Surgical Treatment of Locally Advanced Papillary Thyroid Cancer
Although the majority of the differentiated thyroid carcinomas belong to low-risk group, 10–15% of these tumors present with locally advanced disease. Aerodigestive tract invasion is one of the challenging problems in these patients. Here we have reported a patient who presented with stage IV tracheal invasion of thyroid cancer and underwent bilateral total thyroidectomy, central neck dissection, bilateral modified radical neck dissection, and tracheal resection and primary anastomosis. The histopathologic examination revealed multicentric papillary thyroid carcinoma of diffuse sclerosing variant. The tumor was 6.5 cm with diffuse lymphovascular invasion and extrathyroidal extension. Ten of the dissected 25 lymph nodes were metastatic. Diffuse angiolymphatic and cartilage invasion was found on partial tracheal resection specimen with negative surgical margins. The patient received postoperative adjuvant radioiodine treatment. On the postoperative 6th month, nodal recurrence was detected at lateral neck region level II, and segmental level II lymphadenectomy was performed.
KeywordsThyroid cancer Locally advanced Hemoptysis Tracheal invasion Tracheal resection
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