Recurrence due to dissemination of tumor cells after transoral endoscopic thyroidectomy vestibular approach

Carlos  Navarro-Fernández; Zelik Luna-Peteuil; Agustin Guemes-Meza; Kuauhyama Luna Ortiz

doi:10.18203/issn.2454-5929.ijohns20242048

Authors

Carlos Navarro-Fernández Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico https://orcid.org/0000-0001-8355-5877
Zelik Luna-Peteuil Universitatea de Medicinâ și Farmacie Grigorie T. Popa, Iași, Romania https://orcid.org/0000-0003-1720-0423
Agustin Guemes-Meza Department of Surgery at the Hospital del ISSSTE Irapuato, Mexico https://orcid.org/0000-0002-1862-4036
Kuauhyama Luna Ortiz Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico; Department of General Surgery (Head and Neck), Hospital General Dr. Manuel Gea González, Mexico https://orcid.org/0000-0002-1862-4036

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20242048

Keywords:

Cancer, Recurrence, Thyroid, Transoral endoscopic thyroidectomy vestibular approach

Abstract

The present report aims to document a case of recurrence attributed to residual tumor in a patient with papillary thyroid cancer who underwent Transoral endoscopic thyroidectomy vestibular approach (TOETVA). A 48-year-old female presented with a mass in the central part of the neck. On ultrasound, the lesion was classified as TIRADS 4b. Fine-needle aspiration biopsy revealed papillary carcinoma (cT1b cN0 cM0, stage I). The patient underwent transoral thyroidectomy without complications. The pathology report showed conventional papillary thyroid carcinoma in both lobes, with the predominant lobe measuring 2×1×0.5 cm. Three years later, the patient presented with elevated thyroglobulin levels (1.92) despite adequate TSH suppression. Six months later, a repeat ultrasound showed continued persistence of the lesion at level VI, prompting resection under local anesthesia, which revealed invasive papillary thyroid carcinoma involving soft tissues. TOETVA remains a safe procedure for cancer cases. However, its oncological outcomes have not yet been fully demonstrated, particularly regarding the impact of possible recurrences stemming from residual tumor fragments or cells during the procedure.

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