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Updated: May 24, 2026

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
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Skip lateral neck node metastases in papillary thyroid carcinoma.

Jae Hyun Park1, Yong Sang Lee, Bup Woo Kim

  • 1Department of Surgery, Eulji University Hospital, Eulji University College of Medicine, 1306 Dunsan-dong, Seo-gu, Daejeon, 302-799, South Korea.

World Journal of Surgery
|February 23, 2012
PubMed
Summary

Skip metastases to the lateral compartment in papillary thyroid carcinoma (PTC) occur in 21.8% of patients. These metastases are associated with smaller, upper pole tumors and warrant careful lateral compartment evaluation.

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Area of Science:

  • Oncology
  • Head and Neck Surgery
  • Pathology

Background:

  • Papillary thyroid carcinoma (PTC) commonly metastasizes to lymph nodes, typically in a sequential pattern from central to lateral compartments.
  • A subset of PTC patients exhibit 'skip metastases,' where cancer spreads directly to the lateral compartment without involving the central lymph nodes.
  • Understanding the characteristics of these skip metastases is crucial for accurate staging and treatment planning.

Purpose of the Study:

  • To investigate the clinicopathologic features of papillary thyroid carcinoma (PTC) with skip metastases to the lateral lymph node compartment.
  • To identify factors associated with the occurrence of skip metastases in PTC patients.

Main Methods:

  • Retrospective review of 147 patients with PTC who underwent total thyroidectomy and neck dissection.

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Last Updated: May 24, 2026

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  • Classification of patients based on the presence or absence of skip metastases to the lateral compartment.
  • Statistical analysis of clinicopathologic characteristics, including tumor size, location, multifocality, and metastatic lymph node distribution.

    • Main Results:

    • Skip metastases were identified in 32 patients (21.8%) and were more frequent in primary tumors located in the upper pole and measuring ≤1 cm.
    • Multifocal disease was associated with a lower incidence of skip metastases.
    • Patients with skip metastases had fewer involved lateral lymph nodes, predominantly located at level III and II.

    Conclusions:

    • Skip metastases, though infrequent, occur in a significant minority of PTC patients.
    • The lateral neck compartment requires thorough evaluation for skip metastases, even in cases with small, single-focus, or upper pole primary tumors.
    • These findings underscore the importance of considering non-sequential metastatic patterns in PTC management.