Segmental tracheal resection (nine rings) and reconstruction for carcinoma showing thymus-like differentiation (CASTLE) of the thyroid.

To our knowledge, this is the first video demonstration of a segmental resection and reconstruction of a CASTLE of the thyroid in the peer-reviewed literature. Unique to this case is the significant length of tracheal resection with primary closure, as well as demonstration of concurrent esophageal muscularis resection. Resection and reconstruction of longer segments of cervical trachea require stepwise surgical technique to safely preserve recurrent laryngeal nerve (s), while releasing the larynx and thoracic trachea to minimize tension on the tracheal closure.