A novel combined transoral and transcervical surgical approach for recurrent metastatic medullary thyroid cancer to the parapharyngeal space
| Autor: | Laureano Giraldez, Miguel Garratón, Jaime A. Aponte-Ortiz, Shayanne Lajud |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty endocrine system diseases 030232 urology & nephrology Health Informatics Metastasis 03 medical and health sciences 0302 clinical medicine Parapharyngeal Space Robotic Surgical Procedures Transoral robotic surgery Parapharyngeal space Medicine Humans Thyroid Neoplasms Aged Total thyroidectomy Surgical approach business.industry Thyroid Medullary thyroid cancer Pharyngeal Neoplasms medicine.disease Otorhinolaryngologic Surgical Procedures medicine.anatomical_structure Calcitonin 030220 oncology & carcinogenesis Surgery Radiology Neoplasm Recurrence Local business |
| Zdroj: | Journal of robotic surgery. 14(1) |
| ISSN: | 1863-2491 |
| Popis: | Medullary thyroid cancer (MTC) represents less than 1% of all thyroid cancers. Complete surgical resection remains the mainstay of treatment for locoregional disease. Unfortunately, patients with recurrence may present with metastasis to challenging anatomic locations. We describe the first case of a recurrent MTC metastatic to the parapharyngeal space (PPS) that was managed using a combined transoral robotic surgery (TORS) and transcervical (TC) approach. We review the presentation, natural history, diagnosis and management of recurrent MTC, and describe a novel combined TORS-TC surgical approach for the treatment of PPS metastasis. A 66-year-old male with history of MTC treated with total thyroidectomy in 2000 and a liver resection in 2011 for metastatic MTC was referred to our Head and Neck Surgery Clinic in October 2016 due to increased calcitonin and CEA levels. Exam was significant for mild right tonsillar/pharyngeal bulging and induration. Imaging with PET-CT and MRI showed an enlarging ovoid mass centered within the right PPS without the presence of another systemic metastasis. FNA was consistent with MTC. The patient was taken to the operating room for a combined TORS-TC approach. Final pathology was consistent with metastatic MTC. Until recently, PPS tumors have been managed using highly morbid and cosmetically disfiguring open surgical approach. TORS provides a safe and effective alternative. |
| Databáze: | OpenAIRE |
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