{"id":80935,"date":"2025-05-06T19:11:22","date_gmt":"2025-05-06T17:11:22","guid":{"rendered":"https:\/\/www.revista-portalesmedicos.com\/revista-medica\/?p=80935"},"modified":"2025-05-04T09:20:24","modified_gmt":"2025-05-04T07:20:24","slug":"cancer-de-tiroides-con-compresion-traqueal-aguda","status":"publish","type":"post","link":"https:\/\/www.revista-portalesmedicos.com\/revista-medica\/cancer-de-tiroides-con-compresion-traqueal-aguda\/","title":{"rendered":"C\u00e1ncer de tiroides con compresi\u00f3n traqueal aguda"},"content":{"rendered":"

C\u00e1ncer de tiroides con compresi\u00f3n traqueal aguda<\/strong><\/p>\n

Autor principal:<\/strong> Pedro Roberto Sancho Ortega<\/p>\n

Vol. XX; n\u00ba 09; 429<\/p>\n

Thyroid cancer with acute tracheal compression<\/strong><\/p>\n

Fecha de recepci\u00f3n:<\/strong> 19 de febrero de 2025
\nFecha de aceptaci\u00f3n:<\/strong> 30 de abril de 2025<\/p>\n

Incluido en Revista Electr\u00f3nica de PortalesMedicos.com Volumen XX. N\u00famero 09 Primera quincena de mayo de 2025 \u2013 P\u00e1gina inicial: Vol. XX; n\u00ba 09; 429<\/p>\n

 <\/p>\n

Autores: <\/strong>Pedro Roberto Sancho Ortega; Mar\u00eda Ester Cano Serrano; Sheila Larrayad Sanz; Angie Yurani Ramos de los R\u00edos; Roc\u00edo del Pilar P\u00e9rez Orozco; Lorena Dom\u00ednguez Cuevas; Alba Cirac Oriol.<\/p>\n

Centro de Trabajo actual: <\/strong>Hospital Cl\u00ednico Universitario \u201cLozano Blesa\u201d de Zaragoza (Espa\u00f1a)<\/p>\n

Palabras clave en espa\u00f1ol: <\/strong>c\u00e1ncer, tiroides, compresi\u00f3n, tr\u00e1quea, manejo.<\/p>\n

Palabras clave en ingl\u00e9s: <\/strong>cancer, thyroid, compression, trachea, management.<\/p>\n

Resumen en espa\u00f1ol: <\/strong><\/p>\n

El c\u00e1ncer de tiroides, aunque generalmente de buen pron\u00f3stico, puede complicarse con s\u00edntomas graves como la compresi\u00f3n traqueal aguda. Un paciente de 56 a\u00f1os, diagnosticado con c\u00e1ncer de tiroides papilar en estadio avanzado, present\u00f3 dificultad respiratoria severa, estridor y dolor en la regi\u00f3n cervical. La tomograf\u00eda computarizada mostr\u00f3 una masa tiroidea de grandes dimensiones que desplazaba la tr\u00e1quea y causaba obstrucci\u00f3n. Tras estabilizar al paciente, se realiz\u00f3 una traqueostom\u00eda para asegurar la v\u00eda a\u00e9rea y una cirug\u00eda de tiroidectom\u00eda subtotal. Posteriormente, se inici\u00f3 tratamiento con yodo radiactivo y se indic\u00f3 seguimiento estricto con ecograf\u00edas y an\u00e1lisis de marcadores tumorales. El pron\u00f3stico depende de la respuesta al tratamiento y la presencia de met\u00e1stasis.<\/p>\n

 <\/p>\n

Resumen en ingl\u00e9s: <\/strong><\/p>\n

Thyroid cancer, although generally with a good prognosis, can be complicated by severe symptoms such as acute tracheal compression. A 56-year-old patient, diagnosed with advanced stage papillary thyroid cancer, presented with severe shortness of breath, stridor and pain in the cervical region. CT scan showed a large thyroid mass displacing the trachea and causing obstruction. After stabilising the patient, a tracheostomy was performed to secure the airway and subtotal thyroidectomy surgery. Subsequently, radioactive iodine treatment was started and strict follow-up with ultrasound and tumour marker analysis was indicated. Prognosis depends on the response to treatment and the presence of metastases.<\/p>\n

 <\/p>\n

Los autores de este manuscrito declaran que:<\/p>\n

Todos ellos han participado en su elaboraci\u00f3n y no tienen conflictos de intereses
\nLa investigaci\u00f3n se ha realizado siguiendo las Pautas \u00e9ticas internacionales para la investigaci\u00f3n relacionada con la salud con seres humanos elaboradas por el Consejo de Organizaciones Internacionales de las Ciencias M\u00e9dicas (CIOMS) en colaboraci\u00f3n con la Organizaci\u00f3n Mundial de la Salud (OMS).
\nEl manuscrito es original y no contiene plagio.
\nEl manuscrito no ha sido publicado en ning\u00fan medio y no est\u00e1 en proceso de revisi\u00f3n en otra revista.
\nHan obtenido los permisos necesarios para las im\u00e1genes y gr\u00e1ficos utilizados.
\nHan preservado las identidades de los pacientes.<\/p>\n

