ETA2024 Poster Presentations Thyroid cancer treatment (10 abstracts)
Surgical management of medullary thyroid carcinoma with tracheal invasion
Wejdan mohamed Trabelsi 1 , Alia Methnani 2 , Oumaima Zitoun 3 , Rim Baraham 4 , Mohamed Dhaha 4 , Souheil Jbali 5 , Sawsen Dhambri 4 & Skander Kedous 6
1Salah Azaiez Institut, Ent, Tunis, Tunisia; 2Salah Azaiez Institute, Ent, Ent, Tunis, Tunisia; 3Salah Azaiz Institute, Otorhinolaryngology Department, Tunis, Tunisia; 4Salah Azaeiz Institute, Ent, Ent, Tunis, Tunisia; 5Salah Aziez Institute, Ent, Ent, Tunis, Tunisia; 6Salah Azaeiz Institue, Ent, Ent, Tunis, Tunisia
Introduction: Tracheal infiltration by thyroid carcinoma causes tracheal stenoses and hemoptysis, which is often fatal. Therefore, surgical treatment of thyroid carcinoma should be performed early to ensure patency of the airway.
Aim: This report deals with the diagnosis and surgical treatment of a patient undergoing resection of the trachea for recurrent thyroid medullary carcinoma infiltrating the trachea in Salah Azeize institute in March 2021.
Observation: A 63-year-old man underwent subtotal thyroidectomy with central lymph node dissection and modified left-sided neck dissection in January 2018 under the diagnosis of medullary thyroid carcinoma. The tumor occupied the entire left lobe and was adherent to sternothyroid muscle and the left recurrent nerve who was sacrificed. The area was subsequently irradiated with 56 Gray. There was no sign of recurrence two years after. Two year and nine months later an occult recurrence was suspected, with elevations of serum calcitonin as the only sign. Control tomography noted a tumor in the trachea. A tracheoscopy showed a tumor obstructing about three-quarters of the lumen of the cervical trachea. A length of about 15 mm of the trachea (three rings) was excised and the defect repaired by primary anastomosis. Laryngeal release was performed simultaneously to reduce the tension on the anastomotic sit. The patient is now well, seven months after the operation, with no signs of recurrence of the tumor.
Conclusion : The prognosis after treatment is better in thyroid carcinoma than in most other carcinomas. However, when a progressive tumor has infiltrated into the surrounding tissues, especially the trachea, the tracheal lumen is narrowed, leading to obstruction and often to fatal hemorrhage.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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