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Johns Hopkins Surgery - A Complicated Case of Thyroid Carcinoma that Has Spread

Winter 2014

A Complicated Case of Thyroid Carcinoma that Has Spread

Date: February 1, 2014

Once thyroid carcinoma metastasizes to the lymph nodes, says Jason Prescott, surgery is the best option.
Once thyroid carcinoma metastasizes to the lymph nodes, says Jason Prescott, surgery is the best option.

Endocrine surgeon Jason Prescott knew that the young woman who came to The Johns Hopkins Hospital from Saudi Arabia faced a highly complex operation.

Diagnosed with thyroid cancer in her native country, she had already undergone one procedure to remove her thyroid gland. But a subsequent examination revealed that the cancer had spread to lymph nodes within her neck, which would also have to be removed. This operation carries tremendous risk, including the possibility of severe and permanent nerve damage. Her physician recommended that she visit Johns Hopkins, where a multidisciplinary team of endocrinologists, radiologists, pathologists and surgeons would be available to determine treatment.

"Because there are critically important nerves adjacent to the lymph nodes within the neck, controlling functions like the movement of the tongue, the ability to turn the head to the side, the ability to shrug the shoulders, and quality of the voice," says Prescott, "meticulous care in preserving these nerves is extremely important during this type of surgery. Injury to these nerves can have devastating, permanent effects on quality of life."

After Thyroid Carcinoma Metastazises to the Lymph Nodes

Though thyroid carcinoma tends to be among the least deadly forms of cancer, once it metastasizes to the lymph nodes, management becomes more challenging, with surgery being the best option for successful treatment. When that's the case, Prescott says, a patient's best chance for a good, long-term outcome is through care at a high-volume surgery center that uses a multidisciplinary approach and where the surgeon has extensive experience in operating on that region of the neck. "At Hopkins, we have a uniquely qualified team," he says. "We have the good fortune to have world-renowned endocrinologists who are devoted to caring for this specific disease as well as expert radiologists and pathologists. Every critical component of the team is in place at Johns Hopkins."

Ultimately, Prescott says, the young woman's operation took about seven hours, with all of the affected lymph nodes being successfully removed. As a safeguard, she also had radioactive iodine therapy afterward. "Her prognosis after the surgery is very good," Prescott says. "The chances that this will shorten her life at all are quite small."

To refer a patient: 443-997-1508

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