Feasibility of sentinel lymph node detection in nodular thyroid disease

Area of Science:

• Oncology
• Surgical Pathology
• Nuclear Medicine

Background:

• Sentinel lymph node biopsy (SLNB) is established for melanoma and breast cancer staging.
• Occult lymph node metastases are frequent in well-differentiated thyroid cancer (WDTC).
• Identifying nodal status in WDTC may guide therapeutic decisions.

Purpose of the Study:

• To evaluate the technical feasibility of SLNB in patients with uni-nodular thyroid disease.
• To assess the safety of SLNB in this specific patient population.

Main Methods:

• Prospective study of 30 patients with benign solitary thyroid nodules.
• Preoperative fine-needle aspiration cytology confirmed absence of palpable lymph nodes.
• Isosulfan blue vital dye injected into the nodule to trace lymphatic drainage.

Main Results:

• SLNB was performed in 30 patients; lymphatics observed in 23, sentinel nodes identified in 18 (60% detection rate).
• Nodes located in central (14) and lateral (3) compartments; some in both.
• No intraoperative or postoperative complications reported.

Conclusions:

• SLNB can be safely performed in the thyroid setting.
• The accuracy of SLNB for thyroid neoplasia requires further investigation in larger patient cohorts.
• The role of SLNB in routine thyroid cancer management is yet to be determined.