A case of a successfully resected giant follicular thyroid carcinoma that had caused tracheal stenosis

Abstract

A 52-year-old woman was diagnosed as having a nodular goiter eight years prior and was followed using ultrasound. In July 2008, she was taken to hospital by ambulance since she developed dyspnea, cyanosis, and a disturbance of consciousness. Endotracheal intubation was performed. A computed tomography (CT) scan revealed a giant thyroid tumor extending from the neck to the anterior upper mediastinum with marked tracheal stenosis ; she was transferred to our hospital for treatment. Based on fine needle aspiration cytology, anaplastic carcinoma was ruled out. During surgery, the tumor compressed but did not infiltrate the surrounding tissue ; the tumor had a clear margin. A total thyroidectomy was carried out via a cervical incision. On histopathology, the tumor was diagnosed as a minimally invasive, well differentiated, follicular carcinoma. Endotracheal extubation was performed on P.O.D. 4 and the patient's postoperative course was uneventful. Since 1983 there have been only 4 cases of well differentiated follicular carcinoma of the thyroid causing tracheal stenosis reported in Japan. Follicular tumors of the thyroid have the potential of causing tracheal stenosis ; careful follow-up is recommended for patient's with these tumors.