Well-Differentiated Thyroid Carcinoma Presenting with Sternal Invasion: Complex Resection and Reconstruction in the COVID-19 Era

Background: Advanced thyroid malignancies may invade adjacent structures creating challenging approaches to surgical resection. Methods: We report a 48-year-old gentleman who was found have papillary cancer with invasion of the sternum. Results: The patient presented pain and swelling in upper chest. Computed tomography (CT) scanning demonstrated paratracheal mass manubrium. Core needle biopsy cancer. Surgery performed during COVID-19 pandemic. En bloc total thyroidectomy resection manubrium performed. defect closed using biological mesh, covered pectoralis major flap. Final pathology completely excised T4N1bM1 well-differentiated carcinoma. made an uneventful recovery. Conclusion: sternal can be safely low morbidity. Reconstruction mesh pedicled muscle flap reduce infection risk.