Papillary Adenocarcinoma of the Thyroid Invading the Upper Air Passages

Abstract

The clinical course of papillary adenocarcinoma of the thyroid is delayed but aggressive and lethal in an estimated 11-16% of the patients. Death results in the majority of patients from respiratory obstruction produced by a collar of tumor that has proliferated from residual or multicentric thyroid disease. Review of a large series of cases reveals an incidence of invasion of the aerodigestive tract of 1-6.5%. Six such cases are presented in which resection of the larynx, trachea and pharynx were performed along with total thyroidectomy with local control of the disease and prolonged survival. In five cases conservation surgery was done. Three patients had prior thyroid lobectomy with recurrence and invasion of the air passages 2-5 years later. Intraluminal thyroid carcinoma may be confused with a primary lesion of the larynx, trachea or hypopharynx.

Management of thyroid carcinoma invading the aerodigestive tract

“…Thyroid carcinoma most frequently presents as focal disease confined to the thyroid capsule, making it amenable to isolated thyroid resection. Invasion of the aerodigestive tract by thyroid carcinoma is rare, with reported incidences varying from 1% to 7% 4 . Invasive disease is the source of significant morbidity for patients, including airway obstruction, hemorrhage, and dysphagia.…”

“…Invasion of the aerodigestive tract by thyroid carcinoma is rare, with reported incidences varying from 1% to 7%. 4 Invasive disease is the source of significant morbidity for patients, including airway obstruction, hemorrhage, and dysphagia. Failure to control local disease is a frequent cause of death in these patients.…”

Locally aggressive differentiated thyroid carcinoma

“…Of even greater clinical significance are those unfortunate instances in which local aggressiveness follows upon incomplete excision of the tumor [7,22] or surgical implantation into surrounding tissues owing to incision through the tumor.…”

Surgical management of locally advanced thyroid cancer (narrative review)

“…Неко-торые исследователи опубликовали результаты, свиде-тельствующие об отсутствии статистически значимых различий между исходами после радикального хирур-гического удаления опухоли и после удаления или «бритвенной» резекции ("shaving") опухолевых масс с последующей терапией радиоактивным йодом или дистанционной лучевой терапией [3,5,6]. По данным других авторов, применение более агрессивных хи-рургических методов (резекции щитовидной железы и окружающих вовлеченных структур en bloc с дости-жением отрицательного края резекции) может улуч-шить долгосрочные результаты -локальный контроль и выживаемость [7][8][9][10].…”