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Thyroid carcinoma presenting as an enlarged cervical lymph node
1Department of Surgery, North Shore University Hospital, Manhasset, New York.
American Journal of Surgery
|October 1, 1993
Summary
Differentiated thyroid cancer can initially present as an enlarged cervical lymph node, often with small primary tumors. Surgical management, including neck dissection, yields favorable long-term outcomes for these patients.
Area of Science:
- Oncology
- Surgical Pathology
- Endocrinology
Background:
- Differentiated thyroid cancer typically presents as a thyroid nodule.
- Cervical lymph node metastases are a frequent finding in differentiated thyroid cancer.
- However, initial presentation as an enlarged cervical lymph node is less common.
Purpose of the Study:
- To describe the clinical characteristics, pathological findings, surgical management, and long-term outcomes of differentiated thyroid cancer presenting initially as an enlarged cervical lymph node.
Main Methods:
- Retrospective review of 43 patients with differentiated thyroid cancer initially presenting with an enlarged cervical lymph node.
- Analysis of clinical presentation, pathological findings (including primary tumor size and histology), surgical approach (thyroidectomy with or without modified neck dissection), and patient follow-up.
Main Results:
- 65% of patients had additional lymph node involvement at surgery.
- Papillary carcinoma was the histology in all cases.
- Two-thirds of primary thyroid tumors were 1 cm or smaller.
- 30 out of 43 patients (69.8%) remain alive and disease-free after a mean follow-up of 14.8 years.
Conclusions:
- Differentiated thyroid cancer presenting as an enlarged cervical lymph node, even with small primary tumors, can be effectively managed with surgery.
- Surgical intervention, often involving thyroidectomy and modified neck dissection, leads to favorable long-term survival and disease control in this patient cohort.