[Thyroid malignant tumor with flare up glottic paralysis for first symptom]

Area of Science:

• Otolaryngology
• Endocrinology
• Oncology

Context:

• Thyroid malignant tumors can present with subtle initial symptoms.
• Flare-up glottic paralysis is an uncommon but critical presenting sign.

Purpose:

• To analyze the clinical features of thyroid malignant tumors presenting with sudden glottic paralysis.
• To identify strategies to avoid missed diagnoses and misdiagnoses.

Summary:

• A retrospective study of five thyroid papillary adenocarcinoma cases revealed that unilateral glottic paralysis was the initial symptom in four patients.
• Surgical intervention and recurrent laryngeal nerve dissection were performed, with most patients recovering vocal cord function.
• One advanced case involving laryngeal invasion required extensive surgery and highlighted the importance of early detection.

Impact:

• Highlights the need for thorough investigation of thyroid abnormalities in patients with unexplained glottic paralysis.
• Emphasizes the importance of recurrent laryngeal nerve preservation during thyroid surgery.
• Suggests prompt surgical exploration and pathological assessment for suspected thyroid malignancy presenting with vocal cord dysfunction.