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. 2024 Sep 27;12(10):2204.
doi: 10.3390/biomedicines12102204.

Management of Giant Thyroid Tumors in Patients with Multiple Comorbidities in a Tertiary Head and Neck Surgery Center

Daniela Vrinceanu  1 , Mihai Dumitru  1 , Andreea Marinescu  2 , Crenguta Serboiu  3 , Gabriela Musat  4 , Mihai Radulescu  5 , Matei Popa-Cherecheanu  6 , Catalina Ciornei  7 , Felicia Manole  8
Affiliations

Management of Giant Thyroid Tumors in Patients with Multiple Comorbidities in a Tertiary Head and Neck Surgery Center

Daniela Vrinceanu et al. Biomedicines. .

Abstract

Background/Objectives: The thyroid gland can represent the seat of development for giant tumors exceeding 10 cm in diameter. A retrospective analysis on 21 cases of giant thyroid tumors with comorbidities, operated in the ENT Department of the Bucharest University Emergency Hospital has been conducted. Methods: Giant benign tumors accounted for 28.57% of the cases studied and reached gigantic volumes in an average time interval of 3 years, with an average resection piece weight of 318 g. Malignant tumors accounted for 71.43%, with an average duration of evolution of 7 years, with an average resection piece weight of 581 g. Results: Dysphagia was present in all patients, dyspnea in 47.61% and dysphonia in 38.09% of cases. Total thyroidectomy is the gold standard in giant thyroid tumors, associated with radical neck dissection, extended to groups VI and VII in malignant tumors. In 10 of 11 cases of giant malignant thyroid tumors (90.90%), without anaplastic thyroid carcinoma, the survival at 5 years after multimodal oncologic treatment was favorable. Anticoagulant treatment increased the risk of postoperative reversible recurrent laryngeal nerve lesion. Conclusions: The management of giant thyroid tumors in patients with multiple comorbidities needs a multidisciplinary team including endocrinologist, radiologist, anesthesiologist, pathologist, ENT surgeon, thoracic surgeon, oncologist and radiotherapist.

Keywords: challenges; comorbidities; giant; multidisciplinary; thyroid tumors.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Chart showing the distribution of cases by age group.
Figure 2
Figure 2
Chart depicting the distribution of cases according to clinical presentation.
Figure 3
Figure 3
Chart showing the distribution of cases according to the associated comorbidity.
Figure 4
Figure 4
Chart depicting the distribution of cases according to postoperative complications.
Figure 5
Figure 5
Anaplastic thyroid carcinoma. Left image—clinical aspect. Center image—axial CT scan with tumor displacement of the airway. Right image—resection piece 750 g.
See this image and copyright information in PMC

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