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Incidental Thyroid Tissue in Sentinel Nodes From Oral Squamous Cell Carcinoma
Clare Schilling1,2, Lisette Collins3, Adrian Farrow2
1Head and Neck Academic Centre, University College London, London, UK.
The Laryngoscope
|August 23, 2023
Summary
Incidental thyroid cells (TC) are found in sentinel lymph nodes (SLNs) in 3.6% of oral squamous cell carcinoma (OSCC) patients. These findings are generally not clinically significant and can be managed conservatively.
Area of Science:
- Oncology
- Surgical Pathology
- Head and Neck Cancer
Background:
- Sentinel node biopsy (SNB) is crucial for staging early oral squamous cell carcinoma (OSCC).
- Unexpected findings, such as incidental thyroid cells (TC), can occur in sentinel nodes (SNs).
- The clinical significance of incidental TC in SNs for OSCC patients requires clarification.
Purpose of the Study:
- To assess the prevalence of incidental thyroid cells (TC) in sentinel nodes (SNs) of OSCC patients.
- To evaluate the clinical significance and appropriate management of incidental TC found in SNs.
Main Methods:
- Retrospective review of 278 SNB cases for cT1-T2N0 OSCC.
- Incidental TC identified via TTF-1 or thyroglobulin positivity.
- Comparison with TC incidence in 725 neck dissections; follow-up included thyroid ultrasound and, in some cases, thyroidectomy.
Main Results:
- Incidental TC were detected in 3.6% of SNB cases (10/278 patients).
- TC incidence in SNB (3.6%) was higher than in neck dissections (0.8%).
- No primary thyroid tumors were identified in patients with incidental TC, even after thyroidectomy.
Conclusions:
- The prevalence of incidental TC in SNs of OSCC patients is higher than previously reported.
- Incidental TC in SNs are unlikely to be clinically relevant and do not necessitate aggressive treatment.
- Conservative management is recommended for incidental TC in SNs, absent clear metastatic features.
