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<p>Anaplastic thyroid carcinoma (ATC) is a rare, highly aggressive thyroid malignancy with poor prognosis and high mortality, often due to airway compromise. Emergency airway management could be technically challenging because of rapid local invasion and anatomical distortion. Case Presentation: We report the case of a 58-year-old lady with inoperable ATC who presented with stridor and respiratory distress. Imaging revealed a large mass with right tracheal deviation and retrosternal extension. Emergency intubation was performed with the aid of video laryngoscope. For definitive airway management, tracheostomy was planned. Ultrasound was employed both preoperatively and intraoperatively to localize the trachea, determine its depth, and identify adjacent vascular structures, enabling a lateral tracheostomy despite obscured anatomical landmarks. The procedure was uneventful, and patient discharged post weaning. Conclusion: Ultrasound can be useful in both planning and real time guidance in difficult and distorted airway management anatomies like that of ATC to facilitate safe tracheostomy.</p>

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Ultrasound-Guided Tracheostomy in a Patient with Anaplastic Thyroid Carcinoma Presenting with Acute Airway Obstruction: A Case Report

  • 期刊论文

  • 发表日期：

    2025年11月17日

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  • Priya Ramakrishnan,
  • Arnpriya Pal,
  • Manisa Pattanayak

摘要

Anaplastic thyroid carcinoma (ATC) is a rare, highly aggressive thyroid malignancy with poor prognosis and high mortality, often due to airway compromise. Emergency airway management could be technically challenging because of rapid local invasion and anatomical distortion. Case Presentation: We report the case of a 58-year-old lady with inoperable ATC who presented with stridor and respiratory distress. Imaging revealed a large mass with right tracheal deviation and retrosternal extension. Emergency intubation was performed with the aid of video laryngoscope. For definitive airway management, tracheostomy was planned. Ultrasound was employed both preoperatively and intraoperatively to localize the trachea, determine its depth, and identify adjacent vascular structures, enabling a lateral tracheostomy despite obscured anatomical landmarks. The procedure was uneventful, and patient discharged post weaning. Conclusion: Ultrasound can be useful in both planning and real time guidance in difficult and distorted airway management anatomies like that of ATC to facilitate safe tracheostomy.