Surgery in Malignant Tumors of the Thyroid Gland

Schindel, J

doi:10.1177/000348947108000109

Cited by 22 publications

(1 citation statement)

References 6 publications

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“…The incidence of extrathyroidal invasion in well‐differentiated thyroid carcinoma ranges from 1% to 16% [2, 3, 4, 19, 20, 21]. Papillary thyroid carcinoma is the most common histologic type that invades the upper aerodigestive tract [4], and in our study, preoperative RLN palsy due to malignant infiltration occurred exclusively in patients with papillary thyroid carcinoma.…”

Section: Discussionmentioning

confidence: 58%

Recurrent Laryngeal Nerve Palsy in Well‐differentiated Thyroid Carcinoma: Clinicopathologic Features and Outcome Study

Chan

Lam

et al. 2004

World j. surg.

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Involvement of the recurrent laryngeal nerve (RLN) by well-differentiated thyroid carcinoma may not invariably lead to unilateral cord palsy, although the presence of RLN palsy is associated with locally advanced disease. The present study evaluates the clinicopathologic features and outcomes of patients surgically treated for well-differentiated thyroid carcinoma with documented nonfunctioning RLN at presentation. From 1970 to 2002, 20 of 709 patients undergoing surgical treatment for well-differentiated thyroid carcinoma were found to have ipsilateral unilateral cord palsy by routine preoperative laryngoscopy. There were 5 men and 15 women with a median age of 70 years. Nine patients (45%) did not have a clinically palpable thyroid mass, and hoarseness was the primary presenting symptom. All patients had histologically confirmed pT4 papillary thyroid carcinoma with a median size of 4 cm. Cervical nodal and pulmonary metastases were detected in 14 (70%) and 2 (10%) patients, respectively. The ipsilateral recurrent nerve was transected in all patients because of gross tumor involvement, and 19 patients underwent total or completion total thyroidectomy. Resection was incomplete in 15 patients, including 2 who underwent a debulking procedure and required reoperation for local control. Postoperative radioactive iodine ablation and external-beam irradiation were administered to 18 and 13 patients, respectively. Over a median follow-up of 4.5 years, 10 patients survived without evidence of recurrence, 5 died of disease recurrence, and 5 died of unrelated causes. The 5-year and 10-year cause-specific mortality was 17% and 42%, respectively. Patients developing distant metastasis at presentation or during follow-up had a significantly increased cause-specific mortality (p = 0.002). Preoperative RLN palsy can be the first symptom in patients with locally advanced papillary thyroid carcinoma. Despite the adoption of a relatively conservative surgical treatment, long-term survival can be achieved in selected patients.

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Section: Discussionmentioning

confidence: 58%

Recurrent Laryngeal Nerve Palsy in Well‐differentiated Thyroid Carcinoma: Clinicopathologic Features and Outcome Study

Chan

Lam

et al. 2004

World j. surg.

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Treatment of Patients With Carcinoma of the Thyroid Invading the Airway

Friedman

Danielzadeh²,

Caldarelli³

1994

Archives of Otolaryngology - Head and Neck Surgery

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Surgical management of laryngotracheal and esophageal involvement by locally advanced thyroid cancer

Gillenwater

Goepfert

1999

Semin. Surg. Oncol.

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Well‐differentiated thyroid cancer usually progresses slowly and rarely invades other tissues. However, the rare cases with invasion of local structures, such as the larynx, trachea, or esophagus, present particular management difficulties. In situations with limited involvement of the larynx or trachea, there is controversy over whether a “shave excision” that may leave microscopic disease at the site, or a complete resection that includes removal of a portion of these structures is the better approach. In the case of more extensive involvement of upper aerodigestive tract structures by thyroid carcinomas, the most appropriate method of resection and reconstruction is also at issue. We discuss the literature pertaining to the surgical management of laryngotracheal and esophageal invasion by thyroid carcinoma, review the incidence and presentation of this disease, and make recommendations based on our own experience. Semin. Surg. Oncol. 16:19–29, 1999. © 1999 Wiley‐Liss, Inc.

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Surgery in Malignant Tumors of the Thyroid Gland

Abstract: A case in point: a middle-aged male patient had no serious complaints for over thirty years after a nonradical operation of a thyroid tumor, in spite of disseminate lung metastases which started developing a few years after the operation.

Cited by 22 publications

References 6 publications

Recurrent Laryngeal Nerve Palsy in Well‐differentiated Thyroid Carcinoma: Clinicopathologic Features and Outcome Study

Recurrent Laryngeal Nerve Palsy in Well‐differentiated Thyroid Carcinoma: Clinicopathologic Features and Outcome Study

Treatment of Patients With Carcinoma of the Thyroid Invading the Airway

Surgical management of laryngotracheal and esophageal involvement by locally advanced thyroid cancer

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