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2022
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Patient Information: (Do not provide name of the patient)
Age
  72
Diagnosis
  carcinoma of thyroid
Imaging
  CT scans demonstrated a 12 cm mass arising from the right lobe of the thyroid, crossing midline, with mass-effect on the trachea, and also appearing to exhibit intraluminal extension/tumor thrombus into vasculature.
Pathology
  Right hemithyroidectomy specimen showed carcinoma, widely invasive, compatible with poorly differentiated thyroid carcinoma within a background of well-differentiated follicular carcinoma. Tumor was disrupted, the largest fragment measuring at least 8.8 cm. Extensive lymphovascular invasion was present. The surgical margins were positive. Notably, features of anaplastic thyroid carcinoma were not present. All regional lymph nodes were negative for tumor. A subsequent completion (left) hemithyroidectomy showed extensive intravascular follicular carcinoma. Multiple large vessels showed considerable luminal follicular carcinoma with a well-differentiated appearance, without obvious poorly differentiated or anaplastic features.
Stage
  IVA (T4b N0 M0)
Overall Oncology Management Plan
Surgery (biopsy)
  Right hemithyroidectomy, followed by completion left hemithyroidectomy. Of note is that tumor extended into the parapharyngeal space and was dissected from the hypoglossal nerve and from the underlying carotid artery, internal jugular vein, and vagus nerve. Tumor was sharply dissected off the carotid, which was encircled by tumor. The strap muscles were also involved in the resected portion of the tumor which extended into the mediastinum tumor was also sharply dissected off the trachea and cricoid. Tumor was mobilized from the mediastinum, from the mediastinal vessels.
Images
Session Name
  Head and Neck Specialist Dr. David Sher- July 25, 2022
Session ID
  12089
created_by
  7517
post_id
  12089
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