Ultrasound results revealed a rough tumor, approximately 2 cm, in Ms. Lanh's right thyroid lobe, with biopsy results suspecting papillary thyroid cancer. Dr. Huynh Ba Tan, a Master of Science and Level I Specialist from the Department of Surgical Oncology, Oncology Center, Tam Anh General Hospital Ho Chi Minh City (TP HCM), observed the tumor was in an early stage, not yet spread to the thyroid isthmus. He recommended radical surgery to determine its benign or malignant nature.

Ms. Lanh underwent endoscopic surgery via the oral route to achieve a better cosmetic outcome, avoiding the long scar typically associated with open surgery.

The surgical team made three small incisions inside the lower lip, creating a pathway to the thyroid gland. Surgeons observed the procedure on a screen, carefully maneuvering instruments between organs. They meticulously dissected the recurrent laryngeal nerve, which controls the voice, before removing the right thyroid lobe and isthmus.

Dr. Tan and his surgical team operating on Ms. Lanh. Photo: Tam Anh General Hospital

Dr. Tan explained that oral endoscopic surgery leaves no scar and results in less pain. The top-down surgical approach also helps preserve the recurrent laryngeal nerve and parathyroid glands. However, he cautioned that this is a complex technique. Surgeons must navigate from the oral cavity deep into the neck, where the surgical field is narrow, making instrument manipulation more difficult than in conventional open surgery. Lack of precision could inadvertently damage surrounding structures, potentially causing limb numbness, voice loss, or permanent hoarseness.

Pathological examination confirmed Ms. Lanh had papillary thyroid cancer. The tumor was encapsulated and had not spread to surrounding tissues. Consequently, Ms. Lanh did not require additional treatment or thyroid hormone medication.

Following surgery, the patient experienced no swelling, bruising, or fluid accumulation in the neck area. She was able to speak normally, had no visible neck scar, could eat soft foods like porridge, and was discharged within 24 hours.

Thyroid cancer is a common malignancy with a generally favorable prognosis, even if it has spread to lymph nodes. However, if not detected and treated promptly, malignant cells can metastasize to lymph nodes, bones, and lungs, complicating treatment and significantly affecting a patient's quality of life.

Endoscopic thyroid surgery provides surgeons with a clear view of the structures surrounding the tumor, enhancing the effectiveness of radical removal. It also offers patients benefits such as less pain, faster recovery, and no visible neck scar, ensuring a positive cosmetic outcome.

The oral endoscopic approach is typically reserved for small tumors that have not metastasized to regional lymph nodes or distant sites. This includes papillary thyroid cancer, suspected follicular cancer, and benign conditions like thyroid cysts or single/multi-nodular goiters.

Nguyen Tram

*Patient's name has been changed