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[Clinical study on papillary thyroid carcinoma presenting with lymph node metastasi]
Takatsugu Mizumachi1, Nobuhiko Oridate, Akihiro Homma
1Department of Otolaryngology, Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo.
Nihon Jibiinkoka Gakkai Kaiho
|October 2, 2004
Summary
Occult papillary thyroid carcinoma (PTC) presenting as palpable neck nodes is rare. Thyroid lobectomy with adequate neck dissection may offer better survival than total thyroidectomy, preserving function.
Area of Science:
- Oncology
- Endocrinology
- Surgical Pathology
Background:
- Papillary thyroid carcinoma (PTC) can metastasize to cervical lymph nodes, but diagnosis solely from palpable neck nodes is uncommon.
- Established treatment protocols for PTC presenting initially as cervical lymph node metastasis are lacking.
Observation:
- Retrospective analysis of 8 patients with PTC presenting with palpable lymph node metastasis.
- Diagnosis was confirmed via high thyroglobulin in cystic lesions or pathological examination of lymph nodes initially presumed to be cysts.
- Preoperative imaging did not reveal primary PTC in the thyroid gland for any patient.
Findings:
- All 8 patients survived, with follow-up ranging from 23 to 150 months.
- Thyroid lobectomy with adequate neck dissection was associated with better outcomes compared to total thyroidectomy.
- One recurrence was noted due to insufficient neck dissection.
Implications:
- Thyroid lobectomy and adequate neck dissection may be a preferred approach for occult PTC with lymph node metastasis.
- Preservation of thyroid and parathyroid function is achievable with this approach.
- A prospective study is proposed to validate the effectiveness of thyroid lobectomy and neck dissection in these cases.