Management of Invasive Thyroid Malignancies
Authors List
Naidoo K, Chaplin J, McIvor N, Auckland City Hospital, ORL Department
Aim: To investigate the management of invasive thyroid malignancies in the Auckland region.
Methods: Thirty thyroid operations carried out in an Auckland population, including public and private patients, between March 2010 and 2020 were included in this study. Patients’ clinical records were retrospectively reviewed to obtain information pertaining to patient’s age, thyroid operation performed, fine needle aspirate (FNA) cytology, invasive extent, adjuvant therapy, complications, pathology and staging. These included 15 males and 15 females, between the ages of 18 and 91, with pT3 (26) and pT4 (4) invasive thyroid malignancies. We excluded pT3 tumours based on >4cm criteria alone.
Results: Papillary carcinoma was the most common (87%), of which classical variant was the most common subtype (9/26, 34.6%). Invasive extent was classified as either perithyroidal soft tissue (73%), strap musculature (13%) or trachea (13%). Total thyroidectomy was the common procedure (29/30). Neck dissection was performed in 19 patients, eleven had bilateral procedures performed, eight had unilateral procedures performed. We found nodal disease present in 53% and distant metastases in 17% of our study population.
The recurrent laryngeal nerve was sacrificed in two cases, tracheal resection and primary anastomosis was performed in two cases and tracheal shave in one case. Reconstruction with a pectoralis major rotation flap was also required in one case. Complications included one seroma, one haematoma, two recurrences, one positive margin and three deaths.
Regarding adjuvant therapies, 27 patients had radioactive iodine, four had external beam radiotherapy, three had neither.
Naidoo K, Chaplin J, McIvor N, Auckland City Hospital, ORL Department
Aim: To investigate the management of invasive thyroid malignancies in the Auckland region.
Methods: Thirty thyroid operations carried out in an Auckland population, including public and private patients, between March 2010 and 2020 were included in this study. Patients’ clinical records were retrospectively reviewed to obtain information pertaining to patient’s age, thyroid operation performed, fine needle aspirate (FNA) cytology, invasive extent, adjuvant therapy, complications, pathology and staging. These included 15 males and 15 females, between the ages of 18 and 91, with pT3 (26) and pT4 (4) invasive thyroid malignancies. We excluded pT3 tumours based on >4cm criteria alone.
Results: Papillary carcinoma was the most common (87%), of which classical variant was the most common subtype (9/26, 34.6%). Invasive extent was classified as either perithyroidal soft tissue (73%), strap musculature (13%) or trachea (13%). Total thyroidectomy was the common procedure (29/30). Neck dissection was performed in 19 patients, eleven had bilateral procedures performed, eight had unilateral procedures performed. We found nodal disease present in 53% and distant metastases in 17% of our study population.
The recurrent laryngeal nerve was sacrificed in two cases, tracheal resection and primary anastomosis was performed in two cases and tracheal shave in one case. Reconstruction with a pectoralis major rotation flap was also required in one case. Complications included one seroma, one haematoma, two recurrences, one positive margin and three deaths.
Regarding adjuvant therapies, 27 patients had radioactive iodine, four had external beam radiotherapy, three had neither.
