Papillary adenocarcinoma of the thyroid invading the upper air passages

The clinical course of papillary adenocarcinoma of the thyroid is delayed but aggressive and lethal in an estimated 11-16% of the patients. Death results in the majority of patients from respiratory obstruction produced by a collar of tumor that has proliferated from residual or multicentric thyroid disease. Review of a large series of cases reveals an incidence of invasion of the aerodigestive tract of 1-6.5%. Six such cases are presented in which resection of the larynx, trachea and pharynx were performed along with total thyroidectomy with local control of the disease and prolonged survival. In five cases conservation surgery was done. Three patients had prior thyroid lobectomy with recurrence and invasion of the air passages 2-5 years later. Intraluminal thyroid carcinoma may be confused with a primary lesion of the larynx, trachea or hypopharynx.