Interventional Bronchoscopy for Treatment of Tracheal Obstruction Secondary to Malignant Thyroid Disease-A Case Report

Abstract

Malignant thyroid disorders can cause upper and central airway obstruction. The mechanisms of airway obstruction include extrinsic tracheal compression, tracheal ingrowth, or a combination thereof. Well-differentiated thyroid cancer (WDTC) usually has a better prognosis, but is a less frequent cause of thyroid-induced airway obstruction. However, if WDTC-related tracheal invasion occurs, it is usually associated with a poor prognosis. Surgical resection with tracheal reconstruction remains the mainstay of management of WDTC-related tracheal invasion. In cases with technically or medically inoperable patients with malignant symptomatic airway obstruction, some form of palliative treatment should be considered. Due to recent technical improvements, interventional bronchoscopy with stent placement may provide longstanding airway patency for thyroid cancer-related tracheal obstruction. We report an 86-year-old female patient presenting stridor because of thyroid papillary carcinoma-related tracheal obstruction. After receiving interventional bronchoscopy with an Ultraflex tracheal stent placement, her stridor symptoms immediately improved. Thus, interventional bronchoscopic procedures with stent implant are valuable alternatives to surgery in inoperable thyroid cancer-induced tracheal obstruction.