Advanced metastatic disease presenting with acute airway crisis: what would you do?

Head And Neck Surgery; Medical Ethics
Case Report
10.1102/1470-5206.2012.0006
12
23-26
Advanced metastatic disease presenting with acute airway crisis: what would you do?

Metastatic involvement of the thyroid is extremely rare and can present many years after the primary. Rarely, they cause critical airway obstruction and death as a result. This article describes the case of previously well 68-year-old man, who on presentation with left shoulder pain and mild shortness of breath, was found to have extensive and longstanding left cervical metastatic disease involving the thyroid and left clavicle. With the primary unknown, airway obstruction ensued and the patient died within 5 days of presentation. Several treatment options are available for palliation of airway obstruction, yet it is still a subject that perplexes and divides clinicians. This report aims to inspire debate about end-of-life issues, and emergency management of airway crisis in patients already dying from an aggressive malignant process.

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Editor-in-Chief

Frank Cross
Consultant Vascular and General Surgeon
The London Clinic, UK

Editors

Neil Barnes
Consultant Physician
Barts Health NHS Trust, London, UK
Ali Jawad
Professor of Rheumatology
Barts Health NHS Trust, London, UK

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