Papillary carcinoma of the thyroid gland is the most common, accounting for 75% of all thyroid malignancies, and the most indolent with a survival rate of 98%. Usually it presents as hypoechoic nodules in the thyroid gland. It is very rare for papillary carcinoma to present with large neck mass compromising airway and invading surrounding tissues. These features are more characteristic of anaplastic thyroid carcinoma.
There are many challenges in treating such patients.
1) Airway access to overcome obstruction.
2) Anesthesia concerns.
3) Surgical clearance (as there is soft tissue invasion).
4) Preservation of the recurrent laryngeal nerve.
5) Preserving parathyroids to prevent post-operative hypocalcaemia.
6) Hypopharyngeal and cervical oesophageal integrity and