Varadharajan K, Mathew R, Odutoye B, Williamson P, Madden B
Department of ENT Surgery,West Middlesex University Hospital,London,UK.
Department of ENT,St George's Hospital,London,UK.
J Laryngol Otol. 2015 Jun;129(6):568-71. doi: 10.1017/S0022215115001103. Epub 2015 May 20.
Anaplastic thyroid carcinoma is rare but carries a poor prognosis. Anaplastic thyroid carcinoma leads to tracheal compression, airway compromise and eventually death. Airway compromise, a particularly distressing symptom, can be palliated with tracheal stenting.
A retrospective case note analysis was conducted of patients diagnosed with anaplastic thyroid carcinoma between July 2003 and July 2013.
Twelve patients with anaplastic thyroid carcinoma were identified. Four patients underwent palliative tracheal stenting. Three patients had no dyspnoea at the time of stenting. Two stented patients subsequently developed dyspnoea secondary to stent migration; this was managed successfully with stent exchange. The other stented patient remained asymptomatic with regards to dyspnoea. All non-stented patients died with or from airway compromise.
Tracheal stenting is a relatively safe and effective method for palliation of distressing airway symptoms in patients with anaplastic thyroid carcinoma. Early prophylactic tracheal stenting in anaplastic thyroid carcinoma may be an effective option to prevent development of airway compromise as the disease progresses.
间变性甲状腺癌罕见，但预后较差。间变性甲状腺癌会导致气管受压、气道受损，最终导致死亡。气道受损是一种特别令人痛苦的症状，可通过气管支架置入术缓解。
对2003年7月至2013年7月期间诊断为间变性甲状腺癌的患者进行回顾性病例记录分析。
共确定12例间变性甲状腺癌患者。4例患者接受了姑息性气管支架置入术。3例患者在支架置入时无呼吸困难。2例置入支架的患者随后因支架移位出现呼吸困难，通过更换支架成功处理。另1例置入支架的患者在呼吸困难方面仍无症状。所有未置入支架的患者均因气道受损死亡或死于气道受损。
气管支架置入术是缓解间变性甲状腺癌患者痛苦气道症状的一种相对安全有效的方法。间变性甲状腺癌早期预防性气管支架置入术可能是预防疾病进展时气道受损发生的有效选择。
