title: Management of anaplastic thyroid carcinoma spread over the trachea with mediastinal extension.
abstract: BACKGROUND
  We report a case of treatment of anaplastic thyroid carcinoma spread over the trachea with mediastinal extension.
  
  
  METHODS
  Case report and review of the world literature concerning the treatment of anaplastic thyroid carcinoma are presented.
  
  
  CONCLUSIONS
  The role of surgery in treatment of anaplastic carcinoma remains controversial. Our case we underlined two questions: the appropriateness of the surgery options with extra-thyroid spread and the better surgery approach to anaplastic thyroid carcinoma interesting the mediastinum controlling the great vessels of the neck. Even if curative resection cannot be achieved, surgical resection can immediately reduce the tumor bulk to facilitate the efficacy of post-operative radiotherapy and/or chemotherapy and to achieve a good local control to avoid the need of a subsequent palliative tracheostomy. Tumor upper mediastinal involvement made mandatory to open the sternum in order to allow a more complete resection of the macroscopic mass. The mini-sternotomy represents a valuable alternative that allows reduction in surgical trauma increasing patient's comfort.
  
  
  CONCLUSIONS
  The complete resection of the tumor mass without scarifying vital structures can lead to some prolonged survival. Even if complete resection cannot be achieved, surgical resection can immediately reduce the tumour bulk and achieve good local control of the disease to avoid the palliative tracheotomy.
authors.affiliation: Department of Otorhinolaryngology, Foundation IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.
authors.forename: C E
authors.initials: CE
authors.lastname: Falco
authors.forename: A M
authors.initials: AM
authors.lastname: Grande
authors.forename: S
authors.initials: S
authors.lastname: Nicolardi
authors.forename: M
authors.initials: M
authors.lastname: Viganò
authors.forename: M
authors.initials: M
authors.lastname: Benazzo
mesh_terms: D002277:Carcinoma / Q000556:secondary / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007825:Laryngectomy; D008479:Mediastinal Neoplasms / Q000378:metabolism / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D056346:Sternotomy; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy; D014134:Tracheal Neoplasms / Q000378:metabolism / Q000601:surgery*