Papillary Ca Thyroid

Papillary carcinoma left lobe of thyroid with left vocal cord palsy

This case is being described here to highlight one of the complications of papillary carcinoma thyroid i.e. tracheomalacia.

30 years old male patient came with:

Swelling left side of neck - 5 years duration, not associated with pain / tenderness

Change in voice - 2 months duration

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Clinical photograph of patient showing left thyroid mass

CT scan neck showed:

1. Mass involving the left lobe of thyroid gland with thinning of tracheal cartilages (T1- T3)

2. A possible extension of the mass in to the left tracheo oesophageal groove could also be noted

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CT scan axial neck showing mass left lobe of thyroid with possible erosion of thyroid lamina on the left side

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CT scan axial neck at the level of vocal cord showing the left cord to be abnormal in shape and position

Video laryngoscopy showed left vocal cord paralysis

FNAC: was reported as papillary carcinoma of thyroid

Treatment: Total thyroidectomy was done.

Patient developed noisy breathing in the post operative period. Laryngoscopy showed the right cord to be moving normally.
The patient developed tracheomalacia in the post operative period. Trachoestomy was done to alleviate the symptoms.

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