Published: 2022-08-25

Carcinoma larynx with thyroid gland metastasis: a rare case report

Mahesh Kalloli, Ankit Gupta, Rashmi S. Patil, Kritika Pandey, Kavya Garg


Thyroid gland (TG) metastasis by laryngeal cancer is uncommon. However, now a days following concept of ‘organ preservation’, so ipsilateral hemithyroidectomy is not required in every case with total laryngectomy (TL) for laryngeal cancer. Studies for T3 and T4 laryngeal cancer having, anterior commissure involvement, transglottic growth or subglottic extension indicates thyroidectomy in the majority of cases. Hemithyroidectomies are linked to hypothyroidism in 23–63% of cases and hypoparathyroidism in 25–52% of cases. There is no recognized link between tumour differentiation and TG involvement. According to reports, the prognosis in cases of TG involvement is poor. The tumour differentiation determines whether the spread is contiguous or noncontiguous. Contiguous spread is more likely in well-differentiated carcinomas, while non-contiguous spread is more likely in poorly or moderately differentiated carcinomas. Anatomically, direct TG invasion is only possible through extralaryngeal soft tissue, which includes the cricothyroid and cricopharyngeus muscles. Non-contiguous spread only possible through lymphovascular invasion which is not necessarily, but seen in 87-91% of cases with subglottic extension over 10 mm, as seen in our case also.


Total laryngectomy, Laryngeal carcinoma, Subglottic extension, Thyroid gland metastasis

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Sparano A, Chernock R, Laccourreye O, Weinstein G, FeldmanM. Predictors of thyroid gland invasion in glottic squamous cellcarcinoma. Laryngoscope. 2005;115:1247-50.

Biel MA, Maisel RH. Indications for performing hemithyroidectomy for tumors requiring total laryngectomy. Am J Surg.1985;150:435-9.

Kirchner JA. Pathways and pitfalls in partial laryngectomy. AnnOtol Rhinol Laryngol. 1984;93:301-5.

Donnelly MJ, O’Meara N, O’Dwyer TP. Thyroid dysfunctionfollowing combined therapy for laryngeal carcinoma. Clin Otolaryngol Allied Sci. 1995;20:254-7.

Palmer BV, Gaggar N, Shaw HJ. Thyroid function after radiotherapy and laryngectomy for carcinoma of the larynx. Head Neck Surg. 1981;4:13-5.

Ogura JH. Surgical pathology of cancer of the larynx. Laryngoscope. 1955;65:867-926.

Elliott MS, Odell EW, Tysome JR, Connor SE, Siddiqui A, Jean-non JP, et al. Role of thyroidectomy in advanced laryngealand pharyngolaryngeal carcinoma. Otolaryngol Head Neck Surg. 2010;142:851-5.

Croce A, Moretti A, Bianchedi M. Thyroid gland involve-ment in cancer of the larynx. Acta Otorhinolaryngol Ital. 1991;11:429-35.

Dadas B, Uslu B, Cakir B, Ozdo˘gan HC, Calis¸ AB, Turgut S. Intra-operative management of the thyroid gland in laryngeal cancersurgery. J Otolaryngol. 2001;30:179-83.

Mendelson AA, Al-Khatib TA, Julien M, Payne RJ, Black MJ, Hier MP. Thyroid gland management in total laryngectomy: meta-analysis and surgical recommendations. Otolaryngol Head Neck Surg. 2009;140:298-305.