Endocrine Abstracts

Introduction: Occult or subclinical thyroid carcinomas are not uncommon. Metastases of thyroid cancers may be discovered incidentally during cervical dissection for squamous cell carcinoma of the upper aero digestive tract. The prevalence of these thyroid metastases is estimated to be between 0.3 and 1.6%. The therapeutic impact is poorly codified, partly related to the frequently severe prognosis of those cancer. We aim through this case to discuss the therapeutic consequences of such metastases.

Case report: This is a 46-year-old smoker patient, presented with chronic dysphonia progressing evolving over eight months with intermittent inspiratory dyspnea. Panendoscopy under general anesthesia showed a voluminous left hemilaryngeal tumor extended to the Morgani’s ventricle and the subglottic region. Biopsy confirmed the diagnosis of well-differentiated keratinizing squamous cell carcinoma. The tumor was classified T4AN0M0 according to the UICC/AJCC of 2017. The patient underwent a total laryngectomy with recurrential and functional bilateral lymphadenectomy and total thyroidectomy. The final histopathological examination concluded to a laryngeal squamous cell carcinoma with the presence of lymph node metastasis from papillary thyroid carcinoma. The thyroid gland showed no histological lesions. Iratherapy with cervicofacial external radiotherapy were performed. The patient is currently without evidence of recurrence after 24 months of follow-up.

Discussion/Conclusion: In our case, there was no discussion after the definitive histological findings, as we already performed a total thyroidectomy justified by the subglottic tumor extension. Otherwise, in other cases, incidental histological thyroid metastases should be discussed based on the results of thyroid ultrasound during follow-up and the discovery of a thyroid nodule justifies thyroidectomy for diagnosis confirmation.

Disclosure of interest: none declared