SUCCESSFUL TREATMENT OF A THYROID CANCER PATIENT WITH RIGHT VOCAL CORD PARALYSIS

Persistent hoarseness led to a surprising diagnosis for a 49-year-old man from Cambodia: stage 3 papillary thyroid cancer with right vocal cord paralysis. Thanks to timely intervention at Nam Sai Gon International General Hospital, he underwent successful surgery that removed the tumor and preserved his voice.

Successful Treatment Of A Thyroid Cancer Patient With Right Vocal Cord Paralysis

Mr. C.T. (49 years old, Cambodian) experienced persistent hoarseness for more than a month. Initially, he and his family did not pay much attention to the condition, assuming it was temporary and would resolve on its own. However, his hoarseness gradually worsened and was accompanied by pain while speaking. Recognizing these warning signs, his family brought him to the ENT Department at Nam Sai Gon International General Hospital for examination and treatment.

During his visit, Dr. Le Nhat Vinh, MMed, Specialist Level II, performed an endoscopic examination of the ears, nose, and throat, and recommended a thyroid ultrasound. The results revealed right vocal cord paralysis and a thyroid nodule classified as TIRADS V, with an 87.5% likelihood of malignancy.

To accurately determine the nature of the lesion, Dr. Vinh decided to perform a fine-needle aspiration (FNA) of the thyroid — a cytological technique that helps identify whether a thyroid nodule is benign or malignant. The FNA results confirmed that the patient had stage 3 papillary thyroid carcinoma. Cancer cells had spread to nearby lymph nodes and invaded the right recurrent laryngeal nerve, causing vocal cord paralysis. Urgent surgical intervention was required. The doctor proposed near-total thyroidectomy as the most appropriate treatment approach.

Dr. Le Nhat Vinh, MMed, Specialist Level II explained that there are four types of thyroid cancer: papillary, follicular, medullary, and anaplastic carcinoma. Among them, anaplastic carcinoma is the most aggressive and difficult to treat, while papillary carcinoma is the most common and has the best prognosis. Fortunately, in Mr. T.’s case, the cancer was papillary, giving him a very high chance of successful treatment.

During surgery, due to the tumor’s invasion of the right recurrent laryngeal nerve — which caused vocal cord paralysis — the surgical team focused on thoroughly removing the tumor while preserving the left recurrent laryngeal nerve to maintain the patient’s voice. The operation lasted nearly two hours. The doctors successfully removed the entire tumor and preserved the patient’s voice quality as it was before surgery.

Sharing further insights on thyroid cancer, Dr. Vinh emphasized that it is among the most curable cancers if diagnosed and treated early. However, in its early stages, symptoms are often subtle or non-specific. In reality, many cases of thyroid cancer are discovered incidentally during routine check-ups or while investigating other unrelated conditions. When the symptoms become apparent, the disease has often already progressed.

Common symptoms of thyroid cancer

• Hoarseness caused by tumor invasion of the nerves that control the vocal cords
• Shortness of breath if the tumor affects both recurrent laryngeal nerves or invades the trachea
• Pain or difficulty swallowing when the tumor invades the esophagus

Other warning signs of thyroid cancer

• A firm mass in the front of the neck, in one or both lobes of the thyroid, moving with swallowing
• Skin changes such as redness, dimpling (like orange peel), ulceration, or bleeding over the lump
• Enlarged lymph nodes on one or both sides of the neck, typically in the lower cervical or supraclavicular region

These symptoms often indicate that the disease has reached an advanced stage. Therefore, patients should seek medical attention promptly to undergo proper evaluation and treatment.

To detect thyroid cancer early, regular health screening is highly recommended, particularly for:

• Individuals with a history of thyroid abnormalities — every six months
• Women aged 25 and above, and men aged 40 and above — annual check-ups

Nam Sai Gon International General Hospital accepts both public health insurance and private health insurance. To schedule a consultation at the hospital, please contact our hotline at 1800 67 67.

Nam Sai Gon International General Hospital

No. 88, Street No. 8, Trung Son Residential Area, Binh Hung Commune, Ho Chi Minh City.

Hotline: 18006767

info@nih.com.vn

BRC: No. 0312088602, issued on December 14th, 2012 by the Department of Planning and Investment of Ho Chi Minh City. Medical Examination and Treatment License No. 230/BYT-GPHĐ, issued by the Ministry of Health.