CRCM  Vol.4 No.2 , February 2015
Successful Treatment of Thyroid Carcinoma Invading the Trachea as a Single-Stage Procedure: A Case Report
ABSTRACT
Objective: Locally advanced thyroid carcinoma is relatively rare; extrathyroid extension, such as to the trachea, is one of the most important prognostic factors. Surgical resection is the mainstay of treatment, and appropriate surgical planning is crucial for obtaining a reasonable prognosis and quality of life of the patients. Case Report: Herein, we report a case of advanced thyroid carcinoma involving the trachea. Total thyroidectomy and window resection of the trachea were performed. The tracheal defect was approximately 2.5 × 3.0 cm in size, extending from the first to the third tracheal cartilage, and was reconstructed with auricular cartilage and covered with the sternohyoid muscles of both sides in a single-stage surgical procedure. The tracheal stoma was closed 2 weeks after the surgery. There were no postoperative complications. Conclusion: This reconstruction of the relatively small defect of the trachea provided excellent functional and cosmetic results.

Cite this paper
Endo, K. , Ueno, T. , Kondo, S. , Wakisaka, N. , Murono, S. and Yoshizaki, T. (2015) Successful Treatment of Thyroid Carcinoma Invading the Trachea as a Single-Stage Procedure: A Case Report. Case Reports in Clinical Medicine, 4, 50-54. doi: 10.4236/crcm.2015.42012.
References
[1]   Cody III, H.S. and Shah, J.P. (1981) Locally Invasive, Well-Differentiated Thyroid Cancer. 22 Years’ Experience at Memorial Sloan-Kettering Cancer Center. American Journal of Surgery, 142, 480-483.
http://dx.doi.org/10.1016/0002-9610(81)90379-2

[2]   An, S.Y. and Kim, K.H. (2010) Surgical Management of Locally Advanced Thyroid Cancer. Current Opinion in Otolaryngology Head and Neck Surgery, 18, 119-123.
http://dx.doi.org/10.1097/MOO.0b013e3283374d84

[3]   Andersen, P.E., Kinsella, J., Loree, T.R., Shaha, A.R. and Shah, J.P. (1995) Differentiated Carcinoma of the Thyroid with Extrathyroidal Extension. American Journal of Surgery, 170, 467-470.
http://dx.doi.org/10.1016/S0002-9610(99)80331-6

[4]   Nakao, K., Kurozumi, K., Fukushima, S., Nakahara, M., Tsujimoto, M. and Nishida, T. (2001) Merits and Demerits of Operative Procedure to the Trachea in Patients with Differentiated Thyroid Cancer. World Journal of Surgery, 25, 723-727. http://dx.doi.org/10.1007/s00268-001-0022-7

[5]   Ishihara, T., Kobayashi, K., Kikuchi, K., Kato, R., Kawamura, M. and Ito, K. (1991) Surgical Treatment of Advanced Thyroid Carcinoma Invading the Trachea. Journal of Thoracic and Cardiovascular Surgery, 102, 717-720.

[6]   Hammoud, Z.T. and Mathisen, D.J. (2003) Surgical Management of Thyroid Carcinoma Invading the Trachea. Chest Surgery Clinics of North America, 13, 359-367.
http://dx.doi.org/10.1016/S1052-3359(03)00018-8

[7]   Shin, D.H., Mark, E.J., Suen, H.C. and Grillo, H.C. (1993) 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. Human Pathology, 24, 866-870.
http://dx.doi.org/10.1016/0046-8177(93)90136-5

[8]   McCaffrey, T.V. and Lipton, R.J. (1990) Thyroid Carcinoma Invading the Upper Aerodigestive System. Laryngoscope, 100, 824-830. http://dx.doi.org/10.1288/00005537-199008000-00006

[9]   McCarty, T.M., Kuhn, J.A., Williams Jr., W.L., Ellenhorn, J.D., O’Brien, J.C., Preskitt, J.T., Lieberman, Z.H., Stephens, J., Odom-Maryon, T., Clarke, K.G. and Wagman, L.D. (1997) Surgical Management of Thyroid Cancer Invading the Airway. Annals of Surgical Oncology, 4, 403-408.
http://dx.doi.org/10.1007/BF02305553

[10]   Lawson, V.G. (1983) The Management of Airway Involvement in Thyroid Tumors. Archives of Otolaryngology, 109, 86-90. http://dx.doi.org/10.1001/archotol.1983.00800160020005

[11]   Ebihara, M., Kishimoto, S., Hayashi, R., Miyazaki, M., Shinozaki, T., Daiko, H., Saikawa, M., Sakuraba, M. and Miyamoto, S. (2011) Window Resection of the Trachea and Secondary Reconstruction for Invasion by Differentiated Thyroid Carcinoma. Auris Nasus Larynx, 38, 271-275.
http://dx.doi.org/10.1016/j.anl.2010.09.003

[12]   Nakahira, M., Nakatani, H., Takeuchi, S., Higashiyama, K. and Fukushima, K. (2006) Safe Reconstruction of a Large Cervico-Mediastinal Tracheal Defect with a Pectoralis Major Myocutaneous Flap and Free Costal Cartilage Grafts. Auris Nasus Larynx, 33, 203-206.
http://dx.doi.org/10.1016/j.anl.2005.09.009

[13]   Sugenoya, A., Matsuo, K., Asanuma, K., Shingu, K., Shimizu, T., Masuda, H., Kobayashi, S. and Iida, F. (1995) Management of Tracheal Wall Resection for Thyroid Carcinoma by Tracheocutaneous Fenestration and Delayed Closure Using Auricular Cartilage. Head Neck, 17, 339-342. http://dx.doi.org/10.1002/hed.2880170411

[14]   Asanuma, K., Itoh, N., Kobayashi, S. and Amano, J. (2000) The Long-Term Outcome of the Cartilage Free Graft to the Tracheal Defect. Head Neck, 22, 95-96.
http://dx.doi.org/10.1002/(SICI)1097-0347(200001)22:1<95::AID-HED15>3.0.CO;2-V

 
 
Top