Respir Case Rep. 2016; 5(1): 25-29 | DOI: 10.5505/respircase.2016.48278

ÝNTERAKTÝF OLGU SUNUMU: Astým Tanýsý ile Takip Edilen Tiroid Kanser Olgusu

Sinem Nedime Sökücü¹, Cengiz Özdemir¹, Seda Tural Önür¹, Levent Karasulu¹, Levent Dalar^2
1Yedikule Göðüs Hastalýklarý ve Göðüs Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Bölümü, Ýstanbul
²Ýstanbul Bilim Üniversitesi Týp Fakültesi, Göðüs Hastalýklarý Anabilim Dalý, Ýstanbul

Havayolu darlýðý olan birçok hasta uzun süre yanlýþ tanýlarla takip edilmektedir. Bu hastalarda havayolu darlýðýnýn nedeni benign patolojilere baðlý olabileceði gibi malign hastalýklara sekonder de olabilir ve erken fark edilmezse hayatý tehdit eden boyutlara ulaþabilir. Beþ senedir astým tanýsý ile takip edilen 50 yaþýnda bayan hasta, progresif nefes darlýðý þikâyeti ile baþvurdu. Bronkoskopik deðerlendirmesinde, vokal kordlardan 2 cm sonra sað anterolateral duvara geniþ taban ile oturan üzeri düzgün yüzeyli vasküler yapýdan zengin kitle ile lümenin %90 oranýnda obstrükte olduðu izlendi. Trakea proksimalindeki kitleye diyot lazer ile fotokoagulasyonun ardýndan core out uygulandý ve 16x14x16 stenotik silikon stent yerleþtirildi. Hastanýn trakeal biyopsi patoloji sonucu tiroid karsinomu olarak raporlandý. Cerrahi operasyon planlanan hastada distale migre olan stent çýkartýldý. Hastaya, tiroidektomi sonucu papiller tiroid karsinom tanýsý kondu. Tiroidektomi sonrasý komplikasyonsuz takibe alýndý. Uzun süre obstrüktif havayolu hastalýðý nedeniyle bronkodilatör tedavi almasýna raðmen klinik rahatlamasý olmayan hastalarda ileri tetkiklerle ayýrýcý tanýya gidilmesi önemlidir.

Anahtar Kelimeler: Malign havayolu týkanýklýðý, havayolu stent uygulamasý, tiroid kanser.

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INTERACTIVE CASE REPORT: A Case Report of Thyroid Cancer who Followed an Asthma Diagnosis

Sinem Nedime Sökücü¹, Cengiz Özdemir¹, Seda Tural Önür¹, Levent Karasulu¹, Levent Dalar^2
1Department of Chest Diseases, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Ýstanbul, Turkey
²Department of Pulmonary Medicine, Ýstanbul Bilim University, Faculty of Medicine, Ýstanbul, Turkey

Many patients with airway stenosis are misdiagnosed for a long period. The reason for the airway obstruction in these patient can be due to benign pathology as well as secondary malignant disease. If not recognized early, it can reach life-threatening dimensions. A 50-year-old female patient was admitted with a five-year following the diagnosis of asthma with progressive shortness of breath. Bronchoscopic evaluation revealed a smooth surface structure with rich vascularity 2 cm distal to the vocal cords sitting with a large base of over the right anterolateral wall and obstructing the lumen by 90%. Core out was applied following diode laser photocoagulation of the proximal mass and afterwards a 16x14x16 stenotic stent was positioned. The tracheal biopsy pathology was established a thyroid carcinoma. The distally migrated stent was removed with scheduled surgery. The patient’s thyroidectomy pathology identified a papillary thyroid carcinoma. Following thyroidectomy, the patient was observed without any complication. It is important to underwent differential diagnosis with advanced techniques in patients without clinical relief, despite prolonged bronchodilator treatment for obstructive airway disease.

Keywords: Malignant airway obstruction, airway stending, thyroid cancer.

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