LOCALLY INVASIVE PAPILLARY THYROID CANCER – OUR EXPERIENCE
Autori:
Drago Prgomet, Mario Bilić, Lana Kovač, Zdenka Hutinec, Iva Topić
Sažetak
Dobro diferencirani karcinomi štitnjače, poglavito papilarni karcinomi, tumori su s dobrom prognozom, ali katkad imaju sklonost širenju u okolna tkiva. Širenjem tih tumora osim okolne muskulature i hrskavice, najčešće je zahvaćen gornji aerodigestivni trakt. Tijekom 2 godine (2008–2009) u Klinici za bolesti uha, nosa i grla, kirurgiju glave i vrata, KBC-a Zagreb, liječeno je 233-je bolesnika s dobro diferenciranim karcinomom štitnjače. Među njima bila su 23 slučaja lokalno invazivnoga papilarnoga karcinoma štitnjače. U ovom radu prikazali smo svoje iskustvo u liječenju 23-je bolesnika s lokalno invazivnim papilarnim karcinomom štitnjače sa posebnim osvrtom na ekstratiroidno širenje, kirurški zahvat i postoperacijsko liječenje. Naše su preporuke za liječenje takvih bolesnika totalna tiroidektomija, selektivna disekcija vrata, odstranjenje makroskopski vidljivog tumora, radikalan kirurški zahvat za tumore s intraluminalnim širenjem u područje gornjeg aerodigestivnoga trakta i postoperacijska adjuvantna terapija.
Summary
Differentiated thyroid carcinomas, particularly papillary carcinoma, are the tumors with good prognosis, but sometimes have a tendency to spread into the surrounding tissue. The spread of these tumors usually involves muscle, cartilage and upper aerodigestive tract. During two years (2008–2009) at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Center Zagreb, 233 patients with differentiated thyroid carcinoma were treated. Among them there were 23 cases of locally invasive papillary thyroid carcinoma. In this paper we present our experience in treating 23 patients with locally invasive papillary thyroid carcinoma with special reference to extrathyroid spread, surgery and postoperative treatment. Our recommendations for the treatment of such patients are total thyroidectomy and selective neck dissection, removal of macroscopically visible tumors, radical surgery for tumors with intraluminal expansion in the upper aerodigestive tract and postoperative adjuvant therapy.
