Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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A Case of Tracheal Stent Insertion in Airway Compromise Resulting from Anaplastic Thyroid Cancer

호흡 곤란을 유발한 미분화 갑상선암에서 기관 스텐트 삽입 1예

  • Nam, Woo joo (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, So Yean (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Tae Hwan (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Sang Hyuk (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 남우주 (성균관대학교 의과대학 강북삼성병원 이비인후과교실) ;
  • 김소연 (성균관대학교 의과대학 강북삼성병원 이비인후과교실) ;
  • 김태환 (성균관대학교 의과대학 강북삼성병원 이비인후과교실) ;
  • 이상혁 (성균관대학교 의과대학 강북삼성병원 이비인후과교실)
  • Received : 2016.12.29
  • Accepted : 2017.05.03
  • Published : 2017.05.30
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Abstract

Anaplastic thyroid cancer is a rare disease entity consist 2% of whole thyroid cancer but once diagnosed, it is too fatal to survive. Airway obstruction is a leading cause of death in anaplastic thyroid cancer, which may be caused by both vocal cord palsy, mass effect of the cancer or direct invasion of the cancer itself to the tracheal lumen. Tracheal stent insertion can be a solution for airway compromised cases where surgical excision cannot be performed. The advantage is that the airway problem can be solved without invasive procedure. In this case, we tried expandable tracheal stent insertion for 66 years-old man with anaplastic cancer who visited ER for small amount of hemoptysis and dyspnea. There was severe tracheal narrowing and deviation due to the anaplastic thyroid cancer, ECMO (Extra Corporal Membrane Oxygenation) was used instead of a tracheal intubation for general anesthesia.

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References

  1. Sun C, Li Q, Hu Z, He J, Li C, Li G, et al. Treatment and prognosis of anaplastic thyroid carcinoma: experience from a single institution in China. PloS one 2013;8 (11):e80011. https://doi.org/10.1371/journal.pone.0080011
  2. Lee YK, Park SH, Hwang JY, Ryu CG, Kim JH, Han SH. 정맥-정맥 체외막산소공급 보조 하에 시행한 기도 수술의 마취 3례. 2009.
  3. Shaha AR. Airway management in anaplastic thyroid carcinoma. The Laryngoscope 2008;118 (7):1195-8. https://doi.org/10.1097/MLG.0b013e3181726d36
  4. Kim W-K, Shin JH, Kim JH, Song JW, Song H-Y. Management of tracheal obstruction caused by benign or malignant thyroid disease using covered retrievable self-expandable nitinol stents. Acta Radiologica 2010;51 (7):768-74. https://doi.org/10.3109/02841851.2010.491093
  5. Sosa AF, Michaud GC. Metallic stents in the airway: should we continue to use them and can we remove them? Current Respiratory Care Reports 2013;2 (1):54-60. https://doi.org/10.1007/s13665-012-0036-7
  6. de Mello-Filho FV, Antonio SM, Carrau RL. Endoscopically placed expandable metal tracheal stents for the management of complicated tracheal stenosis. American journal of otolaryngology 2003;24 (1):34-40. https://doi.org/10.1053/ajot.2003.6
  7. Kim JH, Shin JH, Song H-Y, Shim TS, Yoon CJ, Ko G-Y. Benign tracheobronchial strictures: long-term results and factors affecting airway patency after temporary stent placement. American Journal of Roentgenology 2007;188 (4):1033-8. https://doi.org/10.2214/AJR.06.0888
  8. Shin JH, Kim S-W, Shim TS, Jung G-S, Kim T-H, Ko G-Y, et al. Malignant tracheobronchial strictures: palliation with covered retrievable expandable nitinol stent. Journal of vascular and interventional radiology 2003;14 (12):1525-34. https://doi.org/10.1097/01.RVI.0000099525.29957.34
  9. Yerushalmi R, Fenig E, Shitrit D, Bendayan D, Sulkes A, Flex D, et al. Endobronchial stent for malignant airway obstructions. IMAJ-RAMAT GAN- 2006;8 (9):615.
  10. Noppen M, Stratakos G, D'Haese J, Meysman M, Vinken W. Removal of covered self-expandable metallic airway stents in benign disorders: indications, technique, and outcomes. CHEST Journal 2005;127 (2):482-7. https://doi.org/10.1378/chest.127.2.482
  11. 김우찬, 진웅, 나석주, 조건현, 이선희, 곽문섭, et al. 기관지 협착환자에서 기관지내 팽창성 급속 스텐트 삽입후 재발한 기관지협착 치험 2 례. The Korean Journal of Thoracic and Cardiovascular Surgery 1995;28 (5):499-503.
  12. Hind C, Donnelly R. Expandable metal stents for tracheal obstruction: permanent or temporary? A cautionary tale. Thorax 1992;47 (9):757-8. https://doi.org/10.1136/thx.47.9.757
  13. Rajeev P, Ezzat T, Slade M, Sadler GP, Mihai R. Tracheal stenting has minimal impact on survival in anaplastic thyroid carcinoma. World journal of surgery 2013;37 (11):2589-93. https://doi.org/10.1007/s00268-013-2173-8
  14. 권재영, 이혁준, 김해규, 백승완. 심한 기도폐쇄를 동반한 갑상선암 환자에서심장폐우회로를 이용한 마취관리. Korean J Anesthesiol 2004;46:236-40. https://doi.org/10.4097/kjae.2004.46.2.236
  15. Holting T, Meybier H, Buhr H. [Problems of tracheotomy in locally invasive anaplastic thyroid cancer]. Langenbecks Archiv fur Chirurgie 1988;374 (2):72-6.
  16. Gunasekaran S, Osborn J, Morgan A, Griffiths M. Tracheal stenting: a better method of dealing with airway obstruction due to thyroid malignancies than tracheostomy. The Journal of Laryngology & Otology 2004;118 (06):462-4. https://doi.org/10.1258/002221504323219617
  17. Yang R, Yu X, Ma L, Wu F. Emergency management of a patient with severe airway obstruction resulting from poorly differentiated thyroid carcinoma: a case report. Oncology letters 2012;4 (4):771-4. https://doi.org/10.3892/ol.2012.827