Successful surgery for rare case of invasive thyroid cancer in the trachea

DNO - On October 22, Da Nang Hospital announced that doctors from the Department of Thoracic Surgery had successfully performed surgery on patient Nguyen Thi H. (born in 1953, Quang Trach commune, Quang Tri province) with advanced thyroid cancer, the tumor invaded and severely compressed the trachea, and metastasized to many lymph nodes in the neck.

The medical team performed surgery on patient H. Photo: LE HUNG

The patient had a long history of goiter, had difficulty breathing since September 2024 and had prolonged hoarseness. The patient underwent tracheotomy at a local hospital.

One month before admission, the tracheostomy tube fell out, and the patient breathed through the opening on the skin at the tracheostomy site. Because the opening was gradually healing, the patient had increasing difficulty breathing, so he went to the Department of Thoracic Surgery ( Da Nang Hospital) for examination and was admitted.

Here, through CT scan of the neck, doctors recorded a very large thyroid gland with dimensions of 43x48x75mm, heterogeneous hypodense structure, invading and compressing the trachea (trachea lumen narrowed to only 3mm), and invading the left internal jugular vein.

Thyroid ultrasound detected multiple homogeneous solid nodules, suspicious of malignancy. Preoperative cytology results indicated thyroid cancer, monitoring cervical lymph node metastasis.

After a thorough consultation, the team of doctors from the Department of Thoracic Surgery in collaboration with the Department of Anesthesia and Resuscitation performed a 4-hour surgery. The doctors removed the damaged thyroid gland, cleared the neck lymph nodes, and sutured the tracheal opening.

After surgery, the patient's endotracheal tube was removed, he could breathe normally, his voice improved, and no complications of hypocalcemia were recorded (no numbness or withdrawal of limbs).

After 7 days of treatment, the pathology results confirmed that this was papillary thyroid cancer with metastasis to multiple cervical lymph nodes.

Dr. Than Trong Vu, Head of the Department of Thoracic Surgery - who directly performed the surgery on the patient, said that the surgery to remove the entire thyroid gland was difficult due to the large, invasive tumor, the collapsed trachea (diameter at the narrowest point is 3mm), and the tumor compressing the jugular vein.

In addition, the patient had a tracheostomy but the tracheostomy tube slipped out, the tracheostomy hole was closed, so the prognosis for placing an endotracheal tube for anesthesia was difficult and complicated, with many complications that could occur during and after surgery. However, with close coordination between specialists, the surgery was successful, and the patient recovered well.

After surgery, the patient recovered well. Photo: LH

“The incidence of palpable nodules on clinical examination is about 5/100 women and 1/100 men, living in areas with adequate iodine supply. Thyroid cancer, especially papillary type, accounts for about 80% of thyroid cancer cases. The disease usually progresses slowly, with a good prognosis if detected early and treated promptly,” Dr. Vu added.

Through this case, Dr. Vu recommends that when people discover an abnormal mass in the neck area, have difficulty breathing, hoarseness, difficulty swallowing, etc., they should go to a specialized medical facility for early diagnosis and timely treatment to avoid the disease progressing and causing serious complications that threaten life.

Source: https://baodanang.vn/phau-thuat-thanh-cong-ca-ung-thu-tuyen-giap-xam-lan-khi-quan-hiem-gap-3307986.html