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Ann Thorac Surg 1992;54:3-10
© 1992 The Society of Thoracic Surgeons

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Articles

Resectional management of thyroid carcinoma invading the airway

^a General Thoracic Surgical Unit, Massachusetts General Hospital, Boston, Massachusetts USA
^b Department of Surgery, Harvard Medical School, Boston, Massachusetts USA

^_* Address reprint requests to Dr Grillo, Massachusetts General Hospital, Boston, MA 02114.

Fifty-two patients had thyroid carcinoma invading the airway. Thirty-four underwent resection; 18 were male and 16 female. Age ranged from 17 to 79 years. Twenty-seven had resection with airway reconstruction (1 wedge excision, 10 sleeve tracheal resections, 6 tracheal resections with a portion of the cricoid cartilage, and 10 complex laryngotracheoplastic resections). Seven required cervicomediastinal exenteration with mediastinal tracheostomy; 3 of these had esophagectomy with colon interposition. Nineteen tumors were papillary, 6 follicular, 4 mixed papillary and follicular, 1 squamous, 2 undifferentiated giant cell, 1 anaplastic spindle cell carcinoma, and 1 carcinosarcoma. Three postoperative deaths occurred. Thirteen of the 31 survivors died of cancer from [equation] to [equation] years postoperatively (average, 4.4 years). Four died of other diseases. Fourteen are alive from [equation] to [equation] years postoperatively (average, 5.3 years). Only 2 patients had airway recurrence. Resection of the airway invaded by thyroid malignancy in the absence of extensive metastases offers prolonged palliation, avoids suffocation due to bleeding or obstruction, and may produce cure. Airway reconstruction should be performed whenever technically feasible.

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