Near-Total Laryngectomy for Extranodal Infiltration from Papillary Cancer to Larynx and Hypopharynx

Papillary thyroid cancer usually presents with limited loco-regional disease. Rarely extrathyroidal extension to the surrounding vital structures is seen. It is rarer for metastatic node from papillary thyroid cancer to directly infiltrate into the larynx or pharynx. We report a rare case where an extranodal extension from a metastatic papillary thyroid cancer infiltrated into the larynx and pyriform sinus in a 56-year-old female. Near-total laryngectomy with partial pharyngectomy was done for gross removal of the disease to achieve long-term locoregional disease-free survival. Although locally advanced thyroid cancer is rare, once noted, it presents challenge to the surgeon to achieve gross total removal of the tumor. Initial radical resection should be done to achieve gross total removal of the cancer.