Recurrent thyroid cancer with thyroid cartilage invasion treated with larynx preservation surgery

Abstract

　We report a case of recurrent thyroid cancer with thyroid cartilage invasion that was treated with partial resection of the larynx with preservation of laryngeal function. The patient was a 47-year-old man who had previously undergone total thyroidectomy and neck dissection for papillary thyroid carcinoma at another hospital. A recurrent lesion infiltrating the thyroid cartilage was detected 6 years later and so he was referred to our department. Computed tomography revealed a tumor with a maximum diameter of 39mm infiltrating the right plate of the thyroid cartilage. However, the infiltration into the larynx was limited to the paraglottic space, and so larynx preservation was deemed possible. Surgery was performed by removing the right plate of the thyroid cartilage en bloc with the tumor. The mucosa of the pyriform sinus was preserved. Currently, as of 1 year after the surgery, there has been no recurrence. Functional preservation of the larynx in cases of invasive differentiated thyroid carcinoma is a plausible consideration when the tumor has not infiltrated the laryngeal lumen and the framework of the thyroid cartilage（especially anterior-posterior diameter）remains considerably intact.