A 67-YEAR-OLD woman who had recently immigrated from Kiev, Russia, presented to her physician with complaints of dysphagia and hemoptysis. Ten years previously, she had had "thyroid cancer," which had been treated with a right thyroid lobectomy and isthmectomy followed by external beam radiation therapy to the neck. A magnetic resonance imaging study revealed a 4×4×2-cm left thyroid mass eroding through the cricoid and thyroid cartilages and extending into the proximal esophagus. Fiberoptic laryngoscopy showed that the left pyriform sinus was effaced by a fungating mass. Esophagoscopy revealed extrinsic compression of the cervical esophagus. The patient underwent a total laryngectomy and completion thyroidectomy. No cervical adenopathy was detected intraoperatively.
Smith AE, Couch M, Argani P. Pathologic Quiz Case 1. Arch Otolaryngol Head Neck Surg. 1998;124(10):1170-1172. doi:10-1001/pubs.Arch Otolaryngol. Head Neck Surg.-ISSN-0886-4470-124-10-orp8196