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Tracheal resection for thyroid cancer

Published online by Cambridge University Press:  12 April 2012

A M Shenoy ,
R Burrah ,
V Rao ,
P Chavan ,
R Halkud ,
V B Gowda ,
N Ranganath ,
T Shivakumar  and
V Prashanth
A M Shenoy
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
R Burrah*
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
V Rao
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
P Chavan
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
R Halkud
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
V B Gowda
Affiliation:
Department of Anaesthesiology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
N Ranganath
Affiliation:
Department of Anaesthesiology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
T Shivakumar
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
V Prashanth
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
*
Address for correspondence: Dr Rajaram Burrah, Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India560029 Fax: +91 080 6560723 E-mail: rajaram_bv@yahoo.com
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Abstract

Introduction:

Thyroid cancers infiltrating the upper aerodigestive tract are not uncommon. The management of these cases can be demanding, with a high level of surgical skill required to achieve adequate primary resection and reconstruction.

Materials and methods:

This study was a single institution series of seven patients, managed over two years, who underwent tracheal resection for advanced thyroid cancer. All patients were older than 45 years (range, 45–65 years) and were predominantly male (six of seven). All patients presented to us with a swelling in the neck. Fine needle aspiration cytology detected thyroid cancer in all patients. None of the patients required a tracheostomy prior to surgery; however, they all had varying levels of airway compromise. One patient had lung metastasis at presentation. In all patients, the airway was successfully secured with fibre-optic assisted intubation prior to surgery. All patients underwent a total thyroidectomy with tracheal resection and anastomosis. Montgomery's suprahyoid release was utilised to achieve adequate laryngeal drop. None of the patients required a tracheostomy in the post-operative period. All patients received adjuvant therapy with either radioiodine ablation and/or radiotherapy.

Conclusion:

Tracheal resection and primary reconstruction is a feasible surgical procedure for patients with thyroid cancer infiltrating the upper aerodigestive tract, with good clinical outcomes. However, the morbidity of the procedure mandates careful case selection, airway management and meticulous surgical technique.

Keywords

Thyroid NeoplasmsCarcinomaPathologyTracheaSurgical ProceduresOperative

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 6 , June 2012 , pp. 594 - 597
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Hay, ID, McConahey, WM, Goellner, JR. Managing patients with papillary thyroid carcinoma: insights gained from the Mayo Clinic's experience of treating 2512 consecutive patients during 1940 through 2000. Trans Am Clin Climatol Assoc 2002;113:241–60Google Scholar
2Andersen, PE, Kinsella, J, Loree, TR, Shaha, AR, Shah, JP. Differentiated carcinoma of the thyroid with extrathyroidal extension. Am J Surg 1995;170:467–70CrossRefGoogle ScholarPubMed
3Czaja, JM, McCaffrey, TV. The surgical management of laryngotracheal invasion by well-differentiated papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg 1997;123:484–90CrossRefGoogle ScholarPubMed
4Ishihara, T, Yamazaki, S, Kobayashi, K, Inoue, H, Fukai, S, Ito, K et al. Resection of the trachea infiltrated by thyroid carcinoma. Ann Surg 1982;195:496–500CrossRefGoogle ScholarPubMed
5Shin, DH, Mark, EJ, Suen, HC, Grillo, HC. Pathologic staging of papillary carcinoma of the thyroid with airway invasion based on the anatomic manner of extension to the trachea: a clinicopathologic study based on 22 patients who underwent thyroidectomy and airway resection. Hum Pathol 1993;24:866–70CrossRefGoogle Scholar
6Shah, JP, Loree, TR, Dharker, D, Strong, EW, Begg, C, Vlamis, V. Prognostic factors in differentiated carcinoma of the thyroid gland. Am J Surg 1992;164:658–61Google Scholar
7McCaffrey, TV, Bergstralh, EJ, Hay, ID. Locally invasive papillary thyroid carcinoma: 1940–1990. Head Neck 1994;16:165–72Google Scholar
8Cody, HS, Shah, JP. Locally invasive, well-differentiated thyroid cancer: 22 years' experience at Memorial Sloan-Kettering Cancer Center. Am J Surg 1981;142:480–3CrossRefGoogle ScholarPubMed
9McCaffrey, TV, Lipton, RJ. Thyroid carcinoma invading the upper aerodigestive system. Laryngoscope 1990;100:824–30Google Scholar
10Gaissert, HA, Honings, J, Grillo, HC, Donahue, DM, Wain, JC, Wright, CD et al. Segmental laryngotracheal and tracheal resection for invasive thyroid carcinoma. Ann Thorac Surg 2007;83:1952–9Google Scholar
11Friedman, M, Danielzadeh, JA, Caldarelli, DD. Treatment of patients with carcinoma of the thyroid invading the airway. Arch Otolaryngol Head Neck Surg 1994;120:1377–81Google Scholar
12Nishida, T, Nakao, K, Hamaji, M. Differentiated thyroid carcinoma with airway invasion: indication for tracheal resection based on the extent of cancer invasion. J Thorac Cardiovasc Surg 1997;114:84–92CrossRefGoogle ScholarPubMed
13Price, DL, Wong, RJ, Randolph, GW. Invasive thyroid cancer: management of the trachea and esophagus. Otolaryngol Clin North Am 2008;41:1155–68Google Scholar