Intraluminal Invasion of Upper Aerodigestive Tract by Thyroid Carcinoma

Cho, Jung Il; Kim, Young Mo; Choi, Won Suk; Lee, Myung Taek; Lee, Seung Joon; Yang, Tae Yong

Abstract

BACKGROUND AND OBJECTIVES
Thyroid carcinoma infrequently invades the upper aerodigestive tract. However, when invasion occurs, it is the source of significant morbidity and mortality. If the tumor extends into the lumen of the upper aerodigestive tract, more critical problems can happen. There have been much debates about surgical therapy of thyroid carcinoma invading the upper aerodigestive tract whether it should be radical or conservative. This study was designed to investigate the intraluminal extension of the upper aerodigestive tract by thyroid carcinoma and review the spectrum of radical resection.
MATERIALS AND METHODS
From 1996 to 2000, six patients with thyroid carcinoma invading the upper aerodigestive tract (intraluminal involvement) were radically resected at Inha University Hospital. Clinical records were reviewed retrospectively.
RESULTS
The radical resection consisted of a total thyroidectomy and a neck dissection, combined with radical excisions that included three laryngectomies, two laryngopharyngoesophargectomies, and a case of partial pharyngectomy. The histologic types consisted of 5 papillary carcinoma and 1 anaplastic carcinoma. There was one preoperative mortality. Five patients received radioactive iodine therapy postoperatively. One patient died of nodal recurrence at the 13th postoperative month, and 4 patients are still alive with a follow-up period of 19-52 months.
CONCLUSION
Based on our results of these six patients who had intraluminal involvement of the upper aerodigestive tract, we suggest that radical resection might be a worthwhile procedure. But it should be considered that radical resection might cause loss of functions in the head and neck organs, and therefore possibilites of conservative resection should be considered throughly during the preoperative examination.