Abstract
Laryngotracheal reconstruction is performed to treat locally advanced thyroid carcinoma invading the larynx and/or trachea. The reconstructive technique varies. The present report describes the case of a 71-year-old female patient who underwent surgery for thyroid carcinoma involving the larynx. Reconstructive surgical techniques were employed to maintain laryngeal structure and function. An anterolateral thigh flap with free rib cartilage grafts was used to compensate for laryngeal defects. Although a temporary tracheal stoma was constructed, it closed spontaneously after decannulation. Therefore, one-stage laryngeal reconstruction was accomplished. Post-operative histopathological examination revealed focal anaplastic changes in the lesion, which mainly consisted of papillary components. Post-operative positron emission tomography/computed tomography indicated early recurrence in the left side of the neck. Therefore, lenvatinib was started as adjuvant therapy. Complete response was observed with lenvatinib therapy. The patient was alive and had good laryngeal function 26 months after the operation. One-stage laryngeal reconstruction can reduce burden and improve quality of life in patients with thyroid carcinoma involving the larynx. Lenvatinib may be useful for treating early recurrence of anaplastic thyroid carcinoma after reconstructive surgery with a free flap.
Highlights
Advanced thyroid carcinoma can involve the larynx [1,2]
We report a case of incidental Anaplastic thyroid carcinoma (ATC) that invaded the larynx, with long‐term survival with lenvatinib therapy and post‐operative preservation of laryngeal function
Surgical management is thought to be effective in resectable advanced thyroid carcinoma [7,8]
Summary
Advanced thyroid carcinoma can involve the larynx [1,2] In such cases, partial laryngotracheal resection is often performed as surgical treatment. Head and neck surgeons may sometimes encounter ATC incidentally when treating patients with locally advanced differentiated thyroid carcinomas [6]. The cartilage pieces were placed in the subcuta‐ neous burrow under the ALT flap (Fig. 2) This tissue and the laryngeal remnant constituted the reconstructed larynx that was fully functional. Positron emission tomography/computed tomog‐ raphy was performed two months post‐operatively, and early recurrence in the left posterior neck was detected. Positron emission tomog‐ raphy/computed tomography was performed, and we detected no sign of the tumour in the left posterior neck. Post‐operative lenvatinib therapy was highly effective and her speech and swallowing functions were approximately the same as those pre‐operatively (Fig. 4)
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