Papillary Thyroid carcinoma with airway invasion: Diagnosis and treatment.

  • Background
    The aim of the present study is to make a review about the diagnosis of airway invasion in patients with papillary thyroid carcinoma, how were resolved them and the analysis of the results.

    Methods
    Retrospective study of 5 years experience (from June 2013 to June 2018). Patients with diagnosis of papillary thyroid carcinoma with airway invasion where included. Clinical records, surgical and pathology reports have been analysed to assess which principles and procedural details are significant to facilitate efficient diagnosis, staging and treatment.

    Results
    From 913 patients with papillary thyroid carcinoma diagnosis, 13 were T4a with airway invasion (1,18 %) of which 7 had tracheal invasion and 6 laryngeal invasion. In 3 cases were indifferentiated areas into papillary pattern, the remaining 10 patients were well differentiated.
    All patients had airway invasion symptoms like: haemoptysis, dyspnoea, stridor and respiratory insuffiency.
    One case present bilateral recurrent laryngeal nerve palsy at the moment of diagnosis and required a tracheostomy. Another patient didn´t accept surgical treatment.
    In 4 cases total thyroidectomy + total laryngectomy, 3 cases total thyroidectomy + partial laryngectomy, 7 cases total thyroidectomy + partial tracheal resection. Patients with tracheal shaving where not included.
    Three patients with laryngeal invasion and one with tracheal invasion died after radioiodine therapy.

    Conclusion
    With an appropriate operative strategy, patients with locally advanced papillary thyroid carcinoma have an overall good outcome.

 

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