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Journal of Endocrinological Investigation

, Volume 29, Issue 2, pp 131–135 | Cite as

Interventional bronchoscopy in the treatment of tracheal obstruction secondary to advanced thyroid cancer

  • A. Ribechini
  • V. Bottici
  • A. Chella
  • R. Elisei
  • P. Vitti
  • A. Pinchera
  • N. AmbrosinoEmail author
Original Articles

Abstract

Background: Surgery is the choice treatment for symptomatic tracheal obstruction due to malignant thyroid disease. Few additional therapeutic alternatives are available: radiotherapy (RT), chemotherapy (CT) or radioiodine therapy (131I). Only few studies on interventional bronchoscopy (IB) as well as alternative or palliative procedures have been reported so far. This study is a retrospective report of results of IB performed in patients with severe tracheal obstruction due to advanced thyroid cancer. Setting: Pulmonary and Endocrinology Units of a University Hospital. Patients and interventions: From January 2, 2000 to March 1, 2004 14 consecutive patients [5 males, mean age: 62.2±10.7 (SD) yr] underwent IB due to tracheal obstruction for anaplastic (ATC: 7 patients), differentiated (DTC: 5), medullary (MTC: 1) and non-epithelial malignant (NEMN: 1) thyroid cancer. Eight out of 14 patients had local advanced inoperable disease, 6 had local relapse after surgery, 131I or RT. Ten out of 14 patients sufferedfrom severe dyspnea. In 4 patients airway patency was maintained by insertion of a stent; in 3 the tracheal lesion was removed by Nd-YAG laser; in 7 both procedures were performed. Results: All 10 patients with dyspnea showed an improvement in symptoms. Early and late complications were observed in 4 and in 3 patients, respectively. All but 4 DTC patients died 11.9±14.2 months after the diagnosis (4.20±5.1 after IB). In 4 DTC patients still alive 90.7±59.2 since diagnosis and 16.7±9.2 months since IB, the airway dilatations allowed further treatments like 131-I and/or RT. Conclusions: Interventional bronchoscopy, including Nd-YAG laser and airways stenting are alternatives to surgery in inoperable thyroid-induced tracheal obstruction. Moreover, airway dilatation improves dyspnea and may allow further treatment.

En]Keywords

Advanced thyroid cancer airway obstruction bronchoscopy tracheal infiltration airway stent 

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Copyright information

© Italian Society of Endocrinology (SIE) 2006

Authors and Affiliations

  • A. Ribechini
    • 1
  • V. Bottici
    • 2
  • A. Chella
    • 1
  • R. Elisei
    • 2
  • P. Vitti
    • 2
  • A. Pinchera
    • 2
  • N. Ambrosino
    • 1
    Email author
  1. 1.Cardio-Thoracic DepartmentPulmonary UnitPisaItaly
  2. 2.Department of Endocrinology and MetabolismUniversity Hospital of PisaPisaItaly

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