Minocycline-induced black thyroid with black pigmentation of the thyroid cartilage, cricoid cartilage, and trachea found during reconstructive surgery for hypopharyngeal cancer

Black thyroid is characterized by a rare pigment change observed almost exclusively in patients taking minocycline. We present the case of a 72-year-old man diagnosed with T3N3bM0 stage IVB hypopharyngeal squamous cell carcinoma who had been taking minocycline for approximately 18 months as a treatm...

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Bibliographic Details
Published in:Auris, nasus, larynx nasus, larynx, 2022-04, Vol.49 (2), p.299-303
Main Authors: Kondo, Takahito, Nakatsugawa, Munehide, Hirai, Yuji, Takeda, Atsuo, Kikawada, Naiue, Aihara, Yusuke, Chiba, Yuujin, Okimura, Akira, Hirano, Hiroshi, Ogawa, Yasuo, Tsukahara, Kiyoaki
Format: Article
Language:English
Subjects:
Aged
Cricoid Cartilage - surgery
Discoloration
Head and neck cancer
Humans
Hypopharyngeal Neoplasms - pathology
Hypopharyngeal Neoplasms - surgery
Male
Minocycline - adverse effects
Pigmentation
Reconstructive Surgical Procedures
Squamous cell carcinoma
Tetracycline
Thyroid
Thyroid Cartilage - surgery
Thyroid Gland - pathology
Thyroid Neoplasms - pathology
Trachea
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Summary:Black thyroid is characterized by a rare pigment change observed almost exclusively in patients taking minocycline. We present the case of a 72-year-old man diagnosed with T3N3bM0 stage IVB hypopharyngeal squamous cell carcinoma who had been taking minocycline for approximately 18 months as a treatment for prurigo chronica multiformis. Initial treatment consisted of total pharyngolaryngoesophagectomy, bilateral neck dissection, total thyroidectomy, pharyngeal reconstruction using a free jejunal autograft, and creation of a permanent tracheostoma. During surgery, black discoloration of the thyroid and trachea was observed. Postoperative histological findings confirmed the black discoloration, with deposits of dark-brown, melanin-like granules observed in the thyroid, trachea, thyroid cartilage, and cricoid cartilage. Therefore, the black discoloration of the thyroid associated with the use of minocycline can extend to the thyroid cartilage, cricoid cartilage, and trachea. This information is important for surgeons to recognize in order to prevent unnecessary resection due to misdiagnosis.
ISSN:0385-8146
1879-1476
DOI:10.1016/j.anl.2020.08.028