Anaplastik Tiroid Karsinomlu Hastalarda Cerrahi Tedavi Yönetimimiz

Yıl 2022, Cilt: 13 Sayı: 45, 6 - 11, 07.04.2022

Serkan Erkan , Hakan Yabanoğlu , Ramazan Gündoğdu , Murat Kuş

https://doi.org/10.17944/mkutfd.886278

Öz

Amaç: Anaplastik tiroid karsinomu, nadir görülmekle birlikte en agresif seyirli olan tiroid kanseridir. Kısıtlı sayıdaki hastaya cerrahi tedavi uygulanabilmekte ve sonuçları halen yüz güldürücü olmamaktadır. Bu çalışmada kliniğimizde anaplastik tiroid karsinomu nedeniyle tedavi uygulanan hastaların sonuçlarının literatüre sunulması amaçlanmıştır.
Gereç ve Yöntem: 2015-2020 tarihleri arasında kliniğimizde anaplastik tiroid karsinomu tanısı ile tedavi edilen hastaların dosyaları geriye dönük olarak incelendi. Cerrahi tedavileri kliniğimizde yapılan 18 yaşından büyük 10 hasta çalışmaya dahil edildi. Hastaların yaş, cinsiyet, yakınma, ultrasonografi, bilgisayarlı tomografi, iğne biyopsisi sonuçları, preoperatif vokal kord muayeneleri, cerrahi ve onkolojik tedavileri ile survey bilgileri kaydedilerek analiz edildi.
Bulgular: Hastaların 6’sı erkek, 4’ü kadındı. Yaş ortalaması 68,5 (53-86) idi. Hastaların tamamında basıya bağlı nefes darlığı yakınması mevcuttu. Bilgisayarlı tomografi taramalarında 5 hastada akciğer metastazı, 4 hastada rejyonel lenf nodu metastazı bulunmaktaydı. Sekiz hastaya ince iğne aspirasyon biyopsisi yapıldı ve sonucu malignite ile uyumluydu. Preoperatif vokal kord muayenelerinde 7 hastada unilateral paralizi mevcuttu. Hastaların tamamına cerrahi tedavi, ek olarak 8 hastaya kemoradyoterapi, 2 hastaya da radyoterapi yapıldı. Hastaların tümünün postoperatif progresif hastalık bulgusu gösterdiği ve eksitus olduğu görüldü. Ortalama survey 150 (4-420) gündü.
Sonuç: Anaplastik tiroid karsinomu tanı ve tedavi yönetimi güç bir hastalıktır. Multidisipliner yaklaşımla yönetilmesine rağmen halen yüksek mortalite oranlarına sahiptir. Tiroid patolojisi öyküsü olan hastalarda anaplastik karsinom gelişimi olabileceği akılda tutulmalı ve titizlikle değerlendirilmelidir.

Anahtar Kelimeler

bilateral total tiroidektomi, boyun diseksiyonu, metastaz, Anaplastik Tiroid Kanseri

Destekleyen Kurum

Başkent Üniversitesi

Proje Numarası

KA20/375

Teşekkür

Çalışmamıza desteğinden ötürü Başkent Üniversitesine,yazımızı değerlendirme sürecine aldığınız için tarafınıza teşekküreder saygılarımı sunarım.

Our Surgical Treatment Management in Patients with Anaplastic Thyroid Carcinoma

Öz

Objective: Anaplastic thyroid carcinoma is a rare, but most aggressive, thyroid cancer. Surgical treatment can be applied to a limited number of patients and the results are still not satisfactory. In this study, it is aimed to present the results of patients treated for anaplastic thyroid carcinoma in our clinic to the literature.
Materials and Methods: The files of patients who were treated with the diagnosis of anaplastic thyroid carcinoma in our clinic between 2015-2020 were retrospectively analyzed. Ten patients over 18 years of age, who underwent surgical treatments in our clinic, were included in the study. Patients' age, gender, complaints, ultrasonography, computed tomography, needle biopsy results, preoperative vocal cord examinations, surgical and oncological treatments, and survey information were recorded and analyzed.
Results: 6 of the patients were male and 4 were female. The average age was 68.5 (53-86). All patients had shortness of breath due to compression. Computed tomography scans revealed lung metastasis in 5 patients and regional lymph node metastasis in 4 patients. Fine needle aspiration biopsy was performed in eight patients and the result was consistent with malignancy. In preoperative vocal cord examinations, 7 patients had unilateral paralysis. Surgical treatment was applied to all patients, chemoradiotherapy to 8 patients and radiotherapy to 2 patients. It was observed that all of the patients showed signs of postoperative progressive disease and died. Average surveillance was 150 (4-420) days.
Conclusion: Anaplastic thyroid carcinoma is a disease that is difficult to diagnose and treat. Despite being managed with a multidisciplinary approach, it still has high mortality rates. It should be kept in mind that patients with a history of thyroid pathology may develop anaplastic carcinoma and should be evaluated carefully.

Anahtar Kelimeler

Anaplastic thyroid cancer, bilateral total thyroidectomy, neck dissection, metastasis

Proje Numarası

KA20/375

Kaynakça

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