I-123-guided excision of metastatic papillary thyroid cancer

The use of a gamma probe for intraoperative localization of a cervical lymph node, which contained recurrent metastatic papillary thyroid cancer, facilitated a radio-guided minimally invasive outpatient surgical procedure and resulted in complete excision of clinically occult disease. The technique raises the issue of whether nonpalpable regional node recurrences should be locally excised, removed in a formal modified neck dissection, or treated with therapeutic doses of I-131.