A Successful Tracheal Resection and Anastomosis in Papillary Thyroid Carcinoma with Tracheal Invasion

I Gede Budhi Setiawan; Putu Anda Tusta Adiputra

doi:10.3889/oamjms.2018.438

Authors

I Gede Budhi Setiawan Surgical Oncology Division, Department of Surgery, Faculty of Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
Putu Anda Tusta Adiputra Surgical Oncology Division, Department of Surgery, Faculty of Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2018.438

Keywords:

Thyroid cancer, Well-differentiated thyroid carcinoma (DTC), Tracheal invasion

Abstract

BACKGROUND: Well-differentiated thyroid carcinoma (DTC) can be locally aggressive, invading aerodigestive tract. The rationale for aggressive surgical resection in this clinical setting is supported by a long-term local control with a positive impact on survival.

CASE REPORT: A 60-year-old male patient was consulted by a digestive surgeon of unaware thyroid enlargement. Physical and imaging examination showed a suspect of thyroid malignancy. During surgery, we found that a tumour had invaded the anterior side of the trachea. Resection of three tracheal rings was performed, with end-to-end anastomosis. Surgical outcome regarding nervous preservation and parathyroid glands was good as well as cosmetic aspect. During one-year follow-up, no indication of tumour recurrence was found. The management of locally invasive DTC has been controversial yielding the palliative surgery modalities. Advances in surgical technique have given a new perspective of resection in a difficult case. This case report was managed by sleeve resection with end-to-end anastomosis which showed a satisfactory outcome functionally and cosmetically.

CONCLUSION: Sleeve resection with primary reconstruction of the trachea is a simple one-stage procedure which can adequately address the problem of tracheal invasion by thyroid cancer.

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