title: Primary ectopic substernal thyroid cancer with trachea relapse: a case report and opinions of management.
abstract: BACKGROUND
  Ectopic substernal thyroid is a rare symptom of thyroid disease that entirely results from the developmental defects at early stages of thyroid embryogenesis and during its descent. Cases were seldom reported as primary ectopic substernal thyroid cancer, especially those with severe local invasion and tracheal relapse.
  
  
  METHODS
  In this report, the patient presented odynophagia and a sense of progressing swallowing obstruction. She underwent total thyroidectomy and lump resection. However, she refused to use postoperative radioactive iodine or take adjuvant external-beam radiotherapy, except for thyroid hormone replacement therapy. Tracheal relapse was observed after 6 months. Tracheal stent was used to reconstruct the airway twice.
  
  
  CONCLUSIONS
  Trachea invasion might be a worse independent predictor of prognosis than any others and should be given particular attention. Furthermore, tracheal stent might be a palliative option for patients with tracheal relapse.
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
authors.forename: Rui-Min
authors.initials: RM
authors.lastname: Ma
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Lv
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
authors.forename: Shu-Rong
authors.initials: SR
authors.lastname: Zheng
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
authors.forename: Jie
authors.initials: J
authors.lastname: You
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
authors.forename: Du-ping
authors.initials: DP
authors.lastname: Huang
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. guoguilong930@163.com.
authors.forename: Gui-Long
authors.initials: GL
authors.lastname: Guo
mesh_terms: D000368:Aged; D019468:Disease Management; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012086:Reoperation; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D014134:Tracheal Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery
keywords: Ectopic thyroid cancer; Local invasion; Stent; Substernal; Trachea relapse