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Palliative thyroidectomy for malignant lymphoma of the thyroid
Rebecca S Sippel1, Paul G Gauger, Peter Angelos
1Department of Surgery, University of Wisconsin Medical School, Madison, Wisconsin 53792, USA.
Annals of Surgical Oncology
|November 6, 2002
Summary
Palliative thyroidectomy can effectively manage obstructive symptoms in patients with malignant thyroid lymphoma, offering good long-term symptom relief and low morbidity. This surgical approach provides a valuable option for symptom palliation in select cases.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Malignant lymphoma of the thyroid is typically treated with chemotherapy and radiation.
- Fine-needle aspiration usually allows diagnosis without surgery.
- However, airway or esophageal obstruction necessitates palliative thyroidectomy in some patients.
Purpose of the Study:
- To evaluate the outcomes of palliative thyroidectomy in patients with malignant thyroid lymphoma presenting with obstructive symptoms.
Main Methods:
- Retrospective review of 27 patients with malignant thyroid lymphoma and obstructive symptoms treated between 1980 and 2001.
- Patients underwent palliative thyroidectomy, with additional treatments including chemotherapy and/or radiotherapy.
- Symptom-free survival was analyzed using Kaplan-Meier methods.
Main Results:
- The study included 27 patients (mean age 66 years, predominantly female) presenting with dyspnea/stridor, dysphagia/pain, or impending airway obstruction.
- All patients underwent palliative thyroidectomy, with 10 receiving combined chemo- and radiotherapy, 10 radiotherapy alone, and 4 chemotherapy alone.
- The mean actuarial symptom-free survival after palliative surgery was 10 years.
Conclusions:
- Malignant lymphoma of the thyroid can cause obstructive symptoms requiring surgical palliation.
- Palliative thyroidectomy in these patients is associated with good long-term symptom control and low morbidity.