doppler / methods
  • Young Adult