Major vessel invasion by thyroid cancer: a comprehensive review

Introduction: Gross extrathyroidal extension of thyroid cancer is an indicator of a worse cancer prognosis and may lead to major vessel invasion (MVI) that represents an uncommon and highly morbid manifestation of disease progression. Areas covered: This review aims to evaluate the current literature reporting on thyroid cancer that exhibits MVI, with a focus on relevant patient and pathological characteristics, diagnostic evaluation, and management, of this uncommon but challenging thyroid cancer presentation. Expert commentary: Vascular invasion by thyroid cancer is uncommon and has a poor prognosis with high associated perioperative morbidity and mortality. When possible, surgery represents the best management strategy for thyroid cancer exhibiting MVI. In these cases, careful preoperative workup and surgical planning are required in order to balance the goals of maximizing cancer resection while minimizing perioperative mortality and morbidity. Future research should evaluate long-term outcomes following definitive treatment of locally advanced thyroid cancer exhibiting MVI.