Locally aggressive differentiated thyroid carcinoma.

Local infiltration of adjacent anatomic structures and soft tissues of the neck from well-differentiated carcinoma of the thyroid gland is a relatively infrequent occurrence. We report our experience with 21 such cases seen in our department over the past 20 years. All patients were treated by total thyroidectomy and total or partial excision of the infiltrated adjacent structures. Papillary carcinoma was the most frequent type of primary tumor seen. Following the definitive surgery, all patients were scanned with radioactive iodine (131I). In case of isotope entrapment, a curative dose 131I was given. All patients in our series were required to receive thyroid hormone replacement. Four patients died as a result of their disease. Uncontrolled local disease and distant metastases were present at the time of death. Three patients died of unrelated causes. Two-thirds of the patients are still alive (from 1 to 19 years after the treatment).