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Related Concept Videos

Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

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Related Experiment Video

Updated: May 27, 2026

In Vivo Inhibition of MicroRNA to Decrease Tumor Growth in Mice
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Risk Factors for Clinically Negative Level II Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma.

Dongju Kim1, Seunguk Bang2, Gwangju Yu2

  • 1Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03083, Republic of Korea.

Journal of Clinical Medicine
|September 13, 2025
PubMed
Summary

Occult lateral neck lymph node metastasis in papillary thyroid carcinoma is common. The number of metastatic lateral lymph nodes predicts Level II involvement, aiding selective neck dissection.

Keywords:
lymphatic metastasisneck dissectionoccult level II metastasispapillary thyroid carcinomarisk factorthyroid neoplasmultrasonography

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Papillary thyroid carcinoma (PTC) frequently metastasizes to cervical lymph nodes.
  • Lateral lymph node involvement is a key prognostic factor in PTC.
  • Routine Level II dissection in PTC is debated due to morbidity risks.

Purpose of the Study:

  • To identify clinicopathological predictors of occult Level II lymph node metastasis in PTC.
  • To guide selective surgical approaches for lateral neck dissection in PTC patients.

Main Methods:

  • Retrospective analysis of 1247 PTC patients undergoing thyroidectomy (2015-2022).
  • Included 67 patients with clinically positive lateral nodes but negative Level II nodes.
  • Used logistic regression to identify risk factors for occult Level II metastasis.

Main Results:

  • 24 (35.8%) patients had occult Level II metastasis.
  • Occult metastasis linked to larger primary tumors and more central/lateral lymph node metastases.
  • Number of metastatic lateral lymph nodes was the sole independent predictor (OR=1.57, p=0.001).

Conclusions:

  • A significant number of PTC patients have occult Level II lymph node metastasis.
  • Metastatic lateral lymph node count predicts occult Level II involvement.
  • Findings support tailoring lateral neck dissection based on metastatic lymph node burden.