Alsalamah Shmokh, Althunayan Thamer, Alaraifi Abdulaziz, Alessa Mohammed
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
AME Case Rep. 2024 Aug 2;8:87. doi: 10.21037/acr-24-45. eCollection 2024.
Medullary thyroid carcinoma (MTC) is a rare and aggressive type of thyroid cancer. Patients with this condition typically manifest palpable neck swelling and compressive symptoms. Biochemical evaluation and neck ultrasound play vital roles in diagnosis. The management options differ based on the extent of the disease.
This paper describes a 47-year-old male patient diagnosed with MTC invading the trachea and larynx. He presented with a 5 cm × 5 cm hard thyromegaly on the right side with right-sided level IV lymphadenopathy, measuring approximately 2 cm. He underwent total thyroidectomy, total laryngectomy, and bilateral neck dissection. Postoperatively, the patient developed a neck abscess and pharyngocutaneous fistula (PCF), which was managed surgically and had a satisfactory outcome. After 128 days of inpatient care, he was discharged in a stable condition with resolution of complications and had no evidence of local recurrence during the 6-month follow-up.
MTC is a rare type of thyroid neoplasia that can manifest with various symptoms resulting from either the primary lesion or secondary invasion. Surgery remains the mainstay of treatment, however, there are limited options and no approved adjuvant therapies for patients with disseminated MTC. Complications that arise after total thyroidectomy and laryngectomy can be noteworthy and demand careful surveillance and immediate treatment to prevent further deterioration.
甲状腺髓样癌（MTC）是一种罕见且侵袭性强的甲状腺癌。患有这种疾病的患者通常表现为可触及的颈部肿胀和压迫症状。生化评估和颈部超声在诊断中起着至关重要的作用。治疗方案因疾病范围而异。
本文描述了一名47岁男性患者，诊断为MTC侵犯气管和喉。他右侧有一个5厘米×5厘米的硬甲状腺肿大，右侧IV区淋巴结肿大，大小约2厘米。他接受了全甲状腺切除术、全喉切除术和双侧颈部清扫术。术后，患者出现颈部脓肿和咽皮肤瘘（PCF），通过手术治疗，效果满意。经过128天的住院治疗，他病情稳定出院，并发症得到解决，在6个月的随访期间没有局部复发的迹象。
MTC是一种罕见的甲状腺肿瘤，可因原发性病变或继发性侵犯而表现出各种症状。手术仍然是主要的治疗方法，然而，对于播散性MTC患者，选择有限且没有批准的辅助治疗方法。全甲状腺切除术和喉切除术后出现的并发症可能值得关注，需要仔细监测并立即治疗以防止病情进一步恶化。
