Restrictive Hypertropia Caused by Bilateral Isolated Superior Rectus Hypertrophy after Total Thyroidectomy for Thyroid Cancer

甲狀腺癌於甲狀腺切除術後導致雙側上直肌肥大及局限性上斜視之個案報告

陳延誌(Yen-Chih Chen) ； 周介仁(Jie-Ren Jou)

《The Changhua Journal of Medicine》 15卷1期 (2017/03) Pp. 40-44

https://doi.org/10.6501/CJM.1501.006

摘要

The present case report describes an unusual case of bilateral hypertropia caused by bilateral superior rectus hypertrophy after total thyroidectomy for thyroid cancer. A 54-year-old male underwent total thyroidectomy in March 2015 for thyroid cancer. One year later, thyroid-associated ophthalmopathy (TAO) was noted. Orbital computed tomography (CT) revealed bilateral isolated superior rectus (SR) hypertrophy (right ＞ left). In July 2016, the patient underwent bilateral SR recession, following which his eye position became orthophoric in the primary position. This is an unusual manifestation of TAO presenting as restrictive hypertropia due to bilateral isolated superior rectus hypertrophy in a patient that underwent total thyroidectomy for thyroid cancer. Hypertropia can be successfully managed by bilateral muscle recession surgery, with subsequent improvement of the primary eye position and the patient's quality of life.

關鍵字

hypertropia ； superior rectus ； thyroid associated ophthalmopathy ； thyroidectomy

並列摘要

甲狀腺眼病變常見於甲狀腺亢進之患者，於甲狀腺癌接受甲狀腺手術後發生相關之眼外肌病變之病例極為少數。本案例報告為一中年男性本身因甲狀腺癌症於接受過甲狀腺切除手術約一年後產生雙眼複視情形，眼科檢查診斷為甲狀腺眼病變，電腦斷層檢查發現雙側上直肌均有肥厚性病變，經過適當眼外肌矯正手術後病人之斜視有明顯進步。

並列關鍵字

上斜視 ； 上直肌 ； 甲狀腺眼病變 ； 甲狀腺切除術