1991 Volume 52 Issue 9 Pages 2047-2052
A case of follicular adenocarcinoma of the thyroid presenting with stenosis of the cervical esophagus, is reported.
The patient was a 72-year-old woman with the chief complaint of dysphagia. Esophagogram and endoscopy revealed just the stricture of the cervical esophagus, but the histological diagnosis was not obtained. Thyroid scintigraphy and ultrasonography indicated a thyroid cancer invading the esophagus. At operation, a lymph node of 3.0×1.5×1.7 cm in diameter was found to invade the Lt. side of the esophagus and larynx and cause esophageal stricture. Frozen section detected follicular structure in the lymphnode. Total thyroidecotmy, laryngectomy and cervical esophagectomy with bilateral modified radical neck dissection and tracheocutaneostomy were performed. The transplantation of the jejunal free graft between the pharynx and intrathoracic esophagus was done for esophageal substitute. Postoperatively, histological evaluation established the diagnosis of follicular adenocarcinoma of the thyroid.
The cervical esophagus is rarely invaded by the thyroid cancer. In this case the primary lesion in the thyroid was small, and it was first diagnosed when a metastasized lymph node invaded the esophagus. Favorable Prognosis can be expected on the basis of complete resection of all lesions in a case of well differentiated thyroid carcinoma, if it invaded the surrounding organs. The patients is free from recurrence for 1 year and 6 months after operation.
