Incidental cervical metastases from thyroid carcinoma during neck dissection

Area of Science:

• Oncology
• Head and Neck Surgery
• Pathology

Background:

• Head and neck squamous cell carcinoma (HNSCC) management often involves neck dissection.
• The prevalence of occult thyroid cancer metastases in these dissections is not well-established.

Purpose of the Study:

• To determine the prevalence of unsuspected thyroid lymph node metastases in patients undergoing neck dissection for HNSCC.
• To discuss the implications of these findings on patient management.

Main Methods:

• Retrospective analysis of 349 neck dissections in 266 patients with HNSCC between May 2004 and January 2007.
• Pathological examination of surgical specimens to identify thyroid cancer metastases.

Main Results:

• Twenty-one patients (7.9%) had lymph node metastases from thyroid cancer (13 papillary, 8 follicular).
• No thyroid carcinomas were found in patients who underwent total thyroidectomy as part of the management.
• During a mean follow-up of 41 months, no patients died from thyroid cancer.

Conclusions:

• The observed prevalence of thyroid cancer metastasis (7.9%) is higher than previously reported literature values (0.3-1.6%).
• This higher rate may be attributed to the histopathological methods used.
• Patient management should incorporate thyroid ultrasonography and consider the HNSCC prognosis.