Li Pingdong, Fang Xiaolian, Yang Zheng, Chen Xuejun, Chen Xiaohong, Huang Zhigang
Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China.
Gland Surg. 2023 May 30;12(5):628-632. doi: 10.21037/gs-23-88. Epub 2023 Apr 11.
Incidental thyroid carcinomas (ITCs) in patients undergoing head and neck surgery are rare, but there are no standard guidelines for the treatment of this situation. This retrospective study sought to detail our experiences in the treatment of ITCs related to the surgery of head and neck cancers.
We conducted a retrospective analysis of the data about the ITCs in the patients with head and neck cancer, who underwent surgical treatments at Beijing Tongren Hospital in the past 5 years. The number and size of the thyroid nodules, postoperative pathology, follow-up results, and other information were recorded in detail. All the patients underwent surgical treatment and were followed-up for >1 year.
A total of 11 patients (10 male and 1 female) with ITC were included in this study. The patients had an average age of 58 years. Most of the patients (72.7%, 8/11) had laryngeal squamous cell cancer, and 7 were diagnosed with thyroid nodules on ultrasound. The surgical procedures for laryngeal and hypopharyngeal cancers included partial laryngectomy, total laryngectomy, and hypopharyngectomy. All the patients underwent thyroid stimulating hormone (TSH) suppression therapy. No recurrence or mortality events from thyroid carcinoma were observed.
More attention needs to be paid to ITCs in head and neck surgery patients. Additionally, more research and the long-time follow-up of ITC patients are needed to extend understandings. For patients with head and neck cancers, if the suspicious thyroid nodules are found pre-operatively by ultrasound, fine-needle aspiration (FNA) is recommended. If FNA cannot be performed, the guidelines for thyroid nodules should be followed. In patients with postoperative ITC, TSH suppression therapy and follow-up is indicated.
接受头颈外科手术的患者中偶然发现的甲状腺癌（ITC）较为罕见，但对于这种情况的治疗尚无标准指南。这项回顾性研究旨在详述我们在治疗与头颈癌手术相关的ITC方面的经验。
我们对过去5年在北京同仁医院接受手术治疗的头颈癌患者中ITC的数据进行了回顾性分析。详细记录了甲状腺结节的数量和大小、术后病理、随访结果及其他信息。所有患者均接受了手术治疗，并进行了超过1年的随访。
本研究共纳入11例ITC患者（10例男性，1例女性）。患者的平均年龄为58岁。大多数患者（72.7%，8/11）患有喉鳞状细胞癌，7例经超声诊断为甲状腺结节。喉癌和下咽癌的手术方式包括部分喉切除术、全喉切除术和下咽切除术。所有患者均接受了促甲状腺激素（TSH）抑制治疗。未观察到甲状腺癌复发或死亡事件。
在头颈外科手术患者中需要更多关注ITC。此外，需要对ITC患者进行更多研究和长期随访以加深了解。对于头颈癌患者，如果术前超声发现可疑甲状腺结节，建议进行细针穿刺抽吸活检（FNA）。如果无法进行FNA，则应遵循甲状腺结节的相关指南。对于术后ITC患者，应进行TSH抑制治疗及随访。