 <\/p>\n

Caso Cl\u00ednico: <\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

Motivo de consulta<\/strong>:
\n<\/strong>Paciente masculino de 56 a\u00f1os que acude a urgencias por dificultad respiratoria progresiva, estridor y dolor en la regi\u00f3n cervical anterior. Refiere que en los \u00faltimos meses ha tenido problemas para tragar y dificultad para respirar al acostarse.<\/p>\n

\u00a0<\/strong><\/p>\n

Historia cl\u00ednica<\/strong>:
\n<\/strong>El paciente tiene antecedentes de bocio multinodular. En el examen f\u00edsico, se palpa una masa firme en la regi\u00f3n anterior del cuello y se escucha estridor respiratorio al examinarlo. Tiene signos de insuficiencia respiratoria, con taquipnea y cianosis perif\u00e9rica. Se observa adem\u00e1s ronquera progresiva y sensaci\u00f3n de presi\u00f3n en el cuello.<\/p>\n

 <\/p>\n

Pruebas diagn\u00f3sticas<\/strong>:
\n<\/strong>Se realiza una tomograf\u00eda computarizada (TC) cervical que revela una masa tiroidea de aproximadamente 8 cm que comprime y desplaza la tr\u00e1quea, causando una estenosis parcial de la v\u00eda a\u00e9rea. La biopsia por aspiraci\u00f3n con aguja fina (PAAF) confirm\u00f3 un carcinoma papilar de tiroides. Los estudios de funci\u00f3n tiroidea son normales, con niveles de TSH en rango adecuado.<\/p>\n

\u00a0<\/strong><\/p>\n

Tratamiento<\/strong>:
\n<\/strong>Debido a la obstrucci\u00f3n respiratoria aguda, se realiz\u00f3 una traqueostom\u00eda de urgencia para asegurar la v\u00eda a\u00e9rea. Posteriormente, el paciente fue sometido a tiroidectom\u00eda subtotal. Durante la cirug\u00eda, se evidenci\u00f3 invasi\u00f3n local del tumor, por lo que se realiz\u00f3 una disecci\u00f3n cervical de los ganglios linf\u00e1ticos. El paciente fue tratado con yodo radiactivo para eliminar cualquier tejido tiroideo residual y se inici\u00f3 tratamiento con levotiroxina. Adem\u00e1s, se implementaron medidas de manejo respiratorio postoperatorio.<\/p>\n

\u00a0<\/strong><\/p>\n

Pron\u00f3stico<\/strong>:
\n<\/strong>El pron\u00f3stico inicial es moderadamente favorable dado el diagn\u00f3stico de c\u00e1ncer papilar de tiroides, que en general tiene buen pron\u00f3stico, especialmente cuando es localizado. Sin embargo, la invasi\u00f3n de la tr\u00e1quea y la necesidad de una intervenci\u00f3n quir\u00fargica significativa aumentan el riesgo de complicaciones postoperatorias. El pron\u00f3stico depender\u00e1 de la respuesta al tratamiento con yodo radiactivo y de la presencia de met\u00e1stasis a ganglios linf\u00e1ticos cervicales.<\/p>\n

\u00a0<\/strong><\/p>\n

Seguimiento<\/strong>:
\n<\/strong>El paciente ser\u00e1 monitoreado con ecograf\u00eda cervical y an\u00e1lisis de marcadores tumorales (tiroglobulina) cada 3 a 6 meses en los primeros dos a\u00f1os tras la cirug\u00eda, con seguimiento anual a largo plazo. Adem\u00e1s, se programar\u00e1n tomograf\u00edas peri\u00f3dicas para evaluar posibles recurrencias en la tr\u00e1quea o \u00e1reas locales.<\/p>\n

\u00a0<\/strong><\/p>\n

Discusi\u00f3n<\/strong>:
\n<\/strong>El c\u00e1ncer de tiroides con compresi\u00f3n traqueal aguda es una complicaci\u00f3n poco frecuente pero grave. Aunque el c\u00e1ncer de tiroides, especialmente el tipo papilar, tiene un buen pron\u00f3stico general, la obstrucci\u00f3n de la v\u00eda a\u00e9rea puede poner en peligro la vida del paciente y requiere intervenci\u00f3n quir\u00fargica urgente. El tratamiento habitual incluye tiroidectom\u00eda, tratamiento con yodo radiactivo y seguimiento estrecho. La traqueostom\u00eda puede ser necesaria en casos de compresi\u00f3n respiratoria aguda. Las complicaciones respiratorias y la invasi\u00f3n tumoral local son factores que pueden influir negativamente en el pron\u00f3stico.<\/p>\n

\u00a0<\/strong><\/p>\n

Bibliograf\u00eda: <\/strong><\/p>\n

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