Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Papillary thyroid cancer with tracheal invasion
- Radiologic Findings
- Fig 1. Chest PA image shows a lobulated contoured endotracheal mass in the upper trachea.
Fig 2-5. Enhanced chest CT scan show a heterogeneously enhancing lobulated mass in the anterior wall of the upper trachea connecting to a thyroid gland mass. The thyroid gland mass also shows heterogenous enhancement with focal calcification.
- Brief Review
- 1~8% of PTC patients experience tumor invasion to the aerodigestive tract including the trachea, larynx, esophagus and the hypopharynx. Among them, the trachea is the most common site, with an incidence of 35~60% among PTC patients with tumor invasion, followed by the larynx and the esophagus.
Extrathyroidal extension in thyroid cancer represents a gradual mechanism of infiltration from the outer to the inner wall layers of the trachea. When pathologically reviewed, tumor infiltration can be noted to occur in the cartilaginous spaces rather than the cartilaginous ring. The PTC cells invade the laryngotracheal system by bluntly dissecting along blood vessels and collagen fibers oriented perpendicularly to the tracheal lumen in between cartilaginous rings.
With advancement in surgical techniques, radical surgery with extended tracheal resection and tracheal reconstruction can be the choice of treatment for advanced thyroid cancer.
- References
- 1. Thyroid cancer with tracheal invasion: a pathologic estimation. Vincenzo P et al. Gand Surg 2016;5(5): 541-545
- Keywords
- Trachea, Thyroid, Neoplasm_Malignant,