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Retropharyngeal node metastasis from papillary thyroid carcinoma
Naoki Otsuki1, Tasuku Nishikawa, Shigemichi Iwae
1Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Head & Neck
|November 23, 2006
Summary
Metastasis of papillary thyroid carcinoma to the rare retropharyngeal lymph node can occur, especially after neck dissection. Imaging like CT or MRI is recommended for follow-up.
Area of Science:
- Head and Neck Surgery
- Oncology
- Surgical Pathology
Background:
- Papillary thyroid carcinoma (PTC) typically metastasizes to paratracheal and jugular lymph nodes.
- Metastasis to the retropharyngeal lymph node is an uncommon presentation of PTC.
Observation:
- Five patients with PTC metastatic to retropharyngeal lymph nodes underwent surgical resection.
- These metastases presented as parapharyngeal or retropharyngeal masses.
- All patients had prior thyroidectomy and varying degrees of neck dissection.
Findings:
- Surgical resection of metastatic retropharyngeal nodes was successful via a transcervical approach.
- Postoperative aspiration and dysphagia resolved spontaneously within months in 2 patients.
Implications:
- Neck dissection may reroute lymphatic drainage, leading to unusual retrograde metastasis to retropharyngeal nodes.
- Retropharyngeal lymph node metastasis should be considered in PTC follow-up, particularly post-neck dissection.
- Routine neck ultrasonography may miss these metastases; CT or MRI surveillance is recommended.
