Airway invasion in papillary carcinoma of thyroid: A case report

Abstract

Papillary thyroid carcinoma (PTC) usually follows an indolent course with an excellent prognosis; however, gross 
extrathyroidal extension into the airway is rare and represents locally advanced disease. Laryngotracheal invasion poses significant diagnostic and therapeutic challenges and is associated with increased morbidity and disease upstaging. We report the case of a 69-year-old male who presented with progressive dyspnea requiring an emergency tracheostomy. Endoscopic evaluation and biopsy from the subglottic region revealed PTC. Contrast-enhanced computed tomography demonstrated a thyroid mass with direct invasion into the subglottic airway. Owing to extensive laryngotracheal involvement, the patient underwent total thyroidectomy with total laryngectomy and primary tracheoesophageal puncture. Histopathology confirmed PTC with airway invasion. The patient had an uneventful post-operative course and remains disease-free on follow-up.